Evaluation of Cabazitaxel in Patients With Brain Metastasis Secondary to Breast Cancer and NSCLC (CRANIAL)
Brain Metastasis, Breast Cancer, Non Small Cell Lung Cancer
About this trial
This is an interventional treatment trial for Brain Metastasis focused on measuring brain metastasis, breast cancer, HER2 negative, NSCLC
Eligibility Criteria
Inclusion Criteria:
- Signed informed consent
- Age>18, ECOG 0-1
- Histologically confirmed 1) HER2-negative invasive breast carcinoma or 2) NSCLC
- In patients with breast cancer, HER2-negative status by FISH or immunohistochemistry (score 0, or +1).
- In patients with breast cancer, known estrogen and progesterone receptor status.
- Evidence of measurable disease in the brain (at least 1cm)
- Stable or decreasing dosage of steroids for 7 days prior to baseline MRI.
- No evidence of (cortical) cognitive impairment as defined by a Mini-Mental Status Exam (MMSE) score ≥ 25/30.
- No more than 4 prior lines of systemic chemotherapy in the metastatic setting
Adequate hematopoietic function defined as:
- Hemoglobin ≥ 9.0g/dL
- Absolute neutrophilic count ≥ 1.5 x 109L
- Platelet count ≥ 100 x 109L
Adequate hepatic function defined as:
- AST ≤ 2.5 x upper limit of normal (ULN)
- ALT ≤ 2.5 x ULN
- Total bilirubin ≤ 1.0 x ULN
- Adequate renal function defined as serum creatinine ≤ 1.5 x ULN. If creatinine ranges from 1.0 - 1.5 x ULN, creatinine clearance determined by CKD-EPI formula should be calculated and only patients with clearance >60 mL/min are eligible
- Adequate contraceptive method in patients with child-bearing potential.
Exclusion Criteria:
- History of prior whole brain irradiation
- Progressive neurological symptoms requiring immediate brain irradiation
- Pregnancy or lactation
- History of hypersensitivity reaction to taxanes
- History of hypersensitivity to polysorbate 80 containing agents
- Current or planned treatment with strong inhibitors or inducers of cytochrome P450.
- Less than 3 weeks since the last treatment of chemotherapy, biological therapy, and/or immunotherapy
- Leptomeningeal carcinomatosis
- Contra-indication to contrast-enhanced MRI
Sites / Locations
- Institut Jules Bordet
Arms of the Study
Arm 1
Experimental
Cabazitaxel
Eligible patients will receive intravenous 25mg/m2 cabazitaxel every 3 weeks. Contrast-enhanced whole brain MRI will be performed every two cycles. Patients who show ≥50% volumetric reduction in the size of the brain lesion(s) will continue on cabazitaxel until disease progression or unacceptable toxicity. Patients who show evidence of disease progression and/or developed progressive neurological symptoms will be taken off study and offered whole brain irradiation. Patients who do not meet both criteria can have the choice either to continue on study drug or to be taken off study according to the investigator discretion.