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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00976989
Registration number
NCT00976989
Ethics application status
Date submitted
14/09/2009
Date registered
15/09/2009
Date last updated
6/02/2017
Titles & IDs
Public title
A Study of Pertuzumab in Combination With Herceptin and Chemotherapy in Participants With HER2-Positive Breast Cancer
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Scientific title
A Randomised, Multicentre, Multinational Phase II Study to Evaluate Pertuzumab in Combination With Trastuzumab, Given Either Concomitantly or Sequentially With Standard Anthracycline-based Chemotherapy or Concomitantly With a Non-anthracycline-based Chemotherapy Regimen, as Neoadjuvant Therapy for Patients With Locally Advanced, Inflammatory or Early Stage HER2-positive Breast Cancer
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Secondary ID [1]
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2009-012019-17
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Secondary ID [2]
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BO22280
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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 - Pertuzumab
Treatment: Drugs - Trastuzumab
Treatment: Drugs - FEC
Treatment: Drugs - Docetaxel
Treatment: Drugs - TCH
Experimental: T+P Concomitant Anthracycline-based chemotherapy - 5-Fluorouracil, epirubicin with cyclophosphamide (FEC), trastuzumab (T) and pertuzumab (P) every three weeks for three cycles, followed by docetaxel, trastuzumab and pertuzumab every three weeks, for three cycles as neoadjuvant therapy. Trastuzumab every three weeks from Cycle 7 up to Cycle 17 as adjuvant therapy post-surgery.
Experimental: T+P Sequential Anthracycline-based chemotherapy - FEC every three weeks for three cycles, followed by docetaxel, trastuzumab (T) and pertuzumab (P) every three weeks, for three cycles as neoadjuvant therapy. Trastuzumab every three weeks from Cycle 7 up to Cycle 21 as adjuvant therapy post-surgery.
Experimental: T+P Concomitant Non-Anthracycline chemotherapy - Trastuzumab, carboplatin, docetaxel (TCH) and pertuzumab (P) every three weeks, for six cycles as neoadjuvant therapy. Trastuzumab every three weeks from Cycle 7 up to Cycle 17 as adjuvant therapy post-surgery.
Treatment: Drugs: Pertuzumab
840 mg loading dose intravenously (IV), then 420 mg IV 3-weekly.
Treatment: Drugs: Trastuzumab
8 mg/kg loading dose IV, then 6 mg/kg every 3 weeks.
Treatment: Drugs: FEC
5-fluorouracil 500 mg/m\^2, epirubicin 100 mg/m\^2 and cyclophosphamide 600 mg/m\^2.
Treatment: Drugs: Docetaxel
75 mg/m\^2 for the first dose; 100 mg/m\^2 if no dose limiting toxicity occurs.
Treatment: Drugs: TCH
Trastuzumab followed by carboplatin at target area under the plasma concentration-time curve (AUC) 6 and docetaxel at a starting dose of 75 mg/m\^2. All treatments were given every three weeks by the IV route.
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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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Safety: Percentage of Participants With Symptomatic Cardiac Events as Assessed by the Investigator
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Assessment method [1]
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Left ventricular systolic dysfunction (LVSD) as assessed by the Investigator, including Grade 3, 4 or 5 symptomatic LVSD with symptomatic cardiac events.
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Timepoint [1]
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From baseline up to approximately 3.5 years
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Primary outcome [2]
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Safety: Percentage of Participants With Left Ventricular Ejection Fraction (LVEF) Decline During Pre-operative (Neoadjuvant) Period
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Assessment method [2]
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Percentage of participants with LVEF measures decline of = 10% from baseline and to a value of \<50% during the pre-operative (neoadjuvant) period.
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Timepoint [2]
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From baseline up to approximately 18 weeks
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Secondary outcome [1]
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Efficacy: Percentage of Participants With Complete Pathological Response (pCR)
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Assessment method [1]
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pCR is defined as the absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. pCR is evaluated after 6 cycles of treatment and surgery or following withdrawal from the study whichever occurs sooner.
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Timepoint [1]
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At surgery, after 18 weeks (6 cycles) of treatment
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Secondary outcome [2]
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Efficacy: Clinical Response Rate
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Assessment method [2]
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Tumor response is defined as complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD) and is identified as per local practice. Clinical response rate is defined as the percentage of participants who achieve a response of CR or PR at any time pre-surgery. Per Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by mammogram or magnetic resonance imaging (MRI) and clinical breast examination (CBE), CR is disappearance of all target lesions; PR is \>=30% decrease in the sum of the longest diameter of target lesions.
