Phase III Comparison of Adjuvant Chemotherapy W/High-Dose Cyclophosphamide Plus Doxorubicin (AC) vs Sequential Doxorubicin Fol by Cyclophosphamide (A-C) in High Risk Breast Cancer Patients With 0-3 Positive Nodes (Intergroup, CALGB 9394)

Overview[ - collapse ][ - ]

Purpose To compare disease-free survival (DFS), overall survival (s), and toxicity of high-isk primary breast cancer patients with negative axillary lymph nodes or with one to three positive nodes treated with adjuvant high-dose chemotherapy with doxorubicin plus cyclophosphamide (AC), versus high-dose sequential chemotherapy with doxorubicin followed by cyclophosphamide (A-->C).
ConditionHigh Risk
Breast Cancer
Positive Nodes
Cyclophosphamide
Doxorubicin
InterventionDrug: Doxorubicin
Drug: Cyclophosphamide
Drug: G-CSF
Drug: tamoxifen
Drug: ciprofloxacin
PhasePhase 3
SponsorMemorial Sloan-Kettering Cancer Center
Responsible PartyMemorial Sloan-Kettering Cancer Center
ClinicalTrials.gov IdentifierNCT00590785
First ReceivedDecember 26, 2007
Last UpdatedNovember 21, 2013
Last verifiedNovember 2013

Tracking Information[ + expand ][ + ]

First Received DateDecember 26, 2007
Last Updated DateNovember 21, 2013
Start DateAugust 1996
Estimated Primary Completion DateDecember 2014
Current Primary Outcome MeasuresTo compare disease-free survival (DFS), overall survival (s), and toxicity of high-isk primary breast cancer patients with negative axillary lymph nodes or with one to three positive nodes. [Time Frame: Conclusion of the study] [Designated as safety issue: Yes]
Current Secondary Outcome MeasuresTo obtain tumor tissue for biologic studies. The details of these biologic studies will be described in a companion protocol or protocols to be developed through the Intergroup mechanism. [Time Frame: Conclusion of study] [Designated as safety issue: No]

Descriptive Information[ + expand ][ + ]

Brief TitlePhase III Comparison of Adjuvant Chemotherapy W/High-Dose Cyclophosphamide Plus Doxorubicin (AC) vs Sequential Doxorubicin Fol by Cyclophosphamide (A-C) in High Risk Breast Cancer Patients With 0-3 Positive Nodes (Intergroup, CALGB 9394)
Official TitlePhase III Comparison of Adjuvant Chemotherapy W/High-Dose Cyclophosphamide Plus Doxorubicin (AC) vs Sequential Doxorubicin Fol by Cyclophosphamide (A-C) in High Risk Breast Cancer Patients With 0-3 Positive Nodes (Intergroup, CALGB 9394)
Brief Summary
To compare disease-free survival (DFS), overall survival (s), and toxicity of high-isk
primary breast cancer patients with negative axillary lymph nodes or with one to three
positive nodes treated with adjuvant high-dose chemotherapy with doxorubicin plus
cyclophosphamide (AC), versus high-dose sequential chemotherapy with doxorubicin followed by
cyclophosphamide (A-->C).
Detailed DescriptionNot Provided
Study TypeInterventional
Study PhasePhase 3
Study DesignAllocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Condition
  • High Risk
  • Breast Cancer
  • Positive Nodes
  • Cyclophosphamide
  • Doxorubicin
InterventionDrug: Doxorubicin
High-dose doxorubicin + cyclophosphamide (AC) x 6 cycles with G-CSF on Days 3 - 12 and followed in postmenopausal patients and hormone receptor-positive premenopausal patients by tamoxifen 20 mg daily for 5 years.
Drug: Cyclophosphamide
High-dose doxorubicin + cyclophosphamide (AC) x 6 cycles with G-CSF on Days 3 - 12 and followed in postmenopausal patients and hormone receptor-positive premenopausal patients by tamoxifen 20 mg daily for 5 years.
Drug: G-CSF
High-dose doxorubicin + cyclophosphamide (AC) x 6 cycles with G-CSF on Days 3 - 12 and followed in postmenopausal patients and hormone receptor-positive premenopausal patients by tamoxifen 20 mg daily for 5 years.
Other Names:
FilgrastimDrug: tamoxifen
High-dose doxorubicin + cyclophosphamide (AC) x 6 cycles with G-CSF on Days 3 - 12 and followed in postmenopausal patients and hormone receptor-positive premenopausal patients by tamoxifen 20 mg daily for 5 years.
Drug: ciprofloxacin
High-dose sequential doxorubicin x 4 given with G-CSF on Days 3 - 12+ and followed by high-dose cyclophosphamide x 3 (A+C) given with G-CSF and ciprofloxacin on Days 3-12, followed in postmenopausal patients and hormone receptor-positive premenopausal patients by tamxifen 20 mg daily for 5 years.
Study Arm (s)
  • Experimental: 1
  • Experimental: 2

