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CAELYX® as Adjuvant Treatment in Early Stage Luminal B Breast Cancer BREAST CANCER

Primary Purpose

Breast Cancer

Status
Active
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Caelyx®
Sponsored by
European Institute of Oncology
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring early breast cancer, luminal B, adjuvant chemotherapy

Eligibility Criteria

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

Inclusion Criteria:

  • Performance status (ECOG) 0-2
  • Operable histologically confirmed breast cancer
  • Luminal B HER2-negative (ER positive, HER2 negative, and at least one of the following:

Ki- 67 'high' (≥20%) or PgR 'negative or low') or Luminal B HER2-positive (ER positive, HER2 over-expressed or amplified, any Ki-67, any PgR)

  • Early-stage (pT1-3; any nodal status)
  • Candidate to adjuvant chemotherapy and endocrine therapy
  • The tumor must be confined to the breast and axillary nodes without detected metastases elsewhere
  • Patients with synchronous (diagnosed histologically within 2 months) bilateral invasive breast cancer are eligible if all other criteria are met
  • Patients must have had surgery for primary breast cancer with no known clinical residual loco-regional disease
  • Margins must be negative for invasive breast cancer and DCIS
  • Patients should start treatment as close to definitive surgery as possible (no later than 8 weeks)
  • No prior neoadjuvant or adjuvant therapy for breast cancer. Note: Radiotherapy is allowed prior to trial entry. Raloxifene, tamoxifen, or other SERM must be discontinued at least 4 weeks before trial entry.
  • No hormone replacement therapy (HRT)
  • No hormonal therapy, except steroids for adrenal failure, hormones for non-breast cancer related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic.
  • No treatment with bisphosphonates, except for the treatment of osteoporosis
  • Adequate bone marrow, renal, and hepatic function must be assessed within 2 months before trial entry and values must meet the following criteria:
  • WBC ≥ 3.0 x 109/L
  • Granulocyte count ≥ 1.500 x 109/L
  • Hemoglobin ≥ 10.0 g/dL
  • Platelet count ≥ 100 x 109/L
  • Serum creatinine < 1.35 mg/dl - Calculated creatinine clearance at least 50 mL/min
  • Serum bilirubin within normal/reference range
  • AST/ALT within 1.5 x upper normal limit

    • Adequate cardiovascular function defined as the following must be assessed within 2 months before trial entry:
  • LVEF ≥ 50% by echocardiography, radionuclide ventriculography or Multigated Angiography (MUGA) - No ECG evidence of acute ischemia
  • No evidence of medically relevant conduction system abnormalities, which in the opinion of the investigator would preclude trial entry
  • No myocardial infarction within the past 6 months
  • No New York Heart Association (NYHA) class III or IV congestive heart failure
  • Negative pregnancy test (in fertile women).
  • Written Informed Consent (IC) must be signed and dated by the patient and the investigator prior to trial entry.
  • Patients must be accessible for follow-up.
  • Patients should have no psychiatric, addictive, or cognitive disorder that would prevent compliance with protocol requirements.

Exclusion Criteria:

  • Patients with a history of any prior ipsilateral or contralateral invasive breast cancer.
  • Patients with previous or concomitant malignancy diagnosed within the past five years. Patients with adequately treated basal or squamous cell carcinoma of the skin, in situ carcinoma of the cervix or bladder, contra- or ipsilateral in situ breast carcinoma are eligible regardless of the date of diagnosis.
  • Patients with other non-malignant uncontrolled systemic diseases that would preclude trial entry in the opinion of the investigator. Specifically not eligible are patients with uncontrolled active infection, chronic infection such as active HBV or HCV.
  • Patients with myocardial infarction or pulmonary embolism within 6 months prior to trial entry.

Sites / Locations

  • European Institute of Oncology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Caelyx® for 8 courses

Arm Description

Caelyx® administered intravenously at a dose of 20 mg/m2 once every two weeks for 8 courses.

