Title

First Line Therapy for Patients With Metastatic Breast Cancer
An Open-Label, Phase II Study of Weekly ABI-007 as First Line Therapy for Patients With Metastatic Breast Cancer
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    123
The purpose of this study is to determine the toxicity and anti-tumor activity of nab-paclitaxel 100mg/m^2 administered weekly in a 4-week cycle as first line therapy to patients with metastatic breast cancer who received taxanes as part of their adjuvant therapy and patients who did not receive taxanes as part of their adjuvant therapy.
This is an open-label, phase II study to determine the toxicity and antitumor activity of ABI-007 100 mg/m2 administered weekly for 3 weeks followed by a rest week (4-week cycle) as first line therapy to patients with metastatic breast cancer in the following 2 cohorts: Patients who have received a taxane as part of their adjuvant therapy, and patients who did not receive a taxane as part of their adjuvant therapy. Patients will be assessed for antitumor response every 8 weeks.

The last subject received study treatment 11DEC2012. The study was terminated on 31 May 2013 via a notification letter to all investigators on 14 May 2013.
Study Started
Feb 01
2008
Primary Completion
Dec 11
2012
Study Completion
May 31
2013
Results Posted
Jul 18
2014
Estimate
Last Update
Nov 22
2019

Drug ABI-007

100 mg/m^2 ABI-007 weekly for 3 weeks followed by 1 week rest

  • Other names: Nab-paclitaxel, Abraxane

ABI-007 Experimental

100 mg/m^2 ABI-007 was administered by intravenous (IV) infusion over 30 minutes weekly for 3 weeks followed by 1 week rest. Therapy continued until disease progression or unacceptable toxicity.

Criteria

Inclusion Criteria:

Females with pathologically confirmed adenocarcinoma of the breast.
No prior chemotherapy for metastatic breast cancer
At least 12 months between completion of adjuvant chemotherapy and the diagnosis of metastatic disease
Stage IV disease
Measurable disease (must be equal or greater to 2.0 cm using conventional Computed Tomography (CT) or equal or greater to 1.0 cm using spiral CT except for pulmonary lesions that are well documented on conventional CT scan which must be equal or greater than 1.0 cm)
At least 4 weeks since radiotherapy, with full recovery. The measurable disease must be completely outside the radiation portal or there must be radiologic or clinical exam proof of progressive disease within the radiation portal
At least 4 weeks since major surgery, with full recovery
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Age equal or greater to 18
Patients has the following blood counts at Baseline:
Absolute Neutrophil Count (ANC) equal or greater to 1.5 x 10^9 cells/L
Platelets equal or greater to 100 x 10^9 cells/L
Hemoglobin (Hgb) equal or greater to 90 grams/L
Patients has the following blood chemistry levels at Baseline:
Aspartate aminotransferase (AST) Serum glutamic-oxaloacetic transaminase (SGOT), alanine aminotransferase (ALT) serum glutamic:pyruvic transaminase (SGPT)less than or equal to 2.5x upper limit of normal range (ULN);
total bilirubin normal (unless bilirubin elevation is due to Gilbert's (Disease);
alkaline phosphatase less than or equal 2.5x ULN (unless bone metastasis is present in the absence of liver metastasis);
Creatinine less than or equal to 1.5mg/dL
Current sensory neuropathy Grade 0 or 1 by Breast Cancer Index (BCI) Common Toxicity Criteria Adverse Events (CTCAE)
If female of childbearing potential, pregnancy test is negative (within 72 hours of the first dose of study drug).
If fertile, the patient agrees to use an effective method of contraception to avoid pregnancy for the duration of the study
Patient is able to supply unstained slides or 1 tumor block of her primary breast tumor or a biopsy of a current site of metastasis for Secreted protein acidic and rich in cysteine (SPARC) analysis
Informed consent has been obtained

Exclusion Criteria:

Concurrent immunotherapy or hormonal therapy (other than Herceptin) for breast cancer
Parenchymal brain metastases, unless documented to be clinically and radiographically stable for at least 6 months after treatment
Serious intercurrent medical or psychiatric illness, including serious active infection
History of class II-IV congestive heart failure
History of other malignancy within the last 5 years which could affect the diagnoses or assessment of breast cancer, with the exception of basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix
Patients who have received an investigational drug within the previous 3 weeks
Patient is currently enrolled in a different clinical study in which investigational procedures are performed or investigational therapies are administered. Also a patient may not enroll in such clinical trials while participating in this study.
Pregnant or nursing women
Patients with prior hypersensitivity to Taxol or Taxotere

Summary

Abraxane (Prior Taxane Therapy)

Abraxane (No Prior Taxane Therapy)

All Events

Event Type Organ System Event Term Abraxane (