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A Study of Avastin (Bevacizumab) Plus Herceptin (Trastuzumab) in Patients With Primary Inflammatory HER2-Positive Breast Cancer.

An Open Label Study to Assess the Rate of Pathological Complete Response in Patients With Primary Inflammatory HER2-positive Breast Cancer Treated With Avastin + Herceptin Based Chemotherapy

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00717405
Enrollment
52
Registered
2008-07-17
Start date
2008-10-31
Completion date
2014-10-31
Last updated
2016-08-02

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

Conditions

Breast Cancer

Brief summary

This single arm study will assess the efficacy and safety of preoperative treatment with Avastin combined with Herceptin-based chemotherapy in patients with primary inflammatory HER2-positive breast cancer. Patients will be treated with a total of 8 cycles of pre-operative chemotherapy + Avastin + Herceptin. The anticipated time on study treatment is 3-12 months, and the target sample size is \<100 individuals.

Interventions

DRUGStandard chemotherapy

As prescribed

DRUGbevacizumab [Avastin]

15mg/kg iv 3 weekly in cycles 1-8

8mg/kg iv loading dose followed by 6mg/kg iv 3 weekly in cycles 5-8.

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

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

* adult females, \>=18 years of age; * inflammatory breast cancer; * HER2-positive tumors; * performance status 0-2.

Exclusion criteria

* metastases; * previous treatment with chemotherapy, radiation therapy or hormone therapy for a breast tumor; * clinically significant cardiovascular disease, or history of thrombotic disorders.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With a Pathological Complete Response (PCR) According to the Sataloff ClassificationFrom baseline through Week 25 (Up to 6 months)PCR was assessed at the time of definitive surgery according to Sataloff classification and centrally reviewed by an independent committee under blinded conditions. Pathological response was defined based on the therapeutic response at the primary tumor site and axillary lymph nodes. Primary tumor response criteria were as follows: T-A (Total / near total therapeutic effect), T-B (Subjectively greater than \[\>\] 50 percent \[%\] therapeutic effect but less than \[\<\] T-A), T-C (\<50% therapeutic effect, but effect evident), T-D (No therapeutic effect). Axillary lymph node response: N-A (Evidence of therapeutic effect, no metastases), N-B (No therapeutic effect, no nodal metastases), N-C (Nodal metastasis but evident therapeutic effect), N-D (Nodal metastasis with no therapeutic effect). T-A and N-A or T-A and N-B responses were defined as PCR and all other tumor responses as non-responders. Participants with missing values were considered as non-responders.

