Breast Cancer Clinical Trial
Official title:
A Multicenter Phase III Randomized Trial Comparing Docetaxel (Taxotere) and Trastuzumab (Herceptin) With Docetaxel (Taxotere), Carboplatin and Trastuzumab (Herceptin) as First Line Chemotherapy for Patients With Advanced Breast Cancer Containing the HER2 Gene Amplification
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. It is not yet known if docetaxel and trastuzumab are more effective with or without
carboplatin in treating women who have HER2-positive breast cancer.
PURPOSE: Randomized phase III trial to study the effectiveness of combining docetaxel and
trastuzumab with or without carboplatin in treating women who have HER2-positive stage IIIB
or stage IV breast cancer.
OBJECTIVES:
- Compare the time to disease progression in women with HER2-positive stage IIIB, IIIC, or
IV breast cancer treated with docetaxel and trastuzumab (Herceptin) with or without
carboplatin.
- Compare the response rate and duration of overall response in patients treated with
these regimens.
- Compare the overall survival of patients treated with these regimens.
- Compare rate of clinical benefit, defined as complete response, partial response, or
stable disease for more than 24 weeks, in patients treated with these regimens.
- Compare the toxicity of these regimens in these patients.
- Determine pathologic and molecular markers for predicting efficacy of these regimens in
these patients.
- Determine genetic and biochemical markers for predicting risk of cardiac dysfunction and
later cardiac events in patients receiving these regimens.
- Determine whether peripheral levels of shed HER2 extracellular domain constitute a
prognostic and/or predictive factor of time to progression and survival of patients
receiving these regimens.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified
according to prior adjuvant and/or neoadjuvant chemotherapy (none vs with taxanes vs without
taxanes) and participating center. Patients are randomized to 1 of 2 treatment arms.
- Arm I:
- Course 1: Patients receive trastuzumab (Herceptin) IV over 30-90 minutes on days 1,
8, and 15. Patients receive docetaxel IV over 1 hour and carboplatin IV over 30-60
minutes on day 2.
- Courses 2 and all subsequent courses: Patients receive docetaxel IV over 1 hour and
carboplatin IV over 30-60 minutes on day 1 and trastuzumab IV over 30 minutes on
days 1, 8, and 15.
- Arm II: Patients receive docetaxel and trastuzumab as in arm I. In both arms, treatment
repeats every 21 days for up to 8 courses in the absence of disease progression or
unacceptable toxicity. After completion of 8 courses, patients continue to receive
trastuzumab IV over 30 minutes every 21 days in the absence of disease progression.
Patients are followed every 2 months for 3 years.
PROJECTED ACCRUAL: A total of 250 patients (125 per treatment arm) will be accrued for this
study within 18 months.
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