Breast Cancer
Conditions
Keywords
stage I breast cancer, stage II breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, stage IV breast cancer
Brief summary
RATIONALE: Drugs used in chemotherapy, such as docetaxel, work in different ways to stop tumor cells from dividing so they stop growing or die. Giving a chemotherapy drug before surgery may shrink the tumor so that it can be removed. PURPOSE: This phase II trial is studying how well neoadjuvant docetaxel works in treating women who are undergoing surgery for breast cancer.
Detailed description
OBJECTIVES: Primary * Correlate baseline and change in apoptosis and proliferation with clinical and pathological response to neoadjuvant docetaxel followed by surgery in women with newly diagnosed breast cancer. Secondary * Correlate baseline and change in fludeoxyglucose F 18 positron emission tomography uptake with clinical and pathological response in patients treated with this regimen. * Correlate baseline and change in gene expression profiles with clinical and pathological response in patients treated with this regimen. * Correlate baseline and change in tumor and serum proteomic patterns with clinical and pathological response in patients treated with this regimen. OUTLINE: This is a pilot study. * Neoadjuvant chemotherapy: Patients receive docetaxel IV over 1 hour on day 1 and pegfilgrastim subcutaneously (SC) on day 2. Treatment repeats every 14 days for 4 courses in the absence of disease progression or unacceptable toxicity. * Surgery: Within 2-4 weeks after the completion of 4 courses of docetaxel, patients undergo breast-conserving surgery or a mastectomy at the discretion of the treating surgeon. Patients may receive additional chemotherapy prior to surgery at the discretion of the treating physician. * Adjuvant chemotherapy: Patients receive adjuvant chemotherapy at the discretion of the treating physician. * Radiotherapy: Patients undergo radiotherapy after the completion of all chemotherapy at the discretion of the treating physician. * Hormonal therapy: Patients with estrogen- and/or progesterone-positive tumors receive hormonal therapy after the completion of chemotherapy and all local therapies at the discretion of the treating physician. Patients are followed every 6 months. PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study.
Interventions
BIOLOGICALpegfilgrastim
6 mg injection on day 1 of each cycle
DRUGdocetaxel
100 mg per meter-squared, every 14 days for 4 cycles
PROCEDUREconventional surgery
lumpectomy or mastectomy at end of treatment
PROCEDUREneoadjuvant therapy
treatment prior to definitive breast surgery
Sponsors
National Cancer Institute (NCI)
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically confirmed infiltrating carcinoma of the breast * Unresected clinical stage T1c, T2, T3, or T4 lesion, any N * Newly diagnosed disease * Diagnostic mammogram and an ultrasound of the affected breast within 3 months before study entry * Mammogram of the contralateral breast within 6 months before study entry * Clinically measurable disease * Hormone receptor status: * Immunohistochemical staining for estrogen and progesterone and HER2/neu receptors must be obtained on initial diagnostic material PATIENT CHARACTERISTICS: Age * 18 and over Sex * Female Menopausal status * Not specified Performance status * ECOG 0-2 Life expectancy * Not specified Hematopoietic * Absolute neutrophil count at least 1,500/mm\^3 * Platelet count at least 100,000/mm\^3 * Hemoglobin at least 8 g/dL Hepatic * Bilirubin no greater than 1.5 times normal Renal * Creatinine no greater than 1.5 times normal Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No medical condition that would put the patient at unnecessary risk of potentially serious complications during study participation PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * No prior chemotherapy for current breast cancer Endocrine therapy * At least 1 month since prior tamoxifen or raloxifene for breast cancer prevention * No prior endocrine therapy for current breast cancer Radiotherapy * No prior radiotherapy for current breast cancer Surgery * Not specified
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Correlation between change in apoptosis and proliferation with response after definitive surgery | Definitive surgery |
Secondary
| Measure | Time frame |
|---|---|
| Correlation between change in fludeoxyglucose F 18 positron emission tomography uptake with response after definitive surgery | Definitive surgery |
Countries
United States
Outcome results
None listed