TAC Versus TC for Adjuvant Breast Cancer

NCT ID: NCT00493870

Last Updated: 2023-03-02

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1961 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-05-29

Study Completion Date

2020-03-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this research study is to find out what effects (good and bad) TC or TAC has on early stage HER2- breast cancer.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Both TAC (docetaxel, doxorubicin, and cyclophosphamide) and TC (docetaxel and cyclophosphamide) are established adjuvant chemotherapy regimens for early stage breast cancer. TAC, however, due to the inclusion of the anthracycline doxorubicin, carries a high risk of hematologic and cardiotoxic adverse effects. Substantial evidence supports the concept that early stage HER2-negative breast cancers will benefit similarly from anthracycline-based adjuvant and non-anthracycline-based chemotherapy.

Further, approximately 0 to 9% of HER2-negative breast cancers have alterations in the TOP2A gene, which may predict for benefit from anthracycline-based chemotherapy.

We hypothesize that 6 cycles of TC versus 6 cycles of TAC will have similar efficacy in the treatment of early stage HER2-negative breast cancer and that TC will have less toxicity. If this hypothesis were upheld and the anthracycline doxorubicin could be eliminated from the regimen while obtaining similar efficacy in this population of patients, it would not only be an important advance in the understanding of the biology of cancer, but it would also be of significant clinical benefit to women with breast cancer.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Breast Cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

TC

docetaxel 75 mg/m2 and cyclophosphamide 600 mg/m2

Group Type EXPERIMENTAL

Docetaxel

Intervention Type DRUG

Docetaxel 75 mg/m2 IV over 1 hour on Day 1 followed by cyclophosphamide

Cyclophosphamide

Intervention Type DRUG

600 mg/m2 IV over 15-30 minutes on Day 1.

TAC

doxorubicin 50 mg/m2, cyclophosphamide 500 mg/m2 and docetaxel 75 mg/m2

Group Type ACTIVE_COMPARATOR

Docetaxel

Intervention Type DRUG

Docetaxel 75 mg/m2 IV over 1 hour on Day 1 followed by cyclophosphamide

Doxorubicin

Intervention Type DRUG

• Doxorubicin 50 mg/m2 IV push over 5-15 minutes via sidearm through a running IV line on Day 1, followed by cyclophosphamide 500 mg/m2 IV over 15-30 minutes on Day 1, followed by docetaxel 75 mg/m2 IV over 1 hour on Day 1. Administer pegfilgrastim 6 mg SC on Day 2 (or filgrastim 5 mcg/kg SC per standard of care).

Cyclophosphamide

Intervention Type DRUG

600 mg/m2 IV over 15-30 minutes on Day 1.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Docetaxel

Docetaxel 75 mg/m2 IV over 1 hour on Day 1 followed by cyclophosphamide

Intervention Type DRUG

Doxorubicin

• Doxorubicin 50 mg/m2 IV push over 5-15 minutes via sidearm through a running IV line on Day 1, followed by cyclophosphamide 500 mg/m2 IV over 15-30 minutes on Day 1, followed by docetaxel 75 mg/m2 IV over 1 hour on Day 1. Administer pegfilgrastim 6 mg SC on Day 2 (or filgrastim 5 mcg/kg SC per standard of care).

Intervention Type DRUG

Cyclophosphamide

600 mg/m2 IV over 15-30 minutes on Day 1.

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Taxotere Adriamycin Cytoxan

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

A woman will be eligible for inclusion in this study if she meets all of the following criteria:

* Age \>18 to \<70 years old.
* Has known ER and PR status
* Has HER2 nonamplified disease, confirmed by FISH
* Has known menopausal status (see Section 7.3 for criteria)
* Meets 1 of the 3 following criteria:

* T1-3N1-3M0 if ER positive or negative
* T2-3N0M0 if ER positive or negative
* T1N0M0 if ER and PR negative
* Has complete surgical resection of the primary breast tumor: either lumpectomy or mastectomy with sentinel lymph node biopsy or axillary dissection, with clear margins for both invasive and ductal carcinoma in situ (DCIS)
* Has had no prior chemotherapy unless \>5 years ago
* Has an ECOG Performance Status (PS) 0-1
* Has laboratory values of: See protocol for specific details
* Has aspartate aminotransferase (AST) or alanine aminotransferase (ALT) and alkaline phosphatase (ALP) within the ranges shown below. In determining eligibility the more abnormal of the 2 values (AST or ALT) should be used. See protocol for specific details
* Has normal cardiac function as evidenced by a LVEF \>50%, but WNL by institutional standard by multiple gated acquisition (MUGA) scan. An echocardiogram (ECHO) may be used if MUGA is not available, but the same modality must be used consistently throughout the study to evaluate LVEF. Ejection fraction as determined by ECHO must be WNL by institutional standard.
* Has no evidence of metastatic disease outside of breast by physical examination and chest x-ray. Other scans if done as needed by the patient (eg, bone scan; abdominal, chest CT; PET or PET/CT; ultrasound; or MRI should indicate no evidence of metastatic disease
* Has had baseline bilateral mammography
* It has been \<84 days since the date of definitive surgery (eg, mastectomy or, in the case of a breast-sparing procedure, axillary dissection) with adequate wound healing, as determined by the Treating Physician
* Has a negative serum pregnancy test within 7 calendar days prior to registration (female patients of childbearing potential \[not surgically sterilized and between menarche and 1 year postmenopause\])
* If fertile, patient has agreed to use an acceptable method of birth control (barrier contraceptive only) to avoid pregnancy for the duration of the study and for a period of 3 months thereafter
* Has adequate tumor specimen available for FISH analysis of TOP2A status (See Appendix VI).
* Has signed a Patient Informed Consent Form
* Has signed a Patient Authorization Form

Exclusion Criteria

A woman will be excluded from this study if she meets any of the following criteria:

* Has any evidence of metastatic disease following surgical resection of the primary tumor including: positive surgical margins, staging work-up, or physical examination suspicious for malignant disease
* Has T4 disease (ie, patients with fixed tumors, peau d'orange skin changes, skin ulcerations, or inflammatory changes)
* Has Stage IV breast cancer (M1 disease on TNM staging system)
* Has a history of severe hypersensitivity reaction to drugs formulated with polysorbate 80
* Has had neoadjuvant chemotherapy for this breast cancer
* Has ever had a myocardial infarction (MI) or has a history of heart failure, uncontrolled angina, severe uncontrolled arrhythmias, pericardial disease, or electrocardiographic evidence of acute ischemic changes
* Is receiving concurrent immunotherapy, hormonal therapy (eg, tamoxifen, hormone replacement therapy), or radiation therapy. Must discontinue prior to registering on the study.
* Is receiving concurrent investigational therapy or has received such therapy within the past 30 calendar days
* Has peripheral neuropathy \>Grade 1
* Has had a major organ allograft or condition requiring chronic immunosuppression (ie, kidney, liver, lung, heart, bone marrow transplant, or autoimmune diseases). Patients who have received corneal transplants or cadaver skin or bone transplants are eligible.
* Has a serious uncontrolled intercurrent medical or psychiatric illness, including serious viral (including clinically defined AIDS), bacterial or fungal infection; or history of uncontrolled seizures, or diabetes, or CNS disorders deemed by the Treating Physician to be clinically significant, precluding informed consent
* Has active hepatitis B or hepatitis C with abnormal liver function tests (LFTs) or is known to be HIV positive
* Has a history of other malignancy within the last 5 years (except cured basal cell carcinoma of skin, carcinoma in situ of uterine cervix, DCIS, which could affect the diagnosis or assessment of any of the study drugs
* In an obese patient to whom the Treating Physician would not be comfortable administering full doses of study drugs as calculated by the BSA. Obese patients will be treated based on actual body weight. Obese patients treated with full doses based on actual BSA are eligible.
* Is pregnant or breastfeeding
* Is deemed unable to comply with requirements of study
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Sanofi

INDUSTRY

Sponsor Role collaborator

US Oncology Research

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Joanne L Blum, MD

Role: PRINCIPAL_INVESTIGATOR

US Oncology Research

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Birmingham Hematology and Oncology

Birmingham, Alabama, United States

Site Status

Hematology Oncology Associates

Phoenix, Arizona, United States

Site Status

Northern AZ Hematology Oncology Associates-AOA

Sedona, Arizona, United States

Site Status

Arizona Oncology Associates DBA HOPE

Tucson, Arizona, United States

Site Status

Central Hematology Oncology Medical Group, Inc.

