This is an open-label study to assess the efficacy and tolerability of the combination Myocet®/Taxotere®/Herceptin® as primary treatment for HER2 positive breast cancer patients. HER2 status will be confirmed centrally by fluorescence in situ hybridization (FISH). Phase I: Initial doses will be: Myocet: 50-60 mg/m² day 1 every 3 weeks; Taxotere 60-75 mg/m² day 1 every 3 weeks; and Herceptin (4) 2 mg/kg weekly. Sample size will depend on the number of patients recruited during dose escalation. Three patients must be recruited in each dose level. If one out of three experiences a dose-limiting toxicity (DLT), 3 more patients must be recruited in the same dose level. Considering that there are 4 dose levels to be tested, the estimated number of patients is 9 to 24. Patients receiving the recommended dose (RD) will be incorporated into phase II of the study.
Phase II: The average pathological complete response rate reported in other trials is around 11%. The investigators expect to achieve an increase of 14% on this rate; that is, they expect a pathological response rate of 25%. With a= 0.05 and β=0.2, 18 patients are initially needed. If at least 3 pathological complete responses are achieved, recruitment will continue to up to 53 patients. At least 10 pathological complete responses are needed to probe the hypothesis. Considering a 10% post-randomization drop-out rate, a total of 59 patients must be recruited for the trial.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
73
Hospital Universitario Virgen de los Lirios
Alcoy, Alicante, Spain
Hospital Universitario Germans Trias i Pujol
Badalona, Barcelona, Spain
Althaia-Xarxa Assistencial de Manresa
Manresa, Barcelona, Spain
Corporació Sanitaria Parc Taulí
Sabadell, Barcelona, Spain
Consorci Sanitari de Terrassa
Terrassa, Barcelona, Spain
Onkologikoa
Donostia / San Sebastian, Guipúzcoa, Spain
Hospital de la Ribera
Alzira, Valencia, Spain
Complejo Hospitalario Universitario A Coruña
A Coruña, Spain
Hospital Infanta Cristina
Badajoz, Spain
Hospital Clinic i Provincial
Barcelona, Spain
...and 6 more locations
Tolerability (Phase I): Recommended Doses of the combination treatment
Recommended Doses of the combination treatment
Time frame: up to 24 months since last patient included in the Phase I
Efficacy (Phase II): Percentage (%) pathological Complete Response achieved according to Miller and Payne Criteria
% pathological Complete Response achieved according to Miller and Payne Criteria
Time frame: up to 24 months since last patient included in the Phase II
Clinical response rates
Clinical responses evaluated by radiological imaging
Time frame: up to 6 months since last patient treatment
Surgery type (conservative surgery versus mastectomy)
% conservative or mastectomy surgery
Time frame: up to 7 months since last patient treatment
Potential cardiac toxicity
Left ventricular ejection fraction \[LVEF\] by multiple-gated acquisition \[MUGA\])
Time frame: up to 12 months since last patient included
Safety: Adverse Events evaluated according to NCI CTC v2.0
Adverse Events evaluated according to NCI CTC v2.0
Time frame: 24 months since last patient included
Post-surgery node status
according to Miller and Payne Criteria
Time frame: up to 7 months since last patient treatment
Molecular changes in blood and tissue exams
Different biomarkers evaluated
Time frame: 24 months
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