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A Study Of SU011248 Plus Paclitaxel Versus Bevacizumab Plus Paclitaxel In Patients With Advanced Breast Cancer

A Phase 3 Study Of SU011248 In Combination With Paclitaxel Versus Bevacizumab With Paclitaxel In The First-Line Advanced Disease Setting In Patients Having Breast Cancer

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00373256
Enrollment
488
Registered
2006-09-08
Start date
2006-11-30
Completion date
2011-08-31
Last updated
2012-09-10

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

Conditions

Breast Neoplasms

Keywords

Breast cancer, advanced, sunitinib, bevacizumab, paclitaxel, Phase 3

Brief summary

To compare treatment with SU011248 plus paclitaxel versus bevacizumab plus paclitaxel to determine which treatment works better against breast cancer

Detailed description

On May 27, 2009, the independent Data Monitoring Committee (DMC) reviewed the progress of Study A6181094. The DMC determined Study A6181094 had met pre-specified futility criteria and was unlikely to meet its primary endpoint to demonstrate a statistically significant improvement in progression-free survival (PFS) in patients treated with sunitinib plus paclitaxel versus bevacizumab plus paclitaxel. Pfizer notified clinical trial investigators involved in the study and regulatory agencies of these findings. Enrollment in this study has been stopped.

Interventions

DRUGSunitinib

Sunitinib 25 mg daily by oral capsules with titration up to 37.5 mg,

DRUGpaclitaxel

Paclitaxel 90 mg/m2 IV, 3 weekly doses every 28 days until progression or unacceptable toxicity.

DRUGbevacizumab

Bevacizumab 10 mg/kg IV every 2 weeks.

Sponsors

Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Diagnosis of advanced breast cancer. * Measurable disease as per RECIST (Response Evaluation Criterion) in Solid Tumors or bone-only disease. * ECOG (Eastern Cooperative Oncology Group) performance status 0 or 1.

Exclusion criteria

* No prior treatment with cytotoxics in the advanced disease setting. * HER2/neu positive disease unless trastuzumab was previously received or is contraindicated. * Treatment with a taxane in the adjuvant setting unless disease free interval \>12 months after end of treatment.

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free Survival (PFS)From date of randomization through Day 1 and every 8 weeks thereafter up to 18 months or deathTime from date of randomization to the date of the first documentation of objective tumor progression or death due to any cause, whichever occurred first. PFS = (first event date minus randomization date +1) divided by 30.4

Secondary

MeasureTime frameDescription
Duration of Response (DR)From date of randomization through Day 1 and every 8 weeks thereafter up to 18 months or death due to any causeDR=time from the first documentation of objective tumor response (CR or PR) that was subsequently confirmed to first documentation of objective disease progression or death due to any cause, whichever was first. DR was calculated as \[the date response ended (ie, date of progressive disease or death) minus first CR or PR date that was subsequently confirmed +1)\] divided by 30.4.
Overall Survival (OS)From date of randomization up to 5 years. Survival follow-up changed to 28-days after treatment discontinuation when study was discontinued.OS was defined as the time from date of randomization to death due to any cause. OS (in months) was calculated as (date of death minus randomization date +1) divided by 30.4.
Percentage of Participants Surviving at 1 and 2 YearsYear 1, Year 2Percentage of those surviving at the end of one year or end of 2 years from the first dose of study treatment.
European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (EORTC QLQ-C30)Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 monthsEORTC QLQ-C30: global health/QoL, functional domains (physical, role, cognitive, emotional, social), and symptom scales/items (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea). Recall period: past week; response range: not at all to very much, global/QOL range: very poor to excellent. Scale score range: 0 to 100. Higher functional/global QoL score = better functioning and higher symptom score = greater degree of symptoms.
Number of Participants With Objective ResponseFrom date of randomization through Day 1 and every 8 weeks thereafter up to 18 monthsObjective response = participants with confirmed complete response (CR) or partial response (PR) according to the Response Evaluation Criteria in Solid Tumors (RECIST). A CR was defined as the disappearance of all target lesions. A PR was defined as a \> = 30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions.
Euro Quality of Life-5 Dimension (EQ-5D)Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 monthsEQ-5D: health status in 5 dimensions (mobility, self-care, pain/discomfort, anxiety/depression, usual activities). Three-level scale (1=no problem, 2=some problem, and 3=extreme problem). A single score between 1 and 3 is generated for each domain. For each subject, the outcome rating on the 5 domains could be mapped to a single index through an algorithm. The index ranges between 0 and 1, with the higher score indicating a better health state perceived by the subject.
EQ - Visual Analog Scale (EQ-VAS)Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 monthsEQ-VAS score on the self-rated thermometer, indicating the patient's own assessment of their health status from 0 (worst) to 100 (best) imaginable health state.
BiomarkersDay 1 of Cycles 1 through 3 and 5, Day 8 of Cycle 1, and Day 15 of Cycle 1Concentrations of plasma proteins (eg, soluble Vascular Endothelial Growth Factor Receptor 2 \[VEGFR2\] and VEGFR3, VEGF-A, placental growth factor \[PlGF\], soluble KIT, and possibly soluble PDGFRβ and PDGF) that may be associated with angiogenesis and tumor proliferation.
EORTC QLQ Breast Cancer Module (BR23)Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 monthsBR23: measured disease related symptoms of dry mouth, eye pain, hair loss, hot flushes, attractiveness, future health, sexual activity, arm/shoulder pain, breast pain, swollen breast, and skin problems on the breast. Recall period: past week; response range: not at all to very much. Scale score range: 0 to 100. Higher symptom score = greater degree of symptoms.

