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Sponsored by: |
University Medical Centre Groningen |
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Information provided by: | University Medical Centre Groningen |
ClinicalTrials.gov Identifier: | NCT00851110 |
Objectives of the study:
This randomized multicenter phase II study compares the tolerability, toxicity and quality of life between two high-dose chemotherapy regimens based on cyclophosphamide, thiotepa and carboplatin.
Regimen A: full dose CTC. Regimen B: two courses of CTC (tCTC) with 33% dose reduction.
Primary endpoints are:
Secondary endpoint:
Trial design:
This investigation is a multicenter prospective randomized phase II study. Patients eligible for the study will be identified after mastectomy or wide tumor excision with axillary clearance. Following randomization, all patients will receive four courses of cyclophosphamide, epirubicin and fluorouracil (FEC). Patients with early progressive disease at any time will be taken off study. The first chemotherapy course must be given as soon as possible after the surgical procedure, preferably within 3 weeks, but not later than 6 weeks since primary surgery. After the third or fourth FEC course G-CSF is administered and peripheral stem cells will be harvested.
All radiation therapy (including radiation therapy administered as part of a breast conserving strategy) must be postponed until all chemotherapy has been concluded. Questionnaires, comprising the Rotterdam Symptom Checklist (RSCL) and the Short-Form General Health Survey (SF-36) will be sent by mail before randomization, after chemotherapy, 3 months thereafter, further on every l/2 yr till at least 1 year follow-up as performed earlier. [6, 28, 29].
All patients will be randomized before the initiation of chemotherapy.
Condition | Intervention | Phase |
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High-Risk Breast Cancer |
Procedure: stem cell reinfusion Drug: Chemotherapy |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Dose Comparison, Parallel Assignment, Efficacy Study |
Official Title: | A Prospective Randomized Feasibility and Phase II Adjuvant Breast Cancer Study of the Netherlands Working Party for Autotransplantation in Solid Tumors. |
Estimated Enrollment: | 50 |
Study Start Date: | October 2004 |
High-dose chemotherapy with the alkylating agent combination CTC appears to add significantly to the efficacy of conventional dose chemotherapy in patients with high-risk breast cancer, provided that the HER-2/neu gene is not amplified in the tumor. As a high-dose chemotherapy regimen, CTC is associated with significant toxicity [31,32].
Although high-dose alkylating therapy seems to be effective, there is virtually nothing known about the dose-response curve for this combination (for a detailed discussion see the classical paper by E. Frei III [32].
If one assumes that the efficacy increase levels off with increasing dose, the efficacy of tCTC might be almost as great as that of CTC, but with considerably less toxicity. In addition, two closely spaced courses of tCTC might further increase the efficacy of the regimen. There are some suggestions that a double transplant may be more effective than a single one, in multiple myeloma and in Ewing sarcoma. A similar suggestion has also been made for breast cancer (study of Nitz et al ref 4, table 1).
Ages Eligible for Study: | 18 Years to 50 Years |
Genders Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
Inclusion criteria:
Netherlands | |
The Netherlands Cancer Institute | |
Amsterdam, Netherlands, 1066 CX | |
Free University Hospital | |
Amsterdam, Netherlands, 1007 MB | |
Academic Medical Center | |
Amsterdam, Netherlands, 1105 AZ | |
Medisch Spectrum Twente | |
Enschede, Netherlands, 7511 JX | |
University Medical Centre Groningen | |
Groningen, Netherlands, 9713 GZ | |
University Medical Centre Utrecht | |
Utrecht, Netherlands, 3584 CX | |
University Hospital Maastricht | |
Maastricht, Netherlands, 6202 AZ | |
University Medical Centre Nijmegen St. Radboud | |
Nijmegen, Netherlands, 6525 GA | |
Erasmus MC, Daniel den Hoed Cancer Center | |
Rotterdam, Netherlands, 3075 EA | |
Leiden University Medical Centre | |
Leiden, Netherlands, 2333 JS |
Study Director: | Elisabeth G.E. de Vries, MD, PhD | University Medical Centre Groningen |
Study Director: | Sjoerd Rodenhuis, MD, PhD | The Netherlands Cancer Institute |
Study ID Numbers: | METc 2004/110, CKTO 2005-15 |
Study First Received: | February 23, 2009 |
Last Updated: | February 24, 2009 |
ClinicalTrials.gov Identifier: | NCT00851110 History of Changes |
Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
high dose breast cancer adjuvant |
Skin Diseases Adjuvants, Immunologic Breast Neoplasms Carboplatin |
Cyclophosphamide Breast Diseases Thiotepa |
Neoplasms Neoplasms by Site Skin Diseases Breast Neoplasms Breast Diseases |