Clinical Trial: Docetaxel,Carboplatin,Trastuzumab and Bevacizumab for Breast Cancer and Bone Marrow Micrometastases

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Docetaxel, Carboplatin, Trastuzumab and Bevacizumab (TCH+B) For Early-Stage HER-2/Neu(+) Breast Cancer and Bone Marrow Micrometastases

Brief Summary:

RATIONALE: Drugs used in chemotherapy, such as docetaxel and carboplatin, 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 and bevacizumab, 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 chemotherapy together with monoclonal antibody therapy may kill more tumor cells.

PURPOSE: This clinical trial is studying how well giving docetaxel and carboplatin together with trastuzumab and bevacizumab works in treating patients with stage I, stage II, or stage III breast cancer and bone marrow micrometastases.


Detailed Summary:

OBJECTIVES:

Primary

  • Determine the clinical response in patients with HER2/neu-positive stage I-III breast cancer and bone marrow micrometastases treated with docetaxel, carboplatin, trastuzumab, and bevacizumab.

Secondary

  • Investigate the specific contribution of VEGF and CXCL-12 (SDF-1) signaling to bone marrow support of HER2/neu-positive breast cancer cells.
  • Evaluate growth factor and chemokine expression profiles to investigate the potential correlation of expression with patient outcome and frequency of tumor cell clusters (mammospheres with tumor stem cell phenotype) in microenvironment supported cultures.

OUTLINE: Patients receive docetaxel IV, carboplatin IV, and bevacizumab IV over 30-90 minutes on day 1 and trastuzumab IV over 30-90 minutes on days 1, 8, and 15. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. After 6 courses, treatment modifications may apply according to response.

Tumor tissue and bone marrow samples may be collected for further laboratory analysis.

After completion of study therapy, patients are followed up for 30 days.


Sponsor: Case Comprehensive Cancer Center

Current Primary Outcome: Proportion of patients who have a complete response in bone marrow. [ Time Frame: at 4 weeks after completing 6 courses of therapy ]

Original Primary Outcome: Proportion of patients who have a complete response in bone marrow at 4 weeks after completing 6 courses of therapy

Current Secondary Outcome:

  • Specific contribution of VEGF and CXCL-12 (SDF-1) signaling to bone marrow support of HER2/neu-positive breast cancer cells [ Time Frame: pre- and post-treatment ]
  • Potential correlation of growth factor and chemokine expression with patient outcome and frequency of tumor cell clusters (mammospheres with tumor stem cell phenotype) in microenvironment supported cultures [ Time Frame: pre- and post-therapy ]


Original Secondary Outcome:

  • Specific contribution of VEGF and CXCL-12 (SDF-1) signaling to bone marrow support of HER2/neu-positive breast cancer cells
  • Potential correlation of growth factor and chemokine expression with patient outcome and frequency of tumor cell clusters ("mammospheres" with tumor stem cell phenotype) in microenvironment supported cultures


Information By: Case Comprehensive Cancer Center

Dates:
Date Received: July 29, 2009
Date Started: December 2009
Date Completion:
Last Updated: April 17, 2013
Last Verified: April 2013