Breast Cancer
Conditions
Brief summary
The gemcitabine-paclitaxel and gemcitabine-platinum combinations have shown promise in the treatments of MBC; however, the optimal dosing schedules for these combinations have not yet been determined. The primary objective of this study is to compare the response rates of the gemcitabine-paclitaxel, gemcitabine-carboplatin, and gemcitabine-cisplatin combinations when administered on a biweekly schedule in metastatic breast cancer.
Interventions
2500 milligrams per square meter (mg/m2), intravenous (IV), every 14 days x 8 cycles
150 mg/m2, IV, every 14 days x 8 cycles
Area Under the Curve (AUC) 2.5, IV, every 14 days x 8 cycles
50 mg/m2, IV, every 14 days x 8 cycles
Sponsors
Study design
Eligibility
Inclusion criteria
* Female patients with histological or cytological proven diagnosis of breast cancer * Stage IV disease * Performance Status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Scale * Patients had to have previously received anthracycline based regimens as a adjuvant therapy or neo-adjuvant chemotherapy and then progressed and developed metastatic disease * Adequate organ function
Exclusion criteria
* Prior chemotherapy for metastatic disease * Previous radiation therapy is allowed but must not have included whole pelvis radiation * Known or suspected brain metastasis. Serious concomitant disorders that would compromise the safety of the patient or compromise the patient's ability to complete the study, at the discretion of the investigator * Concurrent administration of any other tumor therapy, including cytotoxic chemotherapy, hormonal therapy and immunotherapy (including trastuzumab (Herceptin)) * Peripheral neuropathy of Common Toxicity Criteria (CTC) Grade greater than 1. History of significant neurological or mental disorder, including seizures or dementia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Best Overall Response | baseline to measured progressive disease (tumor assessments were performed every 4 cycles during study therapy, or 3 months during post-therapy until disease progression, death or up to 24 months after randomization) | Response using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Complete Response=disappearance of all target lesions; Partial Response=30% decrease in sum of longest diameter of target lesions; Progressive Disease=20% increase in sum of longest diameter of target lesions; Stable Disease=small changes that do not meet above criteria. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With a Time to Treatment Failure (TTTF) Event | randomization to date of documented disease progression, death on study, start of non-protocol-specified anticancer therapy, or therapy discontinuation due to toxicity, whichever occurred first (up to 6 months) | TTTF event was defined as documented disease progression, death on study, start of non-protocol-specified anticancer therapy, or therapy discontinuation due to toxicity. TTTF for patients who were still participating in study without treatment failure at time of analysis were treated as censored at date of last tumor assessment. TTTF for patients who had discontinued from therapy for reasons other than toxicity and who did not experience treatment failure prior to therapy discontinuation were treated as censored on day of study discontinuation. |
| Progression Free Survival (PFS) | baseline to measured progressive disease or death (tumor assessments were performed every 4 cycles during study therapy, or 3 months during post-therapy until disease progression, death, or up to 24 months after randomization) | PFS was defined as the time from randomizaton to the date of documented disease progression or death on study, whichever occurred first. PFS for participants who discontinued from the study or who had not progressed at the time of analysis were treated as censored at the date of the last tumor assessment. |
| Duration of Response | time of response to progressive disease or death (tumor assessments were performed every 4 cycles during study therapy, or 3 months during post-therapy until disease progression, death, or up to 24 months after randomization) | Duration of response was measured from time of first documentation of complete response (disappearance of all target lesions) or partial response (30% decrease in sum of longest diameter of target lesions), until date of PFS. Duration of response was censored on day of last tumor assessment for patients who had not progressed or who had discontinued study at time of analysis, and for cases where investigator determined patient had progressive disease and discontinued study therapy and/or started a new, non-protocol-specified anti-cancer therapy before documented disease progression. |
| Overall Survival | baseline to date of death from any cause (up to 34 months) | Overall survival time is defined as the time from the date of randomization to date of death due to any cause. Survival time is censored at the date of last contact for patients who are still alive or lost to follow-up. |
Countries
Brazil, China, India, Mexico, South Korea, Turkey (Türkiye)
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Gemcitabine + Paclitaxel Gemcitabine: 2500 milligrams per square meter (mg/m2), intravenous (IV), every 14 days x 8 cycles.
Paclitaxel: 150 mg/m2, IV, every 14 days x 8 cycles | 49 |
| Gemcitabine + Carboplatin Gemcitabine: 2500 milligrams per square meter (mg/m2), intravenous (IV), every 14 days x 8 cycles.
Carboplatin: Area Under the Curve (AUC) 2.5, IV, every 14 days x 8 cycles | 47 |
| Gemcitabine + Cisplatin Gemcitabine: 2500 milligrams per square meter (mg/m2), intravenous (IV), every 14 days x 8 cycles.
