Effect of Perioperative AntiHER-2 Therapy on Early Breast Cancer Study - Biological Phase (EPHOS-B)
OBJECTIVES:
Primary
- To determine whether pre-operative treatment of HER-2 positive breast cancer patients
with anti-HER2 therapy consisting of trastuzumab (Herceptin®) vs lapatinib ditosylate
inhibits proliferation or increases apoptosis.
- To compare trastuzumab (Herceptin®) and lapatinib ditosylate effects on inhibition of
proliferation or increase of apoptosis.
Secondary
- To determine whether pre-operative anti-HER2 treatment reduces serum angiogenic
factors.
OUTLINE: This is a multicenter study. Patients are stratified according to center. Patients
are randomized to 1 of 3 treatment arms.
- Arm I (control): Patients receive no neoadjuvant or adjuvant therapy. Approximately 14
days after randomization, patients undergo either breast-conservation surgery or
mastectomy.
- Arm II (trastuzumab [Herceptin®]): Patients receive neoadjuvant trastuzumab IV over 90
minutes on days 1 and 8. Approximately 11 days after beginning of neoadjuvant therapy,
patients undergo either breast-conservation surgery or mastectomy, and receive adjuvant
trastuzumab on day 15.
- Arm III (lapatinib ditosylate): Patients receive neoadjuvant oral lapatinib ditosylate
once daily on days 1-11. Within 24 hours after completion of neoadjuvant therapy,
patients undergo either breast-conservation surgery or mastectomy, and receive adjuvant
lapatinib ditosylate once daily on days 12-28.
Patients also receive standard adjuvant systemic therapy, including endocrine therapy (for
hormone-sensitive disease) and/or chemotherapy and radiotherapy.
All patients undergo blood and tissue sample collection periodically for biomarker research
studies comprising biomarkers of proliferation, apoptosis, and angiogenesis.
After completion of study treatment, patients are followed up every 6 months for 2 years and
then annually for 10 years.
Peer Reviewed and Funded or Endorsed by Cancer Research UK
Interventional
Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment
Increase in apoptosis, by change in the tumor (morphological apoptosis and activated caspase 3) measured at diagnosis and at surgery (biological phase)
No
Nigel Bundred
Principal Investigator
Wythenshawe Hospital
Unspecified
CDR0000669882
NCT01104571
April 2010
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