Trastuzumab and Capecitabine in Treating Women With Metastatic Breast Cancer

NCT ID: NCT00107393

Last Updated: 2013-07-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 75 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2003-06-30
• Study Completion Date: 2008-11-30

Brief Summary

RATIONALE: 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. Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving trastuzumab together with capecitabine may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving trastuzumab together with capecitabine works in treating women with metastatic breast cancer.

Detailed Description

OBJECTIVES:

Primary

• Determine the median survival time and 2-year survival rate in women with taxane- and anthracycline-refractory HER2/neu-overexpressing metastatic breast cancer treated with trastuzumab (Herceptin®) and capecitabine.

Secondary

• Determine the progression-free survival of patients treated with this regimen.
• Determine the response rate in patients treated with this regimen.
• Determine the clinical benefit rate of this regimen in these patients.
• Determine the safety profile of this regimen in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to prior treatment with trastuzumab (Herceptin®) (yes vs no), HER2/neu status (3+ by immunohistochemistry vs positive by fluorescence in situ hybridization), and class of refractory disease (primary vs secondary vs treatment discontinuation due to adverse events).

Patients receive oral capecitabine once daily on days 1-21 and trastuzumab IV on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed for up to 2 years.

PROJECTED ACCRUAL: A total of 75 patients will be accrued for this study within 3 years.

Conditions

Breast Cancer

Study Design

• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Interventions

trastuzumab

Intervention Type: BIOLOGICAL

capecitabine

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Refractory disease, defined as disease progression, drug-related adverse reaction, or disease relapse during or within 12 months after completion of paclitaxel or docetaxel AND doxorubicin or epirubicin administered in the neoadjuvant, adjuvant, or metastatic setting

• Total neoadjuvant or adjuvant taxane dose > 700 mg/m^2 for paclitaxel or > 240 mg/m^2 for docetaxel
• Total taxane dose > 350 mg/m^2 for paclitaxel or > 120 mg/m^2 for docetaxel in the metastatic setting
• Total neoadjuvant or adjuvant anthracycline dose > 240 mg/m^2 for doxorubicin or epirubicin
• Total anthracycline dose > 120 mg/m^2 for doxorubicin or epirubicin in the metastatic setting
• HER2/neu overexpression

• 3+ by immunohistochemistry or positive by fluorescence in situ hybridization
• No symptomatic brain metastases
• No pleural or pericardial effusion or ascites
• Hormone receptor status:

• Not specified

PATIENT CHARACTERISTICS:

Age

• 20 to 75

Sex

• Female

Menopausal status

• Not specified

Performance status

• ECOG 0-2

Life expectancy

• At least 3 months

Hematopoietic

• Absolute neutrophil count ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3
• Hemoglobin ≥ 9.0 g/dL

Hepatic

• SGOT or SGPT ≤ 2.0 times upper limit of normal (ULN) (< 3.0 times ULN for patients with liver metastases)
• Alkaline phosphatase ≤ 2.5 times ULN
• Bilirubin ≤ 1.5 mg/dL

Renal

• Creatinine ≤ 1.2 mg/dL

Cardiovascular

• LVEF > 50%

Pulmonary

• No interstitial pneumonia with pulmonary fibrosis

Other

• No history of hypersensitivity reactions
• No serious, uncontrolled infection
• No other malignancy
• Not pregnant or nursing

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Prior trastuzumab (Herceptin®) for metastatic disease allowed

Chemotherapy

• See Disease Characteristics
• No prior capecitabine
• At least 2 weeks since prior antimetabolites for metastatic disease
• At least 4 weeks since prior alkylating agents, carcinostatic antibiotics, or other carcinostatic agents

Endocrine therapy

• At least 4 weeks since prior goserelin or leuprolide for metastatic disease
• At least 2 weeks since prior oral endocrine agents for metastatic disease
• No concurrent endocrine therapy

Radiotherapy

• No prior radiotherapy to target lesions
• At least 4 weeks since prior radiotherapy
• No concurrent radiotherapy, including radiotherapy for brain metastases

Surgery

• Not specified

Other

• Concurrent bisphosphonates for bone metastases allowed

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Tohoku University

OTHER

Sponsor Role: lead

Principal Investigators

Noriaki Ohuchi, MD

Role: STUDY_CHAIR

Tohoku University

Locations

Kitakyushu Municipal Medical Center

Fukuoka, , Japan

Hiroshima University Hospital

Hiroshima, , Japan

Hokkaido Cancer Center

Hokkaido, , Japan

Saint Marianna University School of Medicine

Kanagawa, , Japan

National Hospital Organization - Osaka National Hospital

Osaka, , Japan

Osaka Kosei Nenkin Hospital

Osaka, , Japan

Osaka University Graduate School of Medicine

Osaka, , Japan

Tohoku University Graduate School of Medicine

Sendai, , Japan

St. Luke's International Hospital

Tokyo, , Japan

Sakata Municipal Hospital

Yamagata, , Japan

Countries

Japan

References

Ishida T, Kiba T, Takeda M, Matsuyama K, Teramukai S, Ishiwata R, Masuda N, Takatsuka Y, Noguchi S, Ishioka C, Fukushima M, Ohuchi N. Phase II study of capecitabine and trastuzumab combination chemotherapy in patients with HER2 overexpressing metastatic breast cancers resistant to both anthracyclines and taxanes. Cancer Chemother Pharmacol. 2009 Jul;64(2):361-9. doi: 10.1007/s00280-008-0882-8. Epub 2008 Dec 12.

Reference Type: RESULT

PMID: 19082596 (View on PubMed)

Other Identifiers

CDR0000380787

Identifier Type: REGISTRY

Identifier Source: secondary_id

TUGSM-UHA-BC03-01

Identifier Type: -

Identifier Source: org_study_id