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A randomised, open-label phase III study of first line chemotherapy in older metastatic breast cancer patients, comparing intravenous pegylated liposomal doxorubicin with oral capecitabine, and the incorporation of a complete geriatric assessment

Completed
Conditions
Metastatic breast cancer in elderly patients
Cancer
Breast cancer
Registration Number
ISRCTN11114726
Lead Sponsor
Breast Cancer Study Group (Borstkanker Onderzoeks Groep [BOOG]) (The Netherlands)
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
Female
Target Recruitment
154
Inclusion Criteria

1. Female patients with metastatic breast cancer, being eligible for first line chemotherapy
2. Aged greater than 65 years
3. Non-measurable (evaluable) or measurable disease (according to Response Evaluation Criteria in Solid Tumours [RECIST] criteria). In case of evaluable (non-measurable) disease, the presence of an increased tumour marker (either Cancer antigen 15.3 [Ca15.3], Cancer antigen-125 [Ca125], Carcinoembryonic Antigen [CEA], whatever is increased) is obligatory
4. European Cooperative Oncology Group (ECOG) performance score of zero to two
5. May be Human Epidermal growth factor Receptor 2 (HER-2/neu) positive or negative
6. Adequate bone marrow function, acceptable renal function and acceptable liver functions
7. Normal baseline Left Ventricular Ejection Fraction (LVEF) by Multiple Gated Acquisition (MUGA) scan according to the institutional limits, no prior history of myocardial infarction within less than six months, no cardiac insufficiency (New York Heart Association [NYHA] Class II or greater), no clinical evidence of Congestive Heart Failure (CHF) or Myocardial Infarction (MI) within less than six months
8. Written informed consent
9. Patients being willing and able to complete study questionnaires in the Dutch language

Exclusion Criteria

1. No anthracyclin-resistant disease (defined as development of locally recurrent or metastatic disease while on adjuvant anthracycline therapy, or relapse within 12 months after completion of anthracycline therapy) and adjuvant cumulative anthracycline dose (if given in the adjuvant setting) of less than 240 mg/m^2 of doxorubicin (or less than 450 mg/m^2 of epirubicin)
2. Evidence of Metastatic Breast Cancer (MBC) in the central nervous system, unless previously treated and being asymptomatic/controlled for at least three months
3. No current or previous chemotherapy for metastatic breast cancer (unless received in the adjuvant setting); patient may also have received hormonal and/or trastuzumab therapy for metastatic disease, as long as this therapy has been stopped for over two weeks)
4. No other malignancy within the previous five years (except adequately treated in situ carcinoma of cervix, or basal cell carcinoma)
5. No abuse of drugs, alcohol, pharmaceuticals, competing with adequate compliance in this study

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
To compare the Progression Free Survival (PFS) in elderly patients (greater than 65 years of age) with metastatic breast cancer treated with either PEG doxorubicin or capecitabine as first line chemotherapy. The Kaplan-Meier method will be used to estimate the distribution of overall Time To disease Progression (TTP) for each treatment and the two-sided log-rank test with significance level of 0.05 will be used to compare the TTP distribution between the two treatments.
Secondary Outcome Measures
NameTimeMethod
1. To compare the objective response rates (Complete Response [CR] and Partial Response [PR], according to RECIST criteria) between the two treatment regimens, given as first line chemotherapy in MBC in elderly patients<br>2. To compare the rate of clinical benefit (CR, PR, and Stable Disease [SD] over 24 weeks)<br>3. To compare the overall survival between the two treatment regimens<br>4. To evaluate the relation of response and toxicity of the respective chemotherapy regimen with co-morbidity and co-medication
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