Outcomes

Primary Outcome Measures

Feasibility of adjuvant PLD (Caelyx®)
The regimen will be considered feasible if that subject is able to achieve relative dose intensity (RDI) of at least 85% of the 8 cycles of treatment

Secondary Outcome Measures

Adverse event
Grading for all side effects will be according to the National Cancer Institute's (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
percent of patient completing treatment (tolerability)
percent of patients treated according to the protocol and completing the adjuvant program, and percent protocol treatment received
Breast cancer free interval (BCFI)
BCFI is defined as the time from registration to local (including recurrence restricted to the breast after breast conserving treatment), regional, or distant relapse, or contralateral breast cancer.
Disease Free Survival (DFS)
DFS is defined as the time from registration to disease recurrence (includes second malignancies and deaths)
Overall survival (OS)
OS defined as the time from registration to death from any cause

Full Information

First Posted
September 25, 2018
Last Updated
September 18, 2023
Sponsor
European Institute of Oncology
Collaborators
Janssen-Cilag International NV
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1. Study Identification

Unique Protocol Identification Number
NCT03712956
Brief Title
CAELYX® as Adjuvant Treatment in Early Stage Luminal B Breast Cancer BREAST CANCER
Official Title
CAELYX® as Adjuvant Treatment in Early Stage Luminal B Breast Cancer: a Feasibility Phase II Trial
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 25, 2016 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
European Institute of Oncology
Collaborators
Janssen-Cilag International NV

4. Oversight

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

5. Study Description

Brief Summary
A single-center, phase II, single-arm, feasibility study to evaluate PLD (Caelyx®) as an adjuvant chemotherapy regimen in patients with early-stage luminal B breast cancer. The primary endpoint will be to evaluate the feasibility of adjuvant PLD (Caelyx®) for each individual subject. The regimen will be considered feasible if that subject is able to achieve relative dose intensity (RDI) of at least 85% of the 8 cycles of treatment. Caelyx® should be administered intravenously at a dose of 20 mg/m2 once every two weeks for 8 courses.
Detailed Description
In the 2011 St Gallen Consensus Conference, the Panel considered that both anthracyclines and taxanes should be included in the chemotherapy regimen for 'Luminal B' disease1. However, several patients are reluctant to receive a "strong" chemotherapy because of the fear of its toxic effects, and usually ask for a somehow "less intensive" approach, even accepting a possible reduction in the treatment efficacy. One of the reasons why patients refuse chemotherapy more often is the fear of alopecia. Few dermatologic conditions carry as much emotional distress as chemotherapy-induced alopecia. Hair loss negatively affects a patient's perception of appearance, body image, sexuality, and self- esteem. We decided to conduct a single-center, phase II, single-arm, feasibility study to evaluate PLD (Caelyx®) as an adjuvant chemotherapy regimen in patients with early-stage luminal B breast cancer. The primary endpoint will be to evaluate the feasibility of adjuvant PLD (Caelyx®) for each individual subject. The regimen will be considered feasible if that subject is able to achieve relative dose intensity (RDI) of at least 85% of the 8 cycles of treatment. Secondary endpoints will include: Adverse events Tolerability (treatment completion) Breast cancer free interval (BCFI; events are reappearance of invasive breast cancer at any site including contralateral disease) Disease Free Survival (DFS) (includes second malignancies and deaths) Overall survival (OS) Caelyx® should be administered intravenously at a dose of 20 mg/m2 once every two weeks for 8 courses.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
early breast cancer, luminal B, adjuvant chemotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
63 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Caelyx® for 8 courses
Arm Type
Experimental
Arm Description
Caelyx® administered intravenously at a dose of 20 mg/m2 once every two weeks for 8 courses.
Intervention Type
Drug
Intervention Name(s)
Caelyx®
Other Intervention Name(s)
Caelyx
Intervention Description
Caelyx® every two weeks for 8 courses
Primary Outcome Measure Information:
Title
Feasibility of adjuvant PLD (Caelyx®)
Description
The regimen will be considered feasible if that subject is able to achieve relative dose intensity (RDI) of at least 85% of the 8 cycles of treatment
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Adverse event
Description
Grading for all side effects will be according to the National Cancer Institute's (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
Time Frame
4 months
Title
percent of patient completing treatment (tolerability)
Description
percent of patients treated according to the protocol and completing the adjuvant program, and percent protocol treatment received
Time Frame
4 month
Title
Breast cancer free interval (BCFI)
Description
BCFI is defined as the time from registration to local (including recurrence restricted to the breast after breast conserving treatment), regional, or distant relapse, or contralateral breast cancer.
Time Frame
5 years
Title
Disease Free Survival (DFS)
Description
DFS is defined as the time from registration to disease recurrence (includes second malignancies and deaths)
Time Frame
5 years
Title
Overall survival (OS)
Description
OS defined as the time from registration to death from any cause
Time Frame
5 years

