Trial Outcomes & Findings for Neoadjuvant Sequential Administration of Two Gemcitabine Combinations in Operable Breast Cancer (NCT NCT00191789)

NCT ID: NCT00191789

Last Updated: 2010-07-27

Results Overview

Complete pathological response: No invasive tumor cells identified from sections from site of previous cancer. Require evidence corroborating prior presence of invasive cancer, which requires detection of abnormal fibroelastic breast stroma devoid of normal lobular units and contains foamy macrophages with moderate numbers of fibroblasts and mononuclear inflammatory cells. Presence of nondescript collagenised lobules or breast fibrous tissue is not evidence that tumor site has been adequately sampled and macroscopic assessment and sampling is needed until original neoplastic stroma identified.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

65 participants

Primary outcome timeframe

tumor assessment at baseline and during surgery after eight 21-day treatment cycles

Results posted on

2010-07-27

Participant Flow

Participant milestones

Participant milestones
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Overall Study
STARTED
65
Overall Study
COMPLETED
40
Overall Study
NOT COMPLETED
25

Reasons for withdrawal

Reasons for withdrawal
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Overall Study
Adverse Event
5
Overall Study
Patient: Satisfactory Response
5
Overall Study
Patient/Physician: Satisfactory Response
4
Overall Study
Withdrawal by Subject
4
Overall Study
Death - Possibly Study Drug Related
4
Overall Study
Progressive Disease/Lack of Efficacy
2
Overall Study
Death - Not Study-Drug Related
1

Baseline Characteristics

Neoadjuvant Sequential Administration of Two Gemcitabine Combinations in Operable Breast Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 Participants
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Age Continuous
46 years
n=5 Participants
Sex: Female, Male
Female
65 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Indian
65 participants
n=5 Participants
Region of Enrollment
India
65 participants
n=5 Participants
Diagnosis
Histopathological
12 participants
n=5 Participants
Diagnosis
Cytological
53 participants
n=5 Participants
Disease Stage
Stage IIA
3 participants
n=5 Participants
Disease Stage
Stage IIB
30 participants
n=5 Participants
Disease Stage
Stage IIIA
18 participants
n=5 Participants
Disease Stage
Stage IIIB
14 participants
n=5 Participants
Hormone Receptor Status
ER+ / PR+
27 participants
n=5 Participants
Hormone Receptor Status
ER+ / PR-
8 participants
n=5 Participants
Hormone Receptor Status
ER- / PR+
3 participants
n=5 Participants
Hormone Receptor Status
ER- / PR-
25 participants
n=5 Participants
Hormone Receptor Status
No Assessment
2 participants
n=5 Participants
Human Epidermal Growth Factor Receptor 2 (HER-2) Status
0
27 participants
n=5 Participants
Human Epidermal Growth Factor Receptor 2 (HER-2) Status
1+
8 participants
n=5 Participants
Human Epidermal Growth Factor Receptor 2 (HER-2) Status
2+
2 participants
n=5 Participants
Human Epidermal Growth Factor Receptor 2 (HER-2) Status
3+
19 participants
n=5 Participants
Human Epidermal Growth Factor Receptor 2 (HER-2) Status
Not Detected
7 participants
n=5 Participants
Human Epidermal Growth Factor Receptor 2 (HER-2) Status
Insufficient Sample
2 participants
n=5 Participants
Karnofsky Performance Status Scale
100 - Normal no complaints; no evidence of disease
9 participants
n=5 Participants
Karnofsky Performance Status Scale
90 - Normal activity; minor signs of disease
56 participants
n=5 Participants
Menopausal Status
Premenopausal
29 participants
n=5 Participants
Menopausal Status
Postmenopausal
36 participants
n=5 Participants
Body Surface Area
1.44 meters squared (m^2)
n=5 Participants
Height
153 centimeters (cm)
n=5 Participants
Largest Lesion Size
30 millimeters (mm)
n=5 Participants
Weight
57 kilograms (kg)
n=5 Participants

PRIMARY outcome

Timeframe: tumor assessment at baseline and during surgery after eight 21-day treatment cycles

Population: Intent to treat population.

