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A Randomized Phase III Tial Of Paclitaxel Versus Paclitaxel Plus Bevacizumab (rhuMAb VEGF) As First-Line Therapy For Locally Recurrent or Metastatic Breast Cancer


Phase 3
18 Years
N/A
Not Enrolling
Both
Breast Cancer

Thank you

Trial Information

A Randomized Phase III Tial Of Paclitaxel Versus Paclitaxel Plus Bevacizumab (rhuMAb VEGF) As First-Line Therapy For Locally Recurrent or Metastatic Breast Cancer


OBJECTIVES:

- Compare the time to treatment failure in patients with locally recurrent or metastatic
breast cancer treated with paclitaxel with or without bevacizumab.

- Compare the objective response rate, duration of response, overall survival, and time
to progression in patients treated with these regimens.

- Compare the toxicity of these regimens in these patients.

- Compare the quality of life of patients treated with these regimens.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified
according to disease-free interval (no more than 24 months vs more than 24 months), number
of metastatic sites (less than 3 vs 3 or more), treatment with prior adjuvant chemotherapy
(yes vs no), and estrogen receptor status (positive vs negative vs unknown). Patients are
randomized to one of two treatment arms.

- Arm I: Patients receive paclitaxel IV over 1 hour on days 1, 8, and 15 followed by
bevacizumab IV over 30-90 minutes on days 1 and 15.

- Arm II: Patients receive paclitaxel as in arm I. In both arms, courses repeat every 4
weeks in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline and on day 1 of weeks 17 and 33.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then
annually thereafter.

PROJECTED ACCRUAL: A total of 316-650 patients (158-325 per treatment arm) will be accrued
for this study within 31 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed adenocarcinoma of the breast

- Locally recurrent disease that is not amenable to surgical resection with curative
intent OR

- Metastatic disease

- No HER-2-overexpressing (3+) breast cancer unless previously treated with trastuzumab
(Herceptin)

- Unknown HER-2 status allowed provided herceptin-based therapy inappropriate or
not indicated

- No prior or radiologic evidence of CNS metastases, including previously treated,
resected, or asymptomatic brain lesions or leptomeningeal involvement by head CT scan
or MRI

- Hormone receptor status:

- Not specified

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Sex:

- Male or female

Menopausal status:

- Not specified

Performance status:

- ECOG 0-1

Life expectancy:

- Not specified

Hematopoietic:

- Absolute neutrophil count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

- No prior bleeding diathesis

Hepatic:

- Bilirubin no greater than 1.5 mg/dL

- SGOT no greater than 2 times upper limit of normal (ULN) (5 times ULN for known liver
involvement)

- PT/PTT no greater than 1.5 times normal

- INR no greater than 1.5 times normal

Renal:

- Creatinine no greater than 2.0 mg/dL

- No proteinuria by dipstick urinalysis

- Trace proteinuria allowed

- Proteinuria less than 500 mg by 24-hour urine collection if proteinuria at least 1+
by urinalysis

Cardiovascular:

- No clinically significant cardiovascular disease

- No myocardial infarction within the past 12 months

- No unstable angina

- No prior deep vein thrombosis

- No grade 2 or greater peripheral vascular disease

- No uncontrolled congestive heart failure

- No uncontrolled hypertension (systolic blood pressure greater than 170 mmHg and
diastolic blood pressure greater than 95 mm Hg)

- No prior cerebrovascular accident

Pulmonary:

- No prior pulmonary embolism

Other:

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective non-hormonal contraception

- No history of seizures

- No non-healing wound or fracture

- No hypersensitivity to paclitaxel, Cremophor EL, Chinese hamster ovary cell products,
or other recombinant human antibodies

- No active infection requiring parenteral antibiotics

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- See Disease Characteristics

Chemotherapy:

- No prior chemotherapy for locally recurrent or metastatic breast cancer

- At least 12 months since prior adjuvant or neoadjuvant taxane therapy

- At least 3 weeks since prior adjuvant chemotherapy

Endocrine therapy:

- At least 3 weeks since prior hormonal therapy for locally recurrent or metastatic
breast cancer

Radiotherapy:

- At least 3 weeks since prior radiotherapy

- No prior radiotherapy to only site of disease

- No concurrent local radiotherapy for pain control or life-threatening situations
(e.g, superior vena cava syndrome, spinal cord compression, or CNS metastases)

Surgery:

- At least 4 weeks since prior major surgical procedure except placement of vascular
access device or breast biopsy

- At least 7 days since prior minor surgical procedure, including placement of an
access device or fine needle aspiration

Other:

- At least 10 days since prior anticoagulant therapy (low-dose anticoagulant therapy to
maintain patency of a vascular access device allowed)

- At least 10 days since prior and no concurrent daily aspirin (more than 325 mg/day)
or other non-steroidal anti-inflammatory medication known to inhibit platelet
function

- No concurrent dipyridamole, ticlopidine, clopidogrel, or cilostazol

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression-Free Survival

Outcome Time Frame:

Assessed every 3 months for 2 years, then every 6 months for 3 years

Safety Issue:

No

Principal Investigator

Kathy Miller, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Indiana University Melvin and Bren Simon Cancer Center

Authority:

United States: Food and Drug Administration

Study ID:

CDR0000069156

NCT ID:

NCT00028990

Start Date:

December 2001

Completion Date:

May 2009

Related Keywords:

  • Breast Cancer
  • stage IV breast cancer
  • recurrent breast cancer
  • male breast cancer
  • Breast Neoplasms

Name

Location

Mayo Clinic - Jacksonville Jacksonville, Florida  32224
Mayo Clinic Cancer Center Rochester, Minnesota  55905
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
CCOP - Atlanta Regional Atlanta, Georgia  30342-1701
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Illinois Oncology Research Association Peoria, Illinois  61602
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Iowa Oncology Research Association Des Moines, Iowa  50309-1016
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
CCOP - Michigan Cancer Research Consortium Ann Arbor, Michigan  48106
CCOP - Duluth Duluth, Minnesota  55805
CCOP - Cedar Rapids Oncology Project Cedar Rapids, Iowa  52403-1206
Siouxland Hematology-Oncology Sioux City, Iowa  51101-1733
CCOP - Ochsner New Orleans, Louisiana  70121
CCOP - Merit Care Hospital Fargo, North Dakota  58122
Rapid City Regional Hospital Rapid City, South Dakota  57709
CCOP - Sioux Community Cancer Consortium Sioux Falls, South Dakota  57105-1080
CCOP - Dayton Kettering, Ohio  45429
CCOP - Geisinger Clinic and Medical Center Danville, Pennsylvania  17822-2001
CCOP - St. Vincent Hospital Cancer Center, Green Bay Green Bay, Wisconsin  54301
MBCCOP - Gulf Coast Mobile, Alabama  36688
CCOP - Oklahoma Tulsa, Oklahoma  74136
Allegheny General Hospital Pittsburgh, Pennsylvania  15212-4772
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Medcenter One Health System Bismarck, North Dakota  58501
CentraCare Health Plaza Saint Cloud, Minnesota  56303
Altru Cancer Center Grand Forks, North Dakota  58206
CCOP - Mayo Clinic Scottsdale Oncology Program Scottsdale, Arizona  85259