Alhambra, California, United States

Site Status

Comprehensive Blood and Cancer Center

Bakersfield, California, United States

Site Status

St. Jude Hertiage Medical Group

Fullerton, California, United States

Site Status

Wilshire Oncology Medical Group

La Verne, California, United States

Site Status

Antelope Valley Cancer Center

Lancaster, California, United States

Site Status

Pacific Shores Medical Group

Long Beach, California, United States

Site Status

University of California-Los Angeles

Los Angeles, California, United States

Site Status

North Valley Hematology/Oncology Medical Group

Northridge, California, United States

Site Status

Ventura County Hematology-Oncology Specialist

Oxnard, California, United States

Site Status

SAMSUM Clinic

Santa Barbara, California, United States

Site Status

Santa Barabra Hematology Oncology Medical Group, Inc.

Santa Barbara, California, United States

Site Status

Central Coast Medical Oncology Corporation

Santa Maria, California, United States

Site Status

Rocky Mountain Cancer Center-Rose

Denver, Colorado, United States

Site Status

Flordia Cancer Specialist

Fort Myers, Florida, United States

Site Status

Melbourne Internal Medicine Associates

Melbourne, Florida, United States

Site Status

Advanced Medical Specialist

Miami, Florida, United States

Site Status

Florida Cancer Institute

New Port Richey, Florida, United States

Site Status

Ocala Oncology Center

Ocala, Florida, United States

Site Status

Cancer Centers of Florida, P.A.

Ocoee, Florida, United States

Site Status

Suburban Hematology-Oncology Associates, PC

Lawrenceville, Georgia, United States

Site Status

Northwest Georgia Oncology Centers, PC

Marietta, Georgia, United States

Site Status

Hematology Oncology Associates of IL

Chicago, Illinois, United States

Site Status

Cancer Care & Hematology Specialists of Chicagoland

Niles, Illinois, United States

Site Status

Central Indiana Cancer Centers

Indianapolis, Indiana, United States

Site Status

Hope Center

Terre Haute, Indiana, United States

Site Status

Kansas City Cancer Centers-Southwest

Overland Park, Kansas, United States

Site Status

Maryland Oncology Hematology, P.A.

Columbia, Maryland, United States

Site Status

Alliance Hematology Oncology PA

Westminster, Maryland, United States

Site Status

Minnesota Oncology Hematology, P.A.

Minneapolis, Minnesota, United States

Site Status

Missouri Cancer Associates

Columbia, Missouri, United States

Site Status

Arch Medical Services, Inc.

St Louis, Missouri, United States

Site Status

Comprehensive Cancer Center of Nevada

Henderson, Nevada, United States

Site Status

Hematology-Oncology Associates of NNJ, P.A.

Morristown, New Jersey, United States

Site Status

Southern New Mexico Cancer Center

Las Cruces, New Mexico, United States

Site Status

New Mexico Cancer Care Associates

Santa Fe, New Mexico, United States

Site Status

New York Oncology Hematology, P.C.

Albany, New York, United States

Site Status

Interlakes Oncology Hematology, PC

Rochester, New York, United States

Site Status

Cancer Centers of North Carolina

Raleigh, North Carolina, United States

Site Status

Mahoning Valley Hematology Oncology Associates

Boardman, Ohio, United States

Site Status

Oncology Hematology Care, Inc.

Cincinnati, Ohio, United States

Site Status

Greater Dayton Cancer Center

Kettering, Ohio, United States

Site Status

Willamette Valley Cancer Center

Eugene, Oregon, United States

Site Status

Medical Oncology Associates

Kingston, Pennsylvania, United States

Site Status

Rittenhouse Hematology/Oncology

Philadelphia, Pennsylvania, United States

Site Status

Cancer Centers of the Carolinas

Greenville, South Carolina, United States

Site Status

Chattanooga Oncology & Hematology Associates, PC

Chattanooga, Tennessee, United States

Site Status

The Sarah Cannon Research Institute

Nashville, Tennessee, United States

Site Status

Texas Cancer Center-Abilene (South)

Abilene, Texas, United States

Site Status

Texas Oncology, P.A.-Amarillo

Amarillo, Texas, United States

Site Status

Texas Cancer Center

Arlington, Texas, United States

Site Status

Texas Oncology Cancer Center

Austin, Texas, United States

Site Status

Mamie McFaddin Ward Cancer Center

Beaumont, Texas, United States

Site Status

Texas Oncology -Bedford

Bedford, Texas, United States

Site Status

Texas Cancer Center at Medical City

Dallas, Texas, United States

Site Status

Texas Oncology

Dallas, Texas, United States

Site Status

Methodist Charlton Cancer Ctr.

