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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2010-00798 |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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Drugs used in chemotherapy, such as doxorubicin hydrochloride liposome and cyclophosphamide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as trastuzumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving more than one drug (combination chemotherapy) together with trastuzumab may be a better way to block tumor growth.
PRIMARY OBJECTIVES: I. To determine the optimal tolerated dose of Doxil when given in combination with daily oral cyclophosphamide in patients with stage IV breast cancer. (Phase I) II. To determine the efficacy (overall clinical response rate) of the optimal tolerated dose of Doxil when given in combination with daily oral cyclophosphamide and herceptin (for HER2 neu positive patients) in patients with stage IV breast cancer. (Phase II) SECONDARY OBJECTIVES: I. To assess the treatment related toxicity associated with each dose level of this regimen and assess efficacy (overall clinical response rate). (Phase I) II. To assess the safety (treatment related toxicity) of the optimal tolerated dose of Doxil when given in combination with daily oral cyclophosphamide and herceptin (for HER2 neu positive patients) in patients with stage IV breast cancer. (Phase II) III. To assess time to progression and overall survival following treatment with Doxil and daily oral cyclophosphamide and herceptin (for HER2 neu positive patients). (Phase II) IV. To compare the response rate in patients who are heavily pretreated to the response rate in patients who are less heavily pretreated. OUTLINE: This is a phase I, dose-escalation study of pegylated doxorubicin HCl liposome followed by a phase II feasibility study. Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm I | Experimental | Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| pegylated liposomal doxorubicin hydrochloride | Drug | Given IV |
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| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose and Optimal Tolerated Dose of Pegylated Liposomal Doxorubicin Hydrochloride (Doxil) When Given in Combination With Cyclophosphamide (Phase I) | The dose level in which 2 or more patients develop treatment-related toxicity of grade 3 or higher OR require a dose adjustment following the first course of treatment | Up to 24 weeks |
| Efficacy as Assessed by the Overall Clinical Benefit Rate | Count of participants with a clinical benefit (i.e., complete response, partial response, and stable disease). | 18 months |
| Safety as Assessed by Grade 1, 2, 3, 4, Fatal Toxicity, Need for Dose Reduction, Treatment Interruption, or Treatment Discontinuation | Count of participants with grade 1, 2, 3, 4, fatal toxicity, need for dose reduction, treatment interruption, or treatment discontinuation | Periodically during study treatment, up to 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment-related Toxicity (Phase I) | Count of phase I participants with treatment related toxicity. | Up to 24 weeks |
| Time to Progression (Phase II) | Median time to progression. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions or new effusions. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hannah Linden | Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium | Seattle | Washington | 98109 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Cyclophosphamide, Doxil 30 mg/m^2, Trastuzumab | Patients receive oral cyclophosphamide once daily on days 1-28 and 30 mg/m^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Period 1: Doxil 30 mg/m^2 (Phase I) |
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| cyclophosphamide | Drug | Given orally |
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| trastuzumab | Biological | Given IV |
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| Up to 2 years |
| Progression-free Survival (Phase II) | Kaplan-Meier estimate assessed at 18 months | 18 months |
| Overall Survival (Phase II) | Kaplan-Meier estimate assessed at 18 months | 18 months |
| Comparison of Clinical Benefit Rate in 2 Subgroups--heavily Pre-treated (1 or More Regimens for Advanced Disease) vs Less Heavily Pre-treated (no Regimens for Advanced Disease) (Phase II) | Count of participants with a clinical benefit (i.e., complete response, partial response, and stable disease). | Up to 24 weeks |
| FG001 | Cyclophosphamide, Doxil 35 mg/m^2, Trastuzumab | Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV |
| COMPLETED |
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| NOT COMPLETED |
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| Period 2: Doxil 35 mg/m^2 (Phase I) |
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| Period 3: Phase II |
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| ID | Title | Description |
|---|---|---|
| BG000 | Phase I: Cyclophosphamide, Doxil, Trastuzumab | Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV |
| BG001 | Phase II: Cyclophosphamide, Doxil, Trastuzumab | Patients receive oral cyclophosphamide once daily on days 1-28 and pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Maximum Tolerated Dose and Optimal Tolerated Dose of Pegylated Liposomal Doxorubicin Hydrochloride (Doxil) When Given in Combination With Cyclophosphamide (Phase I) | The dose level in which 2 or more patients develop treatment-related toxicity of grade 3 or higher OR require a dose adjustment following the first course of treatment | Posted | Number | mg/m^2 | Up to 24 weeks |
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| Primary | Efficacy as Assessed by the Overall Clinical Benefit Rate | Count of participants with a clinical benefit (i.e., complete response, partial response, and stable disease). | Posted | Count of Participants | Participants | 18 months |
