Exploratory Study of Sunitinib Malate as a Component of Neoadjuvant Therapy for Breast Cancer

An Exploratory Study of the Biological and Clinical Activity of Sunitinib Malate as a Component of Neoadjuvant Therapy for Breast Cancer

The combination of paclitaxel, doxorubicin, and cyclophosphamide is a standard neoadjuvant (given before surgery) treatment for patients that have either inoperable or operable breast cancer. This treatment can help shrink the tumors so they can be removed to help prevent the cancer from spreading to other parts of the body. This study is being done to test the impact of adding sunitinib as a single-agent (Segment 1), followed by sunitinib plus paclitaxel (Segment 2), followed by doxorubicin and cyclophosphamide (Segment 3). We hope the addition of sunitinib will make the treatment more effective, but we don't know if this is true.

Inclusion Criteria:

1. Patients must have histologically-confirmed adenocarcinoma of the breast with operable or inoperable stage 1c (primary tumor > 1.0 cm), II or III disease.
2. Measurable disease by physical examinations or diagnostic breast imaging (mammography, ultrasonography or MR).
3. Pre-treatment core or incisional biopsy. Patients may not have had definitive primary surgery.
4. Male or female, 18 years of age or older.
5. ECOG performance status 0 or 1.
6. Adequate organ function as defined in the protocol.

Exclusion Criteria:

1. Prior radiation therapy, cytotoxic therapy or systemic therapy for breast cancer. Prior use of tamoxifen or raloxifene as chemoprevention is allowed but must be discontinued prior to study entry.
2. Metastatic (Stage IV) breast cancer
3. Patients who have had only a pre-treatment fine needle aspiration (FNA) are excluded.
4. Current therapeutic treatment on another clinical trial with an investigational agent.
5. Any of the following within the 6 months prior to starting study treatment: -myocardial infarction -severe/unstable angina -coronary/peripheral artery bypass graft -congestive heart failure -cerebrovascular accident including transient ischemic attack -pulmonary embolus
6. Ongoing cardiac dysrhythmias of NCI CTCAE grade >=2, atrial fibrillation of any grade, or QTc interval >450 msec for males or >470 msec for females.
7. Hypertension that cannot be controlled by medications.
8. Current treatment with therapeutic doses of any anti-coagulant. Prophylactic use of anticoagulants is allowed.
9. Known human immunodeficiency virus (HIV) infection.
10. Pregnancy or breastfeeding. All female patients with reproductive potential must have a negative pregnancy test prior to first day of study medication.
11. Other severe acute or chronic medical or psychiatric condition, or laboratory abnormality that would impart, in the judgment of the investigator, excess risk associated with study participation or study drug administration, or which, in the judgment of the investigator, would make the patient inappropriate for entry into this study.