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Brief Title: Combination Chemotherapy in Treating Women With Stage I, Stage II, or Stage IIIA (cT1-3, N0-1, M0) Breast Cancer and Positive Axillary Lymph Nodes
Official Title: A Three-Arm Randomized Trial to Compare Adjuvant Adriamycin and Cyclophosphamide Followed by Taxotere (AC-T); Adriamycin and Taxotere (AT); and Adriamycin, Taxotere, and Cyclophosphamide (ATC) in Breast Cancer Patients With Positive Axillary Lymph Nodes
Study ID: NCT00003782
Brief Summary: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving combination chemotherapy after surgery may kill any tumor cells remaining following surgery. It is not yet known which regimen of combination chemotherapy is more effective in treating breast cancer with positive axillary lymph nodes. PURPOSE: Randomized phase III trial to compare the effectiveness of different regimens of combination chemotherapy in treating women who have undergone surgery for stage I, stage II, or stage IIIA breast cancer with positive axillary lymph nodes.
Detailed Description: OBJECTIVES: * Compare the efficacy of adjuvant doxorubicin, cyclophosphamide, and docetaxel given concurrently vs adjuvant doxorubicin and cyclophosphamide followed by docetaxel, in terms of overall survival and disease-free survival, of women with breast cancer and positive axillary lymph nodes. * Compare the efficacy of adjuvant doxorubicin and docetaxel vs regimens containing cyclophosphamide in these patients. * Compare the toxic effects of these regimens in these patients. * Compare the quality of life of patients treated with these regimens. (Quality of life substudy closed to accrual as of 7/20/01.) * Compare the differences in amenorrhea in premenopausal women in each treatment arm and its relationship to symptoms, quality of life (quality of life substudy closed to accrual as of 7/20/01), disease-free survival, and overall survival. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center, number of positive nodes (1-3 vs 4-9 vs at least 10), sequential tamoxifen or anastrozole administration (yes vs no), and type of prior surgery and radiotherapy plan (mastectomy with no local or regional radiotherapy vs mastectomy with local and/or regional radiotherapy vs lumpectomy with local radiotherapy vs lumpectomy with local and regional radiotherapy). Patients are randomized to one of three treatment arms. * Arm 1: Patients receive doxorubicin IV over 15 minutes and cyclophosphamide IV over 30 minutes every 21 days for 4 courses. Three weeks after the last dose of this combination, patients receive docetaxel IV over 1 hour every 21 days for 4 courses. * Arm 2: Patients receive doxorubicin IV over 15 minutes and docetaxel IV over 1 hour every 21 days for 4 courses. * Arm 3: Patients receive doxorubicin IV over 15 minutes, cyclophosphamide IV over 30 minutes, and docetaxel IV over 1 hour every 21 days for 4 courses. Patients in all arms who are estrogen receptor-positive and/or progesterone receptor-positive receive oral tamoxifen daily for 5 years beginning within 3-12 weeks of completion of chemotherapy. Patients who are postmenopausal may receive alternative hormonal therapy at the discretion of the treating physician. Some patients may receive postmastectomy radiotherapy on SWOG-S9927 or NCIC-MA.20 after recovery from chemotherapy. Quality of life and menstrual history are assessed before randomization, on day 1 of course 4, and at 6, 12, 18, and 24 months. (Quality of life substudy closed to accrual as of 7/20/01.) Patients are followed every 6 months for 5 years and then annually thereafter. PROJECTED ACCRUAL: A total of 5,300 patients will be accrued for this study within 4-5 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
Comprehensive Cancer Institute, Huntsville, Alabama, United States
Providence Alaska Medical Center, Anchorage, Alaska, United States
CCOP - Western Regional, Arizona, Phoenix, Arizona, United States
City of Hope Comprehensive Cancer Center, Duarte, California, United States
California Cancer Center, Fresno, California, United States
Sutter Health Western Division Cancer Research Group, Greenbrae, California, United States
Scripps Cancer Center at Scripps Clinic, La Jolla, California, United States
Rebecca and John Moores UCSD Cancer Center, La Jolla, California, United States
Loma Linda University Cancer Institute at Loma Linda University Medical Center, Loma Linda, California, United States
Pacific Shores Medical Group, Long Beach, California, United States
CCOP - Bay Area Tumor Institute, Oakland, California, United States
Chao Family Comprehensive Cancer Center at University of California Irvine Cancer Center, Orange, California, United States
Comprehensive Cancer Centers of the Desert, Palm Springs, California, United States
Stanford Cancer Center at Stanford University Medical Center, Palo Alto, California, United States
Sutter Cancer Center, Sacramento, California, United States
Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego, San Diego, California, United States
Catholic Healthcare West - Westbay Region, San Francisco, California, United States