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| Primary | Safety as Assessed by Grade 1, 2, 3, 4, Fatal Toxicity, Need for Dose Reduction, Treatment Interruption, or Treatment Discontinuation | Count of participants with grade 1, 2, 3, 4, fatal toxicity, need for dose reduction, treatment interruption, or treatment discontinuation | Posted | Count of Participants | Participants | Periodically during study treatment, up to 24 weeks |
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| Secondary | Treatment-related Toxicity (Phase I) | Count of phase I participants with treatment related toxicity. | Posted | Count of Participants | Participants | Up to 24 weeks |
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| Secondary | Time to Progression (Phase II) | Median time to progression. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions or new effusions. | Posted | Median | 95% Confidence Interval | months | Up to 2 years |
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| Secondary | Progression-free Survival (Phase II) | Kaplan-Meier estimate assessed at 18 months | Posted | Number | 95% Confidence Interval | progression free survival probability | 18 months |
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| Secondary | Overall Survival (Phase II) | Kaplan-Meier estimate assessed at 18 months | Posted | Number | 95% Confidence Interval | survival probability | 18 months |
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| Secondary | Comparison of Clinical Benefit Rate in 2 Subgroups--heavily Pre-treated (1 or More Regimens for Advanced Disease) vs Less Heavily Pre-treated (no Regimens for Advanced Disease) (Phase II) | Count of participants with a clinical benefit (i.e., complete response, partial response, and stable disease). | Posted | Count of Participants | Participants | Up to 24 weeks |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cyclophosphamide, Doxil 30 mg/m^2, Trastuzumab | Patients receive oral cyclophosphamide once daily on days 1-28 and 30 mg/m^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV | 0 | 27 | 27 | 27 | ||
| EG001 | Cyclophosphamide, Doxil 35 mg/m^2, Trastuzumab | Patients receive oral cyclophosphamide once daily on days 1-28 and 35 mg/m^2 pegylated doxorubicin HCl liposome IV over 90 minutes on day 1. Treatment repeats every 4-6 weeks in the absence of disease progression or unacceptable toxicity. Some patients with HER2/neu 3+ disease may also receive trastuzumab IV over 30-90 minutes weekly or every 3 weeks at the discretion of the treating physician. pegylated liposomal doxorubicin hydrochloride: Given IV cyclophosphamide: Given orally trastuzumab: Given IV | 0 | 3 | 3 | 3 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Leukopenia | Blood and lymphatic system disorders |
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| Neutropenia | Infections and infestations |
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| Nausea | Gastrointestinal disorders |
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| Vomitting | Gastrointestinal disorders |
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| Anemia | Blood and lymphatic system disorders |
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| Alkaline Phosphatase | Metabolism and nutrition disorders |
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| Constipation | Gastrointestinal disorders |
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| Cough | Respiratory, thoracic and mediastinal disorders |
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| Diarrhea | Gastrointestinal disorders |
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| Fatigue | General disorders |
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| Gastric Reflux | Gastrointestinal disorders |
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| Hand Foot Syndrome | Skin and subcutaneous tissue disorders |
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| Mucositis | Gastrointestinal disorders |
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| Abdominal Pain | Gastrointestinal disorders |
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| Joint Pain | Musculoskeletal and connective tissue disorders |
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| Rash | Skin and subcutaneous tissue disorders |
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| Weight Loss | General disorders |
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| ALT High | Metabolism and nutrition disorders |
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| AST High | Metabolism and nutrition disorders |
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| Erythma | Skin and subcutaneous tissue disorders |
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| Low Hemoglobin | Metabolism and nutrition disorders |
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| Hypocalcemia | Metabolism and nutrition disorders |
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| Hypokalemia | Metabolism and nutrition disorders |
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| Hyponatremia | Metabolism and nutrition disorders |
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| Lymphopenia | Blood and lymphatic system disorders |
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| Taste Alteration | Metabolism and nutrition disorders |
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| Thrombocytopenia | Blood and lymphatic system disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Hannah Linden | University of Washington / Seattle Cancer Care Alliance | 206-288-6989 | hmlinden@uw.edu |
| ID | Term |
|---|---|
| D018567 | Breast Neoplasms, Male |
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C506643 | liposomal doxorubicin |
| D003520 | Cyclophosphamide |
| D000068878 | Trastuzumab |
| ID | Term |
|---|---|
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Counts |
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| Participants |
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