Countries

Germany, Italy, Spain, United States

Participant flow

Participants by arm

ArmCount
Sunitinib + Paclitaxel
Starting sunitinib doses of 25 mg daily. After Cycle 1, escalation to 37.5 mg daily was permitted in the absence of complicated neutropenia and if all 3 Cycle 1 paclitaxel doses were successfully administered at 90 mg/m\^2, at discretion of the investigator. Paclitaxel could have been reduced to 65 mg/m\^2 based on tolerability; re-escalation to 80 or 90 mg/m\^2 upon recovery was permitted.
241
Bevacizumab + Paclitaxel
Bevacizumab 10 mg/kg; infusion duration according to standard of care. Paclitaxel starting dose of 90 mg/m\^2, as a 1 hour infusion. Paclitaxel could have been reduced to 65 mg/m\^2 based on tolerability; re-escalation to 80 or 90 mg/m\^2 upon recovery was permitted.
247
Total488

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event (AE)15
Overall StudyDeath98
Overall StudyLost to Follow-up21
Overall StudyObjective Progression or Relapse111104
Overall StudyOther73107
Overall StudyProtocol Violation02
Overall StudyRefused Treatment-Reason Other Than AE47
Overall StudyStudy Terminated by Sponsor4113

Baseline characteristics

CharacteristicSunitinib + PaclitaxelBevacizumab + PaclitaxelTotal
Age, Customized
18 to 44 years
38 Participants40 Participants78 Participants
Age, Customized
45 to 64 years
144 Participants137 Participants281 Participants
Age, Customized
more than 65 years
59 Participants70 Participants129 Participants
Sex: Female, Male
Female
240 Participants247 Participants487 Participants
Sex: Female, Male
Male
1 Participants0 Participants1 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
232 / 235239 / 242
serious
Total, serious adverse events
89 / 23585 / 242

Outcome results

Primary

Progression-Free Survival (PFS)

Time from date of randomization to the date of the first documentation of objective tumor progression or death due to any cause, whichever occurred first. PFS = (first event date minus randomization date +1) divided by 30.4

Time frame: From date of randomization through Day 1 and every 8 weeks thereafter up to 18 months or death

Population: The intent-to-treat (ITT) population included all patients who were randomized.

ArmMeasureValue (MEDIAN)
Sunitinib + PaclitaxelProgression-Free Survival (PFS)7.4 Months
Bevacizumab + PaclitaxelProgression-Free Survival (PFS)9.2 Months
p-value: 0.998695% CI: [1.1793, 2.2527]Log Rank
Secondary

Biomarkers

Concentrations of plasma proteins (eg, soluble Vascular Endothelial Growth Factor Receptor 2 \[VEGFR2\] and VEGFR3, VEGF-A, placental growth factor \[PlGF\], soluble KIT, and possibly soluble PDGFRβ and PDGF) that may be associated with angiogenesis and tumor proliferation.

Time frame: Day 1 of Cycles 1 through 3 and 5, Day 8 of Cycle 1, and Day 15 of Cycle 1

Population: ITT. Biomarker data were collected, but since the study was stopped early and there were too few events of OS, PFS, etc, data were not analyzed.

Secondary

Duration of Response (DR)

DR=time from the first documentation of objective tumor response (CR or PR) that was subsequently confirmed to first documentation of objective disease progression or death due to any cause, whichever was first. DR was calculated as \[the date response ended (ie, date of progressive disease or death) minus first CR or PR date that was subsequently confirmed +1)\] divided by 30.4.

Time frame: From date of randomization through Day 1 and every 8 weeks thereafter up to 18 months or death due to any cause

Population: ITT. DR was calculated for the subgroup of subjects with objective response. 78 subjects reported CR or PR response and were analyzed for DR in each treatment group.

