Trastuzumab in Treating Women With HER2-Positive Early Breast Cancer

NCT ID: NCT00712140

Last Updated: 2011-09-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

4000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-10-31

Brief Summary

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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. It is not yet known which regimen of trastuzumab is more effective in treating early breast cancer.

PURPOSE: This randomized phase III trial is comparing two trastuzumab regimens to see how well they work in treating women with HER2-positive early breast cancer.

Detailed Description

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OBJECTIVES:

Primary

* Determine disease-free survival of women with HER2-positive early breast cancer treated with neoadjuvant or adjuvant trastuzumab (Herceptin®) for 6 months versus 12 months.

Secondary

* Determine the overall survival of patients treated with these regimens.
* Determine the expected incremental cost effectiveness (cost per quality adjusted life year gained) for 6 months versus 12 months trastuzumab.
* Determine cardiac function as assessed by left ventricular ejection fraction every 3 months during treatment.
* Analyze the predictive factors for development of cardiac damage.

OUTLINE: This is a multicenter study. Patients are stratified according to estrogen receptor status (negative vs positive); chemotherapy timing (adjuvant vs neoadjuvant); chemotherapy type (anthracycline based \[no taxane\] vs taxane and anthracyclines vs taxane-based \[no anthracyclines\]); and trastuzumab (Herceptin®) timing (concurrently vs sequentially \[with respect to chemotherapy\]). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive trastuzumab IV over 30-90 minutes on day 1. Treatment repeats every 3 weeks for up to 12 months in the absence of disease progression or unacceptable toxicity.
* Arm II: Patients receive trastuzumab IV over 30-90 minutes on day 1. Treatment repeats every 3 weeks for up to 6 months in the absence of disease progression or unacceptable toxicity.

All patients also receive standard chemotherapy regimens as per local institutional protocols either concurrently with or sequentially to trastuzumab.

Patients complete quality of life questionnaires using the EuroQoL-5D (EQ-5D) at baseline and periodically during study treatment. Patients also complete a diary on out-of-pocket expenses associated with their condition (i.e., travel expenses, over-the-counter medicines and supplements, complementary therapies not funded by NHS, home help, and time away from work) for cost-effective analysis.

After completion of study therapy, patients are followed every 3 months for 1 year, then every 6 months for 1 year, and annually thereafter.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Study Groups

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Arm I

Patients receive trastuzumab IV over 30-90 minutes on day 1. Treatment repeats every 3 weeks for up to 12 months in the absence of disease progression or unacceptable toxicity. All patients also receive standard chemotherapy regimens as per local institutional protocols either concurrently with or sequentially to trastuzumab.

Group Type ACTIVE_COMPARATOR

trastuzumab

Intervention Type BIOLOGICAL

Given IV

parenteral chemotherapy

Intervention Type DRUG

per the local institutional protocols either concurrently with or sequentially to trastuzumab

Arm II

Patients receive trastuzumab IV over 30-90 minutes on day 1. Treatment repeats every 3 weeks for up to 6 months in the absence of disease progression or unacceptable toxicity. All patients also receive standard chemotherapy regimens as per local institutional protocols either concurrently with or sequentially to trastuzumab.

Group Type EXPERIMENTAL

trastuzumab

Intervention Type BIOLOGICAL

Given IV

parenteral chemotherapy

Intervention Type DRUG

per the local institutional protocols either concurrently with or sequentially to trastuzumab

Interventions

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trastuzumab

Given IV

Intervention Type BIOLOGICAL

parenteral chemotherapy

per the local institutional protocols either concurrently with or sequentially to trastuzumab

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed invasive breast cancer
* No evidence of metastatic disease
* Overexpression of HER2 receptor defined as 3+ or 2+ HER2 positivity measured by fluorescent in situ hybridization (FISH) gene amplification
* Indication for chemotherapy based on the following clinical and histopathological features:

* Receiving or scheduled to receive neoadjuvant chemotherapy

* Time between diagnosis biopsy and start date of chemotherapy should be less than 1 month
* Receiving or scheduled to receive adjuvant chemotherapy

* Completely resected disease, with negative surgical margins (apart from deep margin if full thickness resection)
* Marginally resected disease and/or positive sentinel nodes allowed provided patients undergo completion of surgery (breast and/or axillary clearance) after chemotherapy
* Hormone receptor status known

PATIENT CHARACTERISTICS:

* Menopausal status not specified
* ECOG performance status 0-1
* Adequate bone marrow, hepatic, and renal function
* LVEF normal by ECHO or MUGA
* Not pregnant or nursing
* Fertile patients must use effective contraception
* No clinically significant cardiac abnormalities
* No myocardial infarction within the past 6 months
* No uncontrolled or malignant hypertension
* No history of atrioventricular arrhythmia and/or congestive heart failure (even under medical control), or active second or third degree cardiac block
* No history of allergy to drugs containing polysorbate 20 and the excipient polysorbate 80 (TWEEN 80®) or history of allergy to mouse proteins
* No co-morbidity significantly adding to risks associated with cytotoxic chemotherapy (i.e., severe chronic obstructive pulmonary disease or poorly controlled diabetes)
* No prior diagnosis of malignancy unless managed by surgical treatment only and disease-free for 10 years

