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Brief Title: Myocet + Cyclophosphamide + Metformin Vs Myocet + Cyclophosphamide in 1st Line Treatment of HER2 Neg. Metastatic Breast Cancer Patients
Official Title: Phase II Comparative Study of Myocet Plus Cyclophosphamide in First Line Treatment of HER2 Negative Metastatic Breast Patients
Study ID: NCT01885013
Brief Summary: This is a phase II comparative randomized clinical trial. Eligible patients will be randomized (1:1) to: Arm A: Myocet plus Cyclofosfamide plus Metformin Arm B: Myocet plus Cyclofosfamide Statistical Considerations: In this randomized phase II study, the sample size was calculated basing on the primary end-point (PFS) and assuming an error α = 10% (2-tailed) with a power of 80%. To find an advantage of 4 months of median time to progression (6 months in the control arm B and 10 months in the experimental arm A) will be recruited 112 patients (98 events) for a period of 24 months and will be considered further 12-month of follow-up. The primary analysis of the study will be conducted in accordance with the "intention to treat" principle, the secondary analysis will be conducted in the "per protocol" population.
Detailed Description: MULTICENTER, RANDOMIZED, COMPARATIVE STUDY OF MYOCET PLUS CYCLOPHOSPHAMIDE PLUS METFORMIN VERSUS MYOCET PLUS CYCLOPHOSPHAMIDE IN FIRST LINE TREATMENT OF HER2 NEGATIVE METASTATIC BREAST CANCER PATIENTS. The aim of this study is to determine if the addition of metformin to the regime Myocet / Cyclophosphamide improves disease-free survival in patients with HER2-negative metastatic breast cancer. The primary objective is the evaluation of the clinical efficacy of the combination of Myocet / Cyclophosphamide plus Metformin compared to treatment with only Myocet / Cyclophosphamide, in terms of progression-free survival (PFS). Clinical secondary objectives are: * Objective response rate * Overall survival * Tolerability * Progression-free survival, objective response rate and overall survival according to Homa Index levels. Secondary biological endpoint is the characterization of the metabolic profile of patients (sensitivity in insulin levels). Treatment Arm A (experimental treatment): Metformin 1000 mg, 2 times daily per os\*. Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Cyclophosphamide 600 mg/m2, intravenous infusion, at day 1 every 21 days. \* During cycle 1, patients will assume only metformin from day 1 to day 13 and will begin chemotherapy from day 14. From day 1 to day 3, patients will assume Metformin 1000 mg once a day. Starting from day 4 patients will assume Metformin 1000 mg 2 times a day. Arm B (standard treatment): Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Cyclophosphamide 600 mg/m2, intravenous infusion, on day 1, every 21 days Chemotherapy will be performed for 8 cycles. The treatment will be continued until progression of disease. Statistical Considerations: In this randomized phase II study, the sample size was calculated basing on the primary end-point (PFS) and assuming an error α = 10% (2-tailed) with a power of 80%. To find an advantage of 4 months of median time to progression (6 months in the control arm B and 10 months in the experimental arm A) will be recruited 112 patients (98 events) for a period of 24 months and will be considered further 12-month of follow-up. The primary analysis of the study will be conducted in accordance with the "intention to treat" principle, the secondary analysis will be conducted in the "per protocol" population.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
P.O. M. Bufalini, Cesena, FC, Italy
UO Oncologia Medica IRCCS IRST, Meldola (FC), FC, Italy
Ospedale Civile degli Infermi, Faenza, RA, Italy
Ospedale Umberto I, Lugo, RA, Italy
Ospedale Civile Santa Maria delle Croci, Ravenna, RA, Italy
ULSS n.8 Asolo Ospedale di Castelfranco, Asolo, , Italy
Centro di Riferimento Oncologico CRO, Aviano, , Italy
Ospedale S.Martino, Belluno, , Italy
Azienda Ospedaliera "Antonio Cardarelli", Campobasso, , Italy
P.O. "SS. Annunziata", Chieti, , Italy
Presidio Ospedaliero E. Profili, Fabriano, , Italy
E.O. Galliera, Genova, , Italy
Ospedale di Guastalla, Guastalla, , Italy
Azienda per i Servizi Sanitari n.5 "Bassa Friulana", Latisana, , Italy
Presidio Ospedaliero "Vito Fazzi", Lecce, , Italy
ULSS n.13 di Mirano, Mirano, , Italy
Arcispedale S. Maria Nuova, Modena, , Italy
Azienda Ospedaliera S. Salvatore di Pesaro, Pesaro, , Italy
Ospedale S. Spirito, Pescara, , Italy
Ospedale Civile di Piacenza, Piacenza, , Italy
Azienda Ospedaliera Santa Maria degli Angeli, Pordenone, , Italy
Arcispedale S. Maria Nuova, Reggio Emilia, , Italy
Ospedale Civile degli Infermi, Rimini, , Italy
IRCCS Centro di riferimento Oncologico di Basilicata di Rionero in Vulture, Rionero in Vulture, , Italy
Ospedale Nuovo Regina Margherita, Roma, , Italy
Name: Dino Amadori, MD
Affiliation: IRST IRCCS, Meldola
Role: PRINCIPAL_INVESTIGATOR