Phase IIb Trial of Paclitaxel Plus Carboplatin Versus Paclitaxel Plus Epirubicin as Neoadjuvant Treatment in Locally Advanced Triple-negative Breast Cancer
Overview
- Phase
- Phase 2
- Intervention
- Paclitaxel and epirubicin
- Conditions
- Triple Negative Breast Cancer
- Sponsor
- Chinese Academy of Medical Sciences
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- Pathology of specimens derived from the breast modified radical mastectomy/Breast-conserving surgery
- Last Updated
- 14 years ago
Overview
Brief Summary
This study is to compare the effective of Paclitaxel combined with Epirubicin and Paclitaxel plus Carboplatin in the neoadjuvant treatment for TNBC. And the investigators hypothesized that paclitaxel combined with carboplatin is more sensitive to TNBC compared with Paclitaxel plus Epirubicin,this study will also have a look into the relation of BRCA1 mutation and sensitive to carboplatin.
Detailed Description
It is know that triple-negative breast cancer(TNBC) is more aggressive than non-triple negative breast cancer in both pathological features and clinical prognosis,and there is no standard chemotherapy regimens especially for TNBC. NCCN guidelines recommends Paclitaxel or Epirubicin based regimens as the preferred regimens both for the adjuvant chemotherapy and the treatment of Recurrence and Metastatic breast cancer.The combination of these two drugs is considered as a strong arrangement and therefore,is common used in Triple negative breast cancer patients because of its poor prognosis. According to the results of some retrospective studies, platinum-based chemotherapy regimens showed a promising sensitive to Triple negative breast cancer patients compared with regimens without platinum. This study is to compare the effective of Paclitaxel combined with Epirubicin and Paclitaxel plus Carboplatin in the neoadjuvant treatment for TNBC. And the investigators hypothesized that paclitaxel combined with carboplatin is more sensitive to TNBC compared with Paclitaxel plus Epirubicin,this study will also have a look into the relation of BRCA1 mutation and sensitive to carboplatin.
Investigators
ZHANG Pin
Medicine Oncology Department
Chinese Academy of Medical Sciences
Eligibility Criteria
Inclusion Criteria
- •Women aged from 18 to 70 years;
- •WHO Performance status (ECOG) of 0 or 1
- •Core biopsy histologically proven Ⅱa-Ⅲc phase breast cancer (regardless of the type);
- •Immunohistochemisty（IHC）：ER-，PR-，CerB2-；Triple negative （ER-PR-Her-2-） Hormone receptor negativity is defined as ER\<10%, PR\<10% (IHC), HER2 negativity is defined as IHC 0-1+, or \[IHC 2+ and FISH or CISH negative\]；
- •Adequate hematological function (neutrophil count ³ 2x109/l, platelet count ³ 100x 109/l, Hemoglobin \> 9 g/dl);
- •Adequate hepatic function: ASAT and ALAT £ 1.5 ULN alkaline phosphatases £ 2.5 ULN,total bilirubin £ 1,5 ULN;
- •Adequate renal function: serum creatinine £ 1.5 ULN;
- •Adequate cardiac function, LEVF value \> 50% by Muga scan or echocardiography，and electrocardiogram doe not show specific abnormality；
- •Patients accepting contraception intake during the overall length of treatment if of childbearing potential;
- •Signed written informed consent.
Exclusion Criteria
- •Any tumor ³ T4a (UICC1987) (cutaneous invasion, deep adherence, inflammatory breast cancer);
- •ER+ or PR+ or Her-2 overexpression
- •Any chemotherapy, hormonal therapy or radiotherapy before
- •Previous cancer in the preceding 10 years;
- •Patients already included in another therapeutic trial involving an experimental drug;
- •Patients with other concurrent severe and/or uncontrolled medical disease or infection which could compromise participation in the study;
- •LEVF \< 50% (MUGA scan or echocardiography);
- •Clinically significant cardiovascular disease (e.g. unstable angina, congestive heart failure, uncontrolled hypertension (\>150/90), myocardial infarction or cerebral vascular accidents) within 6 months prior to chemotherapy;
- •Known prior severe hypersensitivity reactions to agents that will be received;
- •Women who are pregnant or breastfeeding. Adequate birth control measures should be taken during study treatment phase;
Arms & Interventions
ET
The control arm receive the paclitaxel plus epirubicin
Intervention: Paclitaxel and epirubicin
PC
the experimental arm which receive the paclitaxel combined with carboplatin
Intervention: Paclitaxel plus carboplatin
Outcomes
Primary Outcomes
Pathology of specimens derived from the breast modified radical mastectomy/Breast-conserving surgery
Time Frame: One week after the surgery
After patients complete the neoadjuvant chemothreapy and receive the surguries,we can get their pathology ，and compare the pCR（pathological complete remission）rates of two amrs
Secondary Outcomes
- follow-up the patient every 3-6 months to obtain the 3 year-DFS(disease free survival ) and OS(overall survival )(we follow up the patients every 6 month ,up to 3 years)