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Effect of Zoledronic Acid as Anti-Cancer Treatment in Metastatic Breast Cancer Patients (MACS1295)

Primary Purpose

First or Second Line HER2-negative Breast Cancer, Metastatic Disease Without Bone Metastasis

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Zoledronic acid
Standard Therapy
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for First or Second Line HER2-negative Breast Cancer focused on measuring HER2-negative, HER2, Metastatic breast cancer, First Line breast cancer, Second Line breast cancer, Breast cancer, Metastatic, Stage IV breast cancer, Progression free survival, PFS, Circulating Tumor Cells, CTCs, Zoledronic acid, HER2-negative metastatic breast cancer patients without bone metastasis

Eligibility Criteria

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

Inclusion Criteria:

  • Written informed consent
  • Female patients (age ≥18 years)
  • HER2-negative metastatic breast cancer (stage IV)
  • Patients will be receiving chemotherapy or hormonal therapy
  • Patients with no bone metastasis and ≤1 prior treatments for metastatic breast cancer. Patients with newly diagnosed metastatic breast cancer may have received adjuvant or neoadjuvant chemotherapy as long as treatment was completed ≥12 months prior to relapse.
  • Asymptomatic brain metastasis is permitted if all of the following criteria are met:

    1. no sign of clinical progression or known progression of brain metastasis
    2. off steroids for at least 2 weeks prior to study enrollment
  • Stable renal function: two serum creatinine determinations of <3 mg/dL, obtained no less than 7 days apart (one value may be obtained within 6 weeks prior to Screening; the second must be obtained during Screening)
  • ECOG performance status of 0 or 1
  • Life expectancy of ≥ 6 months
  • Negative serum pregnancy test
  • Ability and willingness to comply with all study requirements

Exclusion Criteria:

  • Known hypersensitivity to zoledronic acid or other bisphosphonates
  • Patients with history of another malignancy within the last two years prior to study enrollment, except cured basal cell carcinoma of the skin or excised carcinoma in site of the cervix
  • Use of concurrent investigational agents is prohibited. Prior use of investigational agents is permitted if discontinued ≥30 days prior to Screening.
  • No prior therapy with an antiresorptive agent
  • Patients with active brain metastases or meningeal metastases
  • Current or recent (in the six months prior to initial study drug treatment) severe cardiovascular disease (defined as uncontrolled congestive heart failure), hypertension refractory to treatment, or poorly controlled Type I/II diabetes mellitus
  • Current active dental problems including dental abscess or infection of the jawbone (maxilla or mandible) or a current or prior diagnosis of osteonecrosis of the jaw
  • Patients who have received radiotherapy ≤ 4 weeks prior to study enrollment or who have not recovered from radiotherapy-related toxicities. Palliative radiotherapy for bone lesions ≤ 2 weeks prior to study enrollment is allowed
  • Patients who have undergone major surgery (e.g., intra-thoracic, intra-abdominal or intra-pelvic) ≤ 4 weeks prior to study enrollment or who have not recovered from side effects of such therapy
  • Diminished renal capacity: calculated creatinine clearance (CrCl) <30 mL/min (based on Cockcroft-Gault formula)
  • Corrected (i.e., adjusted for serum albumin) serum calcium of <8.0 mg/dL (2.00 mmol/L) or ≥ 12 mg/dL (3.00 mmol/L)
  • Pregnant or breast-feeding females
  • Women of child-bearing potential who are not willing/able to use effective methods of birth control (e.g., abstinence, oral contraceptives or implants, IUD, vaginal diaphragm or sponge, or condom with spermicide)
  • History of non-compliance to medical regimens and/or patients who are considered unreliable
  • History of bone metabolism diseases

Sites / Locations

  • Highlands Oncology Group
  • Clopton Clinic
  • Hematology Oncology Services of Arkansas
  • Kaiser Permanente Medical Group Kaiser Permanente - Hawaii
  • Wilshire Oncology Medical Group
  • Loma Linda University Loma Linda Cancer Center
  • Hematology and Medical Oncology
  • Florida Cancer Specialists DeptofFloridaCancerSpecialists
  • Lakeland Regional Cancer Center Dept. of Lakeland Regional
  • Space Coast Medical Associates
  • Kootenai Medical Center Kootenai Medical Center
  • Oncology Specialists, SC Lutheran General Cancer Instit
  • Cancer Center of Kansas
  • Park Nicollet Institute Dept. of Park Nicollet
  • St. John's Mercy Medical Center St. John's Mercy Med Ctr
  • Hematology Oncology Centers of the Northern Rockies Hema Onc Ctr N. Rockies (4
  • Southeast Nebraska Oncology Cancer Center
  • Reno Oncology Consultants
  • Somerset Hematology Oncology Associates Somerset Hema Oncol Assoc (2)
  • Cooper Cancer Center
  • NYU Langone Arena Oncology
  • Marion L. Shepard Cancer Center
  • Piedmont Hematology and Oncology Associates Piedmont Hem/Onc Assoc (2)
  • Hematology Oncology Center, Inc.
  • Milton S Hershey Medical Center Hershey Medical Center (4)
  • Berks Hematology Oncology
  • Abington Hematology Oncology Associates, Inc
  • The West Clinic
  • Sarah Cannon Research Institute
  • South Texas Oncology and Hematology, PA South Texas Oncology (2)
  • East Texas Medical Center Cancer Institute Tyler Hem/Onc (3)
  • Medical Oncology & Hematology Associates of Northern VA Med. Onc&Hem Assoc. of No.VA
  • Northwest Medical Specialties