ArmMeasureValue (MEDIAN)
Sunitinib + PaclitaxelDuration of Response (DR)6.3 Months
Bevacizumab + PaclitaxelDuration of Response (DR)14.8 Months
Secondary

EORTC QLQ Breast Cancer Module (BR23)

BR23: measured disease related symptoms of dry mouth, eye pain, hair loss, hot flushes, attractiveness, future health, sexual activity, arm/shoulder pain, breast pain, swollen breast, and skin problems on the breast. Recall period: past week; response range: not at all to very much. Scale score range: 0 to 100. Higher symptom score = greater degree of symptoms.

Time frame: Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 months

Population: ITT. BR23 evaluations were not analyzed since enrollment in this study was terminated early for futility at the first interim analysis.

Secondary

EQ - Visual Analog Scale (EQ-VAS)

EQ-VAS score on the self-rated thermometer, indicating the patient's own assessment of their health status from 0 (worst) to 100 (best) imaginable health state.

Time frame: Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 months

Population: ITT. EQ-VAS evaluations were not analyzed since enrollment in this study was terminated early for futility at the first interim analysis.

Secondary

European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (EORTC QLQ-C30)

EORTC QLQ-C30: global health/QoL, functional domains (physical, role, cognitive, emotional, social), and symptom scales/items (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea). Recall period: past week; response range: not at all to very much, global/QOL range: very poor to excellent. Scale score range: 0 to 100. Higher functional/global QoL score = better functioning and higher symptom score = greater degree of symptoms.

Time frame: Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 months

Population: ITT. EORTC QLQ-C30 evaluations were not analyzed since enrollment in this study was terminated early for futility.

Secondary

Euro Quality of Life-5 Dimension (EQ-5D)

EQ-5D: health status in 5 dimensions (mobility, self-care, pain/discomfort, anxiety/depression, usual activities). Three-level scale (1=no problem, 2=some problem, and 3=extreme problem). A single score between 1 and 3 is generated for each domain. For each subject, the outcome rating on the 5 domains could be mapped to a single index through an algorithm. The index ranges between 0 and 1, with the higher score indicating a better health state perceived by the subject.

Time frame: Day 1 of Cycles 1 through 7 and then odd-numbered cycles thereafter until 18 months

Population: ITT. EQ-5D evaluations were not analyzed since enrollment in this study was terminated early for futility at the first interim analysis.

Secondary

Number of Participants With Objective Response

Objective response = participants with confirmed complete response (CR) or partial response (PR) according to the Response Evaluation Criteria in Solid Tumors (RECIST). A CR was defined as the disappearance of all target lesions. A PR was defined as a \> = 30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions.

Time frame: From date of randomization through Day 1 and every 8 weeks thereafter up to 18 months

Population: ITT

ArmMeasureValue (NUMBER)
Sunitinib + PaclitaxelNumber of Participants With Objective Response78 participants
Bevacizumab + PaclitaxelNumber of Participants With Objective Response78 participants
95% CI: [26.4, 38.5]
95% CI: [26.3, 38.4]
Secondary

Overall Survival (OS)

OS was defined as the time from date of randomization to death due to any cause. OS (in months) was calculated as (date of death minus randomization date +1) divided by 30.4.

Time frame: From date of randomization up to 5 years. Survival follow-up changed to 28-days after treatment discontinuation when study was discontinued.

Population: ITT. The median OS for bevacizumab + paclitaxel at the time of data cut off was not reached; therefore, it could not be calculated.

ArmMeasureValue (MEDIAN)
Sunitinib + PaclitaxelOverall Survival (OS)17.6 Months
Bevacizumab + PaclitaxelOverall Survival (OS)NA Months
Secondary

Percentage of Participants Surviving at 1 and 2 Years

Percentage of those surviving at the end of one year or end of 2 years from the first dose of study treatment.

Time frame: Year 1, Year 2

Population: ITT.

ArmMeasureGroupValue (NUMBER)
Sunitinib + PaclitaxelPercentage of Participants Surviving at 1 and 2 YearsYear 176.8 percentage of participants
Sunitinib + PaclitaxelPercentage of Participants Surviving at 1 and 2 YearsYear 235.5 percentage of participants
Bevacizumab + PaclitaxelPercentage of Participants Surviving at 1 and 2 YearsYear 183.7 percentage of participants
Bevacizumab + PaclitaxelPercentage of Participants Surviving at 1 and 2 YearsYear 261.0 percentage of participants
Comparison: 1 year95% CI: [68.7, 83]
Comparison: 2 years95% CI: [20.9, 50.3]
Comparison: 1 year95% CI: [76, 89.1]
Comparison: 2 years95% CI: [43.2, 74.7]

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