Breast Cancer Clinical Trial
Official title:
Adjuvant Therapy of Breast Cancer: Impact of Erythropoiesis Stimulating Factors on Event Free Survival High Risk Breast Cancer Treatment
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor
cells, either by killing the cells or by stopping them from dividing. Giving more than one
drug (combination chemotherapy) may kill more tumor cells. Colony-stimulating factors, such
as darbepoetin alfa, may increase the number of immune cells found in bone marrow or
peripheral blood and may help the immune system recover from the side effects of
chemotherapy. Giving combination chemotherapy together with darbepoetin alfa after surgery
may kill any tumor cells that remain after surgery. It is not yet known whether combination
chemotherapy and darbepoetin alfa are more effective than combination chemotherapy alone in
treating stage III breast cancer.
PURPOSE: This randomized clinical trial is studying how well giving combination chemotherapy
together with darbepoetin alfa works compared to combination chemotherapy alone in treating
women with stage III breast cancer.
OBJECTIVES:
Primary
- Compare the disease-free survival rate in women with stage III breast cancer treated
with adjuvant chemotherapy with vs without darbepoetin alfa.
Secondary
- Compare local recurrence and overall survival in patients receiving these regimens.
- Compare toxicity of these regimens in these patients.
- Compare quality of life and fatigue frequency in patients treated with these regimens.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified
according the chemotherapy regimen (CEF vs TAC). Patients are randomized to 1 of 2 treatment
arms.
- Arm I: Patients receive 1 of the following regimens:
- Regimen CEF: Patients receive cyclophosphamide IV, epirubicin hydrochloride IV,
and fluorouracil IV on day 1.
- Regimen TAC: Patients receive docetaxel IV, doxorubicin hydrochloride IV, and
cyclophosphamide IV on day 1.
Treatment repeats every 3 weeks for 6 courses in the absence of disease progression and
unacceptable toxicity.
- Arm II: Patients receive 1 of the following regimens:
- Regimen CEF: Patients receive regimen CEF as in arm I. Patients receive
darbepoetin alfa if hemoglobin falls to ≤ 13.0 g/dL. Darbepoetin alfa is
discontinued when hemoglobin rises to > 14.0 g/dL.
- Regimen TAC: Patients receive TAC as in arm I and darbepoetin alfa as in arm II,
regimen CEF.
Quality of life is assessed at baseline, before each chemotherapy course, at the completion
of study therapy, and at 6 and 12 months.
After completion of study treatment, patients are followed periodically.
PROJECTED ACCRUAL: A total of 1,234 patients will be accrued for this study.
;
Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment
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