Trial Outcomes & Findings for Doxorubicin Hydrochloride Liposome, Cyclophosphamide, and Trastuzumab in Treating Patients With Stage IV Breast Cancer (NCT NCT00331552)

NCT ID: NCT00331552

Last Updated: 2017-07-26

Results Overview

The dose level in which 2 or more patients develop treatment-related toxicity of grade 3 or higher OR require a dose adjustment following the first course of treatment

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

30 participants

Primary outcome timeframe

Up to 24 weeks

Results posted on

2017-07-26

Participant Flow

Participant milestones

Participant milestones
Measure
Cyclophosphamide, Doxil 30 mg/m^2, Trastuzumab
Patients receive oral cyclophosphamide once daily on days 1-28 and 30 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Cyclophosphamide, Doxil 35 mg/m^2, Trastuzumab
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Period 1: Doxil 30 mg/m^2 (Phase I)
STARTED
3
0
Period 1: Doxil 30 mg/m^2 (Phase I)
COMPLETED
3
0
Period 1: Doxil 30 mg/m^2 (Phase I)
NOT COMPLETED
0
0
Period 2: Doxil 35 mg/m^2 (Phase I)
STARTED
0
3
Period 2: Doxil 35 mg/m^2 (Phase I)
COMPLETED
0
3
Period 2: Doxil 35 mg/m^2 (Phase I)
NOT COMPLETED
0
0
Period 3: Phase II
STARTED
24
0
Period 3: Phase II
COMPLETED
22
0
Period 3: Phase II
NOT COMPLETED
2
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Cyclophosphamide, Doxil 30 mg/m^2, Trastuzumab
Patients receive oral cyclophosphamide once daily on days 1-28 and 30 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Cyclophosphamide, Doxil 35 mg/m^2, Trastuzumab
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Period 3: Phase II
Neurological Symptoms
1
0
Period 3: Phase II
Severe Nausea
1
0

Baseline Characteristics

Doxorubicin Hydrochloride Liposome, Cyclophosphamide, and Trastuzumab in Treating Patients With Stage IV Breast Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=6 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Phase II: Cyclophosphamide, Doxil, Trastuzumab
n=24 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Total
n=30 Participants
Total of all reporting groups
Age, Continuous
49.5 years
n=5 Participants
57 years
n=7 Participants
56.5 years
n=5 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
23 Participants
n=7 Participants
29 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6 Participants
n=5 Participants
24 Participants
n=7 Participants
30 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
White
4 Participants
n=5 Participants
21 Participants
n=7 Participants
25 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Up to 24 weeks

The dose level in which 2 or more patients develop treatment-related toxicity of grade 3 or higher OR require a dose adjustment following the first course of treatment

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=6 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Maximum Tolerated Dose and Optimal Tolerated Dose of Pegylated Liposomal Doxorubicin Hydrochloride (Doxil) When Given in Combination With Cyclophosphamide (Phase I)
30 mg/m^2

PRIMARY outcome

Timeframe: 18 months

Count of participants with a clinical benefit (i.e., complete response, partial response, and stable disease).

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=28 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Efficacy as Assessed by the Overall Clinical Benefit Rate
Complete response
0 Participants
Efficacy as Assessed by the Overall Clinical Benefit Rate
Partial response
6 Participants
Efficacy as Assessed by the Overall Clinical Benefit Rate
Stable disease
15 Participants
Efficacy as Assessed by the Overall Clinical Benefit Rate
Progressive disease
7 Participants

PRIMARY outcome

Timeframe: Periodically during study treatment, up to 24 weeks

Count of participants with grade 1, 2, 3, 4, fatal toxicity, need for dose reduction, treatment interruption, or treatment discontinuation

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=30 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Safety as Assessed by Grade 1, 2, 3, 4, Fatal Toxicity, Need for Dose Reduction, Treatment Interruption, or Treatment Discontinuation
Grade 3 adverse events
14 Participants
Safety as Assessed by Grade 1, 2, 3, 4, Fatal Toxicity, Need for Dose Reduction, Treatment Interruption, or Treatment Discontinuation
Grade 4 adverse events
3 Participants
Safety as Assessed by Grade 1, 2, 3, 4, Fatal Toxicity, Need for Dose Reduction, Treatment Interruption, or Treatment Discontinuation
At least one dose held or reduced
18 Participants
Safety as Assessed by Grade 1, 2, 3, 4, Fatal Toxicity, Need for Dose Reduction, Treatment Interruption, or Treatment Discontinuation
Discontinued due to toxicity
8 Participants

SECONDARY outcome

Timeframe: Up to 24 weeks

Count of phase I participants with treatment related toxicity.

