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A randomized, multicenter, Phase II study of the efficacy and safety of trastuzumab-MCC-DM1 vs. trastuzumab (Herceptin®) and docetaxel (Taxotere®) in patients with metastatic HER2-positive breast cancer who have not received prior chemotherapy for metastatic disease

Conditions
HER2-positive metastatic breast cancer
MedDRA version: 9.1Level: LLTClassification code 10027475Term: Metastatic breast cancer
Registration Number
EUCTR2008-002819-40-AT
Lead Sponsor
F Hoffmann-La Roche Ltd
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
120
Inclusion Criteria

a. Disease-Specific Criteria
1. Histologically or cytologically confirmed adenocarcinoma of the breast with locally advanced or metastatic disease, and a candidate for chemotherapy. Patients with locally advanced disease must have recurrent or progressive disease after failing initial attempts at local control. The disease must be considered to be unresectable.
2. HER2-positive (IHC 3+ or gene-amplified by FISH-positive) based on local laboratory assay results
3. No prior chemotherapy for their MBC (hormonal therapy is allowed.)
4. Measurable disease per modified RECIST
Patients should have at least one target lesion =2 cm on conventional CT scan or =1 cm on a spiral CT scan.
5. Tumor blocks or 11 unstained slides available for confirmatory central laboratory HER2 testing
b. General Criteria
6. Age =18 years
7. Eastern Cooperative Oncology Group (ECOG) PS of 0 or 1
8. Adequate organ function, evidenced by the following laboratory results within approximately 21 days prior to randomization:
Absolute neutrophil count >1500 cells/mm[3]
Platelet count > 100,000 cells/mm[3]
Hemoglobin > 9.0 g/dL
Patients are allowed to be transfused with red blood cells to obtain this level.
Total bilirubin = 1.5 x the upper limit of normal (ULN)
SGOT (AST) and/or SGPT (ALT), and alkine phosphatase =2.5 ×ULN, with the following exception
Patients with bone metastases: alkaline phosphatase =5 ×ULN
Serum Creatinine < 1.5 × ULN
International normalized ratio (INR) and activated partial thromboplastin time (aPTT) < 1.5 ×ULN (unless on therapeutic anticoagulation or due to a lupus anticoagulant)
10. For women of childbearing potential and for men with partners of childbearing potential, agreement to use an highly effective, non-hormonal form of contraception or two effective forms of non-hormonal contraception by the patient and/or the partner. Contraception use must continue for the duration of study treatment and for at least 6 months after the last dose of study treatment. Male patients whose partners are pregnant should use condoms for the duration of the study.
Specific country requirements will be followed (e.g., in the United Kingdom, women of childbearing potential and male subjects and their partners of childbearing potential must use two methods of contraception [one of which must be a barrier method] for the duration of the study).

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

a. Cancer-Related Criteria
1. History of any chemotherapy for MBC
Prior hormonal therapy is allowed.
2. An interval of <6 months from the completion of cytotoxic chemotherapy (excluding hormonal therapy) in the neo-adjuvant or adjuvant setting until the time of metastatic diagnosis. Patients who progress on or within 12 months on single-agent trastuzumab will be considered eligible (unless trastuzumab has been given = 21 days prior to randomization).
3. Trastuzumab = 21 days prior to randomization
4. Hormone therapy < 7 days prior to randomization
5. Current peripheral neuropathy of Grade =3 per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 3.0
6. History of other malignancy within the last 5 years, except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, Stage I uterine cancer, or other cancers with a similar outcome as those previously mentioned.
7. Previous radiotherapy for the treatment of unresectable, locally advanced metastatic breast cancer is not allowed if:
More than 25% of marrow-bearing bone has been irradiated.
The last fraction of radiotherapy has been administered within approximately 3 weeks prior to randomization.
8. Brain metastases that are untreated, symptomatic, or require therapy to control symptoms; or any radiation, surgery, or other therapy to control symptoms from brain metastases within 2 months prior to randomization. CT or magnetic resonance imaging (MRI) scan of the brain is mandatory (within approximately 28 days prior to randomization) in cases of clinical suspicion of brain metastases or in a patient with any prior history of brain metastases.
9. History of exposure to the following cumulative doses of anthracyclines:
Doxorubicin or liposomal doxorubicin > 500 mg/m[2]
Epirubicin > 900 mg/m[2]
Mitoxantrone > 120mg/m[2] and idarubicin > 90 mg/m[2]
If another anthracycline or more than 1 anthracycline has been used, then the cumulative dose must not exceed the equivalent of 500 mg/m[2] of doxorubicin.
b. Cardiopulmonary Function
10. Current unstable angina
11. History of symptomatic congestive heart failure (CHF; New York Heart Association [NYHA] classes II-IV), or ventricular arrhythmia requiring treatment
12. History of myocardial infarction within 6 months prior to randomization
13. LVEF below 50% within approximately 28 days prior to randomization
14. History of a decrease in LVEF <40% or symptomatic CHF with previous trastuzumab treatment
15. Cardiac troponin I = 0.2 ng/mL within approximately 28 days prior to randomization
16. Severe dyspnea at rest because of complications of advanced malignancy or requiring current continuous oxygen therapy
General Criteria
17. Current severe, uncontrolled systemic disease (e.g., clinically significant cardiovascular, pulmonary, or metabolic disease; wound healing disorders; ulcers; or bone fractures)
18. Major surgical procedure or significant traumatic injury within approximately 28 days prior to randomization or anticipation of the need for major surgery during the course of study treatment
19. Current pregnancy or lactation
20. History of receiving any investigational treatment within approximately 28 days prior to randomization
21. Current known infection with HIV, active hepatitis B and/or hepatitis C virus
22. History of intolerance (including Grade 3-4 infusion reaction) or hypersensitivity to trastuzumab, murine proteins, or docetaxel
23. Known hypersensitivity to any

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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