CCOP - Santa Rosa Memorial Hospital, Santa Rosa, California, United States
Kaiser Permanente Medical Center - Vallejo, Vallejo, California, United States
University of Colorado Cancer Center at University of Colorado Health Sciences Center, Denver, Colorado, United States
CCOP - Colorado Cancer Research Program, Incorporated, Denver, Colorado, United States
University of Connecticut Cancer Center at University of Connecticut Health Center, Farmington, Connecticut, United States
Hartford Hospital, Hartford, Connecticut, United States
CCOP - Christiana Care Health Services, Wilmington, Delaware, United States
MBCCOP - Howard University Cancer Center, Washington, District of Columbia, United States
Morton Plant Hospital, Clearwater, Florida, United States
Halifax Medical Center, Daytona Beach, Florida, United States
Baptist Regional Cancer Institute - Jacksonville, Jacksonville, Florida, United States
CCOP - Mount Sinai Medical Center, Miami Beach, Florida, United States
University of Miami Sylvester Cancer Center, Miami, Florida, United States
MD Anderson Cancer Center Orlando, Orlando, Florida, United States
Sarasota Memorial Hospital, Sarasota, Florida, United States
Winship Cancer Institute of Emory University, Atlanta, Georgia, United States
CCOP - Atlanta Regional, Atlanta, Georgia, United States
Medical College of Georgia Comprehensive Cancer Center, Augusta, Georgia, United States
Dwight David Eisenhower Army Medical Center, Fort Gordon, Georgia, United States
Cancer Research Center of Hawaii, Honolulu, Hawaii, United States
North Idaho Cancer Center, Coeur d'Alene, Idaho, United States
John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, United States
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, United States
Creticos Cancer Center at Advocate Illinois Masonic Medical Center, Chicago, Illinois, United States
CCOP - Central Illinois, Decatur, Illinois, United States
CCOP - Evanston, Evanston, Illinois, United States
CCOP - Illinois Oncology Research Association, Peoria, Illinois, United States
CCOP - Carle Cancer Center, Urbana, Illinois, United States
Methodist Cancer Center at Methodist Hospital, Indianapolis, Indiana, United States
St. Vincent Hospital and Health Care Center, Indianapolis, Indiana, United States
Community Hospital, Munster, Indiana, United States
Genesis Medical Center, Davenport, Iowa, United States
CCOP - Iowa Oncology Research Association, Des Moines, Iowa, United States
Holden Comprehensive Cancer Center at University of Iowa, Iowa City, Iowa, United States
CCOP - Wichita, Wichita, Kansas, United States
Markey Cancer Center at University of Kentucky Chandler Medical Center, Lexington, Kentucky, United States
Norton Healthcare Cancer Center, Louisville, Kentucky, United States
Consultants in Blood Disorders and Cancer, Louisville, Kentucky, United States
Stanley S. Scott Cancer Center at Louisiana State University Medical Center - New Orleans, New Orleans, Louisiana, United States
Tulane University Medical Center, New Orleans, Louisiana, United States
CCOP - Ochsner, New Orleans, Louisiana, United States
Eastern Maine Medical Center, Bangor, Maine, United States
Franklin Square Hospital Center, Baltimore, Maryland, United States
National Naval Medical Center, Bethesda, Maryland, United States
Cancer Research Center at Boston Medical Center, Boston, Massachusetts, United States
Lahey Clinic Medical Center - Burlington, Burlington, Massachusetts, United States
Berkshire Medical Center, Pittsfield, Massachusetts, United States
Baystate Medical Center, Springfield, Massachusetts, United States
CCOP - Michigan Cancer Research Consortium, Ann Arbor, Michigan, United States
Josephine Ford Cancer Center at Henry Ford Hospital, Detroit, Michigan, United States
Michigan State University, East Lansing, Michigan, United States
CCOP - Grand Rapids, Grand Rapids, Michigan, United States
CCOP - Kalamazoo, Kalamazoo, Michigan, United States
CCOP - Beaumont, Royal Oak, Michigan, United States
Providence Cancer Institute at Providence Hospital, Southfield, Michigan, United States
CCOP - Duluth, Duluth, Minnesota, United States
Hennepin County Medical Center - Minneapolis, Minneapolis, Minnesota, United States
CCOP - Metro-Minnesota, Saint Louis Park, Minnesota, United States
Ellis Fischel Cancer Center at University of Missouri - Columbia, Columbia, Missouri, United States
CCOP - Kansas City, Kansas City, Missouri, United States
St. Louis University Hospital Cancer Center, Saint Louis, Missouri, United States
CCOP - St. Louis-Cape Girardeau, Saint Louis, Missouri, United States
CCOP - Cancer Research for the Ozarks, Springfield, Missouri, United States
CCOP - Montana Cancer Consortium, Billings, Montana, United States
Methodist Hospital Cancer Center at Nebraska Methodist Hospital - Omaha, Omaha, Nebraska, United States
CCOP - Missouri Valley Cancer Consortium, Omaha, Nebraska, United States
CCOP - Southern Nevada Cancer Research Foundation, Las Vegas, Nevada, United States
CCOP - Northern New Jersey, Hackensack, New Jersey, United States
Cancer Institute of New Jersey, New Brunswick, New Jersey, United States
Newark Beth Israel Medical Center, Newark, New Jersey, United States
