search
Back to results

Adjuvant Platinum and Taxane in Triple-negative Breast Cancer (PATTERN)

Primary Purpose

Triple Negative Breast Cancer

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Paclitaxel Cisplatin
fluorouracil epirubicin cyclophosphamide and docetaxel (FEC-T)
Sponsored by
Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Triple Negative Breast Cancer focused on measuring triple negative breast cancer,local recurrence,distant metastasis

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Women aged from 18 to 70 years;
  2. Histologically proven invasive unilateral breast cancer (regardless of the type);
  3. Initial clinical condition compatible with complete initial resection;
  4. No residual macro or microscopic tumor after surgical excision;
  5. Beginning of chemotherapeutic treatment no later than day 42 after the initial surgery;
  6. positive lymph node or negative lymph node with tumor size > 1.0cm
  7. Patient presenting one of the following criteria (reviewed before randomization by referent pathologist):

    Triple negative (ER-PR-Her-2-) Hormone receptor negativity is defined as ER<1%, PR<1% (IHC), HER2 negativity is defined as IHC 0-1+, or [IHC 2+ and FISH or CISH negative].

  8. No clinically or radiologically detectable metastases (M0);
  9. No peripheral neuropathy > 1;
  10. WHO Performance status (ECOG) of 0 or 1;
  11. Adequate recovery from recent surgery (at least one week must have elapsed from the time of a minor surgery (excluding breast biopsy); at least three weeks for major surgery);
  12. Adequate hematological function (neutrophil count ³ 2x109/l, platelet count ³ 100x 109/l, Hemoglobin > 9 g/dl);
  13. Adequate hepatic function: ASAT and ALAT ≤ 3 ULN alkaline phosphatases ≤ 2.5 ULN,total bilirubin ≤ 1,5 ULN;
  14. Adequate renal function: serum creatinine ≤ 1 ULN;
  15. Patients accepting contraception intake during the overall length of treatment if of childbearing potential;
  16. Adequate cardiac function, LEVF value > 50% by Muga scan or echocardiography;
  17. Signed written informed consent.

Exclusion Criteria:

  1. Bilateral breast cancer or patient with controlateral DCIS;
  2. Any metastatic impairment, including homolateral sub-clavicular node involvement,regardless of its type;
  3. Any T4 lesion (UICC1987) (cutaneous invasion, deep adherence, inflammatory breast cancer);
  4. ER+ or PR+ or Her-2 overexpression
  5. Any clinically or radiologically suspect and non-explored damage to the controlateral breast;
  6. Any chemotherapy, hormonal therapy or radiotherapy before surgery;
  7. Previous cancer (excepted cutaneous baso-cellular epithelioma or uterin peripheral ephitelioma) in the preceding 5 years, including invasive controlateral breast cancer;
  8. Patients already included in another therapeutic trial involving an experimental drug;
  9. Patients with other concurrent severe and/or uncontrolled medical disease or infection which could compromise participation in the study;
  10. LEVF < 50% (MUGA scan or echocardiography);
  11. Clinically significant cardiovascular disease (e.g. unstable angina, congestive heart failure, uncontrolled hypertension (>150/90), myocardial infarction or cerebral vascular accidents) within 6 months prior to randomization;
  12. Known prior severe hypersensitivity reactions to agents containing Cremophor EL;
  13. Women of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and up to 8 weeks after treatment completion;
  14. Women who are pregnant or breastfeeding. Adequate birth control measures should be taken during study treatment phase;
  15. Women with a positive pregnancy test en enrollment or prior to study drug administration;
  16. Patients with any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial;
  17. Individual deprived of liberty or placed under the authority of a tutor.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    6 cycles of PC adjuvant chemotherapy

    3 cycles of FEC followed by 3 cycles of Docetaxel

    Arm Description

    paclitaxel 80 mg/m2 and carboplatin (area under the curve [AUC]= 2) on day 1, 8, 15 every 28 days for six cycles

    fluorouracil 500 mg/m2, epirubicin 100 mg/m2, and cyclophosphamide 500 mg/m2 intravenously on day 1 every 21 days for three cycles followed by docetaxel 100 mg/m2 intravenously

