Sequential vs upfront intensified neoadjuvant chemotherapy in patients with large resectable or locally advanced breast cancer.
Indication
Neoadjuvant
Subindication
Any HER2, any HR
Target sample size
200
Actual accrual
202
Date: 01/05/2009
Estimated study completion date
01/05/2009
Contact
Sponsor
MUMC
Principal Investigator(s)
V.C.G. Tjan-Heijnen
Central datamanagement and randomization
Trialoffice IKO Radboud University Nijmegen, Medical Centre PO Box 9101, HP 485 6500 HB Nijmegen Tel 024 361 68 37 Fax 024 361 90 80 E-mail trialiko@onco.umcn.nl
Monitoring
IKO
Design
Randomization: Arm A: 4xAC followed by 4 D Arm B: 6xTAC
Objectives
To compare the efficacy and tolerability of neoadjuvant chemotherapy with AC followed by T (adriamycine, cyclophosphamide, taxotere) versus TAC (with upfront T) in patients with large resectable or locally advanced breast cancer.
Endpoints
Primary endpoint
Pathologic complete response (pCR) rate to neoadjuvant chemotherapy at surgery.
Secondary endpoints:
The delivered chemotherapy dose and dose-intensity of both chemotherapy regimens.
The tolerability (grade 3 / 4 CTC toxicities) of both chemotherapy regimens.
The clinical responses (partial and complete according to RECIST) of neoadjuvant chemotherapy correlated to pathological responses after neoadjuvant chemotherapy.
The value of breast MRI in evaluating response to neoadjuvant chemotherapy as compared to clinical palpation, ultrasound techniques and histo-pathological outcome.
The false-negative rate of the sentinal node (SN) biopsy after neoadjuvant chemotherapy.
The disease-free (DFS) and overall survival (OS) after 3 and 5 years follow-up.
The relation between pCR and DFS/OS.
The feasibility of the criteria for reporting pathological tumour response in surgical breast and axillary node resection specimens.
The prognostic and predictive value of tumour- and molecular markers, including ER, PgR, c-erbB2, microarray and other tumour characteristic analyses.
Eligibility Criteria
Large resectable or locally advanced breast cancer (T2 ≥3 cm, T3, or T4, and/or LN positive) Measurable disease ≥18 years and ≤70 years Excluded are pts with advanced pulmonary disease of any cause (oxygen dependent)