Secondary

MeasureTime frameDescription
Percentage of Participants Who Were Responders Based on Inflammatory Signs From Baseline at Cycle 5 and Final Treatment VisitBaseline, Cycle 5 (Week 15), Neo-adjuvant treatment final visit (Week 25)Breast tumor was physically evaluated during the study which included assessment for inflammatory signs and for overall clinical response. Participant with response from baseline based on inflammatory signs at Cycle 5 and final treatment visit were presented.
Percentage of Participants Who Were Responders Based on Overall Clinical Response From Baseline at Cycle 5 and Final Treatment VisitBaseline, Cycle 5 (Week 15), Neo-adjuvant treatment final visit (Week 25)Breast tumor was physically evaluated during the study which included assessment for inflammatory signs and for overall clinical response. Participant with response from baseline based on overall clinical response at Cycle 5 and final treatment visit were presented.
Number of Participants Who Underwent MastectomyAnytime between Week 26 and Week 29Surgery included a mastectomy with axillary node dissection and had to be performed at least 4 weeks after the last infusion of neoadjuvant bevacizumab treatment.
Percentage of Participants With Macroscopically Visible TumorAnytime between Week 26 and Week 29Local pathologists assessed the tumor whether it was macroscopically visible or not and percentage of participants for whom the tumor was macroscopically visible was reported.
Percentage of Participants Who Underwent Lymph Node ResectionAnytime between Week 26 and Week 29Among the participants who were planned to undergo mastectomy, lymph node resection was also performed by the physician depending up on the participant's breast cancer grades.
Breast Cancer Marker CA15.3 at Baseline, Neoadjuvant Final Visit and Change From Baseline at Neoadjuvant Final VisitBaseline, Neoadjuvant Final Visit (Week 25)
Percentage of Participants With a PCR According to the Chevallier ClassificationFrom baseline through Week 25 (Up to 6 months)PCR was assessed at the time of definitive surgery according to Chevallier classification and centrally reviewed by an independent committee under blinded conditions. The Chevallier classification for grading of therapeutic effect related to the primary tumor site and axillary lymph nodes was defined by microscopic changes as follows - Grade 1: Disappearance of all tumors either in the breast or in the nodes, Grade 2: Persistence of carcinoma in situ in the breast only and no nodal invasion, Grade 3: Presence of invasive carcinoma with stromal alteration, Grade 4: Presence of invasive carcinoma without modification. Grade 1 response was considered as PCR. Participants with missing values were considered as non-responders.
Disease Free Survival (DFS) DurationUp to 5 YearsDFS was estimated using Kaplan-Meier method.
Percentage of Participants Who Were Recurrence Free at 3 and 5 Years3, 5 yearsA participant was considered recurrence free if the participant did not experience local or regional recurrence (wall or axillaries nodes), or occurrence of distant metastases (including soft tissue and distal lymph nodes).
Recurrence Free Survival (RFS) DurationUp to 5 YearsRFS was estimated using Kaplan-Meier method.
Percentage of Participants Who Were Alive at 3 and 5 Years3, 5 years
Overall Survival (OS) DurationUp to 5 yearsOS was defined as the time from the first administration of neoadjuvant treatment to death of any cause. OS was estimated using Kaplan-Meier method.
Percentage of Participants Who Were Disease Free at 3 and 5 Years3, 5 yearsA participant was considered disease free if the participant did not experience any of the following events: local recurrence in the ipsilateral breast following lumpectomy, regional recurrence, distant recurrence, contralateral breast cancer, second primary cancer (other than squamous or basal cell carcinoma of the skin, melanoma in situ, carcinoma in situ of the cervix, colon carcinoma in situ, or lobular carcinoma in situ of the breast), or death from any cause.

Countries

France

Participant flow

Participants by arm

ArmCount
Bevacizumab + Trastuzumab
Neoadjuvant treatment (Cycles 1-8, 3-week cycle): Participants received 15 mg/kg IV bevacizumab q3w for 8 cycles, 4 cycles of 500 mg/m\^2 IV 5-fluorouracil, 100 mg/m\^2 IV epirubicin, and 500 mg/m\^2 IV cyclophosphamide, q3w, followed by 4 cycles of 100 mg/m\^2 IV docetaxel q3w plus trastuzumab (loading dose of 8 mg/kg and then 6 mg/kg q3w). Participants underwent surgery (mastectomy) after neoadjuvant treatment, maintaining trastuzumab (6 mg/kg). Adjuvant treatment: Participants received radiotherapy 2-4 weeks after surgery and lasted for 4-6 weeks, 6 mg/kg IV trastuzumab q3w and 15 mg/kg IV bevacizumab q3w administered along with/after the radiotherapy (administered up to a cumulative \[neoadjuvant + adjuvant\] total of 18 injections each. Hormonal therapy (at investigator discretion) after the end of radiotherapy was administered for 5 years, if participant was hormone receptor positive.
52
Total52

Baseline characteristics

CharacteristicBevacizumab + Trastuzumab
Age, Continuous51.48 years
STANDARD_DEVIATION 9.78
Sex: Female, Male
Female
52 Participants
Sex: Female, Male
Male
0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
52 / 52
serious
Total, serious adverse events
20 / 52

Outcome results

Primary

Percentage of Participants With a Pathological Complete Response (PCR) According to the Sataloff Classification

PCR was assessed at the time of definitive surgery according to Sataloff classification and centrally reviewed by an independent committee under blinded conditions. Pathological response was defined based on the therapeutic response at the primary tumor site and axillary lymph nodes. Primary tumor response criteria were as follows: T-A (Total / near total therapeutic effect), T-B (Subjectively greater than \[\>\] 50 percent \[%\] therapeutic effect but less than \[\<\] T-A), T-C (\<50% therapeutic effect, but effect evident), T-D (No therapeutic effect). Axillary lymph node response: N-A (Evidence of therapeutic effect, no metastases), N-B (No therapeutic effect, no nodal metastases), N-C (Nodal metastasis but evident therapeutic effect), N-D (Nodal metastasis with no therapeutic effect). T-A and N-A or T-A and N-B responses were defined as PCR and all other tumor responses as non-responders. Participants with missing values were considered as non-responders.

