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Lambert-Falls R, Deutsch MA, Desch C, Zhou K, Perez E. Phase III adjuvant trial of concurrent epirubicin/taxane vs. sequential epirubicin/cyclophosphamide followed by taxane for node positive breast cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
573 Background: This study evaluates whether concurrent epirubicin/taxane (ET) improves disease-free survival (DFS) at 3 yrs compared to the sequential combination of epirubicin/cyclophosphamide followed by a taxane (EC>T) in pts with operable node (+) breast cancer. Methods: Eligible pts were randomized to receive either ET (E 75 mg/m 2) for 8 cycles q21 days or EC>T (E 90 mg/m 2, C 600 mg/m2) for 4 cycles, followed by 4 cycles of a taxane q21 days. Choice of T (paclitaxel 175 mg/m2 or docetaxel 75 mg/m 2) was at the physician’s discretion. The primary endpoint is DFS. A 0.10 increase in the probability of DFS at 3 yrs for the ET arm would be considered clinically relevant. To detect 82 events, 300 subjects per arm are required to provide 90% power at 5% significance level. Results: 617 pts were enrolled from Nov 2000 to June 2003; 308 pts received ET and 309 pts received EC>T. Both treatment arms were well balanced with respect to age, nodal+, ER status, Her-2+ and PS; median age 52.5 (42%<50 years old); 70% ER+; 61% LN (1–3); 16% Her-2+; 87% PS 0. Total of 2206 cycles of treatment were given to ET compared 2314 cycles of treatment to EC>T. At 30 months of median follow-up there were DFS 102 events occurred; 47 events in ET arm (16%) and 55 events in EC>T arm (18%); 63 total deaths; 29 deaths in ET arm and 34 deaths in EC>T arm. The most common toxicities include alopecia (50%), fatigue (31%), nausea and vomiting (30%), dyspepsia (27%), febrile neutropenia (15%), constipation (12%), diarrhea (10%), arthralgia (11%), stomatitis (10%). In cardiac safety f/u, only one pt in ET arm remained LVEF drop >15. Conclusions: Epirubicin can be combined with taxanes in both sequential and concurrent therapies and both regimens are effective and well tolerated. The study is sponsored by Pfizer Inc. No significant financial relationships to disclose.
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Affiliation(s)
- R. Lambert-Falls
- South Carolina Oncology Associates, PA, Columbia, SC; Cancer Center of North Carolina, Raleigh, NC; Virginia Cancer Institute, Richmond, VA; Pfizer Inc., New York, NY; Mayo Clinic, Jacksonville, FL
| | - M. A. Deutsch
- South Carolina Oncology Associates, PA, Columbia, SC; Cancer Center of North Carolina, Raleigh, NC; Virginia Cancer Institute, Richmond, VA; Pfizer Inc., New York, NY; Mayo Clinic, Jacksonville, FL
| | - C. Desch
- South Carolina Oncology Associates, PA, Columbia, SC; Cancer Center of North Carolina, Raleigh, NC; Virginia Cancer Institute, Richmond, VA; Pfizer Inc., New York, NY; Mayo Clinic, Jacksonville, FL
| | - K. Zhou
- South Carolina Oncology Associates, PA, Columbia, SC; Cancer Center of North Carolina, Raleigh, NC; Virginia Cancer Institute, Richmond, VA; Pfizer Inc., New York, NY; Mayo Clinic, Jacksonville, FL
| | - E. Perez
- South Carolina Oncology Associates, PA, Columbia, SC; Cancer Center of North Carolina, Raleigh, NC; Virginia Cancer Institute, Richmond, VA; Pfizer Inc., New York, NY; Mayo Clinic, Jacksonville, FL
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Burstein HJ, Keshaviah A, Baron A, Hart R, Lambert-Falls R, Marcom PK, Gelman R, Winer EP. Trastuzumab and vinorelbine or taxane chemotherapy for HER2+ metastatic breast cancer: The TRAVIOTA study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.650] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
