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A Randomized Phase III Trial of Adjuvant Therapy Comparing Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel With or Without Carboplatin for Node-Positive or High-Risk Node-Negative Triple-Negative Invasive Breast Cancer

NCT No.: NCT02488967

Study Type: INTERVENTIONAL

Phase: Phase III

Region: California - Northern

Acronym: 

Official Title

A Randomized Phase III Trial of Adjuvant Therapy Comparing Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel With or Without Carboplatin for Node-Positive or High-Risk Node-Negative Triple-Negative Invasive Breast Cancer

Purpose

This randomized phase III trial studies how well doxorubicin hydrochloride and cyclophosphamide followed by paclitaxel with or without carboplatin work in treating patients with triple-negative breast cancer. Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether doxorubicin hydrochloride and cyclophosphamide is more effective when followed by paclitaxel alone or paclitaxel and carboplatin in treating triple-negative breast cancer.

Detailed Description

PRIMARY OBJECTIVES: I. To determine whether the addition of carboplatin to an adjuvant chemotherapy regimen of doxorubicin (doxorubicin hydrochloride)/cyclophosphamide followed by paclitaxel will improve the invasive disease-free survival (IDFS) compared to doxorubicin/cyclophosphamide followed by paclitaxel when administered to patients with operable node-positive or high-risk node-negative triple-negative breast cancer.

Sex

Male & Female

Age Limit

18 years & older

Eligibility Criteria

Inclusion Criteria

The patient must have signed and dated an institutional review board (IRB)-approved consent form that conforms to federal and institutional guidelines;
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
The tumor must be unilateral invasive adenocarcinoma of the breast on histologic examination;
All of the following staging criteria (according to the 7th edition of the American Joint Committee on Cancer [AJCC] Cancer Staging Manual) must be met: *By pathologic evaluation, primary tumor must be pT1-3
*By pathologic evaluation, ipsilateral nodes must be pN0, pN1 (pN1mi, pN1a, pN1b, pN1c), pN2a, pN2b, pN3a, or pN3b
*If pN0, tumor must be > 3.0 cm;
The tumor must have been determined to be human epidermal growth factor receptor 2 (HER2)-negative as follows: *Immunohistochemistry (IHC) 0-1+ or *IHC 2+ and in situ hybridization (ISH) non-amplified with a ratio of HER2 to centromere enumerator probe 17 (CEP17) < 2.0, and if reported, average HER2 gene copy number < 4 signals/cells or *ISH non-amplified with a ratio of HER2 to CEP17 < 2.0, and if reported, average HER2 gene copy number < 4 signals/cells;
The tumor must have been determined to be estrogen receptor (ER)-and progesterone receptor (PgR)-negative assessed by current American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines. Patients with < 1% ER and PgR staining by IHC are considered negative;
The patient must have undergone either a mastectomy (total, skin-sparing, or nipple-sparing) or lumpectomy

Exclusion Criteria

T4 tumors including inflammatory breast cancer;
Definitive clinical or radiologic evidence of metastatic disease. Required imaging studies must have been performed within 90 days prior to randomization;
Synchronous or previous contralateral invasive breast cancer (patients with synchronous and/or previous contralateral DCIS or LCIS are eligible);
Any previous history of ipsilateral invasive breast cancer or ipsilateral DCIS (patients with synchronous or previous ipsilateral LCIS are eligible);
History of non-breast malignancies (except for in situ cancers treated only by local excision and basal cell and squamous cell carcinomas of the skin) within 5 years prior to randomization;
Previous therapy with anthracyclines or taxanes for any malignancy;
Chemotherapy administered for the currently diagnosed breast cancer prior to randomization;
Any continued use of sex hormonal therapy, e.g., birth control pills, ovarian hormone replacement therapy. Patients are eligible if these medications are discontinued prior to randomization;
Cardiac disease (history of and/or active disease) that would preclude the use of the drugs included in the treatment regimens. This includes but is not confined to: *Active cardiac disease *History of cardiac disease;
Uncontrolled hypertension defined as sustained systolic blood pressure (BP) > 150 mmHg or diastolic BP > 90 mmHg (patients with initial BP elevations are eligible if initiation or adjustment of BP medication lowers pressure to meet entry criteria);
Active hepatitis B or hepatitis C with abnormal liver function tests

Keywords and/or Specific Medical Conditions

  • Alkylating Agents
  • Adenocarcinoma
  • Antibiotics, Antineoplastic
  • Antimitotic Agents
  • Antineoplastic Agents
  • Antineoplastic Agents, Alkylating
  • Antineoplastic Agents, Phytogenic
  • Antirheumatic Agents
  • BR003
  • Breast Diseases
  • Breast Neoplasms
  • Carboplatin
  • Carcinoma
  • Cyclophosphamide
  • Doxorubicin
  • Enzyme Inhibitors
  • Immunologic Factors
  • Immunosuppressive Agents
  • Liposomal doxorubicin
  • Mitosis Modulators
  • Molecular Mechanisms of Pharmacological Action
  • Myeloablative Agonists
  • Neoplasms
  • Neoplasms by Histologic Type
  • Neoplasms by Site
  • Neoplasms, Glandular and Epithelial
  • Paclitaxel
  • Pharmacologic Actions
  • Physiological Effects of Drugs
  • Skin Diseases
  • Triple Negative Breast Neoplasms
  • Oncology (Adult)

Sponsors

  • NRG Oncology

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