Dallas, Texas, United States

Site Status

Texas Oncology

Dallas, Texas, United States

Site Status

Texas Cancer Center

Denton, Texas, United States

Site Status

El Paso Cancer Treatment Ctr

El Paso, Texas, United States

Site Status

Texas Oncology

Fort Worth, Texas, United States

Site Status

Texas Oncology

Garland, Texas, United States

Site Status

Texas Oncology, P.A.

Houston, Texas, United States

Site Status

Lake Vista Cancer Center

Lewisville, Texas, United States

Site Status

Longview Cancer Center

Longview, Texas, United States

Site Status

South Texas Cancer Center-McAllen

McAllen, Texas, United States

Site Status

Texas Cancer Center of Mesquite

Mesquite, Texas, United States

Site Status

Allison Cancer Center

Midland, Texas, United States

Site Status

Texas Oncology-Odessa

Odessa, Texas, United States

Site Status

Paris Regional Cancer Center

Paris, Texas, United States

Site Status

South Texas Oncology and Hematology, P.A.

San Antonio, Texas, United States

Site Status

San Antonio Tumor and Blood Clinic

San Antonio, Texas, United States

Site Status

HOAST-Medical Dr.

San Antonio, Texas, United States

Site Status

Texas Cancer Center-Sherman

Sherman, Texas, United States

Site Status

Texas Oncology Cancer Center-Sugar Land

Sugar Land, Texas, United States

Site Status

Tyler Cancer Center

Tyler, Texas, United States

Site Status

Texas Oncology Cancer Care and Research

Waco, Texas, United States

Site Status

Texas Oncology PA

Webster, Texas, United States

Site Status

Texoma Cancer Center

Wichita Falls, Texas, United States

Site Status

Fairfax Northern VA Hem-Onc PC

Fairfax, Virginia, United States

Site Status

Virginia Oncology Associates

Norfolk, Virginia, United States

Site Status

Virginia Cancer Institute

Richmond, Virginia, United States

Site Status

Onc and Hem Associates os SW VA, Inc.

Salem, Virginia, United States

Site Status

Highline Medical Oncology

Burien, Washington, United States

Site Status

Pudget Sound Cancer Center-Edmonds

Edmonds, Washington, United States

Site Status

Columbia Basin Hematology and Oncology

Kennewick, Washington, United States

Site Status

Puget Sound Cancer Center-Seattle

Seattle, Washington, United States

Site Status

Cancer Care Northwest-South

Spokane, Washington, United States

Site Status

Northwest Cancer Specialists-Vancouver

Vancouver, Washington, United States

Site Status

Yakima Valley Mem Hosp/North Star Lodge

Yakima, Washington, United States

Site Status

Yakima Valley Memorial Hospital/North Star Lodge

Yakima, Washington, United States

Site Status

Raleigh Regional Cancer Center

Beckley, West Virginia, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Geyer CE Jr, Blum JL, Yothers G, Asmar L, Flynn PJ, Robert NJ, Hopkins JO, O'Shaughnessy JA, Rastogi P, Puhalla SL, Hilton CJ, Dang CT, Gomez HL, Vukelja SJ, Lyss AP, Paul D, Brufsky AM, Colangelo LH, Swain SM, Mamounas EP, Wolmark N. Long-Term Follow-Up of the Anthracyclines in Early Breast Cancer Trials (USOR 06-090, NSABP B-46-I/USOR 07132, and NSABP B-49 [NRG Oncology]). J Clin Oncol. 2024 Apr 20;42(12):1344-1349. doi: 10.1200/JCO.23.01428. Epub 2024 Feb 9.

Reference Type DERIVED
PMID: 38335467 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

11271

Identifier Type: OTHER

Identifier Source: secondary_id

06090

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Docetaxel in Breast Cancer
NCT00312208 COMPLETED PHASE3