Trial of Eribulin/Cyclophosphamide or Docetaxel/Cyclophosphamide as Neoadjuvant Therapy in Locally Advanced HER2-Negative Breast Cancer

NCT ID: NCT01527487

Last Updated: 2016-11-04

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 76 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-06-30
• Study Completion Date: 2016-07-31

Brief Summary

The investigators propose a randomized phase II study evaluating the pCR and toxicity profiles of combination eribulin/cyclophosphamide (ErC) and docetaxel /cyclophosphamide (TC) as neoadjuvant therapy for locally advanced HER2-negative breast cancer.

Conditions

HER2 Negative Breast Cancer

Keywords

breast cancer; eribulin; Halaven; taxotere

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Eribulin+Cyclophosphamide (ErC)

Eribulin (Er): 1.4mg/m2 IV (Days 1 and 8) given short (≤1.5 minutes) IV infusion, per institutional standard

Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard

Group Type: EXPERIMENTAL

Eribulin

Intervention Type: DRUG

1.4 mg/m2 IV (Days 1 \& 8), given short (≤15 minute) IV infusion, per institutional standard

Cyclophosphamide

Intervention Type: DRUG

Cyclophosphamide will be given as an IV infusion (600 mg/m2) on Day 1 of each treatment cycle over approximately 30 minutes, or per institutional standard.

Docetaxel+Cyclophosphamide (TC)

Docetaxel (T): 75 mg/m2 IV (Day 1), given by 1-hour IV infusion

Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard

Group Type: EXPERIMENTAL

Cyclophosphamide

Intervention Type: DRUG

Cyclophosphamide will be given as an IV infusion (600 mg/m2) on Day 1 of each treatment cycle over approximately 30 minutes, or per institutional standard.

Docetaxel

Intervention Type: DRUG

Patients assigned to Treatment Arm 2 will receive docetaxel 75 mg/m2 IV on Day 1 of each treatment cycle every 3 weeks.

Interventions

Eribulin

1.4 mg/m2 IV (Days 1 \& 8), given short (≤15 minute) IV infusion, per institutional standard

Intervention Type: DRUG

Cyclophosphamide

Cyclophosphamide will be given as an IV infusion (600 mg/m2) on Day 1 of each treatment cycle over approximately 30 minutes, or per institutional standard.

Intervention Type: DRUG

Docetaxel

Patients assigned to Treatment Arm 2 will receive docetaxel 75 mg/m2 IV on Day 1 of each treatment cycle every 3 weeks.

Intervention Type: DRUG

Other Intervention Names

Halaven; Cytoxan; Taxotere

Eligibility Criteria

Inclusion Criteria

1. Histologically confirmed invasive adenocarcinoma of the breast.

2. Primary palpable disease confined to the breast and axilla on physical examination (clinical Stage II or III disease). For patients without clinically suspicious axillary adenopathy, the primary must be >2 cm in diameter by physical examination or imaging studies (clinical T2-3, N0-2, M0). For patients with clinically suspicious axillary adenopathy, the primary breast tumor can be any size (clinical T1-3, N1-2, M0). Patients who have had axillary node dissection and have pN3a (i.e. ≥10 involved axillary nodes) are also eligible.

3. Patients entering the trial after undergoing an axillary node dissection will be eligible if they meet other entry criteria.

4. Estrogen receptor (ER) and progesterone receptor (PR) status in the primary tumor known or pending at the time of study registration.

5. Resolution of all acute effects of surgical procedures to ≤ grade 1. For patients who had or will have, a sentinel node and/or axillary node dissection, completion at least 1 week prior to the initiation of study treatment with a well-healed wound is required.

7. Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 0-2.

8. Patients entering this study must be willing to provide release of tumor tissue collected at baseline during a diagnostic procedure if available, and at the time of future surgical procedure(s) for correlative testing. If tissue is not available, the patient will still be eligible for enrollment to the study.

9. No evidence of metastatic disease, as documented by complete staging workup ≤8 weeks prior to initiation of study treatment.

10. No prior treatment for this breast cancer with the exception of criterion #3.

11. HER2-negative tumor status defined as:

• Immunohistochemical (IHC) 0-1+ or
• IHC 2+ or IHC 3+ confirmed as FISH (Fluorescence in situ hybridization) or SISH (Silver in situ hybridization) negative (defined by ratio <2.2)

12. Adequate hematologic function defined as:

• Absolute neutrophil count (ANC) ≥1500/μL
• Hemoglobin (Hgb) ≥10 g/dL
• Platelets ≥100,000/uL

13. Adequate liver function defined as:

• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 x the upper limit of normal (ULN)
• Total bilirubin ≤ the institutional ULN

14. Adequate renal function defined as:

• Serum creatinine ≤1.5 mg/dL x ULN OR calculated creatinine clearance ≥50 mL/min by the Cockcroft-Gault method:

