Vorinostat Before Surgery in Treating Patients With Triple-Negative Breast Cancer
Primary Purpose
Stage II Breast Cancer, Stage IIIA Breast Cancer, Triple-negative Breast Cancer
Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
vorinostat
therapeutic conventional surgery
laboratory biomarker analysis
Sponsored by
About this trial
This is an interventional treatment trial for Stage II Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- Resectable tumor measuring 2cm or more
- Histologically documented, newly diagnosed, triple negative invasive breast cancer characterized by 0% immunohistochemistry (IHC) nuclear staining for ER-alpha, 0% IHC nuclear staining for PR-alpha, and no amplification of human epidermal growth factor receptor 2 (HER2)/neu by fluorescent in situ hybridization (FISH) using institutional standard; standard IHC assays for ER and PR use antibodies to ER-alpha and PR-alpha and PR-beta
- Southwest Oncology Group (SWOG) performance status of less than or equal to 1
- Absolute neutrophil count (ANC) >= 1500/uL
- Hemoglobin (Hgb) >= 9 g/dL
- Platelets >= 100,000/uL
- Aspartate aminotransferase (AST)/serum glutamic oxaloacetic transaminase (SGOT) and alanine aminotransferase (ALT)/serum glutamic pyruvate transaminase (SGPT) =< 2.5 x upper limit of normal (ULN) or =< 5.0 x ULN in patients with liver metastases
- Creatinine =< 2.0 mg/dL or calculated creatinine clearance >= 50 ml/min
- Albumin >= 3 g/dL
- Potassium >= lower limit normal (LLN)
- Phosphorous >= LLN
- Calcium >= LLN
- Magnesium > LLN
- Women of childbearing potential must have a negative serum or urine pregnancy test performed within 7 days prior to start of treatment
- Accessible for treatment and follow-up
- Written informed consent prior to study entry
Exclusion Criteria:
- HER2/neu amplification by FISH
- Concurrent neoadjuvant anti-cancer treatment with chemotherapy, endocrine therapy, biologically targeted therapy or radiotherapy
- Known hypersensitivity to SAHA
- Preexisting hepatic impairment or renal impairment
- Intent to receive additional neoadjuvant therapy prior to surgery
- Concurrent use of an HDAC inhibitor or hydralazine
- Known diagnosis of human immunodeficiency virus (HIV) infection
- Major surgery < 4 weeks prior to starting study drug
- Pregnant or breastfeeding or female of reproductive potential not using an effective method of birth control
- Other concurrent severe, uncontrolled infection or intercurrent illness, including but not limited to ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements
- Prior antiestrogens (selective estrogen receptor modulator [SERM] or aromatase inhibitors) within 6 months of study entry
- Underlying medical, psychiatric or social conditions that would preclude patient from receiving treatment
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment (vorinostat and surgery)
Arm Description
Patients receive vorinostat 400 mg daily PO on days 1-21 followed by surgery within 14 days.
Outcomes
Primary Outcome Measures
Combined PR/ER response
The proportion of patients who achieve sufficient deacetylation of ER and PR will be estimable with a standard error no greater than +/- 0.05. The proportion of patients who exhibit a sufficient change in ER or PR expression can be estimated with similar precision. In addition, paired t-tests and McNamaraâs test will be used to evaluate whether the effect of vorinostat on deacetylation status or gene expression differs between ER or PR, and linear regression analysis will be used to evaluate the association between deacetylation changes and corresponding expression changes in ER and PR genes.
Secondary Outcome Measures
Grade 3 or 4 toxicities using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
The toxicities observed will be summarized in terms of type (organ affected or laboratory determination such as absolute neutrophil count), severity (by NCI Common Toxicity Criteria v4.0 and nadir or maximum values for the laboratory measures), time of onset (i.e. week of treatment), duration, and reversibility or outcome.
Full Information
NCT ID
NCT01695057
First Posted
September 24, 2012
Last Updated
January 27, 2014
Sponsor
University of Southern California
Collaborators
National Cancer Institute (NCI)
1. Study Identification
Unique Protocol Identification Number
NCT01695057
Brief Title
Vorinostat Before Surgery in Treating Patients With Triple-Negative Breast Cancer
Official Title
A Pilot Clinical Trial to Evaluate the Biological Activity of HDAC (Histone Deacetylase Transferases) Inhibition on ER and PR Expression in Triple Negative Invasive Breast Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
January 2014
Overall Recruitment Status
Withdrawn
Why Stopped
Lack of funding
Study Start Date
October 2012 (undefined)
Primary Completion Date
October 2014 (Anticipated)
Study Completion Date
October 2015 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Southern California
Collaborators
National Cancer Institute (NCI)
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This pilot clinical trial studies vorinostat before surgery in treating patients with triple-negative breast cancer. Vorinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving enzyme inhibitor therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate the ability of histone deacetylase (HDAC) inhibition using suberoylanilide hydroxamic acid (SAHA) (vorinostat) to induce expression of the estrogen receptor (ER) and progesterone receptor (PR) genes in solid human triple negative invasive breast cancer.
