Breast Cancer Clinical Trial
Official title:
Prediction of Response to Neoadjuvant Chemotherapy in Women With Operable Breast Cancer
The objective of this study is to develop a biomarker to predict pathological complete response in women treated with neoadjuvant chemotherapy for breast cancer. Such a biomarker would assist physicians in selecting the most effective chemotherapy for the individual patient.
The objective of this study is to develop a biomarker to predict pathological complete
response in women treated with neoadjuvant chemotherapy for breast cancer. Such a biomarker
would assist physicians in selecting the most effective chemotherapy for the individual
patient. The anticipated biomarker will take into account clinical factors (such as tumor
stage, tumor size, and age), phenotypic characteristics of the tumor (determined by
pathological immunohistochemistry and ex vivo ChemoResponse assay), and genotypic
characteristics of the tumor and patient (determined by genomic profiling via gene
expression analysis of tumor RNA). It is expected that collective consideration of all of
these factors will be more predictive of patient response to therapy than any of them alone.
Approximately 224 evaluable subjects will be recruited from approximately 30 US sites. Women
with measurable operable invasive breast cancer diagnosed by core needle biopsy will be
eligible for this study. Additional tumor specimens will be obtained prior to the start of
chemotherapy via core needle biopsies to be used for the ex vivo ChemoResponse Assay and
tumor genomic analysis (gene expression), respectively.
All subjects will receive neoadjuvant chemotherapy with one of two standard of care regimens
that must consist of the following agents: doxorubicin (A), cyclophosphamide (C), and a
taxane (T) such as docetaxel, paclitaxel, or Abraxane (nanoparticle albumin-bound paclitaxel
[nab-paclitaxel]); or, docetaxel (T) and cyclophosphamide (C). These must be administered
per NCCN guidelines by the treating physician.
Upon completion of chemotherapy treatment, women will undergo lumpectomy, modified radical
mastectomy or other surgical procedure determined appropriate by the investigator and at
that time will be evaluated for pathological response. At the time of lumpectomy, modified
radical mastectomy, or other surgical procedure, additional tumor excess will be sent to
Precision Therapeutics, Inc. (Precision) for exploratory analysis if there is no pathologic
complete response (pCR), if there are sufficient tumor cells to send, and if the patient
agrees to have her excess tumor cells sent to Precision for this purpose.
During the patient's course of participation on the study, the treating physician will
remain blinded to the results of the ChemoResponse Assay and genomic analysis. If it is
determined there is no pCR at the time of lumpectomy, modified radical mastectomy or other
surgical procedure, Precision will make available a subsequent report to the physician
containing additional information about chemotherapy drugs other than ACT that could benefit
the further treatment decisions for the patient.
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