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=3 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
n=3 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Treatment-related Toxicity (Phase I)
Grade 2 Neutropenia
0 Participants
1 Participants
Treatment-related Toxicity (Phase I)
Grade 3 Neutropenia
0 Participants
1 Participants

SECONDARY outcome

Timeframe: Up to 2 years

Median time to progression. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions or new effusions.

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=22 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Time to Progression (Phase II)
6.3 months
Interval 3.6 to
Upper bound of confidence interval is infinite.

SECONDARY outcome

Timeframe: 18 months

Kaplan-Meier estimate assessed at 18 months

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=22 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Progression-free Survival (Phase II)
0.16 progression free survival probability
Interval 0.033 to 0.77

SECONDARY outcome

Timeframe: 18 months

Kaplan-Meier estimate assessed at 18 months

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=22 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Overall Survival (Phase II)
0.49 survival probability
Interval 0.32 to 0.76

SECONDARY outcome

Timeframe: Up to 24 weeks

Count of participants with a clinical benefit (i.e., complete response, partial response, and stable disease).

Outcome measures

Outcome measures
Measure
Phase I: Cyclophosphamide, Doxil, Trastuzumab
n=12 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Doxil 35 mg/m^2
n=10 Participants
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Comparison of Clinical Benefit Rate in 2 Subgroups--heavily Pre-treated (1 or More Regimens for Advanced Disease) vs Less Heavily Pre-treated (no Regimens for Advanced Disease) (Phase II)
9 Participants
7 Participants

Adverse Events

Cyclophosphamide, Doxil 30 mg/m^2, Trastuzumab

Serious events: 0 serious events
Other events: 27 other events
Deaths: 0 deaths

Cyclophosphamide, Doxil 35 mg/m^2, Trastuzumab

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Cyclophosphamide, Doxil 30 mg/m^2, Trastuzumab
n=27 participants at risk
Patients receive oral cyclophosphamide once daily on days 1-28 and 30 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Cyclophosphamide, Doxil 35 mg/m^2, Trastuzumab
n=3 participants at risk
Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m\^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV
Blood and lymphatic system disorders
Leukopenia
70.4%
19/27
100.0%
3/3
Infections and infestations
Neutropenia
66.7%
18/27
100.0%
3/3
Gastrointestinal disorders
Nausea
51.9%
14/27
33.3%
1/3
Gastrointestinal disorders
Vomitting
11.1%
3/27
0.00%
0/3
Blood and lymphatic system disorders
Anemia
29.6%
8/27
0.00%
0/3
Metabolism and nutrition disorders
Alkaline Phosphatase
7.4%
2/27
66.7%
2/3
Gastrointestinal disorders
Constipation
11.1%
3/27
0.00%
0/3
Respiratory, thoracic and mediastinal disorders
Cough
11.1%
3/27
0.00%
0/3
Gastrointestinal disorders
Diarrhea
14.8%
4/27
0.00%
0/3
General disorders
Fatigue
44.4%
12/27
0.00%
0/3
Gastrointestinal disorders
Gastric Reflux
7.4%
2/27
0.00%
0/3
Skin and subcutaneous tissue disorders
Hand Foot Syndrome
25.9%
7/27
33.3%
1/3
Gastrointestinal disorders
Mucositis
14.8%
4/27
33.3%
1/3
Gastrointestinal disorders
Abdominal Pain
0.00%
0/27
33.3%
1/3
Musculoskeletal and connective tissue disorders
Joint Pain
7.4%
2/27
0.00%
0/3
Skin and subcutaneous tissue disorders
Rash
25.9%
7/27
0.00%
0/3
General disorders
Weight Loss
7.4%
2/27
33.3%
1/3
Metabolism and nutrition disorders
ALT High
0.00%
0/27
33.3%
1/3
Metabolism and nutrition disorders
AST High
18.5%
5/27
33.3%
1/3
Skin and subcutaneous tissue disorders
Erythma
11.1%
3/27
0.00%
0/3
Metabolism and nutrition disorders
Low Hemoglobin
0.00%
0/27
33.3%
1/3
Metabolism and nutrition disorders
Hypocalcemia
11.1%
3/27
0.00%
0/3
Metabolism and nutrition disorders
Hypokalemia
7.4%
2/27
0.00%
0/3
Metabolism and nutrition disorders
Hyponatremia
14.8%
4/27
33.3%
1/3
Blood and lymphatic system disorders
Lymphopenia
3.7%
1/27
33.3%
1/3
Metabolism and nutrition disorders
Taste Alteration
0.00%
0/27
33.3%
1/3
Blood and lymphatic system disorders
Thrombocytopenia
18.5%
5/27
0.00%
0/3

Additional Information

Dr. Hannah Linden

University of Washington / Seattle Cancer Care Alliance

Phone: 206-288-6989

Results disclosure agreements

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