Biomarkers in Women Receiving Chemotherapy & Celecoxib for Stage II or Stage III Breast Cancer Removable by Surgery
NCT ID: NCT00665457
Last Updated: 2023-09-13
Study Results
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View full resultsBasic Information
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TERMINATED
PHASE2
3 participants
INTERVENTIONAL
2004-04-15
2009-07-31
Brief Summary
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PURPOSE: This phase II clinical trial is studying biomarkers and side effects in women receiving chemotherapy and celecoxib for stage II or stage III breast cancer that can be removed by surgery.
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Detailed Description
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* To determine the safety and efficacy of four courses of neoadjuvant chemotherapy comprising docetaxel, capecitabine, and celecoxib followed by doxorubicin hydrochloride, cyclophosphamide, and celecoxib for the treatment of women with resectable stage II or III breast cancer.
* To determine the mRNA and protein levels of thyraidylate synthase (TS), thymidine phosphylase (TP), vascular endothelial growth factor (VEGF), Multi-Drug Resistance Protein 1 (MDR-1), cyclooxygenase-2 (COX-2), and matrix metalloproteinase-2 (MMP-2) in tumor tissue prior to and following treatment.
* To correlate baseline expression of TS, TP, VEGF, MDR, COX-2, and MMP-2 to tumor response measured by physical exam, breast MRI, breast ultrasound, mammography, and pathologic response.
* To determine if polymorphisms in the genes that encode those proteins also correlate with outcome, if a correlation is found between specific molecular markers and clinical outcome.
OUTLINE:
* Neoadjuvant chemotherapy: Patients receive docetaxel IV over 1 hour on days 1, 8, and 15, oral capecitabine twice daily on days 1-14, and oral celecoxib twice daily on days 1-21. Courses repeat every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Patients then receive doxorubicin hydrochloride IV and cyclophosphamide IV once daily on day 1, oral celecoxib twice daily on days 1-14, and filgrastim subcutaneously once daily on days 3-10. Courses repeat every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Celecoxib is stopped one week prior to surgery.
* Surgery: Patients undergo definitive surgery (either modified radical mastectomy or lumpectomy combined with axillary node dissection). Patients may also undergo adjuvant radiotherapy and hormonal therapy at the discretion of multidisciplinary breast team.
Blood is collected at baseline and examined for genetic polymorphisms associated with functional changes in proteins. Tumor tissue is obtained by needle biopsy at baseline, before the second course of docetaxel/capecitabine/celecoxib, and at surgical resection. Molecular markers and protein expression are assessed by immunohistochemistry using fluorescence-image analysis and real-time reverse-transcriptase PCR.
Patients undergo imaging comprising dynamic MRI, ultrasound, and mammogram at baseline and after the first and second 4 courses of chemotherapy.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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Celecoxib
•Neoadjuvant chemotherapy: Patients receive docetaxel IV over 1 hour on days 1, 8, and 15, oral capecitabine twice daily on days 1-14, and oral celecoxib twice daily on days 1-21. Courses repeat every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Patients then receive doxorubicin hydrochloride IV and cyclophosphamide IV once daily on day 1, oral celecoxib twice daily on days 1-14, and filgrastim subcutaneously once daily on days 3-10. Courses repeat every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Celecoxib is stopped one week prior to surgery.
•Surgery: Patients undergo definitive surgery (either modified radical mastectomy or lumpectomy combined with axillary node dissection). Patients may also undergo adjuvant radiotherapy and hormonal therapy at the discretion of multidisciplinary breast team.
filgrastim
capecitabine
celecoxib
cyclophosphamide
docetaxel
doxorubicin hydrochloride
gene expression analysis
polymorphism analysis
protein expression analysis
reverse transcriptase-polymerase chain reaction
imaging biomarker analysis
immunohistochemistry staining method
laboratory biomarker analysis
pharmacogenomic studies
dynamic contrast-enhanced magnetic resonance imaging
needle biopsy
neoadjuvant therapy
radiomammography
ultrasound imaging
Interventions
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filgrastim
capecitabine
celecoxib
cyclophosphamide
docetaxel
doxorubicin hydrochloride
gene expression analysis
polymorphism analysis
protein expression analysis
reverse transcriptase-polymerase chain reaction
imaging biomarker analysis
immunohistochemistry staining method
laboratory biomarker analysis
pharmacogenomic studies
dynamic contrast-enhanced magnetic resonance imaging
needle biopsy
neoadjuvant therapy
radiomammography
ultrasound imaging
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Stage II-III disease
* Resectable disease
* Must have a primary tumor estimated by mammogram, ultrasound or palpation to be ≥ 3 cm and/or palpable axillary nodes \> 1 cm for whom neoadjuvant chemotherapy is appropriate
* ECOG performance status 0-1
* Absolute granulocyte count \> 2,000/mm\^3
* Platelet count \> 100,000/mm\^3
* Serum bilirubin \< 1.5 times upper limit of normal (ULN)
* Serum creatinine \< 1.5 times ULN
* Fertile patients must use effective contraception during and for 3 months after completion of study therapy
* At least 2 weeks since prior treatment with cyclooxygenase (COX)-2 inhibitors
Exclusion Criteria
* No allergies to sulfa medication, aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs)
* No uncontrolled concurrent illness that might jeopardize the patient's ability to receive the chemotherapy program outlined in this protocol, including any of the following:
* Active infection requiring intravenous antibiotics
* Symptomatic congestive heart failure
* Unstable angina pectoris
* Serious, uncontrolled cardiac arrhythmia
* No other prior malignancy except for adequately treated basal cell or squamous cell skin cancer, noninvasive carcinomas, or other cancers from which the patient has been disease-free for at least 5 years
* No prior chemotherapy or radiation therapy for ipsilateral breast cancer
* No concurrent sorivudine or brivudine to treat herpes simplex or herpes zoster viral infections
* No concurrent participation in another therapeutic clinical trial
19 Years
120 Years
FEMALE
No
Sponsors
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National Cancer Institute (NCI)
NIH
University of Nebraska
OTHER
Responsible Party
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Principal Investigators
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Elizabeth C. Reed, MD
Role: PRINCIPAL_INVESTIGATOR
University of Nebraska
Locations
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Unversity of Nebraska Medical Center
Omaha, Nebraska, United States
Countries
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Other Identifiers
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0085-04-FB
Identifier Type: -
Identifier Source: org_study_id
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