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A Pilot Study of VEGF Inhibition in Patients With Lymphedema Following Breast Cancer Treatment


Phase 1
18 Years
N/A
Not Enrolling
Female
Breast Cancer, Lymphedema

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Trial Information

A Pilot Study of VEGF Inhibition in Patients With Lymphedema Following Breast Cancer Treatment


The primary objective of this study is:

• To assess the degree of improvement in arm edema as measured by changes in arm volume in
patients with ipsilateral lymphedema

The secondary objectives of this study are:

- To assess the degree of improvement in arm edema as measured by changes in arm
interstitial fluid pressure (IFP)

- To assess the degree of improvement in arm edema as measured by changes in
extracellular fluid (ECF) volume based on bioelectrical impedance analysis (BIA) by
lymphometer

- To assess the safety and tolerability of VEGF inhibition in this patient population

- To assess the clinical benefit in patients with ipsilateral lymphedema treated with
vascular endothelial growth factor (VEGF) inhibition by evaluating patient responses
to a quality of life questionnaire (FACT-B+4 lymphedema questions)

- To determine the impact of VEGF inhibition on circulating VEGF levels in patients with
lymphedema


Inclusion Criteria:



1. Have unilateral lymphedema of the ipsilateral arm attributed to prior surgical
treatment or radiation therapy for breast cancer that is severe enough to warrant
therapy in the opinion of the subject and treating physician.

2. All subjects must have greater than a 3 cm total difference in arm circumference
between the affected and unaffected arm measured at five defined points:

- each hand just distal to the thumb

- each wrist at its narrowest point

- each arm 30 cm proximal to the tip of the middle finger

- each arm 40 cm proximal to the tip of the middle finger

- each arm 50 cm proximal to the tip of the middle finger (if possible before the
axilla is reached.)

3. Be at least 18 years of age

4. Have adequate organ function as specified below:

- AST and ALT less than or equal to 2.0 times ULN

- Total bilirubin less than or equal to 1.5 mg/dL

- Serum creatinine less than or equal to 1.5 mg/dL

- Urine protein:creatinine ratio < 1.0*

- LVEF > institutional limits of normal by MUGA or ECHO

- PT INR < 1.5; PTT < 1.5 x normal

- Absolute neutrophil count greater than or equal to 1000/mm3

- Platelets greater than or equal to 100,000/mm3

5. Agree to use effective contraceptive methods during the course of the study if the
subject has child-producing potential

6. Have an ECOG performance status of 0 or 1

Exclusion Criteria:

1. Subjects must not be pregnant, lactating, or refuse to use appropriate birth control

2. Subjects must not have an active infection requiring parenteral or oral antibiotics

3. Subjects must not have clinically significant cardiovascular or cerebrovascular
disease, including:

Any history of:

- Cerebrovascular disease including TIA, stroke or subarachnoid hemorrhage

- Ischemic bowel

- Hypertensive crisis or hypertensive encephalopathy Within the last 12 months

- Myocardial infarction

- Unstable angina

- New York Heart Association (NYHA) grade II or greater congestive heart failure

- Grade II or greater peripheral vascular disease

- DVT or PE Active at study entry

- Uncontrolled hypertension defined as SBP > 150 or DBP > 100

- Uncontrolled or clinically significant arrhythmia.

4. Subjects may not have locally recurrent or metastatic disease

5. Subjects may not require concurrent therapeutic anticoagulation. (NOTE: Prophylactic
doses of coumadin to maintain patency of a vascular access device is allowed). In
addition, subjects with a bleeding diathesis are excluded.

6. Subjects may not have had major surgery within 4 weeks of starting protocol therapy
(NOTE: Placement of a vascular access device is not considered major surgery)

7. Subjects may not have received radiation therapy, chemotherapy or trastuzumab within
the past 6 weeks (NOTE: Concurrent adjuvant hormonal therapy is allowed.)

8. Subjects may not have altered the physical therapy regimen for lymphedema within the
past month

9. Subjects may not have an indwelling venous device in the ipsilateral arm

10. Subjects may not have bilateral lymphedema

11. Subjects may not have a non-healing wound, ulcer or bone fracture.

12. Subjects may not have a known hypersensitivity to any component of Bevacizumab

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Arm Volume

Outcome Time Frame:

baseline, Day 1, Day 22, q 6wks, termination

Safety Issue:

No

Principal Investigator

Kathy Miller, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Indiana University

Authority:

United States: Food and Drug Administration

Study ID:

0606-24

NCT ID:

NCT00393497

Start Date:

April 2007

Completion Date:

January 2011

Related Keywords:

  • Breast Cancer
  • Lymphedema
  • Breast Cancer
  • lymphedema
  • Breast Neoplasms
  • Lymphedema

Name

Location

Indiana University Cancer CenterIndianapolis, Indiana  46202-5265