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Patients without bone metastases

Patients with bone metastases

Arm Description

Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.

Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)

Outcomes

Primary Outcome Measures

Number of Participants With Progression Free Survival (PFS)
Complete Response (CR): disappearance of all target lesions. Any pathological lymph nodes (target or non-target) must have exhibited a reduction in short axis to < 10 mm. Partial Response (PR): at least a 30% decrease in sum of diameters of target lesions, taking as reference the baseline sum of diameters. Progressive Disease (PD): at least 20% increase in sum of diameters of target lesions taking as reference the smallest sum on study accompanied by an absolute increase of at least 5 mm or appearance of one or more new lesions. Stable Disease (SD): neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference smallest sum diameters. PFS is time from enrollment to date of first documented disease progression or death due to any cause. A participant is considered to be censored when data on time to event is missing due to a subject being lost to follow-up or non-occurrence of the outcome event before the completion of the trial.

Secondary Outcome Measures

Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Circulating tumor cells (CTCs) have been associated with poor patient prognosis and outcomes in patients receiving treatment for MBC. CTCs have been evaluated as a potential biomarker for predicting treatment effects and overall survival. Baseline was defined as the last predose measurement for patients who received any study drug and as the later of the screening visit or Visit 2 value for patients who did not receive the study drug. Percentage was calculated as the number of patients with CTC ≥5/7.5 mL against the number of patients with nonmissing CTC values (represented as 'n' in the categories).
Time to Progression (TTP)
Time to progression is defined as the time from the date of enrollment to the date of first documented disease progression or death due to metastatic breast cancer.
Change From Baseline in Urine NTX by Month
NTX= N-telopeptide of type 1 collagen (nmol bce/mmol [nanomoles of bone collagen equivalents per millimole of creatinine]). Baseline was defined as the last predose measurement for patients who received any study drug and as the later of the screening visit or visit 2 value for patients who did not receive study drug.

Full Information

First Posted
May 20, 2010
Last Updated
May 9, 2014
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01129336
Brief Title
Effect of Zoledronic Acid as Anti-Cancer Treatment in Metastatic Breast Cancer Patients
Acronym
MACS1295
Official Title
A Multicenter, Open-label, Randomized Trial to Evaluate the Anti-cancer Effects of Zoledronic Acid and Circulating Tumor Cell Measurements in Patients With HER2-negative Metastatic Breast Cancer Without Bone Metastasis
Study Type
Interventional

2. Study Status

Record Verification Date
May 2014
Overall Recruitment Status
Completed
Study Start Date
June 2010 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

