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ADAPT - Adjuvant Dynamic Marker-Adjusted Personalized Therapy Trial Optimizing Risk Assessment and Therapy Response Prediction in Early Breast Cancer (ADAPT)

Primary Purpose

Breast Cancer

Status
Active
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Epirubicin
Cyclophosphamide
Docetaxel
Paclitaxel
Sponsored by
West German Study Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Female patients, age at diagnosis 18 years and above (consider patients at 70 years and above for ADAPT Elderly)
  • Histologically confirmed unilateral primary invasive carcinoma of the breast
  • Clinical T1 - T4 (except inflammatory breast cancer)
  • All clinical N (cN)
  • No clinical evidence for distant metastasis (M0)
  • Known HR status and HER2 status (local pathology)
  • Tumor block available for central pathology review
  • Performance Status ECOG <= 1 or KI >= 80%
  • Negative pregnancy test (urine or serum) within 7 days prior to start of induction treatment in premenopausal patients
  • Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, must be obtained and documented according to the local regulatory requirements
  • The patient must be accessible for treatment and follow-up

Additional Inclusion criteria for patients receiving chemotherapy:

  • Laboratory requirements for patients receiving neoadjuvant chemotherapy (within 14 days prior to induction treatment):

    • Leucocytes >= 3.5 x 10^9/L
    • Platelets >= 100 x 10^9/L
    • Hemoglobin >= 10 g/dL
    • Total bilirubin <= 1 x ULN
    • ASAT (SGOT) and ALAT (SGPT) <= 2.5 x UNL
    • Creatinine <= 175 µmol/L (2 mg/dl)
  • LVEF within normal limits of each institution measured by echocardiography and normal ECG (within 42 days prior to induction treatment)

Exclusion Criteria:

  • Known hypersensitivity reaction to the compounds or incorporated substances
  • Prior malignancy with a disease-free survival of < 10 years, except curatively treated basalioma of the skin or pTis of the cervix uteri
  • Non-operable breast cancer including inflammatory breast cancer
  • Previous or concurrent treatment with cytotoxic agents for any reason after consultation with the sponsor
  • Concurrent treatment with other experimental drugs. Participation in another interventional clinical trial with or without any investigational not marketed drug within 30 days prior to study entry
  • Male breast cancer
  • Concurrent pregnancy; patients of childbearing potential must implement a highly effective (less than 1% failure rate) non-hormonal contraceptive measures during the study treatment
  • Breast feeding woman
  • Sequential breast cancer
  • Reasons indicating risk of poor compliance
  • Patients not able to consent

Additional Exclusion Criteria for patients receiving chemotherapy:

  • Known polyneuropathy ≥ grade 2
  • Severe and relevant co-morbidity that would interact with the application of cytotoxic agents or the participation in the study including acute cystitis and ischuria and chronic kidney disease
  • Uncompensated cardiac function
  • Inadequate organ function including:

    • Leucocytes < 3.5 x 10^9/l
    • Platelets < 100 x 10^9/l
    • Bilirubin above normal limits
    • Alkaline phosphatase >= 5 x UNL
    • ASAT and/or ALAT associated with AP > 2.5 x UNL

Sites / Locations

  • Breast Center of the University of Munich (LMU) Universitätsfrauenklinik Großhadern
  • Ev. Krankenhaus Bethesda Brustzentrum Niederrhein

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Anthracycline - Taxane

Taxane - Anthracycline

Arm Description

Study sites can choose between either Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q3w OR Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q2w for anthracycline treatment and between either 4 x Docetaxel (100mg/m²) q3w OR 12 x Paclitaxel (80mg/m²) q1w for taxane treatment.

Study sites can choose between either Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q3w OR Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q2w for anthracycline treatment and between either 4 x Docetaxel (100mg/m²) q3w OR 12 x Paclitaxel (80mg/m²) q1w for taxane treatment.