GRF =(140-age) x (weight/kg) x (0.85 if female) (72 x serum creatinine mg/dL)

15. Other laboratory testing:

• Serum magnesium ≥ the institutional lower limit of normal (LLN)
• Serum potassium ≥the institutional LLN

16. Female and ≥18 years of age.

17. Negative serum pregnancy test within <7 days prior to initial trial treatment.

18. Female patients who are not of child-bearing potential, and female patients of child-bearing potential who agree to use adequate contraceptive measures that are approved by their study physician while receiving study treatment and continuing for 3 weeks after the last dose of study drug treatment, who are not breastfeeding, and who have a negative serum pregnancy test prior to start of dosing.

19. Willingness and ability to comply with trial and follow-up procedures.

20. Ability to understand the nature of this trial and give written informed consent.

Exclusion Criteria

1. Clinical T4 lesions, including inflammatory breast cancer. Clinical N3 involvement (e.g., ipsilateral, infraclavicular, supraclavicular, and internal mammary nodes).

2. Peripheral neuropathy (motor or sensory) > grade 1 according to Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0).

3. Patient has received radiotherapy for treatment of previous cancer that included ≥30% of major bone marrow containing areas (e.g., pelvis, lumbar, spine).

4. Known or suspected allergy or hypersensitivity to any of the study drugs (i.e., eribulin, cyclophosphamide, docetaxel) or known hypersensitivity to polysorbate 80.

5. Patients with acute or chronic liver or renal disease or pancreatitis.

6. Known diagnosis of human immunodeficiency virus (HIV), Hepatitis B (HBV) or Hepatitis C (HCV).

7. Concurrent treatment with an ovarian hormonal replacement therapy or with hormonal agents such as raloxifene, tamoxifen or other selective estrogen receptor modulator (SERM). Patients must have discontinued use of such agents prior to beginning study treatment. However, use of GNRH agonists for the purpose of fertility preservation or suppression of heavy menses is permitted (see Section 5.4.1).

8. Patient has any of the following cardiac diseases currently or within the last 6 months:

• Left Ventricular Ejection Fraction (LVEF) <45% as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO)
• Heart rate-corrected QT interval (QTc) > 480 ms on screening electrocardiogram (ECG) (using Bazett's formula)
• Unstable angina pectoris
• Congestive heart failure (New York Heart Association [NYHA] ≥ Grade 2
• Acute myocardial infarction
• Conduction abnormality not controlled with pacemaker or medication
• Significant ventricular or supraventricular arrhythmias (Patients with chronic rate-controlled atrial fibrillation in the absence of other cardiac abnormalities are eligible).
• Valvular disease with significant compromise in cardiac function

9. Chronic use of drugs that cause QTc prolongation. Patients must discontinue use of these drugs 7 days prior to the start of study treatment.

10. Presence of other active cancers, or history of treatment for invasive cancer ≤5 years. Patients with stage I cancer who have received definitive local treatment at least 3 years previously, and are considered unlikely to recur are eligible. All patients with previously treated in situ carcinoma (i.e. non-invasive) are eligible, as are patients with history of non-melanoma skin cancer.

11. Patients may not receive any other investigational or anti-cancer treatments while participating in this trial.

12. Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.

13. Inability or unwillingness to comply with study and/or follow-up procedures outlined in the protocol.

• Minimum Eligible Age: 18 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Eisai Inc.

INDUSTRY

Sponsor Role: collaborator

SCRI Development Innovations, LLC

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Denise A Yardley, MD

Role: STUDY_CHAIR

SCRI Development Innovations, LLC

Locations

Florida Cancer Specialists South

Fort Myers, Florida, United States

Memorial Cancer Institute

Hollywood, Florida, United States

Woodlands Medical Specialists

Pensacola, Florida, United States

Florida Cancer Specialists North

St. Petersburg, Florida, United States

Northeast Georgia Medical Center

Gainesville, Georgia, United States

Mercy Hospital

Portland, Maine, United States

Center for Cancer and Blood Disorders

Bethesda, Maryland, United States

Grand Rapids Oncology Program

Grand Rapids, Michigan, United States

Research Medical Center

Kansas City, Missouri, United States

Nebraska Methodist Cancer Center

Omaha, Nebraska, United States

Oncology Hematology Care, Inc

Cincinnati, Ohio, United States

South Carolina Oncology Associates

Columbia, South Carolina, United States

Tennessee Oncology

Nashville, Tennessee, United States

The Center for Cancer and Blood Disorders

Fort Worth, Texas, United States

Virginia Cancer Institute

Richmond, Virginia, United States

Countries

United States

Other Identifiers

SCRI BRE 197

Identifier Type: -

Identifier Source: org_study_id