Eribulin Mesylate or Paclitaxel as First- or Second-Line Therapy in Treating Patients With Recurrent Stage IIIC-IV Breast Cancer

NCT ID: NCT02037529

Last Updated: 2024-08-20

Study Results

Results available

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

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Basic Information

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Recruitment Status

SUSPENDED

Clinical Phase

PHASE3

Total Enrollment

201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-17

Study Completion Date

2024-10-31

Brief Summary

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This randomized phase III trial studies how well eribulin mesylate or paclitaxel work as first- or second-line therapy in treating patients with stage IIIC-IV breast cancer that has come back. Drugs used in chemotherapy, such as eribulin mesylate and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.

Detailed Description

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PRIMARY OBJECTIVES:

I. To demonstrate that patient-reported Patient-Report Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) data will be able to detect differences in symptoms between participants treated witheribulin mesylate (eribulin) and standard weekly paclitaxel at 12 weeks.

II. To validate rs7349683 in EPHA5 as a predictor of peripheral neuropathy from treatment with a microtubule targeting agent (i.e., eribulin or paclitaxel).

SECONDARY OBJECTIVES:

I. To compare overall survival, progression free survival (PFS), objective response rate (ORR), duration of response (DOR), and time to treatment failure (TTF) in patients receiving eribulin versus standard weekly paclitaxel.

II. To compare the 12 month rate of disease progression in patients receiving eribulin versus standard weekly paclitaxel.

III. To evaluate the clinical value and feasibility of collecting patient-reported symptom toxicity information via the Patient-Report Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE).

IV. To further validate the PRO-CTCAE sensory neuropathy items. V. To compare patient reported neurotoxicity between arms using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) instrument.

VI. To assess the toxicities in patients receiving eribulin versus standard weekly paclitaxel.

CORRELATIVE OBJECTIVES:

I. To compare new metastasis free survival in patients receiving eribulin versus standard weekly paclitaxel.

II. To explore the relationship between common single nucleotide polymorphisms in FGD4, FZD3, and VAC14 as predictors of peripheral neuropathy from treatment with a microtubule targeting agent (i.e., eribulin or paclitaxel).

III. To evaluate circulating nucleosomes and the apoptosis associated M30 neo-epitope as potential biomarkers associated with clinical benefit from treatment with eribulin specifically or the microtubule dynamics inhibitors in general.

VI. To evaluate tubulin isotype expression, mutations, and signaling pathway modifications in tumor tissue as potential biomarkers associated with clinical benefit from treatment with eribulin specifically or the microtubule dynamics inhibitors in general.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive eribulin mesylate intravenously (IV) over 2-5 minutes on days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

ARM B: Patients receive paclitaxel IV over 1 hour on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 12 weeks.

Conditions

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Breast Adenocarcinoma HER2/Neu Negative Invasive Breast Carcinoma Stage IIIC Breast Cancer AJCC v7 Stage IV Breast Cancer AJCC v6 and v7

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm A (eribulin mesylate)

Patients receive eribulin mesylate IV over 2-5 minutes on days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

Eribulin Mesylate

Intervention Type DRUG

Given IV

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Arm B (paclitaxel)

Patients receive paclitaxel IV over 1 hour on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Paclitaxel

Intervention Type DRUG

Given IV

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Interventions

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Eribulin Mesylate

Given IV

Intervention Type DRUG

Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Paclitaxel

Given IV

Intervention Type DRUG

Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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B1939 Mesylate E7389 ER-086526 Halaven Halichondrin B Analog Anzatax Asotax Bristaxol Praxel Taxol Taxol Konzentrat Quality of Life Assessment