Complete pathological response: No invasive tumor cells identified from sections from site of previous cancer. Require evidence corroborating prior presence of invasive cancer, which requires detection of abnormal fibroelastic breast stroma devoid of normal lobular units and contains foamy macrophages with moderate numbers of fibroblasts and mononuclear inflammatory cells. Presence of nondescript collagenised lobules or breast fibrous tissue is not evidence that tumor site has been adequately sampled and macroscopic assessment and sampling is needed until original neoplastic stroma identified.

Outcome measures

Outcome measures
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 Participants
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Number of Patients With Pathological Complete Response (Pathological Complete Response Rate)
13 participants

SECONDARY outcome

Timeframe: baseline through last cycle on study drug (eight 21-day cycles)

Population: Intent to treat population.

Outcome measures

Outcome measures
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 Participants
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Summary of Deaths During Study
Study Disease
0 participants
Summary of Deaths During Study
Study Drug Toxicity: Cardiac arrest
1 participants
Summary of Deaths During Study
Study Drug Toxicity: Infection with neutropenia
1 participants
Summary of Deaths During Study
Study Drug Toxicity: Neutropenic sepsis
2 participants
Summary of Deaths During Study
Myocardial infarction
1 participants

SECONDARY outcome

Timeframe: baseline to measured progressive disease or death from any cause (up to 68 months)

Population: Median was not reached.

PFS was defined as the date of enrollment to the first date of documented disease progression or death from any cause. Because the median was not reached, results are presented as the Outcome: Number of Participants with Disease Progression or Death at Various Timepoints.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: baseline to date of death from any cause up to 68 months

Population: Median was not reached

Overall survival was defined as the date of enrollment to the date of death from any cause. Because the median was not reached, results will be presented as the Outcome: Number of Participants who Died from Any Cause at Various Timepoints.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: baseline to stopping treatment (up to 68 months)

Population: Upper limit of 95% Confidence Interval of median survival was not calculable.

Time to treatment failure was defined as the time from study enrollment to the first observation of disease progression, death as a result of any cause, or early discontinuation of treatment. Time to treatment failure was censored at the date of the last follow-up visit for patients who did not discontinue early, who were still alive, and who have not progressed. Because the upper limit of the 95% Confidence Interval of median survival was not calculable, results are presented as the Outcome: Number of Participants with Time to Treatment Failure at Various Timepoints.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: baseline, after eight 21-day cycles of study drug

The extent and type of surgery was guided by the tumor size, physician and/or patient decision. It was either conservation surgery or mastectomy with axillary lymph node dissection. Results are reported on the number of patients who underwent breast conservation surgery.

Outcome measures

Outcome measures
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 Participants
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Number of Patients Eligible for Breast Conservation Surgery at Baseline and Number of Patients Undergoing Breast Conservation Surgery
Eligible for Surgery at Baseline
0 participiants
Number of Patients Eligible for Breast Conservation Surgery at Baseline and Number of Patients Undergoing Breast Conservation Surgery
Underwent Surgery
18 participiants

POST_HOC outcome

Timeframe: baseline up to 68 months

Population: Intent to treat population.

The cumulative number of participants with an event (either progressive disease or death) are presented at various time points, as well as the number of participants at risk for the event. Participants at risk are the number of participants without progressive disease or still alive at the beginning of each time point.

Outcome measures

Outcome measures
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 Participants
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
3 Months: Number of Patients with Event
5 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
3 Months: Number of Patients at Risk
59 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
6 Months: Number of Patients with Event
8 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
6 Months: Number of Patients at Risk
50 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
12 Months: Number of Patients with Event
11 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
12 Months: Number of Patients at Risk
41 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
24 Months: Number of Patients with Event
15 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
24 Months: Number of Patients at Risk
36 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
48 Months: Number of Patients with Event
21 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
48 Months: Number of Patients at Risk
23 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
68 Months: Number of Patients with Event
21 participants
Number of Participants With Progressive Disease or Death at Various Time Points Throughout the Study
68 Months: Number of Patients at Risk
1 participants

POST_HOC outcome

Timeframe: baseline up to 68 months

Population: Intent to treat population.

The cumulative number of participants with an event (death from any cause) are presented at various time points, as well as the number of participants at risk for the event. Participants at risk are the number of participants still alive at the beginning of each time point.

