Combination Chemotherapy in Treating Patients With Early Stage Breast Cancer That Has Been Removed By Surgery
- Conditions
- Breast Cancer
- Interventions
- Biological: pegfilgrastimProcedure: adjuvant therapy
- Registration Number
- NCT00301925
- Lead Sponsor
- Institute of Cancer Research, United Kingdom
- Brief Summary
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving combination chemotherapy after surgery may kill any remaining tumor cells. It is not yet known which combination chemotherapy regimen is more effective in treating early stage breast cancer that has been removed by surgery.
PURPOSE: This randomized phase III trial is studying four different combination chemotherapy regimens to compare how well they work in treating patients with early stage breast cancer that has been removed by surgery.
- Detailed Description
OBJECTIVES:
Primary
* Compare the disease-free survival (DFS) of patients with completely resected early stage breast cancer receiving 1 of 2 different schedules of adjuvant chemotherapy comprising epirubicin, cyclophosphamide, methotrexate, and fluorouracil versus 1 of 2 different schedules of adjuvant chemotherapy comprising epirubicin and capecitabine.
Secondary
* Compare overall survival (OS) and distant disease-free survival (DFS).
* Compare the tolerability (including serious adverse events \[SAE\], dose-intensity, and toxicity) of these regimens.
* Determine the detailed toxicity of these regimens.
* Determine the quality of life of a subset of these patients.
OUTLINE: This is a multi-center, randomized study. Patients are stratified according to participating center, nodal status (N0 vs N1-3 vs N≥ 4), age (≤ 50 years vs \> 50 years), and estrogen receptor (ER) status (negative vs positive). Patients are randomized to 1 of 4 treatment arms.
* Arm I: Patients receive epirubicin on day 1. Treatment repeats every 3 weeks for 4 courses. Patients then receive cyclophosphamide orally once daily on days 1-14 or IV on days 1 and 8 and methotrexate and fluorouracil on days 1 and 8. Treatment repeats every 28 days for 4 courses.
* Arm II: Patients receive epirubicin on day 1 and pegfilgrastim on day 2. Treatment repeats every 2 weeks for 4 courses. Patients then receive cyclophosphamide, methotrexate and fluorouracil as in arm I.
* Arm III: Patients receive epirubicin as in arm I. Patients then receive oral capecitabine twice daily on days 1-14. Treatment with capecitabine repeats every 3 weeks for 4 courses.
* Arm IV: Patients receive epirubicin and pegfilgrastim as in arm II. Patients then receive capecitabine as in arm III.
In all arms, treatment continues in the absence of unacceptable toxicity.
Beginning 3-6 months later, all patients may undergo radiotherapy at the discretion of the principal investigator. Patients with ER- and/or progesterone receptor-positive disease then receive tamoxifen citrate or an aromatase inhibitor for up to 5 years.
Quality of life is assessed in a cohort of 1,000 patients in week 6, week 8 or 12, and week 20 or 24 during treatment and then at 12 and 24 months after randomization.
After completion of study therapy, patients are followed every 6 months for 2 years and then annually for at least 10 years.
Peer Reviewed and Funded or Endorsed by Cancer Research UK.
PROJECTED ACCRUAL: A total of 4,400 patients will be accrued for this study.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 4400
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Accelerated Epi-CMF epirubicin hydrochloride - Accelerated Epi-CMF fluorouracil - Epi-Capecitabine adjuvant therapy - Accelerated Epi-Capecitabine pegfilgrastim - Accelerated Epi-Capecitabine capecitabine - Accelerated Epi-Capecitabine epirubicin hydrochloride - Accelerated Epi-CMF pegfilgrastim - Epi-CMF adjuvant therapy - Accelerated Epi-Capecitabine adjuvant therapy - Epi-CMF epirubicin hydrochloride - Accelerated Epi-CMF adjuvant therapy - Epi-Capecitabine epirubicin hydrochloride - Epi-Capecitabine capecitabine - Accelerated Epi-CMF cyclophosphamide - Accelerated Epi-CMF methotrexate - Epi-CMF cyclophosphamide - Epi-CMF fluorouracil - Epi-CMF methotrexate -
- Primary Outcome Measures
Name Time Method Disease-free survival (DFS) at 5 years
- Secondary Outcome Measures
Name Time Method Distant DFS at 5 years Detailed toxicity Quality of life Tolerability (including serious adverse events, dose-intensity, and toxicity) Overall survival at 5 years
Trial Locations
- Locations (150)
William Harvey Hospital
🇬🇧Ashford-Kent, England, United Kingdom
Wansbeck General Hospital
🇬🇧Ashington, England, United Kingdom
Tameside General Hospital
🇬🇧Ashton-Under-Lyne, England, United Kingdom
North Devon District Hospital
🇬🇧Barnstaple, England, United Kingdom
Furness General Hospital
🇬🇧Barrow in Furness, England, United Kingdom
Basildon University Hospital
🇬🇧Basildon, England, United Kingdom
Basingstoke and North Hampshire NHS Foundation Trust
🇬🇧Basingstoke, England, United Kingdom
Queen Elizabeth Hospital at University Hospital of Birmingham NHS Trust
🇬🇧Birmingham, England, United Kingdom
City Hospital - Birmingham
🇬🇧Birmingham, England, United Kingdom
Birmingham Heartlands Hospital
🇬🇧Birmingham, England, United Kingdom
Scroll for more (140 remaining)William Harvey Hospital🇬🇧Ashford-Kent, England, United Kingdom