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Primary Systemic Therapy in Operable/Locally Advanced Breast Cancer

Primary Systemic Therapy Using Sequential Docetaxel/Cyclophosphamide/Bevacizumab Followed by Doxorubicin in Operable/Locally Advanced Breast Cancer

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00203502
Enrollment
40
Registered
2005-09-20
Start date
2005-09-30
Completion date
2015-02-28
Last updated
2016-05-11

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

Conditions

Breast Cancer

Keywords

Operable and Locally advanced Breast Cancer

Brief summary

The main purpose of this study is to find out what effects taking the drug bevacizumab together with two chemotherapeutic agents, docetaxel and cyclophosphamide followed by doxorubicin alone before surgery will on breast cancer. Bevacizumab will be given for twelve weeks in combination with chemotherapy then it ill be held during the administration of doxorubicin. Twenty-eight to fifty-six days after undergoing surgery, all patients will receive nine three-weekly infusions of bevacizumab.

Detailed description

Prior to being enrolled in this study, they will undergo an evaluation to determine eligibility. The study doctor will obtain a complete medical history, complete a physical examination including blood pressure and heart rate. The doctor will also obtain a baseline ECG as well as blood tests (approximately two tablespoons of blood). In order to decrease the effects of food, exercise and the sleep/wake cycle variability, all blood samples must be taken between 8AM - 10AM and patients will need to fast (no food or drink) for 10 hours prior to the blood test. Patients will also need to strain from working out prior to the blood test. The study will ask for a list of current medications. Patients will not be eligible if they have a history of or now require long-term anticoagulant (blood thinner) therapy (i.e. Coumadin or anything patients may be taking to prevent blood clots) have an allergy to bevacizumab or any other drugs used in the study. Many of the following evaluations are commonly done to determine diagnosis and/or stage of breast cancer and may have already had some of all of them done. If the following procedures were not done within three weeks, they will need to be done again prior to receiving any study therapy. * Diagnosis of breast cancer by fine needle aspiration or core needle biopsy will be required for entry in this study. * Clip Placement - a clip will be placed in the tumor during the core biopsies as a marker to assist surgeons at the time of surgery. * Tumor Clip Placements - a caliper is similar to a ruler and is used to measure the tumor from the outside of the body instead of always having to use an ultrasound or MRI. * Tumor Ultrasound - this is a non-invasive exam that uses sound waves to produce a picture of your tumor. All study participants will be treated with bevacizumab 15 mg/kg plus docetaxel 75 mg/m2 and cyclophosphamide 500 mg/m2 every three weeks for a total of four treatments. Three weeks after the completion of this part of the treatment patients will start receiving doxorubicin 60 mg/m2 every three weeks for a total of four treatments. All these drugs will be given as intravenous infusion on the first day of each three-week period. Patients will come in for every three week visits and have a physical exam including blood pressure and heart rate. Medications lists will be taken and any side effects that may have been experienced. Tumor caliper measurements will be done and blood will be drawn at each of these visits. A mammogram and MUGA scan will be done again just prior to surgery. Patients will undergo tumor surgery approximately six months after treatment. Patients will need to visit the study physician one month after surgery for another physical examination including blood pressure and heart rate, an assessment of any side effects and a list of current medications.

Interventions

DRUGBevacizumab

IV 15mg/kg 21 days

DRUGCyclophosphamide

500mg per meter squared, IV every 21 days

DRUGDocetaxel

60 mg per meter squared, IV every 21 days

Sponsors

Genentech, Inc.
CollaboratorINDUSTRY
University of Arkansas
Lead SponsorOTHER

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
Yes

Inclusion criteria

* The diagnosis of breast cancer established by biopsy. * Normal kidney function * Normal LVEF evaluated by MUGA Scan * \>18 years of age * Good performance status defined by ECOG scale of 0 or 1 * Consent * Women of childbearing potential must have a negative pregnancy test. * Use of effective means of contraception in subjects of child-bearing potential while on treatment and for at least 3 months thereafter. * Peripheral Neuropathy: must be \< grade 1 * Hematologic (minimal values) * Absolute neutrophil count \>1,500/mm3 * Hemoglobin \>8.0 g/dl * Platelet count \>100,000/mm3 * Hepatic * Total bilirubin \<ULN * AST, ALT, Alkaline Phosphatase must be within range

Exclusion criteria

* Patients with locally advanced breast cancer with skin ulcerations * Stage IV breast cancer * Inflammatory breast cancer * Allergy to any component of the treatment regimen * Women who are breast feeding * Pregnancy or refusal to use effective contraception * Inability to comply with study and/or follow-up procedures. * Current, recent, or planned participation in a experimental drug study * Blood pressure of \>150/100 mmHg. Essential hypertension well controlled with anti hypertensives is not an exclusion criterion. * unstable angina * New York Heart Association Grade II or greater congestive heart failure * history of myocardial infarction within 6 months * history of stroke within 6 months * Clinical significant peripheral vascular disease * Evidence of bleeding diathesis or coagulopathy * Presence of central nervous system or brain metastasis * major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to day 0 * Minor surgical procedure such as fine needle aspirations or core biopsy within 7 days prior to day 0 * Pregnant or lactating * Urine protein: creatinine ratio \>1.0 at screening * History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to Day 0 * Serious, non-healing wound, ulcer, or bone fracture

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Pathological Complete Response.Participants were assessed during surgery, an average of one hourPathological complete response was defined as the absence of residual invasive and in situ cancer on hematoxylin and eosin evaluation of the resected breast.