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Timepoint [2]
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During each 3-week cycle of 6 total cycles: up to 18 weeks
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Secondary outcome [3]
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Efficacy: Time to Clinical Response
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Assessment method [3]
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Time to clinical response is defined as the time from the date of first dose received to the first date of assessment of clinical response. Clinical response is defined as a response of CR or PR at any time pre-surgery. Per RECIST v1.0 for target lesions and assessed by mammogram or MRI and CBE, CR is disappearance of all target lesions; PR is \>=30% decrease in the sum of the longest diameter of target lesions.
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Timepoint [3]
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Up to 18 weeks
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Secondary outcome [4]
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Efficacy: Percentage of Participants Achieving Breast Conserving Surgery
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Assessment method [4]
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This is the percentage of participants who achieved breast conserving surgery out of the intent-to-treat population without inflammatory breast cancer, as these participants received mastectomy irrespective of their response to neoadjuvant (pre-operative) treatment.
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Timepoint [4]
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At approximately 18 weeks
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Secondary outcome [5]
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Efficacy: Percentage of Participants Without an Overall Survival (OS) Event
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Assessment method [5]
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Overall survival (OS) was defined as the time from randomization to the date of death from any cause. Participants who were alive or lost to follow-up were censored at the last known alive date. Participants with no post-baseline information were censored at the date of randomization plus one day.
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Timepoint [5]
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From baseline to end of study up to 5 years
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Secondary outcome [6]
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Efficacy: Percentage of Participants Without a Disease-Free Survival (DFS) Event
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Assessment method [6]
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The DFS was defined as the time from the first date of no disease (i.e., date of surgery) to the first documentation of progressive disease (PD) or death. PD was assessed using RECIST v1.0 and MRI and CBE. It was defined as at least a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 mm or the appearance of one or more new lesions. Any evidence of contralateral disease in situ was not considered as PD. Participants who were withdrawn from the study without documented PD were censored at the date of the last assessment when the participant was known to be disease-free.
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Timepoint [6]
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From baseline to end of study up to 5 years
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Secondary outcome [7]
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Efficacy: Percentage of Participants Without a Progression-Free Survival (PFS) Event
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Assessment method [7]
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Progression-free survival was defined as the time from the date of randomization to the first documentation of PD or death from any cause, whichever occurred first. PD was assessed using RECIST v1.0 and MRI and CBE. It was defined as at least a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 mm or the appearance of one or more new lesions. Participants who were withdrawn from the study without documented PD were censored at the date of the last assessment when the participant was known to be free from PD. Participants without post-baseline assessments but known to be alive were censored at the time of randomization plus one day.
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Timepoint [7]
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From baseline to end of study up to 5 years
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Secondary outcome [8]
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Safety: Percentage of Participants With Cardiac Symptoms Associated With Symptomatic Left Ventricular Systolic Dysfunction (LVSD)
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Assessment method [8]
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Percentage of participants with signs or symptoms of cardiac events.
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Timepoint [8]
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From Baseline to end of Neoadjuvant Period (up to 18 weeks), Adjuvant Period (up to 1.5 years), Follow-up Period (up to 3.5 years)
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Secondary outcome [9]
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Safety: Percentage of Participants With Asymptomatic Left Ventricular Ejection Fraction (LVEF) Events
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Assessment method [9]
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Percentage of participants with LVEF events without signs or symptoms of cardiac events.
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Timepoint [9]
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From baseline to end of Neoadjuvant Period (up to 18 weeks), Adjuvant Period (up to 1.5 years), Follow-up Period (up to 3.5 years)
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Secondary outcome [10]
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Safety: Maximum Decrease in Left Ventricular Ejection Fraction (LVEF) Measures
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Assessment method [10]
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Maximum decrease in LVEF measures is the change from baseline at worst treatment value. LVEF is measured as percentage.
