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Trastuzumab With or Without Everolimus in Treating Women With Breast Cancer That Can Be Removed By Surgery
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), May 2008
Sponsored by: Federation Nationale des Centres de Lutte Contre le Cancer
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00674414
  Purpose

RATIONALE: Monoclonal antibodies, such as trastuzumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. It is not yet known whether giving everolimus together with trastuzumab is more effective than giving trastuzumab alone in treating women with breast cancer.

PURPOSE: This randomized phase II trial is studying trastuzumab and everolimus to see how well they work compared to trastuzumab alone before surgery in treating patients with breast cancer that can be removed by surgery.


Condition Intervention Phase
Breast Cancer
Drug: everolimus
Drug: trastuzumab
Procedure: therapeutic conventional surgery
Phase II

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Everolimus Trastuzumab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label
Official Title: A Phase II, Randomized, Multi-Center Study, Assessing Value of Adding RAD001 to Trastuzumab as Preoperative Therapy of HER-2 Positive Primary Breast Cancer Amenable to Surgery.

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Efficacy as measured by clinical and echographic tumor evaluation [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Disease-free survival at 3 years [ Designated as safety issue: No ]
  • Pathological response assessed after 6 weeks of treatment [ Designated as safety issue: No ]
  • Clinical response predictive factors [ Designated as safety issue: No ]
  • Rate of pathological complete response (pCR) [ Designated as safety issue: No ]
  • Pharmacogenomics, proteomics, immunohistochemistry (IHC), pharmacokinetics [ Designated as safety issue: No ]
  • Toxicity as assessed by the standard NCI CTC-AE v3.0 scale [ Designated as safety issue: Yes ]

Estimated Enrollment: 120
Study Start Date: April 2008
Estimated Primary Completion Date: April 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm I: Active Comparator
Patients receive trastuzumab (Herceptin®) IV once weekly for 6 weeks. Patients then undergo surgery.
Drug: trastuzumab
Trastuzumab (Herceptin®) IV once weekly
Procedure: therapeutic conventional surgery
Patients undergo surgery
Arm II: Experimental
Patients receive trastuzumab as in arm I and oral everolimus once daily for 6 weeks. Within 24 hours after completing everolimus, patients undergo surgery.
Drug: everolimus
Oral everolimus once daily
Drug: trastuzumab
Trastuzumab (Herceptin®) IV once weekly
Procedure: therapeutic conventional surgery
Patients undergo surgery

Detailed Description:

OBJECTIVES:

Primary

  • To evaluate the added efficacy obtained by the association of trastuzumab (Herceptin®) with everolimus as preoperative therapy of primary HER2-positive breast cancer as shown by increased clinical tumor response rate.

Secondary

  • To compare the inhibition of the two pathways, RAS/RAF/MAP kinase and PI3-kinase/AKT/mTor.
  • To evaluate whether the pre-treatment molecular characteristics of tumor and serum or their modifications early in the treatment are predictive of clinical response.
  • To compare the frequency of pathological complete response achieved in the two groups after 6 weeks of treatment.
  • To determine disease-free survival at 3 years.
  • To evaluate safety and tolerability of the two treatment regimens.
  • To analyze the possible relationships between treatment toxicity and constitutional gene polymorphisms linked to the administered agents.
  • To analyze the possible relationships between response and molecular pharmacodynamic assessments, including proteomics (blood samples), Bio-Plex protein array (tumor), and IHC (tumor).
  • To analyze the drug levels and pharmacokinetic assessments of everolimus and trastuzumab (Herceptin®).

OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive trastuzumab (Herceptin®) IV once weekly for 6 weeks. Patients then undergo surgery.
  • Arm II: Patients receive trastuzumab as in arm I and oral everolimus once daily for 6 weeks. Within 24 hours after completing everolimus, patients undergo surgery.

Blood and tumor samples are collected periodically during study for pharmacogenomic, proteomic, and pharmacokinetic studies.

After completion of study treatment, patients are followed periodically for up to 3 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of invasive breast cancer

    • Previously untreated disease
  • Candidate for breast-conserving surgery, as defined by both of the following:

    • Clinical stage cT1-3, cN0-2 disease
    • Clinical stage M0 disease (bone scan, chest X-ray, and liver ultrasound required at screening to exclude metastatic disease)
  • HER2-positive primary tumor, defined as meeting either of the following criteria:

    • IHC 3+
    • IHC 2+ and FISH positive (centralized confirmation)
  • No inflammatory breast cancer or bilateral breast cancer

    • Patients who have been treated for cancer of the contralateral breast can be included if there is at least a 5 year time interval from last systemic treatment for breast cancer before randomization into this study
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

  • WHO performance status 0-1
  • Menopausal status not specified
  • WBC ≥ 3.5 x 10^9/L
  • ANC ≥ 1.5 x 10^9/L
  • Platelet count ≥ 100 x 10^9/L
  • Hb ≥ 10 g/dL
  • Serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • Serum transaminases activity ≤ 2.5 times ULN
  • Alkaline phosphatase ≤ 2.5 times ULN
  • Creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min
  • FEV > 55% by MUGA or ECHO
  • Spirometry and DLCO > 50% of normal
  • O_2 saturation > 88% at rest on room air
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No known hypersensitivity to everolimus, sirolimus, trastuzumab (Herceptin®), or lactulose
  • No hypercholesterolemia/hypertriglyceridemia ≥ grade 3

    • No hypercholesterolemia/hypertriglyceridemia ≥ grade 2 with history of coronary artery disease (despite lipid-lowering treatment if given)
  • No uncontrolled infection
  • No other concurrent severe and/or uncontrolled medical disease which could compromise participation in the study, including any of the following:

    • Uncontrolled hypertension
    • Congestive cardiac failure
    • Ventricular arrhythmias
    • Active ischemic heart disease
    • Myocardial infarction within the past year
    • Chronic liver or renal disease
    • Active gastrointestinal tract ulceration
    • Severely impaired lung function
  • No known history of HIV seropositivity
  • No psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
  • Willing to participate in the biological investigations
  • Not deprived of liberty or placed under guardianship
  • Patients must be affiliated to a Social Security System

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • More than 30 days (from the screening visit) since prior other investigational drugs
  • More than 5 days (from randomization) since prior and no concurrent strong inhibitors or inducers of the isoenzyme CYP3A, including any of the following

    • Rifabutin
    • Rifampicin
    • Clarithromycin
    • Ketoconazole
    • Itraconazole
    • Voriconazole
    • Ritonavir
    • Telithromycin
  • No other concurrent anti-cancer treatments such as chemotherapy, immunotherapy/biological response modifiers, endocrine therapy, or radiotherapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00674414

Locations
France
Centre Regional Rene Gauducheau Recruiting
Nantes-Saint Herblain, France, 44805
Contact: Contact Person     33-2-4067-9977     m-campone@nantes.fnclcc.fr    
Sponsors and Collaborators
Federation Nationale des Centres de Lutte Contre le Cancer
Investigators
Principal Investigator: Mario Campone, MD Centre Regional Rene Gauducheau
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000595159, FRE-FNCLCC-GEP-04/0606 - RAD-H, EUDRACT-2007-004098-24, EU-20851
Study First Received: May 6, 2008
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00674414  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
stage I breast cancer
stage II breast cancer
stage IIIA breast cancer

Study placed in the following topic categories:
Everolimus
Skin Diseases
Trastuzumab
Breast Neoplasms
Breast Diseases

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Immunologic Factors
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Immunosuppressive Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009