Breast Cancer Clinical Trial
Official title:
Multiple Cycles of High Dose Chemotherapy Supported With Filgrastim and Peripheral Blood Progenitor Cells in Patients With Metastatic Breast Cancer
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Combining chemotherapy with peripheral stem cell
transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill
more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of high-dose chemotherapy and peripheral
stem cell transplantation in treating patients with recurrent or refractory metastatic
breast cancer.
OBJECTIVES: I. Determine the effects on 2 year progression-free survival of a regimen
consisting of cyclophosphamide, paclitaxel, and filgrastim (G-CSF) to mobilize peripheral
blood progenitor cells (PBPCs), followed by 2 courses of carboplatin and paclitaxel followed
by 1 course of melphalan, each supported with PBPCs and G-CSF, in patients with recurrent or
refractory, advanced breast cancer. II. Evaluate the feasibility of administering multiple
courses of high dose chemotherapy in an outpatient setting for these patients. III. Evaluate
the rate of complete response to the high dose therapy in these patients.
OUTLINE: This is a multicenter study. Patients receive mobilization therapy consisting of
cyclophosphamide IV over 1 hour followed by paclitaxel IV over 3 hours, then filgrastim
(G-CSF) beginning 24 hours following completion of paclitaxel and continuing through the
last day of leukapheresis. Leukapheresis continues until an adequate number of CD34+ cells
is collected. Following cell count recovery, patients receive 3 courses of high-dose
chemotherapy: 2 courses of paclitaxel IV over 3 hours followed by carboplatin IV over 1
hour, with the first course generally within 21 days after completion of leukapheresis and
the second course 21-35 days after the first; then 1 course of melphalan IV infused over 30
minutes 21-35 days after the previous carboplatin dose. Each course of chemotherapy is
followed 24-48 hours later by the infusion of G-CSF-mobilized peripheral blood progenitor
cells and G-CSF. Patients are followed every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 96 evaluable patients will be accrued for this study over 3
years.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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