5. Study Description

Brief Summary
This study will evaluate zoledronic acid's anti-cancer effects and Circulating Tumor Cell (CTCs) measurements in patients with HER2-negative metastatic breast cancer without bone metastasis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
First or Second Line HER2-negative Breast Cancer, Metastatic Disease Without Bone Metastasis
Keywords
HER2-negative, HER2, Metastatic breast cancer, First Line breast cancer, Second Line breast cancer, Breast cancer, Metastatic, Stage IV breast cancer, Progression free survival, PFS, Circulating Tumor Cells, CTCs, Zoledronic acid, HER2-negative metastatic breast cancer patients without bone metastasis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Patients without bone metastases
Arm Type
Experimental
Arm Description
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Arm Title
Patients with bone metastases
Arm Type
Experimental
Arm Description
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Intervention Type
Drug
Intervention Name(s)
Zoledronic acid
Other Intervention Name(s)
Zometa, bisphosphonates, CZOL446E
Intervention Description
Patients with no bone metastasis (n=150) will receive Standard therapy plus Zoledronic acid administration 4 mg IV monthly during Months 1-18.
Intervention Type
Drug
Intervention Name(s)
Standard Therapy
Intervention Description
Standard Therapy, including chemotherapy and hormonal therapy, was determined at the discretion of the investigator.
Primary Outcome Measure Information:
Title
Number of Participants With Progression Free Survival (PFS)
Description
Complete Response (CR): disappearance of all target lesions. Any pathological lymph nodes (target or non-target) must have exhibited a reduction in short axis to < 10 mm. Partial Response (PR): at least a 30% decrease in sum of diameters of target lesions, taking as reference the baseline sum of diameters. Progressive Disease (PD): at least 20% increase in sum of diameters of target lesions taking as reference the smallest sum on study accompanied by an absolute increase of at least 5 mm or appearance of one or more new lesions. Stable Disease (SD): neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference smallest sum diameters. PFS is time from enrollment to date of first documented disease progression or death due to any cause. A participant is considered to be censored when data on time to event is missing due to a subject being lost to follow-up or non-occurrence of the outcome event before the completion of the trial.
Time Frame
up to 18 months
Secondary Outcome Measure Information:
Title
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Description
Circulating tumor cells (CTCs) have been associated with poor patient prognosis and outcomes in patients receiving treatment for MBC. CTCs have been evaluated as a potential biomarker for predicting treatment effects and overall survival. Baseline was defined as the last predose measurement for patients who received any study drug and as the later of the screening visit or Visit 2 value for patients who did not receive the study drug. Percentage was calculated as the number of patients with CTC ≥5/7.5 mL against the number of patients with nonmissing CTC values (represented as 'n' in the categories).
Time Frame
Baseline, Month 1, 2, 4, 6, 9 and 18
Title
Time to Progression (TTP)
Description
Time to progression is defined as the time from the date of enrollment to the date of first documented disease progression or death due to metastatic breast cancer.
Time Frame
up to 18 months
Title
Change From Baseline in Urine NTX by Month
Description
NTX= N-telopeptide of type 1 collagen (nmol bce/mmol [nanomoles of bone collagen equivalents per millimole of creatinine]). Baseline was defined as the last predose measurement for patients who received any study drug and as the later of the screening visit or visit 2 value for patients who did not receive study drug.
Time Frame
Baseline, Month 2, Month 4

