Secondary Adjuvant Treatment for Patients With Isolated Tumor Cells in Bone Marrow

Breast Cancer Clinical Trial

Official title:

Secondary Adjuvant (Rescue) Treatment With Docetaxel (Taxotere) and Detection of Isolated Tumor Cells in Bone Marrow as a Surrogate Marker for Effect in Node Positive and High Risk Node Negative Breast Cancer After Standard Adjuvant Epirubicin-containing Treatment

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00248703
• Other study ID #: NBCG9
• Secondary ID: S-03032S-03-0143
• Status: Completed
• Phase: Phase 2
• Start date: October 2003
• Est. completion date: April 2022

Study information

• Verified date: April 2022
• Source: Oslo University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to identify patients with persisting tumor cells after standard epirubicin-containing treatment to test a non-cross resistant chemotherapy regimen (docetaxel) for these patients, and to explore the analysis of disseminated tumor cells in bone marrow as a surrogate marker for clinical outcome.

Description:

The presence of disseminating (or isolated) tumor cells (DTC/ITC) in bone marrow (BM) after completion of adjuvant chemotherapy for breast cancer is associated with poor prognosis. Methods for detection of DTC have potential as a tool for monitoring occult residual disease during follow up. Also, there exists potent chemotherapy proven to be effective when anthracycline-based chemotherapy fails (f.ex. docetaxel). Consequently, a study has been started to test DTC detection as a surrogate marker for clinical outcome in localized breast cancer patients, selected by the presence of DTC in BM after standard adjuvant chemotherapy, receiving secondary treatment with docetaxel. In brief, patients having received anthracycline-containing chemotherapy for localized breast cancer are candidates. After informed consent and no radiologic signs of distant metastasis, the first BM aspiration is performed at the end of radiotherapy or 8-12 weeks after the last chemotherapy cycle. The next BM aspiration is performed 6 months later. At that time point the BMs are analyzed for the presence of DTC. If DTC are present in the 6 months BM test (the first BM sample is for exploratory research purposes), 6 cycles of docetaxel are administered (3qw), followed by a third and forth BM analysis 1 month and 13 months after the end of chemotherapy. The patients receiving docetaxel with eradication of the DTC will be clinically compared to those with persistence of DTC after docetaxel treatment.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1128
• Est. completion date: April 2022
• Est. primary completion date: November 2012
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

1. Breast cancer with node positive disease or high risk node negative disease (pT1c/T2GII-IIIN0, pT3N0, cT3N0). Patients < 35 years with pT1a-bN0G2-3.

2. Primary surgery for breast cancer completed

3. Completed 6 cycles of adjuvant (or neoadjuvant) chemotherapy containing anthracycline

4. Age = 18 and < 70 years

5. Eastern Cooperative Oncology Group or WHO performance status < 2

6. Written informed consent prior to beginning protocol specific procedures

7. Laboratory requirements (within 5 weeks prior to end of radiation treatment or within 5 weeks prior to completion of baseline examinations):

Neutrophils = 1.1 10^9/l, Platelets = 100 10^9/l, Hemoglobin = 10 g/dl, ASAT and ALAT = x 2.5 UNL (If ALP > 2.5 = x 5 UNL, then ASAT and ALAT = x 1.5 UNL), ALP = x 5 UNL (If ASAT and ALAT > 1.5 = x 2.5 UNL, then ALP = 2.5 x UNL), Creatinine = 175 umol/l

8. Completed staging analysis including chest X-ray, bone scintigraphy or MRI, liver ultrasound or liver CT scan

Exclusion Criteria:

1. Other (than breast carcinoma) earlier or concomitant carcinoma, except for skin and in situ cervix cancer

2. M1 breast cancer or locoregional recurrence of previously diagnosed breast cancer.

3. Earlier treatment with paclitaxel or docetaxel.

4. Pre-existing motor or sensory neurotoxicity of a severity = grade 2 by NCI criteria (see appendix II)

5. Cardiac disease with symptoms classified as NYHA = 2

6. Definite contraindications for the use of corticosteroids

7. Concurrent treatment with other experimental drugs

8. Concurrent treatment with any other anti-cancer therapy (except for endocrine therapy and trastuzumab)

9. Pregnancy

Related Conditions & MeSH terms

• Breast Cancer
• Breast Neoplasms

Intervention

Drug:
• Docetaxel
Docetaxel 100 mg/m2 3 qw x 6

Locations

Country	Name	City	State
Norway	RRHF	Oslo

Sponsors (9)

Lead Sponsor	Collaborator
Oslo University Hospital	Alesund Hospital, Helse Stavanger HF, Sorlandet Hospital HF, Sykehuset i Vestfold HF, Sykehuset Innlandet HF, Sykehuset Ostfold, Ullevaal University Hospital, University of Tromso

Country where clinical trial is conducted

Norway, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Disease free survival related to presence or absence of disseminated tumor cells		At approximately 8 years maximum FU
Secondary	Predictive value of primary tumor markers on effects of docetaxel		At approximately 8 years maximum FU
Secondary	Explore markers on tumor cells in bone marrow that can predict the effect of docetaxel		At approximately of 8 years maximum FU