Time frame: From baseline through Week 25 (Up to 6 months)

Population: ITT population.

ArmMeasureValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants With a Pathological Complete Response (PCR) According to the Sataloff Classification63.46 percentage of participants
Secondary

Breast Cancer Marker CA15.3 at Baseline, Neoadjuvant Final Visit and Change From Baseline at Neoadjuvant Final Visit

Time frame: Baseline, Neoadjuvant Final Visit (Week 25)

Population: Safety population: Number of participants included all the participants who received at least one infusion of bevacizumab. n included participants who were evaluable at that time point.

ArmMeasureGroupValue (MEAN)Dispersion
Bevacizumab + TrastuzumabBreast Cancer Marker CA15.3 at Baseline, Neoadjuvant Final Visit and Change From Baseline at Neoadjuvant Final VisitBaseline (n=52)39.66 Units per milliliter (U/mL)Standard Deviation 79.49
Bevacizumab + TrastuzumabBreast Cancer Marker CA15.3 at Baseline, Neoadjuvant Final Visit and Change From Baseline at Neoadjuvant Final VisitNeoadjuvant final visit (n=37)29.39 Units per milliliter (U/mL)Standard Deviation 10.06
Bevacizumab + TrastuzumabBreast Cancer Marker CA15.3 at Baseline, Neoadjuvant Final Visit and Change From Baseline at Neoadjuvant Final VisitChange in CA15.3 at neoadjuvant final visit (n=37)-3.39 Units per milliliter (U/mL)Standard Deviation 33.05
Secondary

Disease Free Survival (DFS) Duration

DFS was estimated using Kaplan-Meier method.

Time frame: Up to 5 Years

Population: ITT population.

ArmMeasureValue (MEDIAN)
Bevacizumab + TrastuzumabDisease Free Survival (DFS) DurationNA months
Secondary

Number of Participants Who Underwent Mastectomy

Surgery included a mastectomy with axillary node dissection and had to be performed at least 4 weeks after the last infusion of neoadjuvant bevacizumab treatment.

Time frame: Anytime between Week 26 and Week 29

Population: ITT population.

ArmMeasureValue (NUMBER)
Bevacizumab + TrastuzumabNumber of Participants Who Underwent Mastectomy49 participants
Secondary

Overall Survival (OS) Duration

OS was defined as the time from the first administration of neoadjuvant treatment to death of any cause. OS was estimated using Kaplan-Meier method.

Time frame: Up to 5 years

Population: ITT population.

ArmMeasureValue (MEDIAN)
Bevacizumab + TrastuzumabOverall Survival (OS) DurationNA months
Secondary

Percentage of Participants Who Underwent Lymph Node Resection

Among the participants who were planned to undergo mastectomy, lymph node resection was also performed by the physician depending up on the participant's breast cancer grades.

Time frame: Anytime between Week 26 and Week 29

Population: ITT population. Included participants who underwent mastectomy.

ArmMeasureValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants Who Underwent Lymph Node Resection98.0 percentage of participants
Secondary

Percentage of Participants Who Were Alive at 3 and 5 Years

Time frame: 3, 5 years

Population: ITT population.

ArmMeasureGroupValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants Who Were Alive at 3 and 5 YearsAlive at 3 years90.0 percentage of participants
Bevacizumab + TrastuzumabPercentage of Participants Who Were Alive at 3 and 5 YearsAlive at 5 years81.8 percentage of participants
Secondary

Percentage of Participants Who Were Disease Free at 3 and 5 Years

A participant was considered disease free if the participant did not experience any of the following events: local recurrence in the ipsilateral breast following lumpectomy, regional recurrence, distant recurrence, contralateral breast cancer, second primary cancer (other than squamous or basal cell carcinoma of the skin, melanoma in situ, carcinoma in situ of the cervix, colon carcinoma in situ, or lobular carcinoma in situ of the breast), or death from any cause.

Time frame: 3, 5 years

Population: ITT population.

ArmMeasureGroupValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants Who Were Disease Free at 3 and 5 Years3 years66.7 percentage of participants
Bevacizumab + TrastuzumabPercentage of Participants Who Were Disease Free at 3 and 5 Years5 years60.8 percentage of participants
Secondary

Percentage of Participants Who Were Recurrence Free at 3 and 5 Years

A participant was considered recurrence free if the participant did not experience local or regional recurrence (wall or axillaries nodes), or occurrence of distant metastases (including soft tissue and distal lymph nodes).