Outcome measures

Outcome measures
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 Participants
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Number of Participants Who Died From Any Cause at Various Time Points
3 Months: Number of Patients With Event
3 participants
Number of Participants Who Died From Any Cause at Various Time Points
3 Months: Number of Patients at Risk
60 participants
Number of Participants Who Died From Any Cause at Various Time Points
6 Months: Number of Patients With Event
5 participants
Number of Participants Who Died From Any Cause at Various Time Points
6 Months: Number of Patients at Risk
51 participants
Number of Participants Who Died From Any Cause at Various Time Points
12 Months: Number of Patients With Event
7 participants
Number of Participants Who Died From Any Cause at Various Time Points
12 Months: Number of Patients at Risk
43 participants
Number of Participants Who Died From Any Cause at Various Time Points
26 Months: Number of Patients With Event
11 participants
Number of Participants Who Died From Any Cause at Various Time Points
26 Months: Number of Patients at Risk
37 participants
Number of Participants Who Died From Any Cause at Various Time Points
48 Months: Number of Patients With Event
14 participants
Number of Participants Who Died From Any Cause at Various Time Points
48 Months: Number of Patients at Risk
24 participants
Number of Participants Who Died From Any Cause at Various Time Points
68 Months: Number of Patients With Event
15 participants
Number of Participants Who Died From Any Cause at Various Time Points
68 Months: Number of Patients at Risk
1 participants

POST_HOC outcome

Timeframe: baseline to stopping treatment (up to 68 months)

Population: Intent to treat population.

This outcome is in place of the time to treatment failure outcome. The cumulative number of participants with an event (disease progression, death as a result of any cause, or early discontinuation of treatment) are presented at various time points, as well as the number of participants at risk for the event. Participants at risk are the number of participants without disease progression, are alive, or did not discontinue treatment early at the beginning of each time point.

Outcome measures

Outcome measures
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 Participants
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Number of Participants With Time to Treatment Failure at Various Time Points
3 Months: Number of Patients with Event
11 participants
Number of Participants With Time to Treatment Failure at Various Time Points
3 Months: Number of Patients at Risk
59 participants
Number of Participants With Time to Treatment Failure at Various Time Points
6 Months: Number of Patients with Event
19 participants
Number of Participants With Time to Treatment Failure at Various Time Points
6 Months: Number of Patients at Risk
50 participants
Number of Participants With Time to Treatment Failure at Various Time Points
12 Months: Number of Patients with Event
25 participants
Number of Participants With Time to Treatment Failure at Various Time Points
12 Months: Number of Patients at Risk
41 participants
Number of Participants With Time to Treatment Failure at Various Time Points
24 Months: Number of Patients with Event
29 participants
Number of Participants With Time to Treatment Failure at Various Time Points
24 Months: Number of Patients at Risk
36 participants
Number of Participants With Time to Treatment Failure at Various Time Points
48 Months: Number of Patients with Event
35 participants
Number of Participants With Time to Treatment Failure at Various Time Points
48 Months: Number of Patients at Risk
23 participants
Number of Participants With Time to Treatment Failure at Various Time Points
68 Months: Number of Patients with Event
35 participants
Number of Participants With Time to Treatment Failure at Various Time Points
68 Months: Number of Patients at Risk
1 participants

