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A Double-Blind, Randomized Phase 2b Study Evaluating the Efficacy and Safety of Sorafenib Compared to Placebo When Administered in Combination With Paclitaxel in Patients With Locally Recurrent or Metastatic Breast Cancer


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Breast Cancer

Thank you

Trial Information

A Double-Blind, Randomized Phase 2b Study Evaluating the Efficacy and Safety of Sorafenib Compared to Placebo When Administered in Combination With Paclitaxel in Patients With Locally Recurrent or Metastatic Breast Cancer


OBJECTIVES:

Primary

- Compare progression-free survival of patients with locally recurrent or metastatic
breast cancer treated with sorafenib tosylate and paclitaxel versus placebo and
paclitaxel as first-line therapy.

Secondary

- Compare the objective response rate and duration of response in patients treated with
these regimens.

- Compare the time to progression in patients treated with these regimens.

- Compare the survival of patients treated with these regimens.

- Compare the safety of patients treated with these regimens.

- Compare the change from baseline in the Functional Assessment of Cancer Therapy for
Breast Cancer quality of life assessment score in patients treated with these regimens.

OUTLINE: This is a double-blind, randomized, multicenter study. Patients are stratified
according to site of metastatic disease (visceral [i.e., soft internal organs of the body,
including lungs, heart, and the organs of the digestive, excretory, and reproductive
systems] vs nonvisceral [i.e., osseous or soft tissue] sites). Patients are randomized to 1
of 2 treatment arms.

- Arm I: Patients receive paclitaxel IV over 1 hour once weekly for 3 weeks. Patients
also receive oral sorafenib tosylate twice daily on days 1-28.

- Arm II: Patients receive paclitaxel as in arm I and oral placebo twice daily on days
1-28.

In both arms, treatment repeats every 28 days in the absence of disease progression or
unacceptable toxicity.

Quality of life is assessed at baseline, and every 8 weeks for 24 weeks, and then every 12
weeks for the duration of study participation.

After completion of study therapy, patients are followed every 4 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed adenocarcinoma of the breast

- Locally recurrent or metastatic disease

- Locally recurrent disease not amenable to resection with curative intent

- Measurable or evaluable disease

- No HER-2 overexpression (defined as positive for gene amplification by FISH or 3+
overexpression by IHC)

- No unknown HER-2 status

- No active brain metastases

- Patients with neurological symptoms and known brain metastases treated with
definitive therapy must undergo contrast CT scan or brain MRI to exclude active
brain metastasis

- Previously treated brain metastases allowed provided at least 3 months
since prior definitive therapy (including steroids) AND no evidence of
disease

- Hormone receptor status not specified

PATIENT CHARACTERISTICS:

- Male or female

- Menopausal status not specified

- ECOG performance status 0-1

- Not pregnant or nursing for ≥ 2 weeks after completion of study therapy

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 2 weeks after
completion of study therapy

- Hemoglobin ≥ 9.0 g/dL

- ANC ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Total bilirubin ≤ 1.5 times the upper limit of normal (ULN)

- ALT and AST ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver involvement)

- INR ≤ 1.5 and aPTT within normal limits

- Anticoagulation therapy (e.g., warfarin or heparin) allowed

- Stable INR required for patients on warfarin

- Creatinine ≤ 1.5 times the ULN

- Able to swallow and retain oral medication

- More than 4 weeks since prior significant traumatic injury

- No evidence or history of bleeding diathesis or coagulopathy

- No serious nonhealing wound, ulcer, or bone fracture

- No substance abuse or medical, psychological, or social condition that would
interfere with study participation or evaluation of study results

- No pre-existing peripheral neuropathy ≥ grade 2

- No clinically significant cardiac disease, including any of the following:

- New York Heart Association class II-IV congestive heart failure

- Unstable angina (i.e., angina symptoms at rest) or new-onset angina within the
past 3 months

- Myocardial infarction within the past 6 months

- No cardiac ventricular arrhythmias requiring anti-arrhythmic therapy

- No uncontrolled hypertension (i.e., systolic blood pressure [BP] > 150 mm Hg or
diastolic BP > 90 mm Hg despite optimal medical management)

- No thrombolic, embolic, venous, or arterial events such as a cerebrovascular
accident, including transient ischemic attacks within the past 6 months

- No pulmonary hemorrhage or bleeding event > grade 2 within the past 4 weeks

- No other hemorrhage or bleeding event ≥ grade 3 within the past 4 weeks

- No active clinically serious infection > grade 2

- No known HIV infection or chronic hepatitis B or C

- No other prior or concurrent cancer except carcinoma in situ of the cervix, treated
basal cell skin cancer, superficial bladder tumors (e.g., Ta and Tis), or any cancer
curatively treated for > 5 years

- No known or suspected allergy to sorafenib tosylate or hypersensitivity to paclitaxel
or drugs using the vehicle Cremophor

PRIOR CONCURRENT THERAPY:

- More than 12 months since prior adjuvant or neoadjuvant taxane therapy

- At least 3 weeks since other prior adjuvant chemotherapy

- At least 3 weeks since prior hormonal therapy for locally recurrent or metastatic
disease

