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Gemcitabine Combinations in Metastatic Breast Cancer (MBC), 1st Line

Randomized Phase II Study of Biweekly Gemcitabine-Paclitaxel, Biweekly Gemcitabine-Carboplatin and Biweekly Gemcitabine-Cisplatin as First-Line Treatment in Metastatic Breast Cancer After Anthracycline Failure

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00191854
Enrollment
147
Registered
2005-09-19
Start date
2005-03-31
Completion date
2009-11-30
Last updated
2010-03-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer

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

DRUGgemcitabine

2500 milligrams per square meter (mg/m2), intravenous (IV), every 14 days x 8 cycles

DRUGpaclitaxel

150 mg/m2, IV, every 14 days x 8 cycles

DRUGcarboplatin

Area Under the Curve (AUC) 2.5, IV, every 14 days x 8 cycles

DRUGcisplatin

50 mg/m2, IV, every 14 days x 8 cycles

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No

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

MeasureTime frameDescription
Best Overall Responsebaseline 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

MeasureTime frameDescription
Number of Participants With a Time to Treatment Failure (TTTF) Eventrandomization 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 Responsetime 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 Survivalbaseline 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

ArmCount
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
Total147

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyDeath262329
Overall StudyLost to Follow-up755
Overall StudyScreen Failure001
Overall StudySponsor Decision001
Overall StudyWithdrawal by Subject423

Baseline characteristics

CharacteristicTotalGemcitabine + PaclitaxelGemcitabine + CarboplatinGemcitabine + Cisplatin
Age Continuous48.4 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 participants22 participants29 participants26 participants
Eastern Cooperative Oncology Group Performance Status
1 - Ambulatory, Restricted Strenuous Activity
69 participants27 participants18 participants24 participants
Eastern Cooperative Oncology Group Performance Status
Missing Data
1 participants0 participants0 participants1 participants
Menopausal Status
Missing Data
2 participants0 participants1 participants1 participants
Menopausal Status
Peri Menopausal
12 participants4 participants4 participants4 participants
Menopausal Status
Post Menopausal
93 participants34 participants26 participants33 participants
Menopausal Status
Pre-Menopausal
40 participants11 participants16 participants13 participants
Pathological Diagnosis
Adenocarcinoma
5 participants1 participants2 participants2 participants
Pathological Diagnosis
Carcinoma, Infiltrating Ductal
127 participants42 participants40 participants45 participants
Pathological Diagnosis
Carcinoma, Infiltrating Lobular
12 participants6 participants4 participants2 participants
Pathological Diagnosis
Carcinoma, Undifferentiated
1 participants0 participants1 participants0 participants
Pathological Diagnosis
Comedocarcinoma
1 participants0 participants0 participants1 participants
Pathological Diagnosis
Missing Data
1 participants0 participants0 participants1 participants
Race/Ethnicity
African
2 participants1 participants0 participants1 participants
Race/Ethnicity
Caucasian
21 participants8 participants6 participants7 participants
Race/Ethnicity
East Asian
92 participants30 participants30 participants32 participants
Race/Ethnicity
Hispanic
8 participants2 participants3 participants3 participants
Race/Ethnicity
West Asian (West Indian)
24 participants8 participants8 participants8 participants
Region of Enrollment
Brazil
14 participants5 participants5 participants4 participants
Region of Enrollment
China
76 participants25 participants25 participants26 participants
Region of Enrollment
India
24 participants8 participants8 participants8 participants
Region of Enrollment
Korea, Republic of
16 participants5 participants5 participants6 participants
Region of Enrollment
Mexico
6 participants1 participants2 participants3 participants
Region of Enrollment
Turkey
11 participants5 participants2 participants4 participants
Sex: Female, Male
Female
147 Participants49 Participants47 Participants51 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
48 / 4946 / 4750 / 50
serious
Total, serious adverse events
5 / 493 / 470 / 50

Outcome results

Primary

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.

ArmMeasureGroupValue (NUMBER)
Gemcitabine + PaclitaxelBest Overall ResponseEarly Death from Other Causes1 participants
Gemcitabine + PaclitaxelBest Overall ResponseStable Disease (SD)17 participants
Gemcitabine + PaclitaxelBest Overall ResponseUnknown4 participants
Gemcitabine + PaclitaxelBest Overall ResponseProgressive Disease (PD)14 participants
Gemcitabine + PaclitaxelBest Overall ResponsePartial Response (PR)12 participants
Gemcitabine + PaclitaxelBest Overall ResponseComplete Response (CR)1 participants
Gemcitabine + CarboplatinBest Overall ResponseUnknown1 participants
Gemcitabine + CarboplatinBest Overall ResponseComplete Response (CR)0 participants
Gemcitabine + CarboplatinBest Overall ResponsePartial Response (PR)8 participants
Gemcitabine + CarboplatinBest Overall ResponseStable Disease (SD)25 participants
Gemcitabine + CarboplatinBest Overall ResponseProgressive Disease (PD)11 participants
Gemcitabine + CarboplatinBest Overall ResponseEarly Death from Other Causes2 participants
Gemcitabine + CisplatinBest Overall ResponseProgressive Disease (PD)11 participants
Gemcitabine + CisplatinBest Overall ResponsePartial Response (PR)7 participants
Gemcitabine + CisplatinBest Overall ResponseComplete Response (CR)1 participants
Gemcitabine + CisplatinBest Overall ResponseEarly Death from Other Causes0 participants
Gemcitabine + CisplatinBest Overall ResponseStable Disease (SD)29 participants
Gemcitabine + CisplatinBest Overall ResponseUnknown3 participants
Secondary

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.

ArmMeasureValue (MEDIAN)
Gemcitabine + PaclitaxelDuration of Response5.8 months
Gemcitabine + CarboplatinDuration of Response3.2 months
Gemcitabine + CisplatinDuration of Response5.1 months
Secondary

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.

ArmMeasureValue (NUMBER)
Gemcitabine + PaclitaxelNumber of Participants With a Time to Treatment Failure (TTTF) Event15 participants
Gemcitabine + CarboplatinNumber of Participants With a Time to Treatment Failure (TTTF) Event21 participants
Gemcitabine + CisplatinNumber of Participants With a Time to Treatment Failure (TTTF) Event21 participants
Secondary

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.

ArmMeasureValue (MEDIAN)
Gemcitabine + PaclitaxelOverall Survival15.5 months
Gemcitabine + CarboplatinOverall Survival22.8 months
Gemcitabine + CisplatinOverall Survival20.1 months
Secondary

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.

ArmMeasureValue (MEDIAN)
Gemcitabine + PaclitaxelProgression Free Survival (PFS)4.8 months
Gemcitabine + CarboplatinProgression Free Survival (PFS)4.3 months
Gemcitabine + CisplatinProgression Free Survival (PFS)4.8 months

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026