650 Background: The optimal trastuzumab/chemotherapy regimen for advanced breast cancer is not known. We performed a multicenter, randomized clinical trial to compare TRastuzumab And VInorebline Or TAxane (TRAVIOTA) chemo- and bio-therapy combination treatment given on a weekly schedule for HER2+ metastatic breast cancer. Patients and Methods: Eligible patients had stage IV breast cancer, measurable disease (by RECIST criteria), HER2+ tumors (IHC 3+ or FISH+), no prior chemotherapy or trastuzumab for advanced breast cancer, and LVEF > 50%. Patients were randomized 1:1 to trastuzumab (4 mg/kg loading dose, 2 mg/kg weekly thereafter) with either weekly vinorelbine (25 mg/m2) or weekly taxane (paclitaxel 80 mg/m2 or docetaxel 35 mg/m2, selected by the treating investigator). The primary endpoint was response rate. The study opened in August 2001 and planned to accrue 250 patients. It was closed in December 2003 having accrued only 85 patients. Results are presented for the 81 patients who received any protocol-based therapy. Results: Patients receiving trastuzumab and vinorelbine tended to have higher response rates and TTP than those assigned trastuzumab and taxane therapy but the results were not statistically significant (see Table ). Vinorelbine therapy was associated with more frequent grade 3 or 4 hematological toxicity and dose delay because of myelosuppression. Other toxicities generally reflected the known side effects of the chemotherapy agents. Conclusions: The TRAVIOTA study suggests at least comparable clinical activity of trastuzumab with vinorelbine as with weekly taxane chemotherapy in HER2+ metastatic breast cancer, with side effect profiles consistent with previous experience with these regimens. [Table: see text] [Table: see text]
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Affiliation(s)
- H. J. Burstein
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
| | - A. Keshaviah
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
| | - A. Baron
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
| | - R. Hart
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
| | - R. Lambert-Falls
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
| | - P. K. Marcom
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
| | - R. Gelman
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
| | - E. P. Winer
- Dana-Farber Cancer Institute, Boston, MA; California Pacific Medical Center, San Francisco, CA; Oncology Alliance, Milwaukee, WI; SC Oncology, Columbia, SC; Duke University Medical Center, Durham, NC
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Rubin P, Brufsky A, Lambert-Falls R, Carroll M, Limentani S. A phase II randomized study to compare the neoadjuvant dose dense administration of docetaxel (D) and vinorelbine (V) or D followed by doxorubicin (A) and cyclophosphamide (C) administered to women with stage II or III breast cancer. Toxicity data. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. Rubin
- Moses Cone Regional Cancer Ctr, Greensboro, NC; Univ of Pittsburgh Cancer Institute, Pittsburgh, PA; South Carolina Oncology Assoc, Columbia, SC; Blumenthal Cancer Ctr, Charlotte, NC; Carolinas Hematology-Oncology Assoc, Charlotte, NC
| | - A. Brufsky
- Moses Cone Regional Cancer Ctr, Greensboro, NC; Univ of Pittsburgh Cancer Institute, Pittsburgh, PA; South Carolina Oncology Assoc, Columbia, SC; Blumenthal Cancer Ctr, Charlotte, NC; Carolinas Hematology-Oncology Assoc, Charlotte, NC
| | - R. Lambert-Falls
- Moses Cone Regional Cancer Ctr, Greensboro, NC; Univ of Pittsburgh Cancer Institute, Pittsburgh, PA; South Carolina Oncology Assoc, Columbia, SC; Blumenthal Cancer Ctr, Charlotte, NC; Carolinas Hematology-Oncology Assoc, Charlotte, NC
| | - M. Carroll
- Moses Cone Regional Cancer Ctr, Greensboro, NC; Univ of Pittsburgh Cancer Institute, Pittsburgh, PA; South Carolina Oncology Assoc, Columbia, SC; Blumenthal Cancer Ctr, Charlotte, NC; Carolinas Hematology-Oncology Assoc, Charlotte, NC
| | - S. Limentani
- Moses Cone Regional Cancer Ctr, Greensboro, NC; Univ of Pittsburgh Cancer Institute, Pittsburgh, PA; South Carolina Oncology Assoc, Columbia, SC; Blumenthal Cancer Ctr, Charlotte, NC; Carolinas Hematology-Oncology Assoc, Charlotte, NC
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Lambert-Falls R, Ackerman M, Jones GT, Smith R. A phase II study to evaluate the feasibility of bi-weekly docetaxel followed by bi-weekly doxorubicin and cyclophosphamide as adjuvant therapy for operable breast cancer (T-AC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - M. Ackerman
- South Carolina Oncology Associates, PA, West Columbia, SC
| | - G. T. Jones
- South Carolina Oncology Associates, PA, West Columbia, SC
| | - R. Smith
- South Carolina Oncology Associates, PA, West Columbia, SC
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