Phase II Trial to Compare the Safety of Two Chemotherapy Plus Trastuzumab Regimens as Adjuvant Therapy for HER2-positive Breast Cancer (Study P05048AM2)(COMPLETED)

Overview[ - collapse ][ - ]

Purpose The purpose of this study is to compare the incidence of cardiac dysfunction in subjects with human epidermal growth factor receptor 2 (HER2) positive breast cancer treated with either doxorubicin or pegylated liposomal doxorubicin (PLD), both in combination with trastuzumab.
ConditionBreast Neoplasm
InterventionDrug: doxorubicin, cyclophosphamide, paclitaxel, trastuzumab
Drug: PLD, cyclophosphamide, trastuzumab, paclitaxel
PhasePhase 2
SponsorMerck Sharp & Dohme Corp.
Responsible PartyMerck Sharp & Dohme Corp.
ClinicalTrials.gov IdentifierNCT00550771
First ReceivedOctober 29, 2007
Last UpdatedFebruary 13, 2014
Last verifiedFebruary 2014

Tracking Information[ + expand ][ + ]

First Received DateOctober 29, 2007
Last Updated DateFebruary 13, 2014
Start DateJuly 2007
Estimated Primary Completion DateAugust 2010
Current Primary Outcome MeasuresNumber of Participants Who Experienced Cardiac Events (Level 1 or 2), or Inability to Administer Trastuzumab Either During the 8 Cycles of Chemotherapy or According to Package Insert for a Total Duration of 1 Year [Time Frame: 8 cycles of chemotherapy and subsequently one year of planned trastuzumab treatment] [Designated as safety issue: Yes]Cardiac events defined as:
Level 1: Cardiac death due to heart failure (HF), myocardial infarction or arrhythmia, or probable cardiac death defined as sudden, unexpected death within 24 hours of a definite or probable cardiac event, or severe symptomatic HF, concomitant with a left ventricular ejection fraction (LVEF) drop of >10 percentage points from baseline and to ≤50% LVEF
Level 2: Asymptomatic systolic dysfunction or mildly symptomatic HF concomitant with an LVEF drop of >10 percentage points from baseline and to <50% LVEF; the LVEF drop was to have been confirmed within 3-4 weeks.
Current Secondary Outcome Measures
  • Number of Participants Who Experienced Cardiac Events (Level 1 or 2) or Inability to Administer Trastuzumab During the 8 Cycles of Chemotherapy [Time Frame: During the 8 courses of chemotherapy] [Designated as safety issue: Yes]Cardiac events defined as:
    Level 1: Cardiac death due to heart failure (HF), myocardial infarction or arrhythmia, or probable cardiac death defined as sudden, unexpected death within 24 hours of a definite or probable cardiac event, or severe symptomatic HF, concomitant with a left ventricular ejection fraction (LVEF) drop of >10 percentage points from baseline and to ≤50% LVEF
    Level 2: Asymptomatic systolic dysfunction or mildly symptomatic HF concomitant with an LVEF drop of >10 percentage points from baseline and to <50% LVEF; the LVEF drop was to have been confirmed within 3-4 weeks.
  • Number of Participants Who Experienced Cardiac Events (Level 1 or 2) or Inability to Administer Trastuzumab During 1 Year of Trastuzumab Therapy [Time Frame: During 1 year of trastuzumab therapy] [Designated as safety issue: Yes]Cardiac events defined as:
    Level 1: Cardiac death due to heart failure (HF), myocardial infarction or arrhythmia, or probable cardiac death defined as sudden, unexpected death within 24 hours of a definite or probable cardiac event, or severe symptomatic HF, concomitant with a left ventricular ejection fraction (LVEF) drop of >10 percentage points from baseline and to ≤50% LVEF
    Level 2: Asymptomatic systolic dysfunction or mildly symptomatic HF concomitant with an LVEF drop of >10 percentage points from baseline and to <50% LVEF; the LVEF drop was to have been confirmed within 3-4 weeks.
  • Number of Participants Who Survived Without Relapse [Time Frame: Approximately 2 years] [Designated as safety issue: No]Relapse-free survival would have been determined by Kaplan-Meier method.
    This was not calculated, since the 2 year follow-up was curtailed.

Descriptive Information[ + expand ][ + ]

Brief TitlePhase II Trial to Compare the Safety of Two Chemotherapy Plus Trastuzumab Regimens as Adjuvant Therapy for HER2-positive Breast Cancer (Study P05048AM2)(COMPLETED)
Official TitleRandomized Phase II Multinational Trial to Evaluate the Safety of Two Chemotherapy Plus Trastuzumab Regimens as Adjuvant Therapy in Patients With HER2-positive Breast Cancer: Caelyx + Cyclophosphamide + Trastuzumab (C+C+H) or Doxorubicin + Cyclophosphamide (A+C), Each Followed by Paclitaxel + Trastuzumab (T+H) BACH
Brief Summary
The purpose of this study is to compare the incidence of cardiac dysfunction in subjects
with human epidermal growth factor receptor 2 (HER2) positive breast cancer treated with
either doxorubicin or pegylated liposomal doxorubicin (PLD), both in combination with
trastuzumab.
Detailed DescriptionNot Provided
Study TypeInterventional
Study PhasePhase 2
Study DesignAllocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionBreast Neoplasm
InterventionDrug: doxorubicin, cyclophosphamide, paclitaxel, trastuzumab
doxorubicin 60 mg/m^2 IV push + cyclophosphamide 600 mg/m^2 IV over 30-90 minutes given every 21 days for 4 courses (12 weeks) followed by Paclitaxel 80 mg/m^2 IV over 60 minutes with trastuzumab 2 mg/kg IV over 30 minutes (first administration 4 mg/kg IV over 90 minutes) given weekly for 12 weeks (4 courses)
Drug: PLD, cyclophosphamide, trastuzumab, paclitaxel
PLD 35 mg/m^2 IV over 60 minutes + cyclophosphamide 600 mg/m^2 IV over 30-90 minutes given every 21 days + trastuzumab 2 mg/kg IV over 30 minutes (first dose 4 mg/kg IV over 90 minutes) given once weekly for 4 courses (12 weeks) followed by Paclitaxel 80 mg/m^2 IV over 60 minutes with trastuzumab 2 mg/kg IV over 30 minutes given weekly for 12 weeks (4 courses)
Other Names:
pegylated liposomal doxorubicin (SCH 200746)
Study Arm (s)
  • Active Comparator: Doxorubicin Based Regimen
  • Experimental: Pegylated Liposomal Doxorubicin (PLD) Based Regimen

