Study Of Abraxane® And Carboplatin As First-Line Treatment For Triple Negative Metastatic Breast Cancer

Overview[ - collapse ][ - ]

Purpose Taxanes (such as paclitaxel) are highly active to treat breast cancer. Abraxane® (nanoparticle albumin-bound paclitaxel) compared to standard paclitaxel improves efficacy and tolerability. When combined with a taxane, platinum agents improve response in metastatic breast cancer, with carboplatin conferring less toxicity than cisplatin. The investigators hypothesize that the combination of weekly Abraxane® and carboplatin will lengthen time to progression without producing intolerable toxicity.
ConditionMetastatic Breast Cancer
InterventionDrug: Abraxane
Drug: Carboplatin
PhasePhase 2
SponsorDuke University
Responsible PartyDuke University
ClinicalTrials.gov IdentifierNCT01207102
First ReceivedSeptember 10, 2010
Last UpdatedJuly 9, 2013
Last verifiedJuly 2013

Tracking Information[ + expand ][ + ]

First Received DateSeptember 10, 2010
Last Updated DateJuly 9, 2013
Start DateAugust 2011
Estimated Primary Completion DateDecember 2014
Current Primary Outcome MeasuresPFS [Time Frame: PFS is defined as the interval from study registration to disease progression or death due to any cause, whichever comes first] [Designated as safety issue: No]The primary objective of the trial is to statistically test whether Abraxane® and carboplatin can improve progression-free survival (PFS) as compared to historical controls.
Current Secondary Outcome MeasuresTo assess the safety and tolerability of a combination regimen of weekly Abraxane® and carboplatin to treat women with "triple negative" Stage IV metastatic breast cancer [Time Frame: 2 years] [Designated as safety issue: Yes]The proportion of patients experiencing any neurotoxicity will be tabulated by grade. The proportion of patients experiencing ≥ grade 3 non-hematologic toxicities (excluding neurotoxicity) and the proportion of patients experiencing ≥ grade 3 hematologic toxicities will be calculated with their exact 80% confidence intervals.

Descriptive Information[ + expand ][ + ]

Brief TitleStudy Of Abraxane® And Carboplatin As First-Line Treatment For Triple Negative Metastatic Breast Cancer
Official TitleA Phase II Study of Abraxane® and Carboplatin as First-line Treatment for "Triple Negative" (Demonstrating no Expression for Estrogen, Progesterone, or Human Epidermal Growth Factor Receptor 2 (HER2)Receptors) Metastatic Breast Cancer
Brief Summary
Taxanes (such as paclitaxel) are highly active to treat breast cancer. Abraxane®
(nanoparticle albumin-bound paclitaxel) compared to standard paclitaxel improves efficacy
and tolerability. When combined with a taxane, platinum agents improve response in
metastatic breast cancer, with carboplatin conferring less toxicity than cisplatin. The
investigators hypothesize that the combination of weekly Abraxane® and carboplatin will
lengthen time to progression without producing intolerable toxicity.
Detailed Description
Paclitaxel and cisplatin are well-recognized for their activity in treating a variety of
tumors including breast cancer. As cytotoxins, they have been studied alone and in
combination with other chemotherapeutic agents, and have been incorporated into treatment
regimens for women who fail previous anthracycline-based therapies. Although both agents
are notable for favorable response rates, they are also associated with a variety of adverse
events, some of which may be dose-limiting and having a negative effect on quality of life:
myelosuppression, nausea and vomiting, diarrhea, stomatitis/mucositis, short- and long-term
neuropathy, nephrotoxicity, alopecia and hypersensitivity reactions.

As second-generation compounds, Abraxane® and carboplatin have been shown to improve
response rates and may mediate some of the toxicities associated with paclitaxel and
cisplatin, respectively. Of particular interest is Abraxane's potential to reduce allergic
reactions associated with other taxanes.