OUTLINE:
Patients receive vorinostat 400 mg daily orally (PO) on days 1-21 followed by surgery within 14 days.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage II Breast Cancer, Stage IIIA Breast Cancer, Triple-negative Breast Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Treatment (vorinostat and surgery)
Arm Type
Experimental
Arm Description
Patients receive vorinostat 400 mg daily PO on days 1-21 followed by surgery within 14 days.
Intervention Type
Drug
Intervention Name(s)
vorinostat
Other Intervention Name(s)
L-001079038, SAHA, suberoylanilide hydroxamic acid, Zolinza
Intervention Description
Given PO
Intervention Type
Procedure
Intervention Name(s)
therapeutic conventional surgery
Intervention Description
Undergo surgery
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Combined PR/ER response
Description
The proportion of patients who achieve sufficient deacetylation of ER and PR will be estimable with a standard error no greater than +/- 0.05. The proportion of patients who exhibit a sufficient change in ER or PR expression can be estimated with similar precision. In addition, paired t-tests and McNamaraâs test will be used to evaluate whether the effect of vorinostat on deacetylation status or gene expression differs between ER or PR, and linear regression analysis will be used to evaluate the association between deacetylation changes and corresponding expression changes in ER and PR genes.
Time Frame
21 days
Secondary Outcome Measure Information:
Title
Grade 3 or 4 toxicities using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
Description
The toxicities observed will be summarized in terms of type (organ affected or laboratory determination such as absolute neutrophil count), severity (by NCI Common Toxicity Criteria v4.0 and nadir or maximum values for the laboratory measures), time of onset (i.e. week of treatment), duration, and reversibility or outcome.
Time Frame
Within 3 days prior to surgery
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Resectable tumor measuring 2cm or more
Histologically documented, newly diagnosed, triple negative invasive breast cancer characterized by 0% immunohistochemistry (IHC) nuclear staining for ER-alpha, 0% IHC nuclear staining for PR-alpha, and no amplification of human epidermal growth factor receptor 2 (HER2)/neu by fluorescent in situ hybridization (FISH) using institutional standard; standard IHC assays for ER and PR use antibodies to ER-alpha and PR-alpha and PR-beta
Southwest Oncology Group (SWOG) performance status of less than or equal to 1
Absolute neutrophil count (ANC) >= 1500/uL
Hemoglobin (Hgb) >= 9 g/dL
Platelets >= 100,000/uL
Aspartate aminotransferase (AST)/serum glutamic oxaloacetic transaminase (SGOT) and alanine aminotransferase (ALT)/serum glutamic pyruvate transaminase (SGPT) =< 2.5 x upper limit of normal (ULN) or =< 5.0 x ULN in patients with liver metastases
Creatinine =< 2.0 mg/dL or calculated creatinine clearance >= 50 ml/min
Albumin >= 3 g/dL
Potassium >= lower limit normal (LLN)
Phosphorous >= LLN
Calcium >= LLN
Magnesium > LLN
Women of childbearing potential must have a negative serum or urine pregnancy test performed within 7 days prior to start of treatment
Accessible for treatment and follow-up
Written informed consent prior to study entry
Exclusion Criteria:
HER2/neu amplification by FISH
Concurrent neoadjuvant anti-cancer treatment with chemotherapy, endocrine therapy, biologically targeted therapy or radiotherapy
Known hypersensitivity to SAHA
Preexisting hepatic impairment or renal impairment
Intent to receive additional neoadjuvant therapy prior to surgery
Concurrent use of an HDAC inhibitor or hydralazine
Known diagnosis of human immunodeficiency virus (HIV) infection
Major surgery < 4 weeks prior to starting study drug
Pregnant or breastfeeding or female of reproductive potential not using an effective method of birth control
Other concurrent severe, uncontrolled infection or intercurrent illness, including but not limited to ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements
Prior antiestrogens (selective estrogen receptor modulator [SERM] or aromatase inhibitors) within 6 months of study entry
Underlying medical, psychiatric or social conditions that would preclude patient from receiving treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Agustin Garcia
Organizational Affiliation
University of Southern California
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
Vorinostat Before Surgery in Treating Patients With Triple-Negative Breast Cancer
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