Secondary

MeasureTime frameDescription
Number of Participants With Clinical Complete Response in Breast and the Axillary Lymph Nodes After the Completion of Chemotherapy and Bevacizumab.At completion of chemotherapy treatment, an average of one hourClinical complete response was defined using RECIST response categories as the clinical response to chemotherapy
Percentage of Participants With Grade 3 or 4 Adverse EventsAfter each chemotherapy infusion, approximately one hourPercent of participants who had at least one grade 3 or 4 adverse event
To Measure the Change in Left Ventricular Ejection Fraction (LVEF) From BaselineImmediately before treatment and 1 year after start of treatmentAbsolute change in LVEF, where LVEF values are measured in percentage units
Percentage of Participants With Pathologic Complete Response (pCR) Among Those With Triple Negative Breast Cancerat surgery, one daypCR rate for triple negative patients--percent

Countries

United States

Participant flow

Recruitment details

This study recruited patients from September 9, 2005 through January 17, 2008. Patients were recruited from hematology/oncology clinic at the Winthrop P. Rockefeller Cancer Institute of the University of Arkansas for Medical Sciences.

Participants by arm

ArmCount
Intervention: Drug:Docetaxel + Cyclophosphamide + Avastin
Docetaxel 75mg/m2 + Cyclophosphamide 500 mg/m2 \+ Avastin 15 mg/kg Q 3 weeks X 4 cycles Bevacizumab/Avastin: IV 15mg/kg 21 days Cyclophosphamide: 500mg per meter squared, IV every 21 days Doxorubicin: 60 mg per meter squared, IV every 21 days
40
Total40

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDeath1

Baseline characteristics

CharacteristicIntervention: Drug:Docetaxel + Cyclophosphamide + Avastin
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
11 Participants
Age, Categorical
Between 18 and 65 years
29 Participants
Age, Continuous45 years
Region of Enrollment
United States
40 participants
Sex: Female, Male
Female
40 Participants
Sex: Female, Male
Male
0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
19 / 39
serious
Total, serious adverse events
39 / 39

Outcome results

Primary

Percentage of Participants With Pathological Complete Response.

Pathological complete response was defined as the absence of residual invasive and in situ cancer on hematoxylin and eosin evaluation of the resected breast.

Time frame: Participants were assessed during surgery, an average of one hour

ArmMeasureValue (NUMBER)
Intervention: Drug:Docetaxel + Cyclophosphamide + AvastinPercentage of Participants With Pathological Complete Response.41 percentage of evaluable patients
Secondary

Number of Participants With Clinical Complete Response in Breast and the Axillary Lymph Nodes After the Completion of Chemotherapy and Bevacizumab.

Clinical complete response was defined using RECIST response categories as the clinical response to chemotherapy

Time frame: At completion of chemotherapy treatment, an average of one hour

Population: All participants evaluated surgically

ArmMeasureValue (NUMBER)
Intervention: Drug:Docetaxel + Cyclophosphamide + AvastinNumber of Participants With Clinical Complete Response in Breast and the Axillary Lymph Nodes After the Completion of Chemotherapy and Bevacizumab.53 percentage of pts w/ cCR
Secondary

Percentage of Participants With Grade 3 or 4 Adverse Events

Percent of participants who had at least one grade 3 or 4 adverse event

Time frame: After each chemotherapy infusion, approximately one hour

ArmMeasureValue (NUMBER)
Intervention: Drug:Docetaxel + Cyclophosphamide + AvastinPercentage of Participants With Grade 3 or 4 Adverse Events79 percentage of pts w/ grade 3/4 AE
Secondary

Percentage of Participants With Pathologic Complete Response (pCR) Among Those With Triple Negative Breast Cancer

pCR rate for triple negative patients--percent

Time frame: at surgery, one day

Population: Patients with triple negative breast cancer

ArmMeasureValue (NUMBER)
Intervention: Drug:Docetaxel + Cyclophosphamide + AvastinPercentage of Participants With Pathologic Complete Response (pCR) Among Those With Triple Negative Breast Cancer57 % pCR among triple negative pts
Secondary

To Measure the Change in Left Ventricular Ejection Fraction (LVEF) From Baseline

Absolute change in LVEF, where LVEF values are measured in percentage units

Time frame: Immediately before treatment and 1 year after start of treatment

ArmMeasureValue (MEAN)Dispersion
Intervention: Drug:Docetaxel + Cyclophosphamide + AvastinTo Measure the Change in Left Ventricular Ejection Fraction (LVEF) From Baseline-3.5 Percentage of LVEFStandard Deviation 7

Source: ClinicalTrials.gov · Data processed: Mar 18, 2026