Eligibility Criteria

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Inclusion Criteria

* Informed consent document signed and dated by patient
* Histologic confirmation of invasive adenocarcinoma originating in the breast
* Stage IV disease or stage IIIC disease (using the 7th edition American Joint Committee on Cancer \[AJCC\] criteria) not amenable to local therapy
* Clinical or radiographic evidence of disease progression
* Documentation of HER2 negative breast cancer at the time of protocol registration; (Note: HER2 negativity is defined as 0 or 1+ by immunohistochemistry OR nonamplified or equivocal by fluorescence in situ hybridization \[FISH\]; status may be defined on the basis of historic results on the breast primary or a metastatic site, whichever is most recent; repeat biopsies are not required for participation in this protocol)
* Known hormone receptor status at the time of protocol registration; (Note: estrogen receptor \[ER\] and/or progesterone receptor \[PgR\] status are considered positive with a cut-off of \>= 1% invasive tumor cells; status may be defined on the basis of historic results on the breast primary or a metastatic site, whichever is most recent; repeat biopsies are not required for participation in this protocol)
* Patients must demonstrate resolution of all toxicities related to prior chemotherapy, endocrine therapy, targeted therapy, or biologic therapy to grade =\< 1, including peripheral neuropathy, with the exception of alopecia (any grade permissible)
* No more than one prior chemotherapy regimen for advanced or metastatic breast cancer is allowed; prior chemotherapy for metastatic disease must have been completed \>= 14 days prior to randomization

* Any single agent therapy, and any combination of cytotoxic, endocrine, biological targeted agents, and/or humanized antibodies, scheduled to be administered as a preplanned treatment, given concomitantly, sequentially or both, is considered one regimen
* Planned neoadjuvant chemotherapy and postoperative adjuvant chemotherapy is considered one regimen
* If the dosing of one or more of the chemotherapy components of a regimen must be reduced for toxicity, the modified version of the original regimen is not considered a new regimen
* If one or more of the chemotherapy components of a regimen must be omitted for toxicity, the modified version of the original regimen is not considered a new regimen
* If one of the chemotherapy components of a regimen must be replaced with another similar drug of the same therapeutic class, the modified version of the original regimen is not considered a new regimen; however, if a new component, dissimilar to any of the original components, is added to the regimen, the modified version is considered a new regimen
* If chemotherapy is interrupted for surgery or radiotherapy and then continues with an unchanged schedule and components, treatment is considered as one regimen despite the interruption
* Prior treatment may include a taxane as per the following criteria:

* Prior taxane (including paclitaxel) in the adjuvant or neoadjuvant setting is allowed, provided that the interval between the completion of (neo)adjuvant therapy and disease recurrence is \> 12 months
* Prior taxane in the metastatic setting is allowed, provided that the agent administered in the metastatic setting was not standard paclitaxel
* Any number of prior endocrine therapies is allowed and must be discontinued prior to randomization
* Any number of biologic therapies (e.g., bevacizumab) or immunotherapies is allowed in the absence of co-administered chemotherapy and must have been completed \>= 28 days prior to randomization
* Prior treatment with an investigational agent is allowed but must have been completed \>= 28 days prior to randomization with resolution of all treatment-related toxicities to grade =\< 1.
* Minor surgical procedures must be completed \>= 7 days prior to randomization with documentation of adequate recovery from associated complications to grade =\< 1; these include (but are not limited to) laparoscopy, thoracoscopy, bronchoscopy, mediastinoscopy, endoscopic ultrasonography, skin biopsy, percutaneous needle biopsy, and routine dental procedures; as a precautionary measure, it is recommended, but not strictly required, that placement of a central venous access device, thoracentesis, or paracentesis be done 7 days before the initiation of protocol directed chemotherapy with documentation of adequate recovery from associated complications to grade =\< 1
* Major surgical procedures and open biopsies must be completed \>= 28 days prior to randomization with documentation of adequate recovery from associated complications to grade =\< 1
* Prior radiotherapy must be completed \>= 14 days prior to randomization with documentation of adequate recovery from associated toxicities to grade =\< 1
* Treatment with bisphosphonates or denosumab is allowed and recommended per the standard of care
* Therapeutic anticoagulation is allowed for patients on a stable dose of warfarin or low molecular weight heparin
* Measurable disease is defined as at least one lesion that can be accurately measured with the longest diameter as \>= 1.0 cm by computed tomography (CT) scan or \>= 1.0 cm with calipers by clinical examination; the exceptions to these criteria are pathologic lymph nodes, which must be \>= 1.5 cm in the short axis when assessed by CT scans with slice thickness =\< 0.5 cm
* Non-measurable lesions include the following: small lesions (longest diameter \< 1.0 cm for all lesions other than pathologic lymph nodes, which are \>= 1.0 cm and \< 1.5 cm in the short axis), bone metastases, pleural effusions, pericardial effusions, ascites, inflammatory breast disease, leptomeningeal disease, lymphangitis pulmonis, lymphangitis cutis, and abdominal masses not followed by CT or magnetic resonance imaging (MRI)
* Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
* Life expectancy of \> 12 weeks
* Patients with a history of resected brain metastases are eligible only if they are asymptomatic and have stable MRI scans for 3 consecutive months, including =\< 28 days of study registration
* Patients who receive stereotactic radiosurgery or whole brain radiation for brain metastases are eligible only if they are asymptomatic and have stable MRI scans for 3 consecutive months, including =\< 28 days of study registration
* Obtained =\< 7 days prior to registration: Absolute neutrophil count \>= 1500/uL
* Obtained =\< 7 days prior to registration: Platelet count \>= 100,000/uL
* Obtained =\< 7 days prior to registration: Hemoglobin \>= 9 g/dL
* Obtained =\< 7 days prior to registration: Total bilirubin =\< 1.5 times the upper limit of normal (ULN) except for unconjugated hyperbilirubinemia of Gilbert?s syndrome
* Obtained =\< 7 days prior to registration: Serum glutamic-oxaloacetic transaminase (SGOT) (aspartate aminotransferases \[AST\]) and serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 3 x ULN except in the case of liver metastases, where =\< 5 x ULN is allowed
* Obtained =\< 7 days prior to registration: Creatinine =\< 2.0 mg/dL or creatinine clearance \> 50 mL/min
* Obtained =\< 7 days prior to registration: Corrected QT (QTc) interval =\< 500 msec on the baseline electrocardiogram
* Negative pregnancy test done =\< 72 hours prior to registration for women of childbearing potential only; Note: all female subjects will be considered to be of child-bearing potential unless they are postmenopausal (at least 12 months consecutive amenorrhea, in the appropriate age group and without other known or suspected cause), or have been sterilized surgically (i.e., bilateral tubal ligation \>= 1 menstrual cycle prior to randomization, or have undergone a hysterectomy and/or bilateral oophorectomy)