This study combines these two agents: primarily, to evaluate progression-free survival; and
secondarily, to assess the feasibility and tolerability of this regimen to treat poor
prognosis metastatic breast cancer patients.
Study TypeInterventional
Study PhasePhase 2
Study DesignEndpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionMetastatic Breast Cancer
InterventionDrug: Abraxane
Abraxane® 100 mg/m2 IV over 30 min days 1,8,15 every 28 days
Other Names:
paclitaxel protein-bound particles for injectable suspensionDrug: Carboplatin
area under curve(AUC)=2 over 15 minutes days 1,8,15 every 28 days
Other Names:
Paraplatin
Study Arm (s)Experimental: Abraxane, Carboplatin
Abraxane 100mg/m2 IV days 1, 8 and 15 of a 28 day cycle Carboplatin area under the concentration curve, (AUC)2 IV days 1,8, and 15 of a 28 day Cycle

Recruitment Information[ + expand ][ + ]

Recruitment StatusActive, not recruiting
Estimated Enrollment70
Estimated Completion DateDecember 2014
Estimated Primary Completion DateDecember 2013
Eligibility Criteria
Inclusion Criteria:

- Patients with histologically or cytologically confirmed diagnosis of metastatic
(Stage IV) breast cancer;

- Measurable disease according to Response Evaluation Criteria in Solid Tumors
(RECIST);

- "Triple negative" disease defined as "tumor demonstrating no expression for estrogen,
progesterone or HER2 receptors." (No expression is categorized as ≤ 10% of cells
staining or Allred ≤ 2);

- Aged 18 years or older;

- Eastern Cooperative Oncology Group (ECOG)ECOG/Zubrod performance status of 0 or 1;
life expectancy ≥ 3 months;

- No prior chemotherapy for metastatic disease.

- At least 6 months must have elapsed since prior adjuvant chemotherapy.

- Laboratory tests performed within 14 days of study entry showing:

- Granulocytes ≥ 1,500/µL;

- Platelets ≥ 100,000/µL;

- Hemoglobin ≥ 9.0 gm/dL;

- Total bilirubin ≤ institutional upper limit of normal (ULN);

- Aspartate transaminase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times ULN;

- Alkaline phosphatase ≤ 5 times ULN;

- Estimated creatinine clearance ≥ 60 mL/min.

- Urine protein:creatinine ratio ≤ 1.0. or 24 hour urine protein collection
demonstrating ≤ 1 gram of protein per 24 hours to be eligible.

- left ventricular ejection fraction (LVEF) ≥ 50% by multiple gated acquisition scan
(MUGA)/Echocardiogram;

- Informed consent to receive protocol treatment:

- Cognitive and communication skills adequate to comply with study and/or follow-up
procedures;

- Geographic proximity and ability to comply with weekly study visits for the duration
of the treatment;

- No reproductive potential:

- If pre-menopausal - Negative serum pregnancy test within 3 days prior to
initiation of protocol-based treatment and patient agrees to use contraceptive
method (abstinence, intrauterine device, barrier device with spermicide or
surgical sterilization) during and for 3 months after completion of protocol
treatment;

- If post-menopausal - Amenorrhea for ≥ 12 months or follicle stimulating hormone
(FSH) within post menopausal range.

Exclusion Criteria:

- Pregnant or breast feeding.

- Prior treatment with Abraxane® or carboplatin.

- Prior chemotherapy for metastatic breast cancer.

- Known hypersensitivity to any component of any study drug.

- Active infection.

- Current neuropathy ≥ grade 2.

- central nervous system (CNS) metastases as determined by head CT with contrast or
head MRI.

- Uncontrolled congestive heart failure (CHF), or history of myocardial ischemia (MI),
unstable angina, stroke, or transient ischemia within previous 6 months.

- Uncontrolled serious contraindicated medical condition or illness.
GenderFemale
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesUnited States, China

Administrative Information[ + expand ][ + ]

NCT Number NCT01207102
Other Study ID NumbersPro00019321
Has Data Monitoring CommitteeNo
Information Provided ByDuke University
Study SponsorDuke University
CollaboratorsCelgene Corporation
Investigators Study Chair: Kimberly L Blackwell, MD Duke University
Verification DateJuly 2013

Locations[ + expand ][ + ]

Duke University Medical Center
Durham, North Carolina, United States, 27710
Peking University School of Oncology/Beijing Cancer Hospital
Beijing, China, 100142