Breast Cancer Clinical Trial
Official title:
PANTHER. A Randomized Phase 3 Study Comparing Biweekly and Tailored Epirubicin + Cyclophosphamide Followed by Biweekly Tailored Docetaxel (dtEC→dtT) Versus Three Weekly Epirubicin + Cyclophosphamide + 5-fluorouracil Followed by Docetaxel (FEC→T) in Lymph Node Positive or High Risk Lymph Node Negative Breast Cancer Patients
This is an adjuvant, open, prospective, randomized study to compare:
A. Individually tailored and two weekly dosed epirubicin + cyclophosphamide followed by a
three weeks break followed by biweekly and tailored docetaxel (dtEC→dtT) given every second
week, to
B. Fixed dosed and three weekly epirubicin, cyclophosphamide and 5-fluorouracil, followed by
fixed dosed and three weekly docetaxel (FEC→T).
Patients with primary node-positive or high risk lymph node negative breast cancer will be
eligible for the study.
The primary objective of the phase 3 study is to compare breast cancer relapse-free survival
(BCRFS) between the dtEC→dtT and FE100C→T. To detect a five-year BCRFS difference of 0.710 to
0.790 about 1000 patients per arm will be needed. They will be recruited during four years
and followed another two years for breast cancer events.
Secondary objectives are to compare
1. Distant disease-free survival (DDFS)
2. Event-free survival and
3. Overall survival
4. Health-related quality of life and toxicity analyses according to CTC
5. Outcome in relation to tumour biological factors and polymorphism patterns
1. RFS in relation to the Sorlie classes using immunohistochemical markers and/or gene
expression profiling comparing A vs B arm
2. RFS with receptor positive disease (analyzed in the local laboratories as described
in the CRFs and also analyzed as continuous variables) in the comparison between
the A- and B- arms.
3. RFS with high and low proliferation, respectively, (analyzed in the local
laboratories as described in the CRFs and also analyzed as a continuous variable,
or centrally analyzed), in the comparison between the A- and B-arms.
4. RFS in relation to HER-2/neu status (analyzed in the local laboratories as
described in the CRFs) in the primary cancers in the comparison between the A- and
B-arms and analyzed whether trastuzumab was given in sequence or concurrently.
5. RFS analyzed in relation to other molecular markers (e.g. gene expression
profiling/ sequencing) in the primary cancers and SNPs signatures in normal DNA
(related to toxicities for EC/FEC and docetaxel components, respectively, and given
dose levels and outcome in relation to these factors and in relation QoL) to
outcome per arm.
6. RFS analyzed in relation to tumour associated lymphocytes and Y-box binding protein
in the comparison between the A- and B-arms.
Tumour tissue will be obtained and stored for studies of prognostication and therapy
prediction.
Last patient randomized was September 2011.
Are described under the heading "Outcome measures" ;
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