Adverse Events

Gemcitabine+Doxorubicin+Cisplatin+Surgery

Serious events: 17 serious events
Other events: 64 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 participants at risk
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Blood and lymphatic system disorders
Febrile neutropenia
4.6%
3/65 • Number of events 4
Blood and lymphatic system disorders
Neutropenia
3.1%
2/65 • Number of events 2
Blood and lymphatic system disorders
Pancytopenia
1.5%
1/65 • Number of events 1
Blood and lymphatic system disorders
Thrombocytopenia
1.5%
1/65 • Number of events 1
Cardiac disorders
Cardiac arrest
3.1%
2/65 • Number of events 2
Cardiac disorders
Myocardial infarction
1.5%
1/65 • Number of events 1
Gastrointestinal disorders
Diarrhoea
7.7%
5/65 • Number of events 6
Gastrointestinal disorders
Stomatitis
1.5%
1/65 • Number of events 1
Gastrointestinal disorders
Vomiting
3.1%
2/65 • Number of events 2
General disorders
Fatigue
1.5%
1/65 • Number of events 1
Hepatobiliary disorders
Jaundice
1.5%
1/65 • Number of events 1
Infections and infestations
Neutropenic infection
3.1%
2/65 • Number of events 2
Infections and infestations
Neutropenic sepsis
9.2%
6/65 • Number of events 6
Infections and infestations
Pneumonia
1.5%
1/65 • Number of events 1
Infections and infestations
Postoperative wound infection
1.5%
1/65 • Number of events 1
Infections and infestations
Sepsis
1.5%
1/65 • Number of events 1
Infections and infestations
Viral upper respiratory tract infection
1.5%
1/65 • Number of events 1
Injury, poisoning and procedural complications
Incorrect dose administered
1.5%
1/65 • Number of events 1
Metabolism and nutrition disorders
Hypokalaemia
1.5%
1/65 • Number of events 1
Nervous system disorders
Convulsion
1.5%
1/65 • Number of events 1
Renal and urinary disorders
Renal failure
1.5%
1/65 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pharyngeal inflammation
1.5%
1/65 • Number of events 2

Other adverse events

Other adverse events
Measure
Gemcitabine+Doxorubicin+Cisplatin+Surgery
n=65 participants at risk
Gemcitabine: 1200 mg/m\^2, intravenous (IV) day 1 and day 8 every 21 days x 4 cycles (1-4) then 1000 mg/m\^2, IV, day 1 and day 8 every 21 days x 4 cycles (5-8). Doxorubicin: 60 mg/m\^2, IV, every 21 days x 4 cycles (1-4). Cisplatin: 70 mg/m\^2, IV, every 21 days x 4 cycles (5-8). Surgery follows 8 cycles of chemotherapy. Extent and type of surgery is guided by tumor size, physician and/or patient decision.
Blood and lymphatic system disorders
Anaemia
87.7%
57/65 • Number of events 75
Blood and lymphatic system disorders
Leukopenia
64.6%
42/65 • Number of events 81
Blood and lymphatic system disorders
Neutropenia
69.2%
45/65 • Number of events 148
Blood and lymphatic system disorders
Thrombocytopenia
26.2%
17/65 • Number of events 21
Gastrointestinal disorders
Abdominal pain
10.8%
7/65 • Number of events 7
Gastrointestinal disorders
Constipation
6.2%
4/65 • Number of events 4
Gastrointestinal disorders
Diarrhoea
12.3%
8/65 • Number of events 8
Gastrointestinal disorders
Nausea
6.2%
4/65 • Number of events 4
Gastrointestinal disorders
Stomatitis
20.0%
13/65 • Number of events 16
Gastrointestinal disorders
Vomiting
20.0%
13/65 • Number of events 17
General disorders
Asthenia
16.9%
11/65 • Number of events 14
General disorders
Fatigue
23.1%
15/65 • Number of events 16
General disorders
Pyrexia
10.8%
7/65 • Number of events 7
Investigations
Alanine aminotransferase increased
40.0%
26/65 • Number of events 33
Investigations
Aspartate aminotransferase increased
41.5%
27/65 • Number of events 32
Investigations
Blood alkaline phosphatase increased
13.8%
9/65 • Number of events 12
Investigations
Blood creatinine increased
7.7%
5/65 • Number of events 5
Investigations
Weight decreased
15.4%
10/65 • Number of events 11
Metabolism and nutrition disorders
Decreased appetite
7.7%
5/65 • Number of events 5
Metabolism and nutrition disorders
Dehydration
13.8%
9/65 • Number of events 11
Metabolism and nutrition disorders
Hyperkalaemia
20.0%
13/65 • Number of events 17
Metabolism and nutrition disorders
Hypokalaemia
10.8%
7/65 • Number of events 7
Metabolism and nutrition disorders
Hyponatraemia
9.2%
6/65 • Number of events 7
Skin and subcutaneous tissue disorders
Alopecia
40.0%
26/65 • Number of events 26

Additional Information

Chief Medical Officer

Eli Lilly and Company

Phone: 800-545-5979

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60