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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00545688
Registration number
NCT00545688
Ethics application status
Date submitted
16/10/2007
Date registered
17/10/2007
Date last updated
15/08/2017
Titles & IDs
Public title
A Study of Pertuzumab in Combination With Herceptin in Patients With HER2 Positive Breast Cancer.
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Scientific title
A Randomized, Open Label Study to Compare the Complete Pathological Response Rate Achieved With 4 Combinations of Herceptin, Docetaxel and Pertuzumab in Patients With Locally Advanced, Inflammatory or Early Stage HER2 Positive Breast Cancer
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Secondary ID [1]
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WO20697
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Breast Cancer
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Condition category
Condition code
Cancer
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Herceptin
Treatment: Drugs - Docetaxel
Treatment: Drugs - Pertuzumab
Experimental: 1 -
Experimental: 2 -
Experimental: 3 -
Experimental: 4 -
Treatment: Drugs: Herceptin
8mg/kg iv loading dose, followed by 6mg/kg iv 3-weekly
Treatment: Drugs: Docetaxel
75mg/m2 iv escalating to 100mg/m2 iv 3-weekly
Treatment: Drugs: Pertuzumab
840mg iv loading dose, followed by 420mg iv 3-weekly
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percentage of Participants Achieving Pathological Complete Response (pCR)
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Assessment method [1]
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pCR was defined as an absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. Participants with invalid/missing pCR assessments were defined as non-responders
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Timepoint [1]
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Approximately 4 months from randomization following surgery or early withdrawal, whichever occurred first (Surgery was performed within 2 weeks after Cycle 4)
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Primary outcome [2]
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Percentage of Participants Achieving pCR by Breast Cancer Type
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Assessment method [2]
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pCR was defined as an absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. Based on the type of breast cancer participants were categorized as those with 1. Operable breast cancer, 2. Inflammatory breast cancer and 3. Locally advanced breast cancer. Participants with invalid/missing pCR assessments were defined as non-responders.
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Timepoint [2]
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Approximately 4 months from randomization following surgery or early withdrawal, whichever occurred first (Surgery was performed within 2 weeks after Cycle 4)
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Primary outcome [3]
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Percentage of Participants Achieving pCR by Hormone Receptor Status
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Assessment method [3]
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pCR was defined as an absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. Participants were classified as Estrogen and/or Progesterone positive (+ve), Estrogen and/or Progesterone negative (-ve) or receptor status unknown. Participants with invalid/missing pCR assessments were defined as non-responders.
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Timepoint [3]
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Approximately 4 months from randomization following surgery or early withdrawal, whichever occurred first (Surgery was performed within 2 weeks after Cycle 4)
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Primary outcome [4]
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Percentage of Participants Achieving pCR by Lymph Node Status
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Assessment method [4]
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pCR was defined as an absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. Lymph node status was defined as either negative lymph node at surgery or positive lymph node at surgery. Participants with invalid/missing pCR assessments were defined as non-responders.
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Timepoint [4]
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Approximately 4 months from randomization following surgery or early withdrawal, whichever occurred first (Surgery was performed within 2 weeks after Cycle 4)
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Primary outcome [5]
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Percentage of Participants Achieving pCR by Presence or Absence of Residual Intraductal Carcinoma (DCIS) / Intalobular Carcinoma (LCIS)
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Assessment method [5]
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pCR was defined as an absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. Participants with invalid/missing pCR assessments were defined as non-responders.
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Timepoint [5]
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Approximately 4 months from randomization following surgery or early withdrawal, whichever occurred first (Surgery was performed within 2 weeks after Cycle 4)
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Secondary outcome [1]
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Percentage of Participants Achieving Best Primary Tumor Response (Complete Response [CR], Partial Response [PR], Stable Disease [SD] or Disease Progression [PD]) During Neo-Adjuvant Treatment by X-Ray/Mammography
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Assessment method [1]
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Tumor assessments were made based upon the Response Evaluation Criteria in Solid Tumors (RECIST) criteria - version 1.0. The clinical response at each cycle up to the last assessment prior to surgery was derived for primary breast tumor using the following algorithm: CR: if measurement of '0' is noted at a given cycle as compared to baseline measurement which is greater than (\>)0 at screening or cycle 1 Day 1; PR: if measurement is at least a 30 percent (%) decreased compared to baseline levels . (Reference= baseline size or sum of sizes); SD: if measurement at a given cycle is not sufficient shrinkage to qualify for neither PR nor sufficient increase to qualify for PD compared to baseline levels. PD: if lesion is at least a 20 % increase from measurements at baseline.
