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Trastuzumab and Ixabepilone in Treating Women With HER2-Positive Metastatic Breast Cancer
This study is ongoing, but not recruiting participants.
First Received: March 8, 2004   Last Updated: February 6, 2009   History of Changes
Sponsors and Collaborators: Dana-Farber Cancer Institute
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00079326
  Purpose

RATIONALE: Monoclonal antibodies, such as trastuzumab, can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Drugs used in chemotherapy, such as ixabepilone, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining trastuzumab with ixabepilone may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving trastuzumab together with ixabepilone works in treating women with HER2-positive metastatic breast cancer.


Condition Intervention Phase
Breast Cancer
Biological: trastuzumab
Drug: ixabepilone
Phase II

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Trastuzumab Ixabepilone
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Study Of Trastuzumab In Combination With BMS-247550 In Women With Metastatic Breast Cancer

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

Primary Outcome Measures:
  • Response rate [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Safety and toxicity [ Designated as safety issue: Yes ]
  • Time to disease progression [ Designated as safety issue: No ]
  • Time to treatment failure [ Designated as safety issue: No ]
  • Correlation of tissue biomarkers and blood biomarkers with response [ Designated as safety issue: No ]

Estimated Enrollment: 60
Study Start Date: February 2004
Detailed Description:

OBJECTIVES:

Primary

  • Determine the response rate in 2 cohorts of patients (those with no prior chemotherapy or trastuzumab (Herceptin®) and those with prior trastuzumab and/or chemotherapy) treated with trastuzumab and ixabepilone for HER2-positive metastatic breast cancer.

Secondary

  • Determine the safety and toxicity profile of this regimen in these patients.
  • Determine the time to disease progression in patients treated with this regimen.
  • Determine the time to treatment failure in patients treated with this regimen.
  • Correlate various tissue biomarkers (e.g., HER2/phospho-HER2, EGFR/phospho-EGFR, IGRF-I, phospho-MAPK, phospho-P13K, bcl-2, bcl-xL, MDR-1, MRP, and β-tubulin) and blood biomarkers (HER2-extracellular domain, circulating tumor cells) with response in patients treated with this regimen.

OUTLINE: This is an open-label, multicenter study. Patients are stratified according to prior trastuzumab (Herceptin®) therapy (with or without chemotherapy) for metastatic breast cancer (yes vs no).

Patients receive trastuzumab IV over 30-90 minutes and ixabepilone IV over 3 hours on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

PROJECTED ACCRUAL: A total of 60 patients (30 per stratum) will be accrued for this study within 12-20 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed invasive breast cancer

    • Stage IV disease
  • HER2-overexpressing tumor

    • Must be 3+ positive by immunohistochemistry (IHC) OR positive by fluorescence in situ hybridization (FISH) assay
  • At least 1 measurable lesion

    • At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
  • Prior therapy meets 1 of the following criteria:

    • Cohort 1:

      • No prior chemotherapy or trastuzumab (Herceptin®) for metastatic breast cancer
      • Prior hormonal therapy for metastatic disease or in the adjuvant setting is allowed
      • At least 6 months since prior chemotherapy in the adjuvant setting
      • Prior trastuzumab in the adjuvant setting is allowed if completed at least 12 months before study entry
    • Cohort 2:

      • Must have received 1 prior trastuzumab-containing regimen in the adjuvant or metastatic setting
      • Disease recurrence must have occurred within 12 months after completion of trastuzumab if given in the adjuvant setting
      • Up to 2 prior chemotherapy regimens for metastatic disease are allowed
      • Prior hormonal therapy for metastatic disease is allowed
      • Prior chemotherapy* and/or hormonal therapy for early stage disease is allowed NOTE: *Adjuvant chemotherapy completed less than 6 months before diagnosis of metastatic disease is considered as 1 of 2 possible regimens for metastatic disease
  • History of brain metastasis allowed provided the following criteria are met:

    • More than 4 weeks since treatment completion
    • Currently asymptomatic
    • No concurrent steroids
  • No leptomeningeal carcinomatosis
  • Hormone receptor status:

    • Not specified

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Sex

  • Female

Menopausal status

  • Not specified

Performance status

  • ECOG 0-2 OR
  • Karnofsky 60-100%

Life expectancy

  • More than 6 months

Hematopoietic

  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3

Hepatic

  • ALT ≤ 5 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 times ULN

Renal

  • Not specified

Cardiovascular

  • LVEF ≥ 50%
  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No cardiac arrhythmia

Immunologic

  • Prior grade 1 or 2 hypersensitivity reaction to trastuzumab or taxane therapies allowed provided drug administration was possible
  • No prior grade 3 or 4 allergic reaction to compounds of similar chemical or biological composition to study agents
  • No prior severe Cremophor reactions
  • No ongoing or active infection

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No ≥ grade 2 neuropathy (neuromotor or neurosensory)
  • No other concurrent uncontrolled illness
  • No psychiatric illness or social situation that would preclude study compliance

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • See Disease Characteristics
  • See Chemotherapy

Chemotherapy

  • See Disease Characteristic
  • More than 2 years since prior high-dose chemotherapy with bone marrow transplantation or peripheral blood stem cell support
  • No prior epothilone therapy
  • No other concurrent chemotherapy

Endocrine therapy

  • See Disease Characteristics
  • At least 2 weeks since prior hormonal therapy in the adjuvant or metastatic setting

    • Patients with overt disease progression on prior hormonal therapy are allowed (without waiting 2 weeks) provided they discontinue hormonal treatment before study participation
  • No concurrent hormonal therapy

Radiotherapy

  • At least 7 days since prior radiotherapy in the metastatic or early stage setting
  • No concurrent radiotherapy

Other

  • Concurrent bisphosphonate therapy (e.g., pamidronate) allowed
  • No other concurrent anticancer agents or therapies
  • No other concurrent investigational agents
  • No concurrent antiretroviral therapy for HIV-positive patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00079326

Locations
United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
Cape Cod Hospital
Hyannis, Massachusetts, United States, 02601
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, Massachusetts, United States, 02115
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Lowell General Hospital
Lowell, Massachusetts, United States, 01854
Faulkner Hospital
Boston, Massachusetts, United States, 02130-3400
Sponsors and Collaborators
Dana-Farber Cancer Institute
Investigators
Study Chair: Craig A. Bunnell, MD Dana-Farber Cancer Institute
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000355176, DFCI-03202, NCI-6297
Study First Received: March 8, 2004
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00079326     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
stage IV breast cancer
recurrent breast cancer

Study placed in the following topic categories:
Skin Diseases
Epothilones
Tubulin Modulators
Trastuzumab
Breast Neoplasms
Antimitotic Agents
Breast Diseases
Recurrence

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Skin Diseases
Antineoplastic Agents
Epothilones
Mitosis Modulators
Breast Neoplasms
Antimitotic Agents
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Therapeutic Uses
Tubulin Modulators
Trastuzumab
Breast Diseases

ClinicalTrials.gov processed this record on May 07, 2009