* Female subjects of child-bearing potential must agree to use highly effective contraception during the study treatment and for 3 months after the final dose of study treatment; female subjects exempt from this requirement are subjects who practice total abstinence; if currently abstinent, the subject must agree to use a double barrier method of contraception (i.e., condom and occlusive cap \[diaphragm or cervical/vault caps\]) with spermicide or until they are established on highly effective contraception for at least one menstrual cycle if they become sexually active during the study treatment and for 3 months after the final dose of study treatment
* Highly effective contraception includes:

* Placement of intrauterine device or system
* Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault cap) with spermicide
* Vasectomized partner with confirmed azoospermia
* Male subjects and their female partner who are of child-bearing potential (as defined above), and are not practicing total abstinence, must agree to use highly effective contraception during study treatment and for 3 months after the final dose of study treatment; if currently abstinent, the subject must agree to use a double barrier method of contraception if they become sexually active, or until they are established on highly effective contraception as described above
* Ability to complete questionnaire(s) independently or with assistance
* Willingness to provide blood and tissue samples for correlative research purposes; (Note: these tissue samples are from archived tissue, if available; new biopsies are not required)
* Ability to comprehend and respond to questions using a telephone keypad

Exclusion Criteria

* Prior malignancy, other than carcinoma in situ of the cervix and non-melanoma skin cancers, unless the prior malignancy was diagnosed and definitively treated \>= 5 years previously, there is no subsequent evidence of recurrence, and the patient is considered by a physician to be at \< 30% risk of relapse
* Any of the following:

* Pregnant women
* Nursing women
* Men or women of childbearing potential who are unwilling to employ adequate contraception
* Presence of a serious nonhealing wound, ulcer, or bone fracture
* History of Common Terminology Criteria for Adverse Events (CTCAE) grade \>= 3 hypersensitivity to paclitaxel or Cremophor EL
* Pre-existing peripheral neuropathy grade ?= 2 at registration
* Significant cardiovascular impairment (e.g., New York Heart Association congestive heart failure of grade II or above, unstable angina, myocardial infarction within the past 6 months, or serious cardiac arrhythmia)
* Subjects with known positive human immunodeficiency virus (HIV) status
* History of stroke or transient ischemic attack =\< 6 months prior to registration
* History of uncontrolled seizures; (Note: patients are eligible for the study if the seizures are well controlled with standard medications)
* Severe or uncontrolled intercurrent illness/infection
* Concurrent administration of any other investigational agent considered to have potential efficacy in the treatment of breast cancer
* Prior exposure to eribulin mesylate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Academic and Community Cancer Research United

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Minetta C Liu

Role: PRINCIPAL_INVESTIGATOR

Academic and Community Cancer Research United

Locations

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Mayo Clinic in Arizona

Scottsdale, Arizona, United States

Site Status

Christiana Care Health System-Christiana Hospital

Newark, Delaware, United States

Site Status

MedStar Georgetown University Hospital

Washington D.C., District of Columbia, United States

Site Status

Mayo Clinic in Florida

Jacksonville, Florida, United States

Site Status

University of Illinois

Chicago, Illinois, United States

Site Status

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, United States

Site Status

Illinois CancerCare-Peoria

Peoria, Illinois, United States

Site Status

Carle Cancer Center NCI Community Oncology Research Program

Urbana, Illinois, United States

Site Status

Oncology Associates at Mercy Medical Center

Cedar Rapids, Iowa, United States

Site Status

Iowa-Wide Oncology Research Coalition NCORP

Des Moines, Iowa, United States

Site Status

Siouxland Regional Cancer Center

Sioux City, Iowa, United States

Site Status

Cancer Center of Kansas - Wichita

Wichita, Kansas, United States

Site Status

Ochsner NCI Community Oncology Research Program

New Orleans, Louisiana, United States

Site Status

Lafayette Family Cancer Center-EMMC

Brewer, Maine, United States

Site Status

Cancer Research Consortium of West Michigan NCORP

Grand Rapids, Michigan, United States

Site Status

Essentia Health NCI Community Oncology Research Program

Duluth, Minnesota, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Coborn Cancer Center at Saint Cloud Hospital

Saint Cloud, Minnesota, United States

Site Status

University of Missouri - Ellis Fischel

Columbia, Missouri, United States

Site Status

Heartland Regional Medical Center

Saint Joseph, Missouri, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Heartland Cancer Research CCOP

St Louis, Missouri, United States

Site Status

Cancer Alliance of Nebraska

Omaha, Nebraska, United States

Site Status

University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

New Hampshire Oncology Hematology PA-Hooksett

Hooksett, New Hampshire, United States

Site Status

Dartmouth Hitchcock Medical Center

Lebanon, New Hampshire, United States

Site Status

Hematology Oncology Associates of Central New York-East Syracuse

East Syracuse, New York, United States

Site Status

Mission Hospital-Saint Joseph Campus

Asheville, North Carolina, United States

Site Status

Cone Health Cancer Center at Alamance Regional

Burlington, North Carolina, United States

Site Status

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, North Carolina, United States

Site Status

Southeastern Medical Oncology Center-Goldsboro

Goldsboro, North Carolina, United States

Site Status

FirstHealth of the Carolinas-Moore Regional Hospital

Pinehurst, North Carolina, United States

Site Status

Novant Health Forsyth Medical Center

Winston-Salem, North Carolina, United States

Site Status

Cancer Centers of Southwest Oklahoma Research

Lawton, Oklahoma, United States

Site Status

Providence Portland Medical Center

Portland, Oregon, United States

Site Status

Women and Infants Hospital

Providence, Rhode Island, United States

Site Status

Rapid City Regional Hospital

Rapid City, South Dakota, United States

Site Status

Edwards Comprehensive Cancer Center

Huntington, West Virginia, United States

Site Status

Saint Vincent Hospital Cancer Center Green Bay

Green Bay, Wisconsin, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NCI-2016-02048

Identifier Type: REGISTRY

Identifier Source: secondary_id

RU011201I

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA015083

Identifier Type: NIH

Identifier Source: secondary_id

View Link

RU011201I

Identifier Type: -

Identifier Source: org_study_id

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