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Timepoint [1]
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Baseline up to Cycle 4 (assessed at, Baseline and Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [2]
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Percentage of Participants Achieving Best Overall Response (CR, PR, SD or PD) During Neo-Adjuvant Period by X-Ray/Mammography
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Assessment method [2]
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Tumor assessments were made based on the RECIST criteria - version 1.0 The overall response at each cycle up to the last assessment prior to surgery was derived for: i) the primary breast lesion; (ii) across secondary breast lesions, (iii) across all breast lesions (iv) across axillary nodes (v) across supraclavicular nodes and (vi) across all nodes (vii) across all lesions (overall) using the following algorithm: CR: if measurement of '0' is noted at a given cycle as compared to baseline measurement which is \>0 at screening or cycle 1 day 1; PR: if measurement is at least a 30% decreased compared to baseline levels . (Reference= baseline size or sum of sizes); SD: if measurement at a given cycle is not sufficient shrinkage to qualify for neither PR nor sufficient increase to qualify for PD compared to baseline levels. PD: if lesion is at least a 20 % increase from measurements at baseline. Overall response is derived based on the sum total of breast tumors and all nodes examined.
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Timepoint [2]
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Baseline up to Cycle 4 (assessed at Baseline, Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [3]
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Percentage of Participants Achieving Best Primary Breast Tumor Response (CR, PR, SD or PD) During Neo-Adjuvant Period by Clinical Examination
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Assessment method [3]
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Tumor assessments were made based on the RECIST criteria - version 1.0 The clinical response at each cycle up to the last assessment prior to surgery was derived for primary breast tumor using the following algorithm: CR: if measurement of '0' is noted at a given cycle as compared to baseline measurement which is \>0 at screening or cycle 1 day 1; PR: if measurement is at least a 30% decreased compared to baseline levels . (Reference= baseline size or sum of sizes); SD: if measurement at a given cycle is not sufficient shrinkage to qualify for neither PR nor sufficient increase to qualify for PD compared to baseline levels. PD: if lesion is at least a 20 % increase from measurements at baseline. Overall response is derived based on the sum total of breast tumors and all nodes examined.
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Timepoint [3]
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Baseline up to Cycle 4 (assessed at Baseline, Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [4]
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Percentage of Participants Achieving Best Overall Response (CR, PR, SD or PD) During the Neo-Adjuvant Period by Clinical Examination
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Assessment method [4]
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Tumor assessments were made based on the RECIST criteria - version 1.0 The clinical response at each cycle up to the last assessment prior to surgery was derived for: i) the primary breast lesion; (ii) across secondary breast lesions, (iii) across all breast lesions (iv) across axillary nodes (v) across supraclavicular nodes and (vi) across all nodes (vii) across all lesions (overall) using the following algorithm: CR: if measurement of '0' is noted at a given cycle as compared to baseline measurement which is \>0 at screening or cycle 1 day 1; PR: if measurement is at least a 30% decreased compared to baseline levels . (Reference= baseline size or sum of sizes); SD: if measurement at a given cycle is not sufficient shrinkage to qualify for neither PR nor sufficient increase to qualify for PD compared to baseline levels. PD: if lesion is at least a 20 % increase from measurements at baseline. Overall response is derived based on the sum total of breast tumors and all nodes examined.
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Timepoint [4]
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Baseline up to Cycle 4 (assessed at Baseline, Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [5]
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Percentage of Participants Achieving Clinical Response During Neo-Adjuvant Period by X-Ray/Mammography
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Assessment method [5]
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Clinical response was determined based on tumor measurements by sponsor in combination with tumor response assessment by investigator. Tumor assessments were made based on the RECIST criteria - version 1.0 The clinical response at each cycle up to the last assessment prior to surgery was derived for: i) the primary breast lesion; (ii) across secondary breast lesions, (iii) across all breast lesions (iv) across axillary nodes (v) across supraclavicular nodes and (vi) across all nodes (vii) across all lesions (overall) using the following algorithm: CR: if measurement of '0' is noted at a given cycle as compared to baseline measurement which is \>0 at screening or cycle 1 day 1; PR: if measurement is at least a 30% decreased compared to baseline levels . (Reference= baseline size or sum of sizes). Clinical Responders are participants who have achieved CR or PR during the Neo-adjuvant treatment. Overall response is derived based on the sum total of breast tumors and all nodes examined.
