Preoperative Cisplatin and Bevacizumab in ER-, PR-, Her-2 Negative Breast Cancer

Overview[ - collapse ][ - ]

Purpose The purpose of this study is to find out what effect taking cisplatin in combination with bevacizumab before surgery and then standard chemotherapy plus bevacizumab after surgery will have on participants with ER negative, PR negative and HER-2 negative breast cancer. Cisplatin is used to destroy cancer cells in many types of cancers, and has shown to be effective and have manageable side effects. Bevacizumab is an antibody, which is a protein that attacks a foreign substance in the body. Bevacizumab slows or stops cell growth in cancerous tumors by decreasing the blood supply to the tumors.
ConditionBreast Cancer
InterventionDrug: cisplatin
Drug: bevacizumab
Drug: doxorubicin
Drug: cyclophosphamide
Drug: paclitaxel
PhasePhase 2
SponsorMassachusetts General Hospital
Responsible PartyMassachusetts General Hospital
ClinicalTrials.gov IdentifierNCT00580333
First ReceivedDecember 20, 2007
Last UpdatedApril 29, 2013
Last verifiedApril 2013

Tracking Information[ + expand ][ + ]

First Received DateDecember 20, 2007
Last Updated DateApril 29, 2013
Start DateSeptember 2007
Estimated Primary Completion DateDecember 2013
Current Primary Outcome MeasuresTo determine the pathologic complete response rate after preoperative therapy with cisplatin and bevacizumab in ER-, PR-, HER2-negative early breast cancer. [Time Frame: 2 years] [Designated as safety issue: No]
Current Secondary Outcome Measures
  • To determine the clinical response rate, defined as the number of partial and complete responses, after preoperative therapy with cisplatin and bevacizumab in this patient population. [Time Frame: 2 years] [Designated as safety issue: No]
  • To determine the feasibility and toxicity of administering bevacizumab in combination with standard adjuvant chemotherapy. [Time Frame: 2 years] [Designated as safety issue: Yes]
  • To describe a panel of molecular assays for an association with clinical response and, if feasible, with pathologic complete response in ER-, PR-, HER2-negative subjects treated with cisplatin and bevacizumab in the preoperative setting. [Time Frame: 2 years] [Designated as safety issue: No]

Descriptive Information[ + expand ][ + ]

Brief TitlePreoperative Cisplatin and Bevacizumab in ER-, PR-, Her-2 Negative Breast Cancer
Official TitleA Phase II Trial of Preoperative Cisplatin and Bevacizumab in ER-, PR-, Her-2 Negative Breast Cancer
Brief Summary
The purpose of this study is to find out what effect taking cisplatin in combination with
bevacizumab before surgery and then standard chemotherapy plus bevacizumab after surgery
will have on participants with ER negative, PR negative and HER-2 negative breast cancer.
Cisplatin is used to destroy cancer cells in many types of cancers, and has shown to be
effective and have manageable side effects. Bevacizumab is an antibody, which is a protein
that attacks a foreign substance in the body. Bevacizumab slows or stops cell growth in
cancerous tumors by decreasing the blood supply to the tumors.
Detailed Description
- To prepare for surgery, a small "clip" will be placed into the tumor area so that the
surgeon can locate the site of the tumor at the time of surgery. This is a standard
procedure for breast cancer.

- The study drugs will be given in four 3-week cycles (about 3 months). Participants
will come into the clinic each day they receive study treatment intravenously.
Cisplatin will be given on day one of the treatment cycle (once every 3 weeks) for four
cycles. Bevacizumab will be given on day one of the treatment cycle for three cycles.

- On day one of each 3-week cycle a physical exam, routine blood tests and urine test
will be performed. 7-8 days after chemotherapy, blood tests and a hearing test will be
performed. A preoperative study visit will take place 7-10 days before surgery and a
physical exam, routine blood tests, EKG and an MRI of the breast will be performed.

- Surgery to remove the tumor will occur at least three weeks after the last dose of
cisplatin and is considered standard of care.

- Postoperative chemotherapy will begin at least three weeks after surgery. Everyone on
the research study will receive four 2-week cycles of doxorubicin and cyclophosphamide
plus bevacizumab. After the 8 weeks, the doctor will decide which of the following two
treatment regimens the participant will receive: Bevacizumab for four 2-week cycles
(once every two weeks) or; Paclitaxel plus bevacizumab for four 2-week cycles (once
every two weeks).

