Locally Advanced HER2-negative Breast Cancer
Conditions
Brief summary
The purpose of this study is to determine whether weekly paclitaxel followed by weekly doxorubicin plus daily oral cyclophosphamide without granulocyte colony-stimulating factor (G-CSF) is feasible in the treatment of locally advanced HER2-negative breast cancer.
Interventions
Metronomic chemotherapy as described below: 1. Paclitaxel 100 mg/m2 once a week for 8 weeks followed by; 2. Doxorubicin 24 mg/m2 once a week concomitant to oral cyclophosphamide 100 mg/day (fix dose) for 9 weeks.
Sponsors
Study design
Eligibility
Inclusion criteria
* Locally advanced breast cancer diagnosed by guided core biopsy * T \> 2 cm (any N), or any T and node positive (needle biopsy is required) * Non-metastatic disease assessed by computed tomography and bone scintigraphy * Histological grade 2 and Ki67 \> 15% or * Histological grade 3 or * Any triple negative (TN) or * Inflammatory breast cancer (IBC) * Normal left ventricular ejection fraction (LVEF) * HER2-negative disease
Exclusion criteria
* Another malignancy within the last 5 years (except curatively treated skin carcinoma, in situ cervix carcinoma, in situ ductal carcinoma of the breast, or in situ lobular carcinoma of the breast) * Clinically significant comorbidities as cardiovascular diseases, chronic obstructive pulmonary disease (COPD), renal or liver failure, psychiatric disorders * LVEF value below institutional limits of normal * Predominant lobular carcinoma histology * Grade 1 tumors * Detected or suspicious distant metastasis * Neutrophils less than 1,500/µL, platelets less than 100,000/µL, hemoglobin less than 10 g/dL, AST more than 2.5x upper limit of normal (ULN), total bilirubin more than ULN, alkaline phosphatase more than 1.5x ULN * Male sex * HER2-positive breast cancer
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of febrile neutropenia | 18 weeks | Incidence of febrile neutropenia with modified metronomic schedule (whithout GCSF) will be no higher than 10% |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy | From the beginning of treatment until surgery, progression and death | Efficacy will be assessed by: 1. Tumor measurements using MRI 2. Pathologic complete response 3. Progression-free survival 4. Overall survival |
Countries
Brazil