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Timepoint [5]
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Baseline up to Cycle 4 (assessed at Baseline, Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [6]
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Percentage of Participants Achieving Clinical Response During Neo-Adjuvant Period by Clinical Examination
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Assessment method [6]
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Tumor assessments were made based on the RECIST criteria - version 1.0 The clinical response at each cycle up to the last assessment prior to surgery was derived for: i) the primary breast lesion; (ii) across secondary breast lesions, (iii) across all breast lesions (iv) across axillary nodes (v) across supraclavicular nodes and (vi) across all nodes (vii) across all lesions (overall) using the following algorithm: CR: if measurement of '0' is noted at a given cycle as compared to baseline measurement which is \>0 at screening or cycle 1 day 1; PR: if measurement is at least a 30% decreased compared to baseline levels . (Reference= baseline size or sum of sizes). Clinical Responders are participants who have achieved CR or PR during the Neo-adjuvant treatment. Primary breast tumor clinical response is based on primary breast tumor assessment. Overall response is derived based on the sum total of breast tumors and all nodes examined.
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Timepoint [6]
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Baseline up to Cycle 4 (assessed at Baseline, Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [7]
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Time to Clinical Response During Neo-Adjuvant Treatment Period
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Assessment method [7]
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Time to clinical response was defined as the time from the date of first dose received to the date of assessment of clinical response. Time to Clinical response was determined by Kaplan-Meier estimates. Tumor assessments were made based on the RECIST criteria - version 1.0. The clinical response at each cycle up to the last assessment prior to surgery was derived for: i) the primary breast lesion; (ii) across secondary breast lesions, (iii) across all breast lesions (iv) across axillary nodes (v) across supraclavicular nodes and (vi) across all nodes (vii) across all lesions (overall) using the following algorithm: CR: if measurement of '0' is noted at a given cycle as compared to baseline measurement which is \>0 at screening or cycle 1 day 1; PR: if measurement is at least a 30% decreased compared to baseline levels . (Reference= baseline size or sum of sizes). Clinical Responders are participants who have achieved CR or PR during the Neo-adjuvant treatment.
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Timepoint [7]
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Baseline up to Cycle 4 (assessed at Baseline, Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [8]
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Percentage of Participants With Progressive Disease During Neo-Adjuvant Treatment Period
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Assessment method [8]
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Tumor assessments were made based upon the Response Evaluation Criteria in Solid Tumors (RECIST) criteria - version 1.0. The clinical response at each cycle up to the last assessment prior to surgery was derived for: i) the primary breast lesion; (ii) across secondary breast lesions, (iii) across all breast lesions (iv) across axillary nodes (v) across supraclavicular nodes and (vi) across all nodes (vii) across all lesions (overall) using the following algorithm: PD: if lesion is at least a 20 % increased from measurements at baseline. Percentage of participants along with 95% Confidence Interval (CI) for one sample binomial using Pearson-Clopper method were reported. Missing investigator assessments were considered as no progressive disease.
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Timepoint [8]
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Baseline up to Cycle 4 (assessed at Baseline, Day 1 of Cycles 1-4 Pre-Surgery) Up to approximately 24 months
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Secondary outcome [9]
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Percentage of Participants Achieving Breast Conserving Surgery For Whom Mastectomy Was Planned
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Assessment method [9]
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Breast Conserving Surgery (BCS) was defined as quadrantectomy, lumpectomy, no surgery, sentinel node biopsy, axillary surgical resection or other method of avoiding mastectomy.
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Timepoint [9]
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Surgery (Within 2 weeks after Cycle 4) Up to approximately 24 months
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Secondary outcome [10]
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Percentage of Participants Who Were Progression Free and Disease Free
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Assessment method [10]
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Disease-free survival (DFS) was defined as the time from first date of no disease to first documentation of PD or death. Participants without progression after surgery were considered Disease Free. Any evidence of contralateral disease in-situ was not considered as PD. Participants who were withdrawn from the study without documented progression and for whom evaluations were made, were censored at date of last assessment when participant was known to be disease-free. Progression-free survival (PFS) was defined as time from date of randomization to first documentation of PD or death. Any evidence of contralateral disease in-situ was not considered as PD. Participants who were withdrawn from study without documented progression and for whom evaluations were made, were censored at date of last assessment when the participant was known to be free from progressive disease. Participants without post baseline assessments but known to be alive were censored at the time of randomization.
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Timepoint [10]
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Randomization up to a maximum of 329 weeks
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Secondary outcome [11]
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Progression Free and Disease Free Survival
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Assessment method [11]
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DFS was defined as the time from the first date of no disease (date of surgery) to the first documentation of PD or death. Participants without progression after surgery were considered Disease Free. Any evidence of contralateral disease in-situ was not considered as PD. PFS was defined as the time from the date of randomization to the first documentation of PD or death. Any evidence of contralateral disease in-situ was not considered as PD. DFS and PFS were determined using Kaplan-Meier estimates.