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment181
Estimated Completion DateAugust 2010
Estimated Primary Completion DateAugust 2010
Eligibility Criteria
Inclusion Criteria:

- Subjects with operable, node-positive or high-risk node-negative (see #3 below)
HER2-positive breast carcinoma are eligible for the study, provided they satisfy the
following criteria.

- Subjects must demonstrate willingness to and be able to participate in the study
and to adhere to dose and visit schedules

- Subjects must be of female gender and >= 18 years of age

- Subjects must have been diagnosed with operable, histologically confirmed
adenocarcinoma of the breast with no clinical or radiological evidence of
metastatic disease but with otherwise high or intermediate risk tumor
characteristics:

- node-positive: T1-3, N1-2, M0 (level of T [tumor involvement], N [lymph
node involvement], & M [matastases]) OR

- node-negative AND at least one of the following features:

- Tumor >2 cm or

- Tumor >1 cm and

- Negative estrogen receptor/progesterone receptor (ER/PR) or

- Malignancy Grade 2-3 or

- Presence of peritumoral vascular invasion or

- Age <35 years

- HER2-positive by fluorescence in situ hybridization (FISH)(with gene
amplification) or 3+ using

immunohistochemistry

- Subjects must have had complete resection (R0) of the primary tumor and axillary
lymph nodes (or must have negative sentinel node[s])

- Baseline left ventricular ejection fraction (LVEF) by multiple gated acquisition
(MUGA) scan or echocardiogram (ECHO) >=55%

- Easter Cooperative Oncology Group (ECOG)-performance status of 0-1

- Adequate postoperative bone marrow function with neutrophils >=1.5 x 10^9/l,
platelets >=100 x 10^9/l and hemoglobin >= lower limit of normal (LLN)

- Adequate renal function: calculated creatinine clearance >=50 ml/min

- Adequate postoperative liver function with a total bilirubin < upper limit of normal
(ULN), alkaline phosphatase <2.5 times the ULN and aspartate aminotransferase (AST)
<1.5 times the ULN

- Subjects must be free of any clinically relevant disease that would, in the principal
investigator's and/or sponsor's opinion, interfere with the conduct of the study or
study evaluations

- Subjects of childbearing potential (including women who are less than one year
postmenopausal and will be sexually active during the study) must agree to use a
medically accepted method of contraception, while receiving protocol-specified
medication and for 30 days (or as per local requirements) after stopping the
medication or be surgically sterilized prior to screening

- Subjects must be able to provide written informed consent

Exclusion Criteria:

- Subject who meets any of the following exclusion criteria will be disqualified from
participation in the study:

- Clinical or radiological evidence of metastatic disease

- Prior radiotherapy, chemotherapy or biotherapy for the currently diagnosed
breast cancer prior to randomization

- Clinically significant pericardial effusion

- Serious cardiac illness including, but not confined to

- history of documented congestive heart failure

- history of any form of cardiomyopathy or active treatment for any form of
cardiomyopathy

- history of angina pectoris or documented transmural myocardial infarction,
or active angina pectoris requiring medication

- serious ventricular arrhythmias requiring medication or implantable
cardioverter-defibrillator (ICD) therapy, uncontrolled supraventricular
arrhythmias

- clinically significant valvular disease

- poorly controlled arterial hypertension (systolic blood pressure (BP) >180
mmHg, diastolic BP >100 mmHg)

- Sensory/motor neuropathy > grade 2 as defined by National Cancer Institure -
Common Toxicity Criteria (NCI-CTC)

- Pregnancy, or intending to become pregnant during the study

- Nursing (breastfeeding) or intending to be nursing during the study

- Any of the following clinical conditions:

- Chronic obstructive pulmonary disease, requiring chronic treatment

- Clinically significant active infections

- A history of a psychological illness of condition, preventing the subject
to understand the requirements of the study

- Unstable regulation of diabetes mellitus

- A situation or condition that, in the opinion of the investigator, may interfere
with optimal participation in the study

- Is on staff, affiliated with, or a family member of the staff personnel directly
involved with this study

- Usage of any investigational product within 30 days prior to enrollment

- Participation in any other interventional clinical study involving drug, device
or biological. This would not prohibit the patient from participating in a
quality of life (QOL), questionnaire, blood collection, or observational study.

- Allergy to or sensitivity to the study drug or its excipients
GenderFemale
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesNot Provided

Administrative Information[ + expand ][ + ]

NCT Number NCT00550771
Other Study ID NumbersP05048
Has Data Monitoring CommitteeNot Provided
Information Provided ByMerck Sharp & Dohme Corp.
Study SponsorMerck Sharp & Dohme Corp.
CollaboratorsNot Provided
Investigators Not Provided
Verification DateFebruary 2014