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Phase II Study With Abraxane, Bevacizumab and Carboplatin in Triple Negative Metastatic Breast Cancer
This study is currently recruiting participants.
Verified by Duke University, May 2007
First Received: May 25, 2007   Last Updated: June 8, 2007   History of Changes
Sponsors and Collaborators: Duke University
Genentech
Information provided by: Duke University
ClinicalTrials.gov Identifier: NCT00479674
  Purpose

Taxanes (such as paclitaxel) are highly active to treat breast cancer. Abraxane® (nanoparticle albumin-bound paclitaxel) compared to standard paclitaxel improves efficacy and tolerability. When combined with a taxane, platinum agents improve response in metastatic breast cancer, with carboplatin conferring less toxicity than cisplatin. Monoclonal antibodies including bevacizumab target VEGF to reduce angiogenesis. We hypothesize that the previously-untested combination of weekly Abraxane® and carboplatin plus biweekly bevacizumab will lengthen time to progression without producing intolerable toxicity.


Condition Intervention Phase
Breast Cancer
Drug: Abraxane
Drug: Bevacizumab
Drug: Carboplatin
Phase II

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Paclitaxel Carboplatin Bevacizumab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Historical Control, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase II Study of Abraxane®, Carboplatin and Bevacizumab in "Triple Negative" (Demonstrating No Expression for Estrogen, Progesterone, or Her2 Receptors) Metastatic Breast Cancer

Further study details as provided by Duke University:

Primary Outcome Measures:
  • To assess the safety and tolerability of a combination regimen of weekly Abraxane® and carboplatin plus biweekly bevacizumab to treat women with Stage IV or inoperable Stage III "triple negative" metastatic breast cancer. NCI CTCAE Version 3.0 to assess [ Time Frame: two years ]

Secondary Outcome Measures:
  • Clinical: To assess progression-free survival (PFS) in measurable disease patients according to RECIST criteria. Compare disease status with serial CT scans using RECIST Correlative: To evaluate sequential plasma samples for presence [ Time Frame: two years ]

Estimated Enrollment: 70
Study Start Date: May 2007
Estimated Study Completion Date: May 2009
Detailed Description:

Anthracycline-based chemotherapy is widely used as adjuvant treatment for breast cancer. In addition to the challenge posed by anthracycline-induced cardiotoxicity, there are issues surrounding previous treatment with anthracyclines which limit its utility in the metastatic disease setting. Many patients with advanced disease will have had prior anthracycline-based adjuvant therapy, may have reached a maximum cumulative lifetime dose, or developed refractory disease, creating an obvious need for non-anthracycline treatment strategies.3 Platinum- and taxane-based chemotherapies as first-line therapy for metastatic breast cancer have demonstrated significant activity, producing single-agent response rates > 50%; in combination these rates increased to > 60% in both previously untreated and in patients who previously received anthracyclines.3 However, overall survival has remained relatively unchanged.4 As there is currently no standard of care for patients with metastatic breast cancer, various physical and psychological factors must be considered when evaluating chemotherapy treatment options, including the patient's tumor biology and growth rate, presence and extent of metastases, history of prior treatment and response, sensitivity and tolerance to therapy, and quality of life.2 Strategies to develop combination, higher dose, or sequential regimens using these active agents, while improving response rates and/or time to progression, may produce increased toxicity without increased survival.2 Because metastatic breast cancer remains essentially incurable using cytotoxic therapy alone, the study of targeted biologics offers new opportunities to enhance drug delivery via their ability to regulate specific receptors that are associated with clinically aggressive disease processes.

  Eligibility

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

Inclusion Criteria:

  • Tissue block containing tumor to confirm metastatic breast cancer is required;
  • Measurable disease according to RECIST criteria
  • “Triple negative” disease defined as tumor demonstrating no expression for estrogen, progesterone or HER2 receptors. "No expression" is categorized as ≤ 10% of cells staining or Allred ≤ 2;
  • Aged 18 years or older;
  • ECOG/Zubrod performance status of 0 or 1; life expectancy ≥ 3 months;
  • Patients may have received 0 - 1 prior therapies (except taxanes in the metastatic setting). An interval of at least 1 week must have elapsed since prior chemotherapy or hormonal therapy for metastatic disease; at least 6 months must have elapsed since prior adjuvant therapy;
  • ≥ 2 weeks between surgery and study enrollment (≥ 4 weeks between major surgery (defined as open abdominal/thoracic/cardiac) and study enrollment;
  • Laboratory tests performed within 14 days of study entry:

    • Granulocytes ≥ 1,500/µL;
    • Platelets ≥ 100,000/µL;
    • Hemoglobin ≥ 9 gm/dL;
    • Total bilirubin ≤ institutional upper limit of normal (ULN);
    • Aspartate transaminase (AST) and alanine aminotransferase (ALT) ≤ 5 times ULN;

      • Alkaline phosphatase ≤ 2.5 times ULN;
    • Estimated creatinine clearance ≥ 60 mL/min.
  • LVEF ≥ 50% by MUGA/Echocardiogram;
  • Informed consent to receive protocol treatment, to provide biologic specimens, and to complete neurotoxicity questionnaires;
  • Cognitive and communication skills to comply with study and/or follow-up procedures;
  • No reproductive potential:

    • If pre-menopausal: Negative serum pregnancy test and patient agreement to use adequate contraceptive method (abstinence, intrauterine device, barrier device with spermicide or surgical sterilization) during and for 3 months after completion of treatment.
    • If post-menopausal: Amenorrhea for ≥ 12 months.