- At the end of the postoperative chemotherapy, the participant will return to the clinic
for a medical history, physical exam, vital signs, performance status, routine blood
tests, MUGA or Echo Scans, and a hearing test.
Study TypeInterventional
Study PhasePhase 2
Study DesignAllocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionBreast Cancer
InterventionDrug: cisplatin
Preoperatively: Given intravenously on day one of the treatment cycle (once every 3 weeks) for four cycles
Drug: bevacizumab
Preoperatively: Given intravenously on day 1 of the treatment cycle (once every three weeks) for three cycles Postoperatively: Intravenously for four 2-week cycles (once every two weeks) and after the 8 weeks (study doctor will determine course of treatment) for an additional four 2-week cycles with or with out paclitaxel
Drug: doxorubicin
Postoperative: Given intravenously for four 2-week cycles
Drug: cyclophosphamide
Postoperative: Given intravenously for four two-week cycles
Drug: paclitaxel
Postoperative: 8 weeks after postoperative chemotherapy regimen (study doctor will determine course of treatment) paclitaxel for four 2-week cycles (once every two weeks)
Study Arm (s)Experimental: Cisplatin/Avastin

Recruitment Information[ + expand ][ + ]

Recruitment StatusActive, not recruiting
Estimated Enrollment40
Estimated Completion DateDecember 2013
Estimated Primary Completion DateDecember 2010
Eligibility Criteria
Inclusion Criteria:

- All tumors must be ER-, PR- and HER2-negative

- Clinical stage T2 or T3, NO-3, MO. Subjects with inflammatory breast cancer are not
eligible

- For subjects with clinically negative axilla, a sentinel lymph node biopsy will be
performed either up front or after preoperative therapy at the discretion of the
subject's physicians; for subjects with a clinically positive axilla, a needle
aspiration or core biopsy will be performed to confirm the presence of metastatic
disease in the lymph nodes.

- 18 years of age or older

- Performance status of 0 or 1

- Use of an effective means of contraception in subjects of child-bearing potential

- Normal organ function as described in the protocol

Exclusion Criteria:

- Any prior cytotoxic chemotherapy or radiation for the current breast cancer

- HER2-negative ipsilateral breast recurrence, unless prior treatment consisted of
excision alone for DCIS or breast-conserving treatment and hormonal therapy for DCIS
or invasive cancer

- Life expectancy of less than 12 weeks

- Current, recent, or planned participation in an experimental durg study other than a
Genentech-sponsored bevacizumab cancer study

- Renal dysfunction for which exposure to cisplatin would require dose modifications

- Steroid dependent asthma

- Peripheral neuropathy of any etiology that exceeds grade 1

- Uncontrolled diabetes

- History of malignancy treated without curative intent

- Any other pre-existing medical condition that would represent toxicity in excess of
grade 1

- Inadequately controlled hypertension

- Any prior history of hypertensive crisis or hypertensive encephalopathy

- NYHA Grade II or greater congestive hear failure

- History of myocardial infarction or unstable angina within 12 months prior to study
enrollment

- Any history of stroke or transient ischemic attack at any time

- Known CNS disease

- Significant vascular disease

- Symptomatic peripheral vascular disease

- Evidence of bleeding diathesis or coagulopathy

- Major surgical procedure, open biopsy, or significant traumatic injury within 21 days
prior to study enrollment

- History of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess
within 6 months prior to study enrollment

- Serious, non-healing wound, ulcer or bone fracture

- Proteinuria at screening

- Known hypersensitivity to any component of bevacizumab

- Pregnant or lactating
GenderBoth
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesUnited States

Administrative Information[ + expand ][ + ]

NCT Number NCT00580333
Other Study ID Numbers06-202
Has Data Monitoring CommitteeYes
Information Provided ByMassachusetts General Hospital
Study SponsorMassachusetts General Hospital
CollaboratorsDana-Farber Cancer Institute
Beth Israel Deaconess Medical Center
Brigham and Women's Hospital
Genentech
Investigators Principal Investigator: Paula D. Ryan, MD Fox Chase Cancer Center
Verification DateApril 2013

Locations[ + expand ][ + ]

Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02115
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02115