Outcomes

Primary Outcome Measures

Identification of a responder sub-population with intermediate and high risk, which due to therapy has outcome comparable to HR+/RS≤11

Secondary Outcome Measures

Overall survival

Full Information

First Posted
January 25, 2013
Last Updated
March 23, 2023
Sponsor
West German Study Group
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1. Study Identification

Unique Protocol Identification Number
NCT01779206
Brief Title
ADAPT - Adjuvant Dynamic Marker-Adjusted Personalized Therapy Trial Optimizing Risk Assessment and Therapy Response Prediction in Early Breast Cancer
Acronym
ADAPT
Official Title
Adjuvant Dynamic Marker-Adjusted Personalized Therapy Trial Optimizing Risk Assessment and Therapy Response Prediction in Early Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 2012 (Actual)
Primary Completion Date
September 2019 (Actual)
Study Completion Date
October 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
West German Study Group

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Trial for the optimization of risk assessment and therapy success prediction in patients with early breast cancer by the use of biomarkers in advance to therapy decision-making to personalize therapies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
4936 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Anthracycline - Taxane
Arm Type
Active Comparator
Arm Description
Study sites can choose between either Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q3w OR Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q2w for anthracycline treatment and between either 4 x Docetaxel (100mg/m²) q3w OR 12 x Paclitaxel (80mg/m²) q1w for taxane treatment.
Arm Title
Taxane - Anthracycline
Arm Type
Experimental
Arm Description
Study sites can choose between either Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q3w OR Epirubicin (90mg/m²) Cyclophosphamide (600mg/m²) q2w for anthracycline treatment and between either 4 x Docetaxel (100mg/m²) q3w OR 12 x Paclitaxel (80mg/m²) q1w for taxane treatment.
Intervention Type
Drug
Intervention Name(s)
Epirubicin
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Primary Outcome Measure Information:
Title
Identification of a responder sub-population with intermediate and high risk, which due to therapy has outcome comparable to HR+/RS≤11
Time Frame
3 Years
Secondary Outcome Measure Information:
Title
Overall survival
Time Frame
3 Years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female patients, age at diagnosis 18 years and above (consider patients at 70 years and above for ADAPT Elderly) Histologically confirmed unilateral primary invasive carcinoma of the breast Clinical T1 - T4 (except inflammatory breast cancer) All clinical N (cN) No clinical evidence for distant metastasis (M0) Known HR status and HER2 status (local pathology) Tumor block available for central pathology review Performance Status ECOG <= 1 or KI >= 80% Negative pregnancy test (urine or serum) within 7 days prior to start of induction treatment in premenopausal patients Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, must be obtained and documented according to the local regulatory requirements The patient must be accessible for treatment and follow-up Additional Inclusion criteria for patients receiving chemotherapy: Laboratory requirements for patients receiving neoadjuvant chemotherapy (within 14 days prior to induction treatment): Leucocytes >= 3.5 x 10^9/L Platelets >= 100 x 10^9/L Hemoglobin >= 10 g/dL Total bilirubin <= 1 x ULN ASAT (SGOT) and ALAT (SGPT) <= 2.5 x UNL Creatinine <= 175 µmol/L (2 mg/dl) LVEF within normal limits of each institution measured by echocardiography and normal ECG (within 42 days prior to induction treatment) Exclusion Criteria: Known hypersensitivity reaction to the compounds or incorporated substances Prior malignancy with a disease-free survival of < 10 years, except curatively treated basalioma of the skin or pTis of the cervix uteri Non-operable breast cancer including inflammatory breast cancer Previous or concurrent treatment with cytotoxic agents for any reason after consultation with the sponsor Concurrent treatment