    Outcomes

    Primary Outcome Measures

    disease-free survival
    time from random assignment to first relapse (local, regional and distant), contralateral breast cancer

    Secondary Outcome Measures

    distant disease-free survival
    time from random assignment to distant recurrence or death
    relapse-free survival
    time from the date of randomization to local, regional, distant relapse or death
    disease-free survival gBRCA1 mutation carriers and homologous recombination repair (HRR)-related gene mutation carriers
    overall survival
    time from randomization until death with any cause

    Full Information

    First Posted
    October 6, 2010
    Last Updated
    May 17, 2020
    Sponsor
    Fudan University
    Collaborators
    Chinese Anti-Cancer Association
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT01216111
    Brief Title
    Adjuvant Platinum and Taxane in Triple-negative Breast Cancer (PATTERN)
    Official Title
    A Prospective, Randomized, Open-label, Multicentric,phaseIII Clinical Trial Compared With PC and CEF100 Followed by Docetaxel as Adjuvant Chemotherapy Regimen for Chinese Primary Triple Negative Breast Cancer Patients
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2020
    Overall Recruitment Status
    Completed
    Study Start Date
    January 1, 2011 (Actual)
    Primary Completion Date
    April 20, 2016 (Actual)
    Study Completion Date
    April 20, 2016 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Fudan University
    Collaborators
    Chinese Anti-Cancer Association

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    Previous studies in Western country show that triple-negative breast cancer has aggressive clinical and pathological features compared with non-triple negative breast cancer, including onset at a young age, advanced clinical stage, high histologic and nuclear grade and more distant recurrence. According to the characteristics of triple negative breast tumor, the TNBC patients can benefit neither from hormonal therapies nor from target therapies against Her2 receptors. The only systemic therapy currently available is chemotherapy, and prognosis remains poor. It becomes more and more important to investigate the sensitive chemotherapy regimen for triple negative patients. Cisplatin-based regimen was active for the patients of lung cancer, colorectal cancer and ect. Triple negative breast cancer patients were more sensitive to platinum-based chemotherapy regimens according to the results of some retrospective studies. The investigators hypothesized that paclitaxel combined with cisplatin is more sensitive to triple negative breast cancer compared with CEF followed by docetaxel.
    Detailed Description
    Eligibility Female adults(18-70 years old) are eligible if they had histologically confirmed primary breast cancer. Patients also had Eastern Cooperative Oncology Group(ECOG) Performance status of 0 or 1, absolute neutrophil count (ANC)>1500/mm3,hemoglobin >90g/dL, and platelet count >100,000/mm3,creatinine<2.5 times the upper limit of normal(ULN)), transaminases<3 times ULN or alkaline phosphatase<4 times ULN if transaminases was normal, and total bilirubin <1.5 times ULN. Exclusion criteria were active infection, pregnancy, other primary malignancy (except in situ carcinoma of cervix or adequately treated nonmelanomatous carcinoma of the skin), any documented distant metastasis and uncontrolled systemic diseases. This study protocol was approved by institutional ethic review boards and conducted according to guidelines for good clinical practice and the Helsinki Declaration.All patients provided written informed consent. Outcome Measures Primary Endpoint:5 year Disease Free Survival(DFS) Second Endpoints:5 year distant disease free survival (DDFS) 5 year event free survival (EFS) 5 year overall survival (OS) 5 year DFS in gBRCA1 mutation carriers and homologous recombination repair (HRR)-related gene mutation carriers

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Triple Negative Breast Cancer
    Keywords
    triple negative breast cancer,local recurrence,distant metastasis