MBCCOP - University of New Mexico HSC, Albuquerque, New Mexico, United States
New York Oncology Hematology, P.C. - Albany Regional Cancer Center, Albany, New York, United States
Lincoln Medical and Mental Health Center, Bronx, New York, United States
MBCCOP-Our Lady of Mercy Cancer Center, Bronx, New York, United States
Charles R. Wood Foundation Cancer Center at Glens Falls Hospital, Glens Falls, New York, United States
Staten Island University Hospital, Staten Island, New York, United States
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C., Syracuse, New York, United States
Alamance Cancer Center, Burlington, North Carolina, United States
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill, Chapel Hill, North Carolina, United States
Leo W. Jenkins Cancer Center of University Health Systems of Eastern Carolina, Greenville, North Carolina, United States
CCOP - Southeast Cancer Control Consortium, Winston-Salem, North Carolina, United States
Comprehensive Cancer Center at Wake Forest University, Winston-Salem, North Carolina, United States
CCOP - Merit Care Hospital, Fargo, North Dakota, United States
Akron City Hospital, Akron, Ohio, United States
Aultman Hospital Cancer Center at Aultman Health Foundation, Canton, Ohio, United States
Jewish Hospital of Cincinnati, Incorporated, Cincinnati, Ohio, United States
Charles M. Barrett Cancer Center at University Hospital, Cincinnati, Ohio, United States
CCOP - Columbus, Columbus, Ohio, United States
Arthur G. James Cancer Hospital - Ohio State University, Columbus, Ohio, United States
CCOP - Dayton, Kettering, Ohio, United States
CCOP - Toledo Community Hospital, Toledo, Ohio, United States
South Pointe Hospital - Cancer Care Center, Warrensville Heights, Ohio, United States
CCOP - Oklahoma, Tulsa, Oklahoma, United States
CCOP - Columbia River Oncology Program, Portland, Oregon, United States
John and Dorothy Morgan Cancer Center at Lehigh Valley Hospital, Allentown, Pennsylvania, United States
Geisinger Medical Center, Danville, Pennsylvania, United States
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia, Philadelphia, Pennsylvania, United States
Albert Einstein Cancer Center, Philadelphia, Pennsylvania, United States
Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
Hillman Cancer Center at University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, United States
Reading Hospital and Medical Center, Reading, Pennsylvania, United States
Mercy Hospital Cancer Center - Scranton, Scranton, Pennsylvania, United States
CCOP - MainLine Health, Wynnewood, Pennsylvania, United States
Wellspan Health - York Cancer Center, York, Pennsylvania, United States
CCOP - Greenville, Greenville, South Carolina, United States
CCOP - Upstate Carolina, Spartanburg, South Carolina, United States
Thompson Cancer Survival Center, Knoxville, Tennessee, United States
Baptist Cancer Institute - Memphis at Baptist Memorial Hospital - Memphis, Memphis, Tennessee, United States
Medical City Dallas Hospital, Dallas, Texas, United States
Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas, Dallas, Texas, United States
Baylor College of Medicine, Houston, Texas, United States
Joe Arrington Cancer Research and Treatment Center, Lubbock, Texas, United States
University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
CCOP - Scott and White Hospital, Temple, Texas, United States
Utah Valley Regional Medical Center - Provo, Provo, Utah, United States
Green Mountain Oncology Group, Bennington, Vermont, United States
Virginia Oncology Associates - Newport News, Newport News, Virginia, United States
Eastern Virginia Medical School, Norfolk, Virginia, United States
MBCCOP - Massey Cancer Center, Richmond, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia, Inc., Roanoke, Virginia, United States
CCOP - Virginia Mason Research Center, Seattle, Washington, United States
Puget Sound Oncology Consortium, Seattle, Washington, United States
CCOP - Northwest, Tacoma, Washington, United States
Charleston Area Medical Center, Charleston, West Virginia, United States
Camden-Clark Memorial Hospital, Parkersburg, West Virginia, United States
CCOP - St. Vincent Hospital Cancer Center, Green Bay, Green Bay, Wisconsin, United States
CCOP - Marshfield Clinic Research Foundation, Marshfield, Wisconsin, United States
St. Luke's Medical Center, Milwaukee, Wisconsin, United States
Medical College of Wisconsin Cancer Center, Milwaukee, Wisconsin, United States
Tom Baker Cancer Center - Calgary, Calgary, Alberta, Canada
CancerCare Manitoba, Winnipeg, Manitoba, Canada
Credit Valley Hospital, Mississauga, Ontario, Canada
Ottawa Regional Cancer Centre, Ottawa, Ontario, Canada
St. Michael's Hospital - Toronto, Toronto, Ontario, Canada
Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
Royal Victoria Hospital - Montreal, Montreal, Quebec, Canada
Montreal General Hospital, Montreal, Quebec, Canada
Jewish General Hospital - Montreal, Montreal, Quebec, Canada
St. Mary's Hospital Center, Montreal, Quebec, Canada
Hopital du Saint-Sacrement, Quebec, Quebec City, Quebec, Canada
Name: Norman Wolmark, MD
Affiliation: NSABP Foundation Inc
Role: PRINCIPAL_INVESTIGATOR