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Timepoint [11]
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Randomization up to a maximum of 329 weeks
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Eligibility
Key inclusion criteria
* female patients, >=18 years of age;
* locally advanced, inflammatory or early stage invasive breast cancer;
* HER2 positive (HER2+++ by IHC or FISH/CISH+).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* metastatic disease (Stage IV) or bilateral breast cancer;
* previous anticancer therapy or radiotherapy for any malignancy;
* other malignancy, other than cancer in situ of the cervix, or basal cell cancer;
* insulin-dependent diabetes;
* clinically relevant cardiovascular disease.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
26/06/2006
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
22/09/2014
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Sample size
Target
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Accrual to date
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Final
417
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Recruitment in Australia
Recruitment state(s)
VIC,WA
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Recruitment hospital [1]
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Geelong Hospital; Andrew Love Cancer Centre - Geelong
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Recruitment hospital [2]
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Mount Medical Center - Perth
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Recruitment postcode(s) [1]
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3220 - Geelong
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Recruitment postcode(s) [2]
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6000 - Perth
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Recruitment outside Australia
Country [1]
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Austria
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State/province [1]
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Vienna
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Country [2]
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Austria
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State/province [2]
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Wien
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Country [3]
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Brazil
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State/province [3]
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RS
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Country [4]
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Brazil
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State/province [4]
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SC
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Country [5]
0
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Brazil
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State/province [5]
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SP
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Country [6]
0
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Canada
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State/province [6]
0
0
New Brunswick
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Country [7]
0
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Canada
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State/province [7]
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Ontario
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Country [8]
0
0
Canada
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State/province [8]
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Quebec
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Country [9]
0
0
Israel
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State/province [9]
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Jerusalem
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Country [10]
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Israel
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State/province [10]
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Kfar-Saba
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Country [11]
0
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Israel
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State/province [11]
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Tel Aviv
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Country [12]
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Italy
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State/province [12]
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Emilia-Romagna
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Country [13]
0
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Italy
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State/province [13]
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Friuli-Venezia Giulia
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Country [14]
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Italy
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State/province [14]
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Lombardia
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Country [15]
0
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Italy
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State/province [15]
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Veneto
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Country [16]
0
0
Korea, Republic of
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State/province [16]
0
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Seoul
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Country [17]
0
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Mexico
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State/province [17]
0
0
Aguascalientes
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Country [18]
0
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Mexico
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State/province [18]
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Mexico City
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Country [19]
0
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Mexico
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State/province [19]
0
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Puebla
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Country [20]
0
0
Peru
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State/province [20]
0
0
Arequipa
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Country [21]
0
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Peru
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State/province [21]
0
0
Lima
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Country [22]
0
0
Poland
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State/province [22]
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0
Lublin
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Country [23]
0
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Poland
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State/province [23]
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Olsztyn
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Country [24]
0
0
Poland
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State/province [24]
0
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Poznan
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Country [25]
0
0
Poland
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State/province [25]
0
0
Warszawa
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Country [26]
