HER2-positive Breast Cancer Clinical Trial
Official title:
Adjuvant Therapy for High-Risk Localized Breast Cancer Using Weekly Adriamycin + Daily Oral Cytoxan With Continuous G-CSF Support for 12 Weeks Followed by Weekly Abraxane™ for 12 Weeks With Concurrent Herceptin for Subjects With HER-2/Neu Positive Disease, Phase II
RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide,
and paclitaxel albumin-stabilized nanoparticle formulation, work in different ways to stop
the growth of tumor cells, either by killing the cells or by stopping them from dividing.
Colony-stimulating factors, such as filgrastim, 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. Monoclonal antibodies, such as trastuzumab, can block tumor growth
in different ways. Some block the ability of tumor cells to grow and spread. Others find
tumor cells and help kill them or carry tumor-killing substances to them. Giving combination
chemotherapy and filgrastim together with trastuzumab may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving doxorubicin hydrochloride,
cyclophosphamide, and filgrastim together followed by paclitaxel albumin-stabilized
nanoparticle formulation and trastuzumab works in treating patients with breast cancer
previously treated with surgery
PRIMARY OBJECTIVES:
I. To assess disease-free survival following a dose-intensive weekly regimen of Adriamycin +
oral cyclophosphamide augmented with G-CSF support followed by Abraxane and Herceptin if
appropriate for adjuvant treatment of high risk breast cancer patients.
SECONDARY OBJECTIVES:
I. To assess the toxicity associated with this regimen. II. To assess the delivered dose
intensity of the regimen. III. To assess time to treatment failure and overall survival of
the regimen. IV. To assess the incidence and severity of delayed nausea and vomiting with
this regimen.
OUTLINE:
Patients receive dose-intensive chemotherapy comprising doxorubicin hydrochloride IV over
10-15 minutes on day 1, oral cyclophosphamide once daily on days 1-7, and filgrastim
subcutaneously on days 2-7. Courses repeat every 7 days for up to 12 weeks in the absence of
disease progression or unacceptable toxicity. Beginning 1 week later, patients then receive
paclitaxel albumin-stabilized nanoparticle formulation IV over 30 minutes once a week for 12
weeks in the absence of disease progression or unacceptable toxicity. Patients with HER-2/neu
positive disease also receive trastuzumab IV over 30-90 minutes once a week for 1 year in the
absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months for 2 years,
every 6 months for 2 years, and then annually thereafter.
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