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Brief Title: Trastuzumab in Treating Women With HER2-Positive Early Breast Cancer
Official Title: Persephone: Duration of Trastuzumab With Chemotherapy in Women With Early Stage Breast Cancer: Six Months Versus Twelve
Study ID: NCT00712140
Brief Summary: RATIONALE: 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. It is not yet known which regimen of trastuzumab is more effective in treating early breast cancer. PURPOSE: This randomized phase III trial is comparing two trastuzumab regimens to see how well they work in treating women with HER2-positive early breast cancer.
Detailed Description: OBJECTIVES: Primary * Determine disease-free survival of women with HER2-positive early breast cancer treated with neoadjuvant or adjuvant trastuzumab (Herceptin®) for 6 months versus 12 months. Secondary * Determine the overall survival of patients treated with these regimens. * Determine the expected incremental cost effectiveness (cost per quality adjusted life year gained) for 6 months versus 12 months trastuzumab. * Determine cardiac function as assessed by left ventricular ejection fraction every 3 months during treatment. * Analyze the predictive factors for development of cardiac damage. OUTLINE: This is a multicenter study. Patients are stratified according to estrogen receptor status (negative vs positive); chemotherapy timing (adjuvant vs neoadjuvant); chemotherapy type (anthracycline based \[no taxane\] vs taxane and anthracyclines vs taxane-based \[no anthracyclines\]); and trastuzumab (Herceptin®) timing (concurrently vs sequentially \[with respect to chemotherapy\]). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive trastuzumab IV over 30-90 minutes on day 1. Treatment repeats every 3 weeks for up to 12 months in the absence of disease progression or unacceptable toxicity. * Arm II: Patients receive trastuzumab IV over 30-90 minutes on day 1. Treatment repeats every 3 weeks for up to 6 months in the absence of disease progression or unacceptable toxicity. All patients also receive standard chemotherapy regimens as per local institutional protocols either concurrently with or sequentially to trastuzumab. Patients complete quality of life questionnaires using the EuroQoL-5D (EQ-5D) at baseline and periodically during study treatment. Patients also complete a diary on out-of-pocket expenses associated with their condition (i.e., travel expenses, over-the-counter medicines and supplements, complementary therapies not funded by NHS, home help, and time away from work) for cost-effective analysis. After completion of study therapy, patients are followed every 3 months for 1 year, then every 6 months for 1 year, and annually thereafter.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
Addenbrooke's Hospital, Cambridge, England, United Kingdom
Cumberland Infirmary, Carlisle, England, United Kingdom
Derbyshire Royal Infirmary, Derby, England, United Kingdom
Eastbourne District General Hospital, Eastbourne, England, United Kingdom
Luton and Dunstable Hospital, Luton, England, United Kingdom
Clatterbridge Centre for Oncology, Merseyside, England, United Kingdom
James Cook University Hospital, Middlesbrough, England, United Kingdom
Mount Vernon Cancer Centre at Mount Vernon Hospital, Northwood, England, United Kingdom
Peterborough Hospitals Trust, Peterborough, England, United Kingdom
New Cross Hospital, Wolverhampton, England, United Kingdom
Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom
Name: Helena Earl, MBBS, PhD, FRCP
Affiliation: Cambridge University Hospitals NHS Foundation Trust
Role: PRINCIPAL_INVESTIGATOR