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Combination Chemotherapy in Treating Patients With Breast Cancer

Phase 3
Completed
Conditions
Breast Cancer
Interventions
Registration Number
NCT00003088
Lead Sponsor
Alliance for Clinical Trials in Oncology
Brief Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving drugs at different times or combining more than one drug may kill more tumor cells. It is not yet known which chemotherapy regimen is more effective for breast cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of chemotherapy consisting of either doxorubicin, cyclophosphamide, or paclitaxel given at different times with that of combination chemotherapy consisting of doxorubicin plus cyclophosphamide followed by paclitaxel in treating women with stage II or stage IIIA breast cancer.

Detailed Description

OBJECTIVES: I. Compare the sequential chemotherapy with doxorubicin, paclitaxel and cyclophosphamide to combined doxorubicin and cyclophosphamide followed by paclitaxel for disease free and overall survival in women with node positive stage II or IIIA breast cancer. II. Determine whether increasing the dose density of adjuvant chemotherapy will improve disease free and overall survival. III. Compare the toxicity in patients treated with these regimens.

OUTLINE: This is a randomized study. Patients are randomized into one of four arms (sequential chemotherapy every 2 weeks vs every 3 weeks vs concurrent chemotherapy followed by paclitaxel every 2 weeks vs every 3 weeks). All tumor should be removed by either a modified radical mastectomy or a segmental mastectomy plus axillary node dissection. Adjuvant chemotherapy is started within 84 days following the last surgical procedure. Arm I: Patients receive sequential chemotherapy every 3 weeks. Doxorubicin IV is administered once every 3 weeks for 4 doses. Paclitaxel IV is then administered over 3 hours once every 3 weeks for 4 doses. Cyclophosphamide IV is administered once every 3 weeks for 4 doses following paclitaxel. Arm II: Patients receive sequential chemotherapy every 2 weeks. Doxorubicin IV is administered once every 2 weeks for 4 doses. Paclitaxel IV is then administered over 3 hours once every 2 weeks for 4 doses. Cyclophosphamide IV is administered once every 2 weeks for 4 doses following paclitaxel. Filgrastim (G-CSF) is administered by subcutaneous injection on days 3-10 after each dose of doxorubicin, paclitaxel, and cyclophosphamide. Arm III: Patients receive combination chemotherapy every 3 weeks. Combination doxorubicin IV and cyclophosphamide IV is administered once every 3 weeks for 4 doses. Paclitaxel IV is administered over 3 hours once every 3 weeks for 4 doses following combination chemotherapy. Arm IV: Patients receive combination chemotherapy every 2 weeks. Combination doxorubicin IV and cyclophosphamide IV is administered once every 2 weeks for 4 doses. Paclitaxel IV is administered over 3 hours once every 2 weeks for 4 doses following combination chemotherapy. G-CSF is administered by subcutaneous injection on days 3-10 after each dose of doxorubicin/cyclophophamide and after each dose of paclitaxel. After completion of all chemotherapy, patients receive tamoxifen orally for 5 years. Patients undergo radiotherapy 4-6 weeks after the completion of chemotherapy. Patients are followed every 6 months for 5 years, then annually until death.