* Prior basal cell carcinoma, cervical carcinoma in situ, or ductal carcinoma in situ of the breast allowed if treated by surgery only
* No concomitant medical or psychiatric problems that might preclude completion of treatment or follow-up

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* No prior chemotherapy or radiotherapy
* Concurrent radiotherapy allowed
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Warwick Medical School

OTHER

Sponsor Role lead

Principal Investigators

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Helena Earl, MBBS, PhD, FRCP

Role: PRINCIPAL_INVESTIGATOR

Cambridge University Hospitals NHS Foundation Trust

Locations

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Addenbrooke's Hospital

Cambridge, England, United Kingdom

Site Status RECRUITING

Cumberland Infirmary

Carlisle, England, United Kingdom

Site Status RECRUITING

Derbyshire Royal Infirmary

Derby, England, United Kingdom

Site Status RECRUITING

Eastbourne District General Hospital

Eastbourne, England, United Kingdom

Site Status RECRUITING

Luton and Dunstable Hospital

Luton, England, United Kingdom

Site Status RECRUITING

Clatterbridge Centre for Oncology

Merseyside, England, United Kingdom

Site Status RECRUITING

James Cook University Hospital

Middlesbrough, England, United Kingdom

Site Status RECRUITING

Mount Vernon Cancer Centre at Mount Vernon Hospital

Northwood, England, United Kingdom

Site Status RECRUITING

Peterborough Hospitals Trust

Peterborough, England, United Kingdom

Site Status RECRUITING

New Cross Hospital

Wolverhampton, England, United Kingdom

Site Status RECRUITING

Aberdeen Royal Infirmary

Aberdeen, Scotland, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Facility Contacts

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Helena Earl, MBBS, PhD, FRCP

Role: primary

44-1223-336-800

Contact Person

Role: primary

44-1228-523-444

Contact Person

Role: primary

44-1332-347-141 ext. 2407

Contact Person

Role: primary

44-1323-417-400

Contact Person

Role: primary

44-845-127-0127

Contact Person

Role: primary

44-151-334-1155

Contact Person

Role: primary

44-1642-850-850

Contact Person

Role: primary

44-1923-826-111

Contact Person

Role: primary

44-1733-874-510

Contact Person

Role: primary

44-190-230-7999

Contact Person

Role: primary

44-84-5456-6000

References

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Earl H, Hiller L, Vallier AL, Loi S, McAdam K, Hughes-Davies L, Rea D, Howe D, Raynes K, Higgins HB, Wilcox M, Plummer C, Mahler-Araujo B, Provenzano E, Chhabra A, Gasson S, Balmer C, Abraham JE, Caldas C, Hall P, Shinkins B, McCabe C, Hulme C, Miles D, Wardley AM, Cameron DA, Dunn JA. Six versus 12 months' adjuvant trastuzumab in patients with HER2-positive early breast cancer: the PERSEPHONE non-inferiority RCT. Health Technol Assess. 2020 Aug;24(40):1-190. doi: 10.3310/hta24400.

Reference Type DERIVED
PMID: 32880572 (View on PubMed)

Earl HM, Hiller L, Vallier AL, Loi S, McAdam K, Hughes-Davies L, Harnett AN, Ah-See ML, Simcock R, Rea D, Raj S, Woodings P, Harries M, Howe D, Raynes K, Higgins HB, Wilcox M, Plummer C, Mansi J, Gounaris I, Mahler-Araujo B, Provenzano E, Chhabra A, Abraham JE, Caldas C, Hall PS, McCabe C, Hulme C, Miles D, Wardley AM, Cameron DA, Dunn JA; PERSEPHONE Steering Committee and Trial Investigators. 6 versus 12 months of adjuvant trastuzumab for HER2-positive early breast cancer (PERSEPHONE): 4-year disease-free survival results of a randomised phase 3 non-inferiority trial. Lancet. 2019 Jun 29;393(10191):2599-2612. doi: 10.1016/S0140-6736(19)30650-6. Epub 2019 Jun 6.

Reference Type DERIVED
PMID: 31178152 (View on PubMed)

Other Identifiers

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WMS-PERSEPHONE

Identifier Type: -

Identifier Source: secondary_id

MREC-PERSEPHONE

Identifier Type: -

Identifier Source: secondary_id

EUDRACT: 2006-007018-39

Identifier Type: -

Identifier Source: secondary_id

ISRCTN 52968807

Identifier Type: -

Identifier Source: secondary_id

MREC 07/MRE08/35

Identifier Type: -

Identifier Source: secondary_id

EU-20858

Identifier Type: -

Identifier Source: secondary_id

CRUK-BRD/07/137

Identifier Type: -

Identifier Source: secondary_id

CDR0000598391

Identifier Type: -

Identifier Source: org_study_id

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