with other experimental drugs. Participation in another interventional clinical trial with or without any investigational not marketed drug within 30 days prior to study entry Male breast cancer Concurrent pregnancy; patients of childbearing potential must implement a highly effective (less than 1% failure rate) non-hormonal contraceptive measures during the study treatment Breast feeding woman Sequential breast cancer Reasons indicating risk of poor compliance Patients not able to consent Additional Exclusion Criteria for patients receiving chemotherapy: Known polyneuropathy ≥ grade 2 Severe and relevant co-morbidity that would interact with the application of cytotoxic agents or the participation in the study including acute cystitis and ischuria and chronic kidney disease Uncompensated cardiac function Inadequate organ function including: Leucocytes < 3.5 x 10^9/l Platelets < 100 x 10^9/l Bilirubin above normal limits Alkaline phosphatase >= 5 x UNL ASAT and/or ALAT associated with AP > 2.5 x UNL
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nadia Harbeck, Prof. Dr.
Organizational Affiliation
Breast Center of the University of Munich (LMU) Universitätsfrauenklinik Großhadern, Munich, Germany
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ulrike Nitz, Prof. Dr.
Organizational Affiliation
Ev. Krankenhaus Bethesda Brustzentrum Niederrhein, Mönchengladbach, Germany
Official's Role
Study Chair
Facility Information:
Facility Name
Breast Center of the University of Munich (LMU) Universitätsfrauenklinik Großhadern
City
Munich
State/Province
Bavaria
ZIP/Postal Code
81377
Country
Germany
Facility Name
Ev. Krankenhaus Bethesda Brustzentrum Niederrhein
City
Mönchengladbach
State/Province
NRW
ZIP/Postal Code
41061
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
23958221
Citation
Hofmann D, Nitz U, Gluz O, Kates RE, Schinkoethe T, Staib P, Harbeck N. WSG ADAPT - adjuvant dynamic marker-adjusted personalized therapy trial optimizing risk assessment and therapy response prediction in early breast cancer: study protocol for a prospective, multi-center, controlled, non-blinded, randomized, investigator initiated phase II/III trial. Trials. 2013 Aug 19;14:261. doi: 10.1186/1745-6215-14-261.
Results Reference
background
PubMed Identifier
35404683
Citation
Nitz UA, Gluz O, Kummel S, Christgen M, Braun M, Aktas B, Ludtke-Heckenkamp K, Forstbauer H, Grischke EM, Schumacher C, Darsow M, Krauss K, Nuding B, Thill M, Potenberg J, Uleer C, Warm M, Fischer HH, Malter W, Hauptmann M, Kates RE, Graser M, Wurstlein R, Shak S, Baehner F, Kreipe HH, Harbeck N. Endocrine Therapy Response and 21-Gene Expression Assay for Therapy Guidance in HR+/HER2- Early Breast Cancer. J Clin Oncol. 2022 Aug 10;40(23):2557-2567. doi: 10.1200/JCO.21.02759. Epub 2022 Apr 11.
Results Reference
derived
PubMed Identifier
33736679
Citation
Graeser M, Schrading S, Gluz O, Strobel K, Herzog C, Umutlu L, Frydrychowicz A, Rjosk-Dendorfer D, Wurstlein R, Culemann R, Eulenburg C, Adams J, Nitzsche H, Prange A, Kummel S, Grischke EM, Forstbauer H, Braun M, Potenberg J, von Schumann R, Aktas B, Kolberg-Liedtke C, Harbeck N, Kuhl CK, Nitz U. Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials. Breast Cancer Res. 2021 Mar 18;23(1):36. doi: 10.1186/s13058-021-01413-y.
Results Reference
derived
PubMed Identifier
33281950
Citation
Nitz U, Gluz O, Kreipe HH, Christgen M, Kuemmel S, Baehner FL, Shak S, Aktas B, Braun M, Ludtke-Heckenkamp K, Forstbauer H, Grischke EM, Nuding B, Darsow M, Schumacher C, Krauss K, Malter W, Thill M, Warm M, Wuerstlein R, Kates RE, Harbeck N. The run-in phase of the prospective WSG-ADAPT HR+/HER2- trial demonstrates the feasibility of a study design combining static and dynamic biomarker assessments for individualized therapy in early breast cancer. Ther Adv Med Oncol. 2020 Nov 23;12:1758835920973130. doi: 10.1177/1758835920973130. eCollection 2020.
Results Reference
derived

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ADAPT - Adjuvant Dynamic Marker-Adjusted Personalized Therapy Trial Optimizing Risk Assessment and Therapy Response Prediction in Early Breast Cancer

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