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent Female patients (age ≥18 years) HER2-negative metastatic breast cancer (stage IV) Patients will be receiving chemotherapy or hormonal therapy Patients with no bone metastasis and ≤1 prior treatments for metastatic breast cancer. Patients with newly diagnosed metastatic breast cancer may have received adjuvant or neoadjuvant chemotherapy as long as treatment was completed ≥12 months prior to relapse. Asymptomatic brain metastasis is permitted if all of the following criteria are met: no sign of clinical progression or known progression of brain metastasis off steroids for at least 2 weeks prior to study enrollment Stable renal function: two serum creatinine determinations of <3 mg/dL, obtained no less than 7 days apart (one value may be obtained within 6 weeks prior to Screening; the second must be obtained during Screening) ECOG performance status of 0 or 1 Life expectancy of ≥ 6 months Negative serum pregnancy test Ability and willingness to comply with all study requirements Exclusion Criteria: Known hypersensitivity to zoledronic acid or other bisphosphonates Patients with history of another malignancy within the last two years prior to study enrollment, except cured basal cell carcinoma of the skin or excised carcinoma in site of the cervix Use of concurrent investigational agents is prohibited. Prior use of investigational agents is permitted if discontinued ≥30 days prior to Screening. No prior therapy with an antiresorptive agent Patients with active brain metastases or meningeal metastases Current or recent (in the six months prior to initial study drug treatment) severe cardiovascular disease (defined as uncontrolled congestive heart failure), hypertension refractory to treatment, or poorly controlled Type I/II diabetes mellitus Current active dental problems including dental abscess or infection of the jawbone (maxilla or mandible) or a current or prior diagnosis of osteonecrosis of the jaw Patients who have received radiotherapy ≤ 4 weeks prior to study enrollment or who have not recovered from radiotherapy-related toxicities. Palliative radiotherapy for bone lesions ≤ 2 weeks prior to study enrollment is allowed Patients who have undergone major surgery (e.g., intra-thoracic, intra-abdominal or intra-pelvic) ≤ 4 weeks prior to study enrollment or who have not recovered from side effects of such therapy Diminished renal capacity: calculated creatinine clearance (CrCl) <30 mL/min (based on Cockcroft-Gault formula) Corrected (i.e., adjusted for serum albumin) serum calcium of <8.0 mg/dL (2.00 mmol/L) or ≥ 12 mg/dL (3.00 mmol/L) Pregnant or breast-feeding females Women of child-bearing potential who are not willing/able to use effective methods of birth control (e.g., abstinence, oral contraceptives or implants, IUD, vaginal diaphragm or sponge, or condom with spermicide) History of non-compliance to medical regimens and/or patients who are considered unreliable History of bone metabolism diseases
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Highlands Oncology Group
City
Fayetteville
State/Province
Arkansas
ZIP/Postal Code
72753
Country
United States
Facility Name
Clopton Clinic
City
Jonesboro
State/Province
Arkansas
ZIP/Postal Code
72401
Country
United States
Facility Name
Hematology Oncology Services of Arkansas
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
Kaiser Permanente Medical Group Kaiser Permanente - Hawaii
City
Anaheim
State/Province
California
ZIP/Postal Code
92807
Country
United States
Facility Name
Wilshire Oncology Medical Group
City
La Verne
State/Province
California
ZIP/Postal Code
91750
Country
United States
Facility Name
Loma Linda University Loma Linda Cancer Center
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Facility Name
Hematology and Medical Oncology
City
Waterbury
State/Province
Connecticut
ZIP/Postal Code
06708
Country
United States
Facility Name
Florida Cancer Specialists DeptofFloridaCancerSpecialists
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33901
Country
United States
Facility Name
Lakeland Regional Cancer Center Dept. of Lakeland Regional
City
Lakeland
State/Province
Florida
ZIP/Postal Code
33803
Country
United States
Facility Name
Space Coast Medical Associates
City
Titusville
State/Province
Florida
ZIP/Postal Code
32796
Country
United States
Facility Name
Kootenai Medical Center Kootenai Medical Center
City
Coeur d'Alene
State/Province
Idaho
ZIP/Postal Code
83814
Country
United States
Facility Name
Oncology Specialists, SC Lutheran General Cancer Instit
City
Park Ridge
State/Province
Illinois
ZIP/Postal Code
60068-0736
Country
United States
Facility Name
Cancer Center of Kansas
City
Witchita
State/Province
Kansas
ZIP/Postal Code
67214-3728
Country
United States
Facility Name
Park Nicollet Institute Dept. of Park Nicollet
City
St. Louis Park
State/Province
Minnesota
ZIP/Postal Code
55416
Country
United States
Facility Name
St. John's Mercy Medical Center St. John's Mercy Med Ctr
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Hematology Oncology Centers of the Northern Rockies Hema Onc Ctr N. Rockies (4
City
Billings
State/Province
Montana
ZIP/Postal Code
59101
Country
United States
Facility Name
Southeast Nebraska Oncology Cancer Center
City
Lincoln
State/Province
Nebraska
ZIP/Postal Code
68510
Country
United States
Facility Name
Reno Oncology Consultants
City
Reno
State/Province
Nevada
ZIP/Postal Code
89502
Country
United States
Facility Name
Somerset Hematology Oncology Associates Somerset Hema Oncol Assoc (2)
City
Somerset
State/Province
New Jersey
ZIP/Postal Code
08873
Country
United States
Facility Name
Cooper Cancer Center
City
Voorhees
State/Province
New Jersey
ZIP/Postal Code
08043
Country
United States
Facility Name
NYU Langone Arena Oncology
City
Lake Success
State/Province
New York
ZIP/Postal Code
11042
Country
United States
Facility Name
Marion L. Shepard Cancer Center
City
Washington
State/Province
North Carolina
ZIP/Postal Code
27889
Country
United States
Facility Name
Piedmont Hematology and Oncology Associates Piedmont Hem/Onc Assoc (2)
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Hematology Oncology Center, Inc.
City
Elyria
State/Province
Ohio
ZIP/Postal Code
44035
Country
United States
Facility Name
Milton S Hershey Medical Center Hershey Medical Center (4)
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Berks Hematology Oncology
City
West Reading
State/Province
Pennsylvania
ZIP/Postal Code
19611
Country
United States
Facility Name
Abington Hematology Oncology Associates, Inc
City
Willow Grove
State/Province
Pennsylvania
ZIP/Postal Code
19090
Country
United States
Facility Name
The West Clinic
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38120
Country
United States
Facility Name
Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
South Texas Oncology and Hematology, PA South Texas Oncology (2)
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78258
Country
United States
Facility Name
East Texas Medical Center Cancer Institute Tyler Hem/Onc (3)
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States
Facility Name
Medical Oncology & Hematology Associates of Northern VA Med. Onc&Hem Assoc. of No.VA
City
Reston
State/Province
Virginia
ZIP/Postal Code
20190
Country
United States
Facility Name
Northwest Medical Specialties
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98405
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.NovartisClinicalTrials.com
Description
Related Info

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Effect of Zoledronic Acid as Anti-Cancer Treatment in Metastatic Breast Cancer Patients

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