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    647 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    6 cycles of PC adjuvant chemotherapy
    Arm Type
    Experimental
    Arm Description
    paclitaxel 80 mg/m2 and carboplatin (area under the curve [AUC]= 2) on day 1, 8, 15 every 28 days for six cycles
    Arm Title
    3 cycles of FEC followed by 3 cycles of Docetaxel
    Arm Type
    Active Comparator
    Arm Description
    fluorouracil 500 mg/m2, epirubicin 100 mg/m2, and cyclophosphamide 500 mg/m2 intravenously on day 1 every 21 days for three cycles followed by docetaxel 100 mg/m2 intravenously
    Intervention Type
    Drug
    Intervention Name(s)
    Paclitaxel Cisplatin
    Intervention Description
    Paclitaxel 80 mg/m2 D1,8,15 Cisplatin AUC=2 D1,8,15 1 cycle = 28days PC*6
    Intervention Type
    Drug
    Intervention Name(s)
    fluorouracil epirubicin cyclophosphamide and docetaxel (FEC-T)
    Intervention Description
    fluorouracil 500 mg/m2, epirubicin 100 mg/m2, and cyclophosphamide 500 mg/m2 intravenously on day 1 every 21 days for three cycles followed by docetaxel 100 mg/m2 intravenously
    Primary Outcome Measure Information:
    Title
    disease-free survival
    Description
    time from random assignment to first relapse (local, regional and distant), contralateral breast cancer
    Time Frame
    5 year
    Secondary Outcome Measure Information:
    Title
    distant disease-free survival
    Description
    time from random assignment to distant recurrence or death
    Time Frame
    5 year
    Title
    relapse-free survival
    Description
    time from the date of randomization to local, regional, distant relapse or death
    Time Frame
    5 year
    Title
    disease-free survival gBRCA1 mutation carriers and homologous recombination repair (HRR)-related gene mutation carriers
    Time Frame
    5 year
    Title
    overall survival
    Description
    time from randomization until death with any cause
    Time Frame
    5 year

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Women aged from 18 to 70 years; Histologically proven invasive unilateral breast cancer (regardless of the type); Initial clinical condition compatible with complete initial resection; No residual macro or microscopic tumor after surgical excision; Beginning of chemotherapeutic treatment no later than day 42 after the initial surgery; positive lymph node or negative lymph node with tumor size > 1.0cm Patient presenting one of the following criteria (reviewed before randomization by referent pathologist): Triple negative (ER-PR-Her-2-) Hormone receptor negativity is defined as ER<1%, PR<1% (IHC), HER2 negativity is defined as IHC 0-1+, or [IHC 2+ and FISH or CISH negative]. No clinically or radiologically detectable metastases (M0); No peripheral neuropathy > 1; WHO Performance status (ECOG) of 0 or 1; Adequate recovery from recent surgery (at least one week must have elapsed from the time of a minor surgery (excluding breast biopsy); at least three weeks for major surgery); Adequate hematological function (neutrophil count ³ 2x109/l, platelet count ³ 100x 109/l, Hemoglobin > 9 g/dl); Adequate hepatic function: ASAT and ALAT ≤ 3 ULN alkaline phosphatases ≤ 2.5 ULN,total bilirubin ≤ 1,5 ULN; Adequate renal function: serum creatinine ≤ 1 ULN; Patients accepting contraception intake during the overall length of treatment if of childbearing potential; Adequate cardiac function, LEVF value > 50% by Muga scan or echocardiography; Signed written informed consent. Exclusion Criteria: Bilateral breast cancer or patient with controlateral DCIS; Any metastatic impairment, including homolateral sub-clavicular node involvement,regardless of its type; Any T4 lesion (UICC1987) (cutaneous invasion, deep adherence, inflammatory breast cancer); ER+ or PR+ or Her-2 overexpression Any clinically or radiologically suspect and non-explored damage to the controlateral breast; Any chemotherapy, hormonal therapy or radiotherapy before surgery; Previous cancer (excepted cutaneous baso-cellular epithelioma or uterin peripheral ephitelioma) in the preceding 5 years, including invasive controlateral breast cancer; Patients already included in another therapeutic trial involving an experimental drug; Patients with other concurrent severe and/or uncontrolled medical disease or infection which could compromise participation in the study; LEVF < 50% (MUGA scan or echocardiography); Clinically significant cardiovascular disease (e.g. unstable angina, congestive heart failure, uncontrolled hypertension (>150/90), myocardial infarction or cerebral vascular accidents) within 6 months prior to randomization; Known prior severe hypersensitivity reactions to agents containing Cremophor EL; Women of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and up to 8 weeks after treatment completion; Women who are pregnant or breastfeeding. Adequate birth control measures should be taken during study treatment phase; Women with a positive pregnancy test en enrollment or prior to study drug administration; Patients with any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial; Individual deprived of liberty or placed under the authority of a tutor.