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: Performance status (ECOG) 0-2 Operable histologically confirmed breast cancer Luminal B HER2-negative (ER positive, HER2 negative, and at least one of the following: Ki- 67 'high' (≥20%) or PgR 'negative or low') or Luminal B HER2-positive (ER positive, HER2 over-expressed or amplified, any Ki-67, any PgR) Early-stage (pT1-3; any nodal status) Candidate to adjuvant chemotherapy and endocrine therapy The tumor must be confined to the breast and axillary nodes without detected metastases elsewhere Patients with synchronous (diagnosed histologically within 2 months) bilateral invasive breast cancer are eligible if all other criteria are met Patients must have had surgery for primary breast cancer with no known clinical residual loco-regional disease Margins must be negative for invasive breast cancer and DCIS Patients should start treatment as close to definitive surgery as possible (no later than 8 weeks) No prior neoadjuvant or adjuvant therapy for breast cancer. Note: Radiotherapy is allowed prior to trial entry. Raloxifene, tamoxifen, or other SERM must be discontinued at least 4 weeks before trial entry. No hormone replacement therapy (HRT) No hormonal therapy, except steroids for adrenal failure, hormones for non-breast cancer related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic. No treatment with bisphosphonates, except for the treatment of osteoporosis Adequate bone marrow, renal, and hepatic function must be assessed within 2 months before trial entry and values must meet the following criteria: WBC ≥ 3.0 x 109/L Granulocyte count ≥ 1.500 x 109/L Hemoglobin ≥ 10.0 g/dL Platelet count ≥ 100 x 109/L Serum creatinine < 1.35 mg/dl - Calculated creatinine clearance at least 50 mL/min Serum bilirubin within normal/reference range AST/ALT within 1.5 x upper normal limit Adequate cardiovascular function defined as the following must be assessed within 2 months before trial entry: LVEF ≥ 50% by echocardiography, radionuclide ventriculography or Multigated Angiography (MUGA) - No ECG evidence of acute ischemia No evidence of medically relevant conduction system abnormalities, which in the opinion of the investigator would preclude trial entry No myocardial infarction within the past 6 months No New York Heart Association (NYHA) class III or IV congestive heart failure Negative pregnancy test (in fertile women). Written Informed Consent (IC) must be signed and dated by the patient and the investigator prior to trial entry. Patients must be accessible for follow-up. Patients should have no psychiatric, addictive, or cognitive disorder that would prevent compliance with protocol requirements. Exclusion Criteria: Patients with a history of any prior ipsilateral or contralateral invasive breast cancer. Patients with previous or concomitant malignancy diagnosed within the past five years. Patients with adequately treated basal or squamous cell carcinoma of the skin, in situ carcinoma of the cervix or bladder, contra- or ipsilateral in situ breast carcinoma are eligible regardless of the date of diagnosis. Patients with other non-malignant uncontrolled systemic diseases that would preclude trial entry in the opinion of the investigator. Specifically not eligible are patients with uncontrolled active infection, chronic infection such as active HBV or HCV. Patients with myocardial infarction or pulmonary embolism within 6 months prior to trial entry.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elisabetta Munzone, MD
Organizational Affiliation
European Institute of Oncology
Official's Role
Principal Investigator
Facility Information:
Facility Name
European Institute of Oncology
City
Milan
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

CAELYX® as Adjuvant Treatment in Early Stage Luminal B Breast Cancer BREAST CANCER

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