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Timepoint [10]
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From baseline up to approximately 3.5 years
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Eligibility
Key inclusion criteria
* female participants, age >/=18 years
* advanced, inflammatory or early stage unilateral invasive breast cancer
* HER2-positive breast cancer
* baseline left ventricular ejection fraction (LVEF) >/=55%
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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, except for carcinoma in situ of the cervix, or basal cell carcinoma
* clinically relevant cardiovascular disease
* current chronic treatment with corticosteroids of >10mg methylprednisolone or equivalent
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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
1/11/2009
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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
1/01/2016
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Sample size
Target
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Accrual to date
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Final
225
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
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Bahamas
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Nassau
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Bosnia and Herzegovina
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Banja Luka
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Bosnia and Herzegovina
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Sarajevo
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Brazil
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RS
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Brazil
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SP
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Canada
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British Columbia
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Canada
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Ontario
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Canada
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Quebec
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Croatia
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Pula
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Germany
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Heidelberg
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Germany
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Kiel
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Germany
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Regensburg
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Germany
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Trier
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Germany
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Troisdorf
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Germany
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Ulm
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Greece
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Heraklion
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Greece
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Thessaloniki
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Italy
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Lazio
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Italy
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Lombardia
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Korea, Republic of
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Daegu
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Korea, Republic of
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Seoul
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Mexico
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Mexico City
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Mexico
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Xalapa
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New Zealand
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Auckland
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Portugal
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Aveiro
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Portugal
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Lisboa
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Romania
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Bucharest
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Romania
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Cluj Napoca
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Romania
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Iasi
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Serbia
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Belgrade
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South Africa
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Durban
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South Africa
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Pretoria
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Spain
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Guipuzcoa
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Spain
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Barcelona
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Spain
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Cordoba
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Spain
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Madrid
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Sweden
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Eskilstuna
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Sweden
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Stockholm
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Sweden
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Sundsvall
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Sweden
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Umea
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Switzerland
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Baden
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Switzerland
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Zürich
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Taiwan
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Taichung
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Taiwan
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Taipei
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United Kingdom
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Bournemouth
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United Kingdom
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Derby
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United Kingdom
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Guildford
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United Kingdom
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Newcastle Upon Tyne
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United Kingdom
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Southampton
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United Kingdom
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Truro
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United Kingdom
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Westcliffe-on-sea
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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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Ethics approval
Ethics application status
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Summary
Brief summary
This 3 arm study will assess the tolerability, safety and efficacy of 3 neoadjuvant treatment regimens in participants with locally advanced, inflammatory or early stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Before surgery, participants will be randomized to receive either A) 6 cycles of pertuzumab plus trastuzumab (Herceptin), with 5-fluorouracil/epirubicin/cyclophosphamide (FEC) for cycles 1-3 and docetaxel for cycles 4-6, or B) FEC for cycles 1-3 followed by pertuzumab plus trastuzumab with docetaxel for cycles 4-6, or C) 6 cycles of pertuzumab plus trastuzumab with docetaxel and carboplatin. Pertuzumab will be administered at a loading dose of 840 mg intravenously (iv), then 420 mg iv 3-weekly, trastuzumab at a loading dose of 8 mg/kg iv, then 6 mg/kg iv 3-weekly, docetaxel at 75 mg/m\^2 iv, increased to 100 mg/m\^2 iv 3-weekly, and FEC and carboplatin iv 3-weekly at standard doses. Following surgery participants will receive trastuzumab 6 mg/kg iv 3-weekly for a total of 1 year, as well as adequate chemo-, radio- and hormone therapy. Anticipated time on study treatment is 4-12 months, and target sample size is 200-300.
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Trial website
https://clinicaltrials.gov/study/NCT00976989
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Trial related presentations / publications
Schneeweiss A, Chia S, Hickish T, Harvey V, Eniu A, Waldron-Lynch M, Eng-Wong J, Kirk S, Cortes J. Long-term efficacy analysis of the randomised, phase II TRYPHAENA cardiac safety study: Evaluating pertuzumab and trastuzumab plus standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer. Eur J Cancer. 2018 Jan;89:27-35. doi: 10.1016/j.ejca.2017.10.021. Epub 2017 Dec 8. 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. Schneeweiss A, Chia S, Hegg R, Tausch C, Deb R, Ratnayake J, McNally V, Ross G, Kiermaier A, Cortes J. Evaluating the predictive value of biomarkers for efficacy outcomes in response to pertuzumab- and trastuzumab-based therapy: an exploratory analysis of the TRYPHAENA study. Breast Cancer Res. 2014 Jul 8;16(4):R73. doi: 10.1186/bcr3690. Schneeweiss A, Chia S, Hickish T, Harvey V, Eniu A, Hegg R, Tausch C, Seo JH, Tsai YF, Ratnayake J, McNally V, Ross G, Cortes J. Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase II cardiac safety study (TRYPHAENA). Ann Oncol. 2013 Sep;24(9):2278-84. doi: 10.1093/annonc/mdt182. Epub 2013 May 22.
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Public notes
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Contacts
Principal investigator
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Address
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Hoffmann-La Roche
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT00976989
Download to PDF