Recruitment Information[ + expand ][ + ]

Recruitment StatusActive, not recruiting
Estimated Enrollment60
Estimated Completion DateDecember 2014
Estimated Primary Completion DateDecember 2014
Eligibility Criteria
- Patients must have been diagnosed with primary invasive adenocarcinoma of the breast.
Those patients with the special types including pure tubular, mucinous and papillary
carcinoma are not eligible. Patients must not have sarcoma, lymphoma, or apocrine,
adenocystic or squamous cell cancer of the breast. Patients must not have recurrent
invasive breast cancer. Metaplastic carcinomas are eligible as a variant form of
adenocarcinoma.

- Patients must have undergone an axillary dissection, and at least 6 nodes must have
een removed and examined. Nodal involvement by tumor must be negative or must not
xceed three positive nodes.

- disease must be considered sufficiently high-risk by the investigator to justify the
use of chemotherapy. To be eligible, disease must satisfy one of the following
requirements:

1. Tumor is both ER negative and PgR negative and greater than 1.0 cm in greatest
diameter. Negative is defined as c 10 fmollmg cytosol protein if measured in
these units; othennrise negative is defined according to institutional
standards.

2. Tumor that is greater than 2.0 cm in greatest diameter irrespective of hormone
receptor status (including unknown).

3. Tumor involves one to three axillary lymph nodes.

- Breast cancer was not locally advanced at diagnosis. This is left to investigator
judgement, but generally should exclude patients with fixed tumors, fixed nodes, peau
d'orange skin changes, skin ulcerations or inflammatory changes (T4 disease).

- Patient Is currently free of breast cancer (no evidence of disease). This is also
left to investigator judgement, but generally should include no evidence of distant
disease on chest x-ray or mgmmogram of the opposite breast prior to registration,
within 3 months prior to surgery; and no gross or microscopically positive surgical
margins noted in the final surgery or pathology reports. Patients with synchronous
bilateral breast cancer may be considered, provided both breasts are treated with
curative intent and that eligibility is based on the side with the most adverse
prognostic features.

- Registration must be within 84 days of mastectomy, or within 84 days of axillary
dissection if the patient's most extensive breast surgery was a breast sparing
procedure. Patients not having mastectomy or breast sparing surgery are ineligible.
Patients must not have had prior chemotherapy for this breast cancer. Patients must
not have had systemic therapy of any type for a previous breast cancer.

- Patients must not have had external beam radiotherapy for this breast cancer prior to
registration. Brachytherapy (interstitial radiation therapy) at the time of breast
sparing procedure is acceptable and would not render the patient Ineligible. (If
external beam radiotherapy is planned to be given with brachytherapy, it must be
delayed until after chemotherapy is complete.) Patients whose most extensive breast
surgery was a breast sparing procedure must be planning to receive radiotherapy after
chemotherapy is complete.

- Patients must have adequate hematologic, hepatic, renal and cardiac function for high
dose chemotherapy and adequate health for long-term follow-up. This must Include
normal WBC (2 4,0001pl). neutrophll count (2 1,50O/pl), platelet count (2
Institutional lower limit of normal), and LVEF (left ventricular ejection fraction by
institutional criteria); bilirubin within 1.5 times institutional upper limit of
normal; creatinine within 1.5 times institutional upper limit of normal; and no
serious disease other than breast cancer.

- Pregnant or nursing women may not participate. Men are ineligible. Women of
childbearing potential must be planning to use effective contraception.

- All patients must be informed of the Investigational nature of this study and give
written informed consent in accordance with institution and federal guidelines.

- At the time of registration, the date of institutional review board approval for this
study must be provided to the Statistical Center.
GenderFemale
AgesN/A
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesUnited States

Administrative Information[ + expand ][ + ]

NCT Number NCT00590785
Other Study ID Numbers96-041
Has Data Monitoring CommitteeNot Provided
Information Provided ByMemorial Sloan-Kettering Cancer Center
Study SponsorMemorial Sloan-Kettering Cancer Center
CollaboratorsCancer and Leukemia Group B
Investigators Principal Investigator: Clifford Hudis, MD Memorial Sloan-Kettering Cancer Center
Verification DateNovember 2013

Locations[ + expand ][ + ]

Memorial Sloan Kettering Cancer Center
New York, New York, United States, 10065