Time frame: 3, 5 years

Population: ITT population.

ArmMeasureGroupValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants Who Were Recurrence Free at 3 and 5 Years3 years69.7 percentage of participants
Bevacizumab + TrastuzumabPercentage of Participants Who Were Recurrence Free at 3 and 5 Years5 years65.4 percentage of participants
Secondary

Percentage of Participants Who Were Responders Based on Inflammatory Signs From Baseline at Cycle 5 and Final Treatment Visit

Breast tumor was physically evaluated during the study which included assessment for inflammatory signs and for overall clinical response. Participant with response from baseline based on inflammatory signs at Cycle 5 and final treatment visit were presented.

Time frame: Baseline, Cycle 5 (Week 15), Neo-adjuvant treatment final visit (Week 25)

Population: ITT population. Number of participants analyzed included participants for whom tumor physical examination was performed and were evaluated for response from baseline assessment of inflammatory signs. n included number of participants who were evaluable at a particular time point.

ArmMeasureGroupValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants Who Were Responders Based on Inflammatory Signs From Baseline at Cycle 5 and Final Treatment VisitResponse from baseline at Week 15 (n=43)88.4 percentage of participants
Bevacizumab + TrastuzumabPercentage of Participants Who Were Responders Based on Inflammatory Signs From Baseline at Cycle 5 and Final Treatment VisitResponse from baseline at Week 25 (n=42)100.0 percentage of participants
Secondary

Percentage of Participants Who Were Responders Based on Overall Clinical Response From Baseline at Cycle 5 and Final Treatment Visit

Breast tumor was physically evaluated during the study which included assessment for inflammatory signs and for overall clinical response. Participant with response from baseline based on overall clinical response at Cycle 5 and final treatment visit were presented.

Time frame: Baseline, Cycle 5 (Week 15), Neo-adjuvant treatment final visit (Week 25)

Population: ITT population. Number of participants analyzed included participants for whom tumor physical examination was performed. n included number of participants who were evaluable at a particular time point.

ArmMeasureGroupValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants Who Were Responders Based on Overall Clinical Response From Baseline at Cycle 5 and Final Treatment VisitResponse from baseline at Week 15 (n=44)90.9 percentage of participants
Bevacizumab + TrastuzumabPercentage of Participants Who Were Responders Based on Overall Clinical Response From Baseline at Cycle 5 and Final Treatment VisitResponse from baseline at Week 25 (n=45)97.8 percentage of participants
Secondary

Percentage of Participants With a PCR According to the Chevallier Classification

PCR was assessed at the time of definitive surgery according to Chevallier classification and centrally reviewed by an independent committee under blinded conditions. The Chevallier classification for grading of therapeutic effect related to the primary tumor site and axillary lymph nodes was defined by microscopic changes as follows - Grade 1: Disappearance of all tumors either in the breast or in the nodes, Grade 2: Persistence of carcinoma in situ in the breast only and no nodal invasion, Grade 3: Presence of invasive carcinoma with stromal alteration, Grade 4: Presence of invasive carcinoma without modification. Grade 1 response was considered as PCR. Participants with missing values were considered as non-responders.

Time frame: From baseline through Week 25 (Up to 6 months)

Population: ITT population.

ArmMeasureValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants With a PCR According to the Chevallier Classification53.85 percentage of participants
Secondary

Percentage of Participants With Macroscopically Visible Tumor

Local pathologists assessed the tumor whether it was macroscopically visible or not and percentage of participants for whom the tumor was macroscopically visible was reported.

Time frame: Anytime between Week 26 and Week 29

Population: ITT population. Included participants who underwent mastectomy.

ArmMeasureValue (NUMBER)
Bevacizumab + TrastuzumabPercentage of Participants With Macroscopically Visible Tumor26.5 percentage of participants
Secondary

Recurrence Free Survival (RFS) Duration

RFS was estimated using Kaplan-Meier method.

Time frame: Up to 5 Years

Population: ITT population.

ArmMeasureValue (MEDIAN)
Bevacizumab + TrastuzumabRecurrence Free Survival (RFS) DurationNA months

Source: ClinicalTrials.gov · Data processed: Mar 27, 2026