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Epirubicin, Docetaxel, and Pegfilgrastim in Treating Women With Locally Advanced or Inflammatory Breast Cancer

Primary Purpose

Breast Cancer

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
pegfilgrastim
docetaxel
epirubicin hydrochloride
Sponsored by
NCIC Clinical Trials Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, inflammatory breast cancer

Eligibility Criteria

16 Years - undefined (Child, Adult, Older Adult)FemaleDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed invasive adenocarcinoma of the breast, meeting any of the following criteria: T4, NX, M0 Any T, N2-N3, M0 Inflammatory breast cancer (redness over at least one-third of the breast), M0 No evidence of metastatic disease by chest x-ray, abdominal ultrasound or CT scan and bone scan Diagnosed within the past 8 weeks Hormone receptor status: Not specified PATIENT CHARACTERISTICS: Age 16 and over Sex Female Menopausal status Not specified Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute granulocyte count at least 2,000/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10 g/dL Hepatic Bilirubin less than upper limit of normal (ULN) Must meet criteria for 1 of the following: ALT and AST no greater than 1.5 times ULN AND alkaline phosphatase no greater than 2.5 times ULN ALT and AST normal AND alkaline phosphatase no greater than 5 times ULN Renal Creatinine no greater than 1.5 times ULN Cardiovascular Resting LVEF normal by MUGA or echocardiogram No congestive heart failure No angina pectoris No myocardial infarction within the past year No uncontrolled hypertension No uncontrolled arrhythmias Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective non-hormonal contraception No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or curatively treated carcinoma in situ of the cervix No symptomatic peripheral neuropathy grade 2 or greater No active infection No history of significant neurological or psychiatric disorders, including dementia or seizures No peptic ulcer No unstable diabetes mellitus No contraindication to dexamethasone No known sensitivity to E. coli-derived or polyethylene glycol products Willing to undergo core biopsies once prior to registration and core biopsies at 2 other timepoints while on study Geographically accessible for treatment and follow-up PRIOR CONCURRENT THERAPY: Biologic therapy No prior immunotherapy for breast cancer Chemotherapy No prior chemotherapy for breast cancer Endocrine therapy No prior hormonal therapy for breast cancer No concurrent corticosteroids except for premedication or hypersensitivity reaction No concurrent oral contraception Radiotherapy No prior radiotherapy for breast cancer Surgery No prior surgery for breast cancer other than biopsy Other No prior systemic therapy for breast cancer No other concurrent investigational drugs or anticancer treatment No concurrent preventative IV antibiotics

Sites / Locations

  • CancerCare Manitoba
  • Atlantic Health Sciences Corporation
  • Odette Cancer Centre
  • Univ. Health Network-Princess Margaret Hospital
  • CHA-Hopital Du St-Sacrement

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pegfilgrastim, docetaxel and epirubicin

Arm Description

Outcomes

Primary Outcome Measures

Toxic effects
Findings were presented at ASCO 2010
Response (phase II)
Response was presented at ASCO 2010. Duration of response will be analyzed in 2015

Secondary Outcome Measures

Full Information

First Posted
August 6, 2003
Last Updated
August 3, 2023
Sponsor
NCIC Clinical Trials Group
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1. Study Identification

Unique Protocol Identification Number
NCT00066443
Brief Title
Epirubicin, Docetaxel, and Pegfilgrastim in Treating Women With Locally Advanced or Inflammatory Breast Cancer
Official Title
A Phase I/II Study Of Increasing Doses Of Epirubicin And Docetaxel Plus Pegfilgrastim For Locally Advanced Or Inflammatory Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
November 3, 2003 (Actual)
Primary Completion Date
January 6, 2010 (Actual)
Study Completion Date
January 16, 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NCIC Clinical Trials Group

