Although approximately 50% of new diagnosis breast cancers are in patients above the age of 65, elderly people remain substantially under-represented in clinical trials, and therefore are under-treated. A recent trial of the CALBG in patient's ≥ 65 years with medium risk of breast cancer demonstrated an improved disease-free and overall survival for those treated with AC or CMF compared to those treated with capecitabine alone. The primary aim of the ICE II trial is to determine the compliance and toxicity of epirubicin plus cyclophosphamide (EC) or CMF versus nab-paclitaxel plus capecitabine as adjuvant therapy in non frail elderly patients.
Primary Objective: Phase II: To determine the compliance and safety of epirubicin plus cyclophosphamide or CMF (EC/CMF) and nab-paclitaxel in combination with capecitabine (PX). Secondary Objective(s): 1. To compare the disease-free survival (DFS) and distant disease free survival (DDFS) with epirubicin plus cyclophosphamide or CMF (EC/CMF) vs. nab-paclitaxel in combination with capecitabine (PX). 2. To compare the overall survival (OS) with epirubicin plus cyclophosphamide or CMF (EC/CMF) vs nab-paclitaxel in combination with capecitabine (PX). 3. To analyze the efficacy of treatments in subgroups according to clinical stratification factors. 4. To determine prognostic factors on tumor tissue collected from primary surgery and to correlate them with study treatment effect. 5. To compare the geriatric assessments scores (Charlson, VES-13, IADL, G8) at baseline and end of therapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
400
4 cycles of chemotherapy with epirubicin plus cyclophosphamide (EC) on day 1 q22
6 cycles CMF on days 1 and 8 q29 Cyclophosphamide (500mg/qm), Methotrexate (40 mg/qm), 5 FU (600mg/qm)
6 cycles of weekly nab-paclitaxel 100 mg/m2 on days 1, 8, 15 q22 with a week of rest every 6 weeks in combination with capecitabine 2000 mg/m2, days 1 - 14 orally, divided into 2 daily doses every 3 weeks for 6 cycles
German Breast Group, GBG Forschungs GmbH
Neu-Isenburg, Germany
To determine the compliance and safety of epirubicin plus cyclophosphamide or CMF (EC/CMF) and nab-paclitaxel in combination with capecitabine (PX).
Time frame: 4 months after Last Patient Out
To compare the disease-free survival (DFS) and distant disease free survival (DDFS) with epirubicin plus cyclophosphamide or CMF (EC/CMF) vs. nab-paclitaxel in combination with capecitabine (PX).
Time frame: After 4.5 years of Follow Up
To compare the overall survival (OS) with epirubicin plus cyclophosphamide or CMF (EC/CMF) vs nab-paclitaxel in combination with capecitabine (PX).
Time frame: After 4.5 years of Follow Up
To analyze the efficacy of treatments in subgroups according to clinical stratification factors.
Time frame: After 4.5 years of Follow Up
To determine prognostic factors on tumor tissue collected from primary surgery and to correlate them with study treatment effect.
Time frame: After 4.5 years of Follow Up
To compare the geriatric assessment scores (Charlson, VES-13, IADL, G8) at baseline and end of therapy
Time frame: 4 months after Last Patient Out
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