Exclusion Criteria:

  • Pregnant or breast feeding;
  • Prior treatment with Abraxane®, carboplatin or bevacizumab, or any taxane for metastatic breast cancer;
  • Known hypersensitivity to any component of any study drug;
  • Active infection;
  • Current neuropathy ≥ grade 2;
  • CNS metastases as determined by head CT with contrast;
  • History of bleeding within the past 6 months or active bleeding disorder;
  • Serious non-healing wound, ulcer or bone fracture;
  • Uncontrolled CHF, or history of MI, unstable angina, stroke, or transient ischemia within previous 6 months;
  • Inadequately controlled hypertension (defined as systolic blood pressure < 150 and/or diastolic blood pressure > 100 mmHg on antihypertensive medications; prior history of hypertensive crisis or hypertensive encephalopathy;
  • Proteinuria (defined as urine protein: creatinine (UPC) ratio ≥ 1.0 or urine dipstick ≥ 2+.
  • Significant vascular disease (aortic aneurysm, aortic dissection) or symptomatic peripheral vascular disease;
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within previous 6 months;
  • Uncontrolled serious contraindicated medical condition or psychiatric illness.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00479674

Contacts
Contact: Kathryn Clarke, BSN 919-668-3810 kathryn.clarke@duke.edu
Contact: Kimberly Blackwell, MD 919-668-1748 kimberly.blackwell@duke.edu

Locations
United States, Florida
Palm Beach Cancer Center Institute Recruiting
West Palm Beach, Florida, United States, 33401-3406
Contact: Karen Minder, BSN     561-366-4128     karen.minder@pbcancer.com    
Contact: Elisabeth McKeen, MD     561-366-4151     elisabeth.mckeen@pbcancer.com    
Principal Investigator: Elisabeth McKeen, MD            
United States, North Carolina
Duke University Medical Center Recruiting
Durham, North Carolina, United States, 27710
Contact: Kimberly Blackwell, MD     919-668-1748     kimberly.blackwell@duke.edu    
Contact: Kathryn Clarke, BSN     919-3810     kathryn.clarke@duke.edu    
Principal Investigator: Kimberly Blackwell, MD            
Moses Cone Regional Cancer Center Not yet recruiting
Greensboro, North Carolina, United States, 27403
Contact: Peter Rubin, MD     336-832-1100     peter.rubin@mosescone.com    
Contact: Vivian Sheidler, BSN     336-832-0836     vivian.sheidler@mosescone.com    
Principal Investigator: Peter Rubin, MD            
Forsyth Regional Cancer Center Not yet recruiting
Winston-Salem, North Carolina, United States, 27103-3019
Contact: Elizabeth White     336-718-8461     ecwhite@novanthealth.org    
Contact: Julie Jester, BSAH     336-718-8491     jmjester@novanthealth.org    
Principal Investigator: Judith Hopkins, MD            
Presbyterian Health Care Not yet recruiting
Charlotte, North Carolina, United States, 28204
Contact: Jami Linn, BSN     704-384-8823     jalinn@novanthelath.org    
Principal Investigator: Richard Reiling, MD            
Northeast Oncology Associates Not yet recruiting
Concord, North Carolina, United States, 28205
Contact: Sheri Broshahan, BSN     704-783-1520     sbrosnahan@northeastmedical.org    
Principal Investigator: Garry Schwartz, MD            
United States, South Carolina
South Carolina Oncology Associates Not yet recruiting
Columbia, South Carolina, United States, 29210
Contact: Jennifer Peelman, BS     803-461-3095     jjpeelman@sconcology.net    
Principal Investigator: Rosemary Lambert-Falls, MD            
United States, Virginia
Viginia Oncology Associates Not yet recruiting
Newport News, Virginia, United States, 23606-4209
Contact: Elizabeth Harding, MD     757-873-9400     elizabeth.harden@usoncology.com    
Sponsors and Collaborators
Duke University
Genentech
Investigators
Principal Investigator: Kimberly Blackwell, MD Duke University
  More Information

No publications provided

Study ID Numbers: DCRO_BR_2006_01
Study First Received: May 25, 2007
Last Updated: June 8, 2007
ClinicalTrials.gov Identifier: NCT00479674     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by Duke University:
Metastatic Breast Cancer
Advanced Breast Cancer
Hormone Receptor AND Her2/neu Negative
Triple Negative
Triple Negative Breast Cancer
Stage IV or Inoperable Stage III Breast Cancer

Study placed in the following topic categories:
Estrogens
Skin Diseases
Progesterone
Breast Neoplasms
Bevacizumab
Carboplatin
Antimitotic Agents
Hormones
Angiogenesis Inhibitors
Paclitaxel
Tubulin Modulators
Antineoplastic Agents, Phytogenic
Breast Diseases

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Skin Diseases
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Mitosis Modulators
Breast Neoplasms
Bevacizumab
Carboplatin
Antimitotic Agents
Angiogenesis Inhibitors
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Paclitaxel
Therapeutic Uses
Tubulin Modulators
Growth Inhibitors
Angiogenesis Modulating Agents
Antineoplastic Agents, Phytogenic
Breast Diseases

ClinicalTrials.gov processed this record on May 07, 2009