0
0
Russian Federation
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State/province [26]
0
0
Leningrad
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Country [27]
0
0
Russian Federation
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State/province [27]
0
0
Kazan
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Country [28]
0
0
Russian Federation
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State/province [28]
0
0
Moscow
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Country [29]
0
0
Russian Federation
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State/province [29]
0
0
Petrozavodsk
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Country [30]
0
0
Russian Federation
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State/province [30]
0
0
Pyatigorsk
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Country [31]
0
0
Russian Federation
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State/province [31]
0
0
Ryazan
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Country [32]
0
0
Russian Federation
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State/province [32]
0
0
Samara
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Country [33]
0
0
Russian Federation
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State/province [33]
0
0
Soshi
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Country [34]
0
0
Russian Federation
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State/province [34]
0
0
St Petersburg
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Country [35]
0
0
Russian Federation
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State/province [35]
0
0
Ulyanovsk
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Country [36]
0
0
Spain
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State/province [36]
0
0
Barcelona
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Country [37]
0
0
Spain
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State/province [37]
0
0
Vizcaya
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0
0
Spain
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State/province [38]
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0
Cordoba
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Country [39]
0
0
Spain
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State/province [39]
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0
Madrid
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Country [40]
0
0
Spain
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State/province [40]
0
0
Valencia
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Country [41]
0
0
Spain
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State/province [41]
0
0
Zaragoza
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Country [42]
0
0
Sweden
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State/province [42]
0
0
Stockholm
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Country [43]
0
0
Sweden
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State/province [43]
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0
Uppsala
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0
0
Switzerland
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State/province [44]
0
0
Baden
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Country [45]
0
0
Switzerland
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State/province [45]
0
0
Zürich
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Country [46]
0
0
Taiwan
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State/province [46]
0
0
Taipei
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Country [47]
0
0
Thailand
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State/province [47]
0
0
Bangkok
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Country [48]
0
0
Thailand
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State/province [48]
0
0
Songkhla
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Country [49]
0
0
Turkey
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State/province [49]
0
0
Izmir
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Country [50]
0
0
Turkey
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State/province [50]
0
0
Sihhiye, ANKARA
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Country [51]
0
0
United Kingdom
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State/province [51]
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0
Coventry
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Country [52]
0
0
United Kingdom
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State/province [52]
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0
Manchester
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Hoffmann-La Roche
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This 4 arm study will evaluate the efficacy and safety of 4 neoadjuvant treatment regimens in female patients with locally advanced, inflammatory or early stage HER2 positive breast cancer. Before surgery, patients will be randomized to one of 4 treatment arms, to receive 4 cycles of a)Herceptin + docetaxel b)Herceptin + docetaxel + pertuzumab c)Herceptin + pertuzumab or 4)pertuzumab + docetaxel. Pertuzumab will be administered at a loading dose of 840mg iv, then 420mg iv 3-weekly, Herceptin at a loading dose of 8mg/kg iv then 6mg/kg 3-weekly, and docetaxel at a dose of 75mg/m2 escalating to 100mg/m2 3-weekly. During the entire pre- and post-surgery period all patients will receive adequate chemotherapy as per standard of care, as well as any surgery and/or radiotherapy as required. The anticipated time on study treatment is 3-12 months, and the target sample size is 100-500 individuals.
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Trial website
https://clinicaltrials.gov/study/NCT00545688
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Trial related presentations / publications
Bianchini G, Kiermaier A, Bianchi GV, Im YH, Pienkowski T, Liu MC, Tseng LM, Dowsett M, Zabaglo L, Kirk S, Szado T, Eng-Wong J, Amler LC, Valagussa P, Gianni L. Biomarker analysis of the NeoSphere study: pertuzumab, trastuzumab, and docetaxel versus trastuzumab plus docetaxel, pertuzumab plus trastuzumab, or pertuzumab plus docetaxel for the neoadjuvant treatment of HER2-positive breast cancer. Breast Cancer Res. 2017 Feb 9;19(1):16. doi: 10.1186/s13058-017-0806-9. Swain SM, Schneeweiss A, Gianni L, Gao JJ, Stein A, Waldron-Lynch M, Heeson S, Beattie MS, Yoo B, Cortes J, Baselga J. Incidence and management of diarrhea in patients with HER2-positive breast cancer treated with pertuzumab. Ann Oncol. 2017 Apr 1;28(4):761-768. doi: 10.1093/annonc/mdw695. Erratum In: Ann Oncol. 2018 Apr 1;29(4):1075. doi: 10.1093/annonc/mdx336. Ann Oncol. 2018 Jul 1;29(7):1607. doi: 10.1093/annonc/mdx802. Ann Oncol. 2019 Aug 1;30(8):1404. doi: 10.1093/annonc/mdy538. Gianni L, Pienkowski T, Im YH, Tseng LM, Liu MC, Lluch A, Staroslawska E, de la Haba-Rodriguez J, Im SA, Pedrini JL, Poirier B, Morandi P, Semiglazov V, Srimuninnimit V, Bianchi GV, Magazzu D, McNally V, Douthwaite H, Ross G, Valagussa P. 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol. 2016 Jun;17(6):791-800. doi: 10.1016/S1470-2045(16)00163-7. Epub 2016 May 11. Gianni L, Pienkowski T, Im YH, Roman L, Tseng LM, Liu MC, Lluch A, Staroslawska E, de la Haba-Rodriguez J, Im SA, Pedrini JL, Poirier B, Morandi P, Semiglazov V, Srimuninnimit V, Bianchi G, Szado T, Ratnayake J, Ross G, Valagussa P. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial. Lancet Oncol. 2012 Jan;13(1):25-32. doi: 10.1016/S1470-2045(11)70336-9. Epub 2011 Dec 6.
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Results are available at
https://clinicaltrials.gov/study/NCT00545688
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