Adjuvant FEC Versus EP in Breast Cancer (MIG5)
- Conditions
- Chemotherapy, AdjuvantBreast Cancer
- Interventions
- Registration Number
- NCT02450058
- Lead Sponsor
- IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
- Brief Summary
In this multicenter, randomized phase III trial, node positive early breast cancer patients are randomly assigned to receive either 6 cycles of FEC (5-fluorouracil 600 mg/m2, epirubicin 60 mg/m2 and cyclophosphamide 600 mg/m2, on day 1, every three weeks) or 4 cycles of EP (epirubicin 90 mg/m2 and paclitaxel 175 mg/m2, on day 1, every three weeks). The primary study endpoint is overall survival (OS). Secondary endpoints include toxicity and event free survival (EFS).
- Detailed Description
At the time the Gruppo Oncologico Nord-Ovest- Mammella Intergruppo trial 5 (GONO-MIG5) was designed in 1996, paclitaxel was known to have efficacy in patients with advanced breast cancer, but its role was still to be established in the adjuvant setting. Therefore the GONO-MIG5 trial was designed to compare a standard anthracycline-containing chemotherapy regimen, i.e. 5fluorouracil, epirubicin, ciclophosphamide (FEC), given for 6 cycles to a new regimen containing both epirubicin and paclitaxel (EP), given concurrently, for 4 cycles. This latter regimen was chosen on the basis of the results obtained in metastatic breast cancer patients, where the combination of doxorubicin and paclitaxel was associated with more than 90% of objective response . Only four cycles of the new regimen were planned since the expected toxicity, particularly the cardiotoxicity, was high, and a short treatment duration was hoped to be the best strategy to obtain a favourable balance between the toxicity and the expected high efficacy.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 1055
- Women with histologically confirmed breast cancer who had undergone radical mastectomy or breast-conserving surgery in addition to full ipsilateral axillary lymph node dissection
- Lymph node-positive disease with less than 10 involved axillary lymph nodes
- Surgery performed not more than 5 weeks before randomization
- ECOG performance status 0
- Absolute neutrophil count ≥ 2,000/mm³
- WBC ≥ 3,000/mm³
- Platelet count ≥ 100,000/mm³
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 1.5 times ULN
- Postoperative regional radiotherapy limited to the remaining breast admitted for patients who received breast-conserving surgery
- Written informed consent
- Prior or concurrent ipsilateral or contralateral invasive breast carcinoma within the last 10 years
- Metastatic disease, including metastasis in the ipsilateral supraclavicular lymph nodes
- Prior chemotherapy or prior cytotoxic regimens or prior hormonal therapy
- Pregnant or nursing
- Other serious medical illness requiring medication, uncontrolled infections
- Other malignancy except adequately treated, cone-biopsied in situ carcinoma of the cervix or basal cell or squamous cell carcinoma of the skin
- Recent myocardial infarction, congestive heart failure, or serious arrhythmia
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description FEC 5-fluorouracil 5-Fluorouracil 600 mg/m2, epirubicin 60 mg/m2 and cyclophosphamide 600 mg/m2, intravenously on day 1, every 21 days FEC epirubicin 5-Fluorouracil 600 mg/m2, epirubicin 60 mg/m2 and cyclophosphamide 600 mg/m2, intravenously on day 1, every 21 days FEC cyclophosphamide 5-Fluorouracil 600 mg/m2, epirubicin 60 mg/m2 and cyclophosphamide 600 mg/m2, intravenously on day 1, every 21 days EP epirubicin Epirubicin 90 mg/m2 and paclitaxel 175 mg/m2, 3-hour infusion on day 1, every 21 days EP paclitaxel Epirubicin 90 mg/m2 and paclitaxel 175 mg/m2, 3-hour infusion on day 1, every 21 days
- Primary Outcome Measures
Name Time Method overall survival within 11 years since the enrolment of the 1st patient estimated from the date of randomization to the date of death from any cause
- Secondary Outcome Measures
Name Time Method event free survival within 11 years since the enrolment of the 1st patient from the date of randomization to the date of local recurrence, distant metastases, second primary cancer, or death from any cause
toxicity as measured according to the World Health Organization Criteria within the first 30 days after the end of chemotherapy
Trial Locations
- Locations (8)
Federico Castiglione
🇮🇹Alba, Italy
Ornella Garrone
🇮🇹Cuneo, Italy
Lucia Del Mastro
🇮🇹Genoa, Italy
Giovanna Cavazzini
🇮🇹Mantova, Italy
Andrea Michelotti
🇮🇹Pisa, Italy
Tiziana Scotto
🇮🇹Sassari, Italy
Antonio Durando
🇮🇹Torino, Italy
Saverio Danese
🇮🇹Torino, Italy