- No prior chemotherapy for locally recurrent or metastatic breast cancer

- More than 4 weeks since prior major surgery or open biopsy

- At least 3 weeks since prior radiotherapy

- Previously irradiated area must not be the only site of disease

- More than 30 days or 5 half-lives, whichever is longer, since prior investigational
drug

- No prior or concurrent bevacizumab or any other licensed or investigational
drugs that target VEGF or VEGF-receptor

- More than 3 weeks since prior and no concurrent Hypericum perforatum (St. John's wort
) or rifampin (rifampicin)

- No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin,
carbamazepine, or phenobarbital)

- No concurrent irinotecan hydrochloride or doxorubicin hydrochloride

- No other concurrent anticancer therapy (i.e., chemotherapy, radiotherapy, surgery,
immunotherapy, biologic therapy, or tumor embolization)

- No concurrent nonconventional therapies (e.g., herbal)

- No concurrent palliative radiotherapy

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Outcome Measure:

Progression-free survival

Outcome Time Frame:

At disease progression or death

Safety Issue:

No

Principal Investigator

William J. Gradishar, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Robert H. Lurie Cancer Center

Authority:

United States: Federal Government

Study ID:

NU 07B1

NCT ID:

NCT00499525

Start Date:

June 2007

Completion Date:

December 2014

Related Keywords:

  • Breast Cancer
  • male breast cancer
  • recurrent breast cancer
  • stage IIIB breast cancer
  • stage IIIC breast cancer
  • stage IV breast cancer
  • stage IIIA breast cancer
  • Breast Neoplasms

Name

Location

Hinsdale Hematology Oncology Associates Hinsdale, Illinois  60521
Sutter Cancer Center Sacramento, California  95816
Mountain States Tumor Institute at St. Luke's Regional Medical Center Boise, Idaho  83712-6297
Gundersen Lutheran Center for Cancer and Blood La Crosse, Wisconsin  54601
Robert H. Lurie Comprehensive Cancer Center at Northwestern University Chicago, Illinois  60611
Decatur Memorial Hospital Cancer Care Institute Decatur, Illinois  62526
Helen and Harry Gray Cancer Center at Hartford Hospital Hartford, Connecticut  06102-5037
Midwest Center for Hematology/Oncology Joliet, Illinois  60432
Hematology/Oncology of the North Shore at Gross Point Medical Center Skokie, Illinois  60076
Fort Wayne Medical Oncology and Hematology Fort Wayne, Indiana  46815
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Cascade Cancer Center at Evergreen Hospital Medical Center Kirkland, Washington  98034-3013
Hematology-Oncology Associates of Illinois Chicago, Illinois  60611-2998
Eastern Connecticut Hematology and Oncology Associates Norwich, Connecticut  06360
Kellogg Cancer Care Center Highland Park, Illinois  60035
Highlands Oncology Group - Fayetteville Fayetteville, Arkansas  72703
Fountain Valley, California  92708
Piedmont Hematology-Oncology Associates Winston-Salem, North Carolina  27103
Kentuckiana Cancer Institute, PLLC Louisville, Kentucky  40202
Hematology and Oncology Associates of Rhode Island Cranston, Rhode Island  02920
Pacific Cancer Medical Center, Incorporated Anaheim, California  92801
Medical and Surgical Specialists, LLC Galesburg, Illinois  61401
Northeast Georgia Cancer Care, LLC - Medical Oncology Athens, Georgia  30607
Cancer Institute at Alexian Brothers Elk Grove Village, Illinois  60007
Cancer Prevention and Treatment Center at Dominican and Watsonville Community Hospital Soquel, California  95073
Essex Oncology of North Jersey Belleville, New Jersey  07109
Nebraska Hematology-Oncology, PC Lincoln, Nebraska  68506
Family Medicine of Vincennes Clinical Trial Center Vincennes, Indiana  47591
Northwest Alabama Cancer Center, PC - Muscle Shoals Muscle Shoals, Alabama  35661
Pacific Coast Hematology/Oncology Medical Group, Incorporated Fountain Valley, California  92708
Desert Hematology-Oncology Medical Group, Incorporated Rancho Mirage, California  92270
Medical Oncology and Hematology, PC at Harold Leever Cancer Center Waterbury, Connecticut  06708
George Washington University Cancer Institute Washington, District of Columbia  20037
Pasco Hernando Oncology Associates, PA - Brooksville Brooksville, Florida  34613
Pasco Hernando Oncology Associates, PA - New Port Richey New Port Richey, Florida  34652
Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center Columbia, Missouri  65201
Sussex County Medical Associates - Sparta Sparta, New Jersey  07871
Tri-County Hematology/Oncology Associates, Incorporated Canton, Ohio  44718
Hematology Oncology Consultants, Incorporated Columbus, Ohio  43235
West Clinic - East Memphis Memphis, Tennessee  38120
Patients' Comprehensive Cancer Center - Carrollton Carrollton, Texas  75010-4602
Oncology Consultants - Memorial City Houston, Texas  77024