Cisplatin: 50 mg/m2, IV, every 14 days x 8 cycles | 51 |
| Total | 147 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Death | 26 | 23 | 29 |
| Overall Study | Lost to Follow-up | 7 | 5 | 5 |
| Overall Study | Screen Failure | 0 | 0 | 1 |
| Overall Study | Sponsor Decision | 0 | 0 | 1 |
| Overall Study | Withdrawal by Subject | 4 | 2 | 3 |
Baseline characteristics
| Characteristic | Total | Gemcitabine + Paclitaxel | Gemcitabine + Carboplatin | Gemcitabine + Cisplatin |
|---|---|---|---|---|
| Age Continuous | 48.4 years STANDARD_DEVIATION 8.9 | 49.8 years STANDARD_DEVIATION 8.8 | 46.0 years STANDARD_DEVIATION 6.9 | 49.2 years STANDARD_DEVIATION 10.3 |
| Eastern Cooperative Oncology Group Performance Status 0 - Fully Active | 77 participants | 22 participants | 29 participants | 26 participants |
| Eastern Cooperative Oncology Group Performance Status 1 - Ambulatory, Restricted Strenuous Activity | 69 participants | 27 participants | 18 participants | 24 participants |
| Eastern Cooperative Oncology Group Performance Status Missing Data | 1 participants | 0 participants | 0 participants | 1 participants |
| Menopausal Status Missing Data | 2 participants | 0 participants | 1 participants | 1 participants |
| Menopausal Status Peri Menopausal | 12 participants | 4 participants | 4 participants | 4 participants |
| Menopausal Status Post Menopausal | 93 participants | 34 participants | 26 participants | 33 participants |
| Menopausal Status Pre-Menopausal | 40 participants | 11 participants | 16 participants | 13 participants |
| Pathological Diagnosis Adenocarcinoma | 5 participants | 1 participants | 2 participants | 2 participants |
| Pathological Diagnosis Carcinoma, Infiltrating Ductal | 127 participants | 42 participants | 40 participants | 45 participants |
| Pathological Diagnosis Carcinoma, Infiltrating Lobular | 12 participants | 6 participants | 4 participants | 2 participants |
| Pathological Diagnosis Carcinoma, Undifferentiated | 1 participants | 0 participants | 1 participants | 0 participants |
| Pathological Diagnosis Comedocarcinoma | 1 participants | 0 participants | 0 participants | 1 participants |
| Pathological Diagnosis Missing Data | 1 participants | 0 participants | 0 participants | 1 participants |
| Race/Ethnicity African | 2 participants | 1 participants | 0 participants | 1 participants |
| Race/Ethnicity Caucasian | 21 participants | 8 participants | 6 participants | 7 participants |
| Race/Ethnicity East Asian | 92 participants | 30 participants | 30 participants | 32 participants |
| Race/Ethnicity Hispanic | 8 participants | 2 participants | 3 participants | 3 participants |
| Race/Ethnicity West Asian (West Indian) | 24 participants | 8 participants | 8 participants | 8 participants |
| Region of Enrollment Brazil | 14 participants | 5 participants | 5 participants | 4 participants |
| Region of Enrollment China | 76 participants | 25 participants | 25 participants | 26 participants |
| Region of Enrollment India | 24 participants | 8 participants | 8 participants | 8 participants |
| Region of Enrollment Korea, Republic of | 16 participants | 5 participants | 5 participants | 6 participants |
| Region of Enrollment Mexico | 6 participants | 1 participants | 2 participants | 3 participants |
| Region of Enrollment Turkey | 11 participants | 5 participants | 2 participants | 4 participants |
| Sex: Female, Male Female | 147 Participants | 49 Participants | 47 Participants | 51 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 48 / 49 | 46 / 47 | 50 / 50 |
| serious Total, serious adverse events | 5 / 49 | 3 / 47 | 0 / 50 |
Outcome results
Best Overall Response
Response using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Complete Response=disappearance of all target lesions; Partial Response=30% decrease in sum of longest diameter of target lesions; Progressive Disease=20% increase in sum of longest diameter of target lesions; Stable Disease=small changes that do not meet above criteria.
