Combination Chemotherapy With or Without Trastuzumab in Treating Women With Breast Cancer - Full Text View

Sponsored by:	Federation Nationale des Centres de Lutte Contre le Cancer
Information provided by:	National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:	NCT00054587

Purpose

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which regimen of chemotherapy plus radiation therapy with or without trastuzumab is more effective in treating breast cancer.

PURPOSE: Randomized phase III trial to compare two different chemotherapy regimens plus radiation therapy with or without trastuzumab in treating women who have breast cancer that has spread to lymph nodes in the axilla (under the arm).

Condition	Intervention	Phase
Breast Cancer	Biological: trastuzumab Drug: cyclophosphamide Drug: docetaxel Drug: epirubicin hydrochloride Drug: fluorouracil Procedure: adjuvant therapy Radiation: radiation therapy	Phase III

Study Type:	Interventional
Study Design:	Treatment, Randomized, Open Label, Active Control
Official Title:	Randomized And Multicentric Opened Phase III Study Evaluating The Concomitant Administration Of Docetaxel 75MG/M2 and Epirubicine 75MG/M2 Versus FEC 100 In Non Metastatic With Positive Lymphatic Nodes Breast Cancer Subjects, And The Sequential Addition Of Herceptin In (HER2+++) And (HER2++ And FISH+) Subjects

Resource links provided by NLM:

Genetics Home Reference related topics: breast cancer

MedlinePlus related topics: Breast Cancer Cancer Radiation Therapy

Drug Information available for: Cyclophosphamide Fluorouracil Epirubicin hydrochloride Epirubicin Docetaxel Trastuzumab

U.S. FDA Resources

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

Study Start Date:

June 2001

Detailed Description:

OBJECTIVES:

Compare the efficacy of adjuvant cyclophosphamide, epirubicin, and fluorouracil vs adjuvant docetaxel and epirubicin, in terms of 5-year survival without relapse, in women with nonmetastatic adenocarcinoma of the breast with lymph node invasion.
Determine survival of patients treated with these regimens.
Compare the tolerability of trastuzumab (Herceptin) in patients treated with these regimens.
Determine the efficacy and tolerability of trastuzumab in patients with hormone receptor-positive tumors.
Evaluate the quality of life of patients treated with these regimens.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to participating center. Patients are treated in 2 parts.

Part I: Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive fluorouracil IV, or epirubicin IV, and cyclophosphamide IV on day 1. Treatment repeats every 3 weeks for 6 courses. Patients then undergo radiotherapy 5 days a week for 5 weeks.
- Arm II: Patients receive epirubicin IV over 10 minutes and docetaxel IV over 1 hour on day 1. Treatment repeats every 3 weeks for 6 courses. Patients then undergo radiotherapy as in arm I.

Patients with HER2/neu-positive tumors then proceed to part II. Patients with HER2/neu-negative tumors receive no further treatment.

Patients with hormone (estrogen or progesterone) receptor-positive tumors also receive oral tamoxifen daily beginning after chemotherapy is completed and continuing for 5 years.

Part II: Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive trastuzumab (Herceptin) IV over 30-90 minutes every 3 weeks for 1 year.
- Arm II: Patients are followed without treatment. Patients not receiving trastuzumab are followed at 4 months, 6 months, every 4 months for 1 year, and then every 6 months for 3 years. Patients receiving trastuzumab are followed at 4 months and then every 6 months for 3 years.

PROJECTED ACCRUAL: A total of 2,600 patients will be accrued for this study within 3 years.

Eligibility

Ages Eligible for Study:	18 Years to 64 Years
Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No

Criteria

DISEASE CHARACTERISTICS:

Histologically confirmed nonmetastatic, unilateral adenocarcinoma of the breast
- Axillary lymph node invasion (N1, N2, or N3)
- No cutaneous invasion
- No T4a or greater disease
No clinically or radiologically suspected metastases
No clinically or radiologically suspected contralateral lesion
No deeply adherent or inflammatory disease
Complete surgical resection performed, including removal of at least 5 lymph nodes, and with no residual tumor, within the past 42 days
No prior breast cancer
Hormone receptor status:
- Not specified

PATIENT CHARACTERISTICS:

Age

18 to 64

Sex

Female

Menopausal status

Not specified

Performance status

WHO 0-1

Life expectancy

Not specified

Hematopoietic

WBC at least 2,000/mm^3
Platelet count at least 100,000/mm^3

Hepatic

ALT and AST no greater than 1.5 times upper limit of normal (ULN)
Alkaline phosphatase no greater than 2.5 times ULN
Bilirubin no greater than ULN
Hepatitis B and hepatitis C negative
No hepatic dysfunction

Renal

Creatinine less than 1.3 mg/dL OR
Creatinine clearance greater than 60 mL/min

Cardiovascular

ECHO normal
LVEF at least 50%

Pulmonary

FEV normal
No dyspnea at rest
No supplemental oxygen dependence

Other

Not pregnant
Fertile patients must use effective contraception
HIV negative
No active infection
No other prior malignancy except basal cell skin cancer or carcinoma in situ of the cervix
No contraindication to anthracycline therapy
No chronic medical or psychological condition
No geographic or social reason that would preclude study therapy