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy such as epirubicin and docetaxel use different ways to stop tumor cells from dividing so they stop growing or die. Colony-stimulating factors such as pegfilgrastim may increase the number of immune cells found in bone marrow or peripheral blood and may help a person's immune system recover from the side effects of chemotherapy. PURPOSE: Phase I/II trial to study the effectiveness of combining epirubicin and docetaxel with pegfilgrastim in treating women who have locally advanced or inflammatory breast cancer.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose and recommended phase II dose of docetaxel and epirubicin when given with pegfilgrastim in women with locally advanced or inflammatory breast cancer. (Phase I, group 1 closed to accrual as of 9/13/04 and Phase II, group 1 closed to accrual as of 5/10/06) Determine the toxicity of this regimen in these patients. Determine the clinical and pathological response rate and duration of response in patients treated with this regimen. Determine drug sensitivity and resistance in patients treated with this regimen. Determine prognostic and predictive markers in patients treated with this regimen. OUTLINE: This is a nonrandomized, multicenter, dose-escalation study of docetaxel and epirubicin. Phase I: Group 1 (21-day regimen) (closed to accrual as of 09/13/04): Patients receive epirubicin IV over 15 minutes and docetaxel IV over 60 minutes on day 1 and pegfilgrastim subcutaneously on day 2. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients with objective response after 6 courses may receive additional therapy at the discretion of the physician. Group 2 (14-day regimen): Patients receive epirubicin IV over 15 minutes and docetaxel IV over 60 minutes on day 1 and pegfilgrastim subcutaneously on day 2. Treatment repeats every 14 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Patients with objective response after 8 courses may receive additional therapy at the discretion of the physician. Cohorts of 3-6 patients receive escalating doses of epirubicin and docetaxel until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Phase II: Group 1 (21-day regimen) (closed to accrual as of 5/10/06): Patients receive treatment as in phase I with epirubicin and docetaxel at the recommended Phase II dose. Group 2 (14-day regimen): Patients receive treatment as in phase I with epirubicin and docetaxel at the recommended Phase II dose. Patients are followed at 1 month, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter. PROJECTED ACCRUAL: Approximately 90 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, inflammatory breast cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
93 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pegfilgrastim, docetaxel and epirubicin
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
pegfilgrastim
Intervention Description
Dose escalation schedule A&B = 6mg fixed dose once per cycle on day 2
Intervention Type
Drug
Intervention Name(s)
docetaxel
Intervention Description
Dose Escalation schedule A = 75-85 mg/m2 Dose Escalation schedule B = 50-75 mg/m2
Intervention Type
Drug
Intervention Name(s)
epirubicin hydrochloride
Intervention Description
Dose escalation schedule A = 75-120 mg/m2 IV Dose escalation schedule B = 50-90 mg/m2 IV
Primary Outcome Measure Information:
Title
Toxic effects
Description
Findings were presented at ASCO 2010
Time Frame
7 years
Title
Response (phase II)
Description
Response was presented at ASCO 2010. Duration of response will be analyzed in 2015
Time Frame
12 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed invasive adenocarcinoma of the breast, meeting any of the following criteria: T4, NX, M0 Any T, N2-N3, M0 Inflammatory breast cancer (redness over at least one-third of the breast), M0 No evidence of metastatic disease by chest x-ray, abdominal ultrasound or CT scan and bone scan Diagnosed within the past 8 weeks Hormone receptor status: Not specified PATIENT CHARACTERISTICS: Age 16 and over Sex Female Menopausal status Not specified Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute granulocyte count at least 2,000/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10 g/dL Hepatic Bilirubin less than upper limit of normal (ULN) Must