PROJECTED ACCRUAL: A total of 2,000 patients will be accrued for this study within 22 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
2005
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sequential chemotherapy 21 dayscyclophosphamidePatients received doxorubicin 60 mg/m\^2 every 3 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 3 weeks for four cycles followed by cyclophosphamide 600 mg/m\^2 every 3 weeks for four cycles.
Sequential chemotherapy 21 daysdoxorubicin hydrochloridePatients received doxorubicin 60 mg/m\^2 every 3 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 3 weeks for four cycles followed by cyclophosphamide 600 mg/m\^2 every 3 weeks for four cycles.
Sequential chemotherapy 21 dayspaclitaxelPatients received doxorubicin 60 mg/m\^2 every 3 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 3 weeks for four cycles followed by cyclophosphamide 600 mg/m\^2 every 3 weeks for four cycles.
Concurrent chemotherapy 14 dayscyclophosphamidePatients received doxorubicin 60 mg/m\^2 plus cyclophosphamide 600 mg/m\^2 every 2 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 2 weeks for four cycles with filgrastim days 3 to 10 of each cycle at 5 µg/kg rounded to either 300 or 480 µg total dose.
Concurrent chemotherapy 14 daysdoxorubicin hydrochloridePatients received doxorubicin 60 mg/m\^2 plus cyclophosphamide 600 mg/m\^2 every 2 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 2 weeks for four cycles with filgrastim days 3 to 10 of each cycle at 5 µg/kg rounded to either 300 or 480 µg total dose.
Sequential chemotherapy 14 dayspaclitaxelPatients received doxorubicin 60 mg/m2 every 2 weeks for four cycles followed by paclitaxel 175 mg/m2 every 2 weeks for four cycles followed by cyclophosphamide 600 mg/m2 every 2 weeks for four cycles, with filgrastim days 3 to 10 of each cycle (a total of seven doses) at 5 µg/kg, which could be rounded to either 300 or 480 µg total dose.
Sequential chemotherapy 14 dayscyclophosphamidePatients received doxorubicin 60 mg/m2 every 2 weeks for four cycles followed by paclitaxel 175 mg/m2 every 2 weeks for four cycles followed by cyclophosphamide 600 mg/m2 every 2 weeks for four cycles, with filgrastim days 3 to 10 of each cycle (a total of seven doses) at 5 µg/kg, which could be rounded to either 300 or 480 µg total dose.
Concurrent chemotherapy 14 dayspaclitaxelPatients received doxorubicin 60 mg/m\^2 plus cyclophosphamide 600 mg/m\^2 every 2 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 2 weeks for four cycles with filgrastim days 3 to 10 of each cycle at 5 µg/kg rounded to either 300 or 480 µg total dose.
Sequential chemotherapy 14 daysdoxorubicin hydrochloridePatients received doxorubicin 60 mg/m2 every 2 weeks for four cycles followed by paclitaxel 175 mg/m2 every 2 weeks for four cycles followed by cyclophosphamide 600 mg/m2 every 2 weeks for four cycles, with filgrastim days 3 to 10 of each cycle (a total of seven doses) at 5 µg/kg, which could be rounded to either 300 or 480 µg total dose.
Concurrent chemotherapy 21 dayscyclophosphamidePatients received doxorubicin 60 mg/m\^2 plus cyclophosphamide 600 mg/m\^2 every 3 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 3 weeks for four cycles.
Concurrent chemotherapy 21 dayspaclitaxelPatients received doxorubicin 60 mg/m\^2 plus cyclophosphamide 600 mg/m\^2 every 3 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 3 weeks for four cycles.
Concurrent chemotherapy 21 daysdoxorubicin hydrochloridePatients received doxorubicin 60 mg/m\^2 plus cyclophosphamide 600 mg/m\^2 every 3 weeks for four cycles followed by paclitaxel 175 mg/m\^2 every 3 weeks for four cycles.
Primary Outcome Measures
NameTimeMethod
Disease free survival4 years
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (19)

CCOP - Scottsdale Oncology Program

🇺🇸

Scottsdale, Arizona, United States

CCOP - Carle Cancer Center

🇺🇸

Urbana, Illinois, United States

CCOP - Duluth

🇺🇸

Duluth, Minnesota, United States

Siouxland Hematology-Oncology

🇺🇸

Sioux City, Iowa, United States

CentraCare Clinic

🇺🇸

Saint Cloud, Minnesota, United States

Quain & Ramstad Clinic, P.C.

🇺🇸

Bismarck, North Dakota, United States

Altru Health Systems

🇺🇸

Grand Forks, North Dakota, United States

Saskatchewan Cancer Agency

🇨🇦

Regina, Saskatchewan, Canada

CCOP - Sioux Community Cancer Consortium

🇺🇸

Sioux Falls, South Dakota, United States

CCOP - Ochsner

🇺🇸

New Orleans, Louisiana, United States

CCOP - Illinois Oncology Research Association

🇺🇸

Peoria, Illinois, United States

CCOP - Ann Arbor Regional

🇺🇸

Ann Arbor, Michigan, United States

CCOP - Iowa Oncology Research Association

🇺🇸

Des Moines, Iowa, United States

CCOP - Cedar Rapids Oncology Project

🇺🇸

Cedar Rapids, Iowa, United States

CCOP - Toledo Community Hospital Oncology Program

🇺🇸

Toledo, Ohio, United States

CCOP - Merit Care Hospital

🇺🇸

Fargo, North Dakota, United States

Mayo Clinic Cancer Center

🇺🇸

Rochester, Minnesota, United States

CCOP - Missouri Valley Cancer Consortium

🇺🇸

Omaha, Nebraska, United States

Rapid City Regional Hospital

🇺🇸

Rapid City, South Dakota, United States

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