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    10963602
    Citation
    Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge O, Pergamenschikov A, Williams C, Zhu SX, Lonning PE, Borresen-Dale AL, Brown PO, Botstein D. Molecular portraits of human breast tumours. Nature. 2000 Aug 17;406(6797):747-52. doi: 10.1038/35021093.
    Results Reference
    background
    PubMed Identifier
    17438091
    Citation
    Carey LA, Dees EC, Sawyer L, Gatti L, Moore DT, Collichio F, Ollila DW, Sartor CI, Graham ML, Perou CM. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2007 Apr 15;13(8):2329-34. doi: 10.1158/1078-0432.CCR-06-1109.
    Results Reference
    background
    PubMed Identifier
    17011236
    Citation
    Yehiely F, Moyano JV, Evans JR, Nielsen TO, Cryns VL. Deconstructing the molecular portrait of basal-like breast cancer. Trends Mol Med. 2006 Nov;12(11):537-44. doi: 10.1016/j.molmed.2006.09.004. Epub 2006 Sep 29.
    Results Reference
    background
    PubMed Identifier
    18171422
    Citation
    Reis-Filho JS, Tutt AN. Triple negative tumours: a critical review. Histopathology. 2008 Jan;52(1):108-18. doi: 10.1111/j.1365-2559.2007.02889.x.
    Results Reference
    background
    PubMed Identifier
    17329194
    Citation
    Cleator S, Heller W, Coombes RC. Triple-negative breast cancer: therapeutic options. Lancet Oncol. 2007 Mar;8(3):235-44. doi: 10.1016/S1470-2045(07)70074-8.
    Results Reference
    background
    PubMed Identifier
    17671126
    Citation
    Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, Lickley LA, Rawlinson E, Sun P, Narod SA. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res. 2007 Aug 1;13(15 Pt 1):4429-34. doi: 10.1158/1078-0432.CCR-06-3045.
    Results Reference
    background
    PubMed Identifier
    16773436
    Citation
    Hayes DF, Ethier S, Lippman ME. New guidelines for reporting of tumor marker studies in breast cancer research and treatment: REMARK. Breast Cancer Res Treat. 2006 Nov;100(2):237-8. doi: 10.1007/s10549-006-9253-5. Epub 2006 Jun 14. No abstract available.
    Results Reference
    background
    PubMed Identifier
    32789480
    Citation
    Yu KD, Ye FG, He M, Fan L, Ma D, Mo M, Wu J, Liu GY, Di GH, Zeng XH, He PQ, Wu KJ, Hou YF, Wang J, Wang C, Zhuang ZG, Song CG, Lin XY, Toss A, Ricci F, Shen ZZ, Shao ZM. Effect of Adjuvant Paclitaxel and Carboplatin on Survival in Women With Triple-Negative Breast Cancer: A Phase 3 Randomized Clinical Trial. JAMA Oncol. 2020 Sep 1;6(9):1390-1396. doi: 10.1001/jamaoncol.2020.2965.
    Results Reference
    derived

    Learn more about this trial

    Adjuvant Platinum and Taxane in Triple-negative Breast Cancer (PATTERN)

    We'll reach out to this number within 24 hrs