Time frame: baseline to measured progressive disease (tumor assessments were performed every 4 cycles during study therapy, or 3 months during post-therapy until disease progression, death or up to 24 months after randomization)
Population: Number of all randomized participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Gemcitabine + Paclitaxel | Best Overall Response | Early Death from Other Causes | 1 participants |
| Gemcitabine + Paclitaxel | Best Overall Response | Stable Disease (SD) | 17 participants |
| Gemcitabine + Paclitaxel | Best Overall Response | Unknown | 4 participants |
| Gemcitabine + Paclitaxel | Best Overall Response | Progressive Disease (PD) | 14 participants |
| Gemcitabine + Paclitaxel | Best Overall Response | Partial Response (PR) | 12 participants |
| Gemcitabine + Paclitaxel | Best Overall Response | Complete Response (CR) | 1 participants |
| Gemcitabine + Carboplatin | Best Overall Response | Unknown | 1 participants |
| Gemcitabine + Carboplatin | Best Overall Response | Complete Response (CR) | 0 participants |
| Gemcitabine + Carboplatin | Best Overall Response | Partial Response (PR) | 8 participants |
| Gemcitabine + Carboplatin | Best Overall Response | Stable Disease (SD) | 25 participants |
| Gemcitabine + Carboplatin | Best Overall Response | Progressive Disease (PD) | 11 participants |
| Gemcitabine + Carboplatin | Best Overall Response | Early Death from Other Causes | 2 participants |
| Gemcitabine + Cisplatin | Best Overall Response | Progressive Disease (PD) | 11 participants |
| Gemcitabine + Cisplatin | Best Overall Response | Partial Response (PR) | 7 participants |
| Gemcitabine + Cisplatin | Best Overall Response | Complete Response (CR) | 1 participants |
| Gemcitabine + Cisplatin | Best Overall Response | Early Death from Other Causes | 0 participants |
| Gemcitabine + Cisplatin | Best Overall Response | Stable Disease (SD) | 29 participants |
| Gemcitabine + Cisplatin | Best Overall Response | Unknown | 3 participants |
Duration of Response
Duration of response was measured from time of first documentation of complete response (disappearance of all target lesions) or partial response (30% decrease in sum of longest diameter of target lesions), until date of PFS. Duration of response was censored on day of last tumor assessment for patients who had not progressed or who had discontinued study at time of analysis, and for cases where investigator determined patient had progressive disease and discontinued study therapy and/or started a new, non-protocol-specified anti-cancer therapy before documented disease progression.
Time frame: time of response to progressive disease or death (tumor assessments were performed every 4 cycles during study therapy, or 3 months during post-therapy until disease progression, death, or up to 24 months after randomization)
Population: Randomized patients who had either a complete response or partial response. Censored patients: Gemcitabine + Paclitaxel = 4; Gemcitabine + Carboplatin = 4; Gemcitabine + Cisplatin = 14.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Gemcitabine + Paclitaxel | Duration of Response | 5.8 months |
| Gemcitabine + Carboplatin | Duration of Response | 3.2 months |
| Gemcitabine + Cisplatin | Duration of Response | 5.1 months |
Number of Participants With a Time to Treatment Failure (TTTF) Event
TTTF event was defined as documented disease progression, death on study, start of non-protocol-specified anticancer therapy, or therapy discontinuation due to toxicity. TTTF for patients who were still participating in study without treatment failure at time of analysis were treated as censored at date of last tumor assessment. TTTF for patients who had discontinued from therapy for reasons other than toxicity and who did not experience treatment failure prior to therapy discontinuation were treated as censored on day of study discontinuation.
Time frame: randomization to date of documented disease progression, death on study, start of non-protocol-specified anticancer therapy, or therapy discontinuation due to toxicity, whichever occurred first (up to 6 months)
Population: Number of randomized patients. Censored patients: Gemcitabine + Paclitaxel = 34; Gemcitabine + Carboplatin = 26; Gemcitabine + Cisplatin = 30.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Gemcitabine + Paclitaxel | Number of Participants With a Time to Treatment Failure (TTTF) Event | 15 participants |
| Gemcitabine + Carboplatin | Number of Participants With a Time to Treatment Failure (TTTF) Event | 21 participants |
| Gemcitabine + Cisplatin | Number of Participants With a Time to Treatment Failure (TTTF) Event | 21 participants |
Overall Survival
Overall survival time is defined as the time from the date of randomization to date of death due to any cause. Survival time is censored at the date of last contact for patients who are still alive or lost to follow-up.
Time frame: baseline to date of death from any cause (up to 34 months)
Population: Number of randomized patients. Censored patients: Gemcitabine + Paclitaxel = 23; Gemcitabine + Carboplatin = 24; Gemcitabine + Cisplatin = 22.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Gemcitabine + Paclitaxel | Overall Survival | 15.5 months |
| Gemcitabine + Carboplatin | Overall Survival | 22.8 months |
| Gemcitabine + Cisplatin | Overall Survival | 20.1 months |
Progression Free Survival (PFS)
PFS was defined as the time from randomizaton to the date of documented disease progression or death on study, whichever occurred first. PFS for participants who discontinued from the study or who had not progressed at the time of analysis were treated as censored at the date of the last tumor assessment.
Time frame: baseline to measured progressive disease or death (tumor assessments were performed every 4 cycles during study therapy, or 3 months during post-therapy until disease progression, death, or up to 24 months after randomization)
Population: Number of randomized patients. Censored patients: Gemcitabine + Paclitaxel = 20; Gemcitabine + Carboplatin = 18; Gemcitabine + Cisplatin = 28.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Gemcitabine + Paclitaxel | Progression Free Survival (PFS) | 4.8 months |
| Gemcitabine + Carboplatin | Progression Free Survival (PFS) | 4.3 months |
| Gemcitabine + Cisplatin | Progression Free Survival (PFS) | 4.8 months |