PRIOR CONCURRENT THERAPY:

Biologic therapy

Not specified

Chemotherapy

At least 4 weeks since prior chemotherapy
No other concurrent chemotherapy
No contraindication to anthracycline therapy

Endocrine therapy

No prior hormonal therapy

Radiotherapy

No prior radiotherapy

Surgery

See Disease Characteristics

Other

At least 4 weeks since prior experimental therapy

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00054587

Locations

France
C.H. Bourg En Bresse
Bourg En Bresse, France, 01012
Centre de Lutte Contre le Cancer Georges-Francois Leclerc
Dijon, France, 21079
Centre Eugene Marquis
Rennes, France, 35042
Centre Hospitalier d'Annecy
Annecy, France, 74011 Cedex
Centre Hospitalier de Lagny
Lagny Sur Marne, France, 77405
Centre Hospitalier de Mulhouse
Mulhouse, France, 68051
Centre Hospitalier General Andre Boulloche
Montbeliard, France, 25209
Centre Hospitalier Regional Metz Thionville
Metz, France, 57038
Centre Jean Perrin
Clermont-Ferrand, France, 63011
Centre Paul Papin
Angers, France, 49036
Centre Paul Strauss
Strasbourg, France, 67065
Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle
Montpellier, France, 34298
Centre Regional Francois Baclesse
Caen, France, 14076
Centre Regional Rene Gauducheau
Nantes-Saint Herblain, France, 44805
Institut Prive de Cancerologie
Grenoble, France, 38100
Clinique du Petit Colmouilins
Harfleur, France, 76700
Clinique Saint - Pierre
Perpignan, France
Clinique Sainte Clotilde
Sainte Clotilde, France, 97492
CMC Les Ormeaux
Le Havre, France, 76600
Hopital Andre Mignot
Le Chesnay, France, 78157
Hopital Avicenne
Paris, France, 75674
Hopital Intercommunal De Creteil
Creteil, France, 94010
Hopitaux Universitaire de Strasbourg
Strasbourg, France, 67091
Institut Bergonie
Bordeaux, France, 33076
Institut Claudius Regaud
Toulouse, France, 31052
Institut Gustave Roussy
Villejuif, France, F-94805
Institut J. Paoli and I. Calmettes
Marseille, France, 13273
Institut Jean Godinot
Reims, France, 51056
CHU Poitiers
Poitiers, France, 86021

Sponsors and Collaborators

Federation Nationale des Centres de Lutte Contre le Cancer

Investigators

Study Chair:

Marc Spielmann, MD

Institut Gustave Roussy

More Information

Additional Information:

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

Publications:

Spielmann M, Roché H, Humblet Y, et al.: 3-year follow-up of trastuzumab following adjuvant chemotherapy in node positive HER2-positive breast cancer patients: results of the PACS-04 trial. [Abstract] Breast Cancer Res Treat 106 (1): A-72, S19, 2007.

Spielmann M, Roché H, Delozier T, et al.: Safety analysis from PACS 04--a phase III trial comparing 6 cycles of FEC100 with 6 cycles of ET75 for node-positive early breast cancer patients, followed by sequential trastuzumab in HER2+patients: preliminary results. [Abstract] J Clin Oncol 24 (Suppl 18): A-632, 2006.

Study ID Numbers:	CDR0000269909, FRE-FNCLCC-PACS-04/0005, EU-20236
Study First Received:	February 5, 2003
Last Updated:	February 6, 2009
ClinicalTrials.gov Identifier:	NCT00054587 History of Changes
Health Authority:	United States: Federal Government

Keywords provided by National Cancer Institute (NCI):

stage II breast cancer
stage IIIA breast cancer

Study placed in the following topic categories:

Antimetabolites
Skin Diseases
Immunologic Factors
Adjuvants, Immunologic
Breast Neoplasms
Cyclophosphamide
Epirubicin
Immunosuppressive Agents

Docetaxel
Anti-Bacterial Agents
Fluorouracil
Trastuzumab
Antineoplastic Agents, Alkylating
Antirheumatic Agents
Alkylating Agents
Breast Diseases

Additional relevant MeSH terms:

Antimetabolites
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Skin Diseases
Immunologic Factors
Antineoplastic Agents
Physiological Effects of Drugs
Breast Neoplasms
Cyclophosphamide
Antibiotics, Antineoplastic
Epirubicin
Immunosuppressive Agents

Pharmacologic Actions
Docetaxel
Neoplasms
Neoplasms by Site
Therapeutic Uses
Fluorouracil
Myeloablative Agonists
Trastuzumab
Antineoplastic Agents, Alkylating
Antirheumatic Agents
Alkylating Agents
Breast Diseases

ClinicalTrials.gov processed this record on September 10, 2009