meet criteria for 1 of the following: ALT and AST no greater than 1.5 times ULN AND alkaline phosphatase no greater than 2.5 times ULN ALT and AST normal AND alkaline phosphatase no greater than 5 times ULN Renal Creatinine no greater than 1.5 times ULN Cardiovascular Resting LVEF normal by MUGA or echocardiogram No congestive heart failure No angina pectoris No myocardial infarction within the past year No uncontrolled hypertension No uncontrolled arrhythmias Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective non-hormonal contraception No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or curatively treated carcinoma in situ of the cervix No symptomatic peripheral neuropathy grade 2 or greater No active infection No history of significant neurological or psychiatric disorders, including dementia or seizures No peptic ulcer No unstable diabetes mellitus No contraindication to dexamethasone No known sensitivity to E. coli-derived or polyethylene glycol products Willing to undergo core biopsies once prior to registration and core biopsies at 2 other timepoints while on study Geographically accessible for treatment and follow-up PRIOR CONCURRENT THERAPY: Biologic therapy No prior immunotherapy for breast cancer Chemotherapy No prior chemotherapy for breast cancer Endocrine therapy No prior hormonal therapy for breast cancer No concurrent corticosteroids except for premedication or hypersensitivity reaction No concurrent oral contraception Radiotherapy No prior radiotherapy for breast cancer Surgery No prior surgery for breast cancer other than biopsy Other No prior systemic therapy for breast cancer No other concurrent investigational drugs or anticancer treatment No concurrent preventative IV antibiotics
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maureen E. Trudeau, BSc, MA, MD, FRCPC
Organizational Affiliation
Toronto Sunnybrook Regional Cancer Centre
Official's Role
Study Chair
Facility Information:
Facility Name
CancerCare Manitoba
City
Winnipeg
State/Province
Manitoba
ZIP/Postal Code
R3E 0V9
Country
Canada
Facility Name
Atlantic Health Sciences Corporation
City
Saint John
State/Province
New Brunswick
ZIP/Postal Code
E2L 4L2
Country
Canada
Facility Name
Odette Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M4N 3M5
Country
Canada
Facility Name
Univ. Health Network-Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Facility Name
CHA-Hopital Du St-Sacrement
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1S 4L8
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing URL
https://www.ctg.queensu.ca/docs/public/policies/DataSharingandAccessPolicy.pdf
Citations:
PubMed Identifier
19771508
Citation
Parissenti AM, Chapman JA, Kahn HJ, Guo B, Han L, O'Brien P, Clemons MP, Jong R, Dent R, Fitzgerald B, Pritchard KI, Shepherd LE, Trudeau ME. Association of low tumor RNA integrity with response to chemotherapy in breast cancer patients. Breast Cancer Res Treat. 2010 Jan;119(2):347-56. doi: 10.1007/s10549-009-0531-x.
Results Reference
result
PubMed Identifier
26543765
Citation
Trudeau ME, Chapman JA, Guo B, Clemons MJ, Dent RA, Jong RA, Kahn HJ, Pritchard KI, Han L, O'Brien P, Shepherd LE, Parissenti AM. A phase I/II trial of epirubicin and docetaxel in locally advanced breast cancer (LABC) on 2-weekly or 3-weekly schedules: NCIC CTG MA.22. Springerplus. 2015 Oct 21;4:631. doi: 10.1186/s40064-015-1392-x. eCollection 2015.
Results Reference
result
PubMed Identifier
26208483
Citation
Parissenti AM, Guo B, Pritzker LB, Pritzker KP, Wang X, Zhu M, Shepherd LE, Trudeau ME. Tumor RNA disruption predicts survival benefit from breast cancer chemotherapy. Breast Cancer Res Treat. 2015 Aug;153(1):135-44. doi: 10.1007/s10549-015-3498-9. Epub 2015 Jul 25.
Results Reference
derived
PubMed Identifier
26063893
Citation
Pritzker K, Pritzker L, Generali D, Bottini A, Cappelletti MR, Guo B, Parissenti A, Trudeau M. RNA Disruption and Drug Response in Breast Cancer Primary Systemic Therapy. J Natl Cancer Inst Monogr. 2015 May;2015(51):76-80. doi: 10.1093/jncimonographs/lgv015.
Results Reference
derived

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Epirubicin, Docetaxel, and Pegfilgrastim in Treating Women With Locally Advanced or Inflammatory Breast Cancer

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