Letrozole Plus Oral Cyclophosphamide Plus/Minus Sorafenib as Primary Systemic Treatment in Post-menopausal, Estrogen Receptor Positive, Breast Cancer Patients
Inclusion Criteria:
- 1. Women in postmenopausal status
- 2. Age> 60 or age > 18 and unfit for chemotherapy with commonly employed regimens in
breast cancer patients
- 3. Diagnosis of invasive BC, T>2, N0-N2, M0,
- 4. Endocrine Responsive disease according to San Gallen criteria
- 5. ECOG Performance Status of 0 or 2
- 6. Life expectancy of at least 12 weeks
- 7. In case of recent surgery, the wound must be completely healed prior to receiving
Sorafenib
- 8. Subjects with at least one uni-dimensional(for RECIST) or bi-dimensional(for WHO)
measurable lesion. Lesions must be measured by CT-scan or MRI
- 9. Adequate bone marrow, liver and renal function as assessed by the following
laboratory requirements to be conducted within 7 days prior to screening:
- 10. Hemoglobin > 9.0 g/dl
- 11. Absolute neutrophil count (ANC) >1,500/mm3
- 12. Platelet count 100,000/μl
- 13. Total bilirubin < 1.5 times the upper limit of normal
- 14. ALT and AST < 2.5 x upper limit of normal (< 5 x upper limit of normal for
patients with liver involvement of their cancer)
- 15. Alkaline phosphatase < 4 x ULN
- 16. PT-INR/PTT < 1.5 x upper limit of normal [Patients who are being therapeutically
anticoagulated with an agent such as coumadin or heparin will be allowed to
participate provided that no prior evidence of underlying abnormality in these
parameters exists.]
- 17. Serum creatinine < 1.5 x upper limit of normal.
Exclusion Criteria:
- 1. History of cardiac disease:congestive heart failure >NYHA class 2;active CAD (MI
more than 6 mo prior to study entry is allowed); cardiac arrythmias requiring
anti-arrythmic therapy( beta blockers or digoxin are permitted) or uncontrolled
hypertension.
- 2. History of HIV infection or chronic hepatitis B or C (This criteria should be
modified to allow Hepatitis B or C in protocols looking at HCC patient population).
- 3. Active clinically serious infections (> grade 2 NCI-CTC version 3.0)
- 4. Symptomatic metastatic brain or meningeal tumors (unless the patient is > 6 months
from definitive therapy, has a negative imaging study within 4 weeks of study entry
and is clinically stable with respect to the tumor at the time of study entry)
- 5. Patients with seizure disorder requiring medication (such as steroids or
anti-epileptics)
- 6. History of organ allograft The organ allograft may be allowed as protocol
specific.
- 7. Patients with evidence or history of bleeding diathesis
- 8. Patients undergoing renal dialysis
- 9. Previous or concurrent cancer that is distinct in primary site or histology from
the cancer being evaluated in this study EXCEPT cervical carcinoma in situ, treated
basal cell carcinoma, superficial bladder tumors [Ta, Tis & T1] or any cancer
curatively treated > 3 years prior to study entry