This trial combines dose dense chemotherapy with doxorubicin and cyclophosphamide (AC) followed by standard, every 3 week docetaxel and GW572016 (lapatinib) for neoadjuvant treatment of Her2neu positive stage II/III breast cancer. The purpose of the study was to determine whether lapatinib combined with chemotherapy was safe and resulted in an increase in pathologic complete response rates.
Lapatinib acts as a dual inhibitor of both epidermal growth factor receptor (EGFR) and ErbB-2 (Her2/neu) tyrosine kinase activity. EGFR and ErbB2 receptors are frequently over-expressed or altered in human cancers including breast cancer. This study plans to determine the antitumor activity of this regimen and its effectiveness preventing tumor growth and spread. Neoadjuvant chemotherapy which achieves pathologic complete responses (pCR) has been shown to predict improved long-term survival and serves as a surrogate for clinical outcome. By using this primary endpoint we can obtain statistical data with smaller patient numbers and at a lower overall cost. Additionally, we hope to correlate clinical and radiologic outcomes with gene expression data.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
21
1250 mg, tablets, oral daily during treatment with docetaxel (3-week cycles x 4 cycles)
60 mg/m2, intravenously every 2 weeks for 4 cycles. Given as first treatment with cyclophosphamide.
600 mg/m2, intravenously every 2 weeks for 4 cycles. Given as first treatment with doxorubicin.
Santa Clara Valley Medical Center
San Jose, California, United States
Stanford University School of Medicine
Stanford, California, United States
Percentage of Participants With Pathologic Complete Response (pCR)
Pathologic Complete Response (pCR) rate, assessed as no evidence of invasive disease in excised surgical specimens of breast and/or axilla, in participants who received at least 1 cycle of docetaxel and lapatinib and at least one follow-up evaluation.
Time frame: 12 weeks
Disease-free Survival (DFS)
Disease-free survival (DFS) is expressed as the percentage of participants who were disease-free and alive at the time of analysis.
Time frame: 42 months (median follow-up)
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100 mg/m2, intravenously every 3 weeks for 4 cycles (after treatment cycles of doxorubicin and cyclophosphamide
6 mg, subcutaneously on day 2 of all cytotoxic chemotherapy treatments.
300 or 480 mcg, subcutaneously on days 3 to 10 after cytotoxic chemotherapies.
8 mg, oral taken twice a day for 3 days starting 24 hours before docetaxel
Loading dose 8 mg/kg, then 6 mg/kg, intravenously every 3 weeks for 1 year