Title

ABI-007 (Nab-Paclitaxel) and Gemcitabine in Treating Women With Metastatic Breast Cancer
Phase II Trial of Weekly Nab (Nanoparticle Albumin Bound)-Paclitaxel (Nab-paclitaxel) (Abraxane®) in Combination With Gemcitabine in Patients With Metastatic Breast Cancer
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    gemcitabine paclitaxel ...
  • Study Participants

    50
RATIONALE: Drugs used in chemotherapy, such as ABI-007(Nab-Paclitaxel((Nanoparticle Albumin Bound)-Paclitaxel)) and gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving ABI-007 together with gemcitabine works in treating women with metastatic breast cancer.
OBJECTIVES:

Primary

Determine the antitumor activity of ABI-007 and gemcitabine, in terms of response rate in women with metastatic breast cancer.
Determine the toxicity profile of this regimen, in terms of incidence and severity of observed toxic effects, in these patients.

Secondary

* Determine the time to disease progression and survival of patients treated with this regimen.

OUTLINE: This is a multicenter study. Patients receive ABI-007 IV over 30 minutes and gemcitabine IV over 30 minutes on days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months for up to 5 years.

PROJECTED ACCRUAL: A total of 43 patients will be accrued for this study within 20 months.
Study Started
Aug 31
2005
Primary Completion
May 31
2010
Study Completion
Aug 31
2010
Results Posted
May 26
2011
Estimate
Last Update
Jun 02
2011
Estimate

Drug Gemcitabine

1000 mg/m2 (IV over 30 min) (days 1 and 8) on 21 day cycle

  • Other names: Gemzar

Drug Paclitaxel protein-bound particles for injectable suspension (albumin-bound)

125 mg/m2 (IV over 30 min) (days 1 and 8) on 21 day cycle

  • Other names: nab (nanoparticle albumin-bound)-Paclitaxel, Abraxane

Criteria

DISEASE CHARACTERISTICS:

Histologically or cytologically confirmed invasive breast cancer

- Clinical evidence of metastatic disease

+ No bone metastases or other non-measurable disease as the only evidence of metastasis

Measurable disease, defined as at least 1 measurable lesion

- The following are considered non-measurable disease:

Small lesions (< 2 cm)
Bone lesions
Leptomeningeal disease
Ascites
Pleural or pericardial effusions
Inflammatory breast disease
Lymphangitis cutis or pulmonis
Abdominal masses that are not confirmed and followed by imaging techniques
Cystic lesions
HER2(human epidermal growth factor receptor 2)-positive disease allowed provided patient has received prior treatment with trastuzumab
No evidence of active brain metastasis, including leptomeningeal involvement

Hormone receptor status:

Not specified

PATIENT CHARACTERISTICS:

Age

18 and over Sex
Female Menopausal status
Not specified Performance status
ECOG 0-1 Life expectancy
At least 12 weeks Hematopoietic
Absolute neutrophil count ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Hemoglobin ≥ 9 g/dL Hepatic
AST and ALT ≤ 2.5 times upper limit of normal (ULN)
Bilirubin ≤ 1.5 times ULN Renal
Creatinine ≤ 1.5 mg/dL Other
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 30 days after completion of study treatment
No pre-existing peripheral neuropathy > grade 1
No other clinically significant illness or significant medical condition that would preclude study participation
No history of allergy or hypersensitivity to paclitaxel protein-bound particles in an injectable suspension, paclitaxel, gemcitabine, albumin, drug product excipients, or agents that are chemically similar to study drugs
No serious medical risk factors involving any of the major organ systems that would preclude study participation
No active stage III or IV invasive non-breast malignancy within the past 5 years

PRIOR CONCURRENT THERAPY:

Biologic therapy

See Disease Characteristics Chemotherapy
No more than 1 prior adjuvant chemotherapy regimen
No prior chemotherapy for metastatic disease
At least 6 months since prior adjuvant or neoadjuvant taxane
More than 2 weeks since prior cytotoxic chemotherapy
Prior neoadjuvant chemotherapy allowed
No other concurrent chemotherapy Endocrine therapy
Prior hormonal treatment as adjuvant therapy or for metastatic disease allowed Radiotherapy
Prior radiotherapy to target lesion allowed provided there is evidence of disease progression after completion of treatment
More than 2 weeks since prior radiotherapy, except radiotherapy to a non-target lesion only or single-dose palliative radiotherapy
No concurrent radiotherapy Surgery
Not specified Other
More than 2 weeks since prior investigational drugs
No concurrent participation in another clinical trial that is studying investigational procedures or therapies
Concurrent bisphosphonates (e.g., pamidronate or zoledronate) allowed for palliation of pain or lytic lesions from breast cancer

Summary

Nab-paclitaxel/Gemcitabine

All Events

Event Type Organ System Event Term Nab-paclitaxel/Gemcitabine

Proportion of Patients With Confirmed Responses

Confirmed tumor response (complete and partial) as measured by RECIST(Response Evaluation Criteria In Solid Tumors) criteria on 2 consecutive evaluations at least 6 weeks apart. Confirmed tumor response is at least a 30% decrease in the sum of the longest diameter of target lesions and no new lesions.

Nab-paclitaxel/Gemcitabine

Assessable

50.0
participants

Confirmed response

25.0
participants

Progression-free Survival

Progression-free survival was defined as the number of months from registration to the date of disease progression or death, with patients who are alive and progression free being censored on the date of their last evaluation.

Nab-paclitaxel/Gemcitabine

7.9
months (Median)
95% Confidence Interval: 5.4 to 10.0

Overall Survival

Overall survival time was defined as the number of days from registration to the date of death or last follow-up

Nab-paclitaxel/Gemcitabine

Adverse Event

Number of patients that experienced adverse events (grade 3 or more occurring in >5% of patients) as measured by NCI CTCAE (Common Terminology Criteria for Adverse Events) v3.0

Nab-paclitaxel/Gemcitabine

Anemia

7.0
participants

Arthralgia

4.0
participants

Aspartate aminotransferase (AST)

3.0
participants

Dyspnea

7.0
participants

Fatigue

14.0
participants

Myalgia

3.0
participants

Nausea

3.0
participants

Neuropathy

3.0
participants

Neutropenia

27.0
participants

Pain-abdominal

3.0
participants

Thrombocytopenia

6.0
participants

Vomiting

4.0
participants

Age Continuous

56
years (Median)
Full Range: 29.0 to 86.0

Dominant disease site

Estrogen receptor status

HER2 (human epidermal growth factor receptor 2) status

Number of metastatic sites

Performance Score

Progesterone receptor status

Region of Enrollment

Sex/Gender, Customized

Overall Study

Nab-paclitaxel/Gemcitabine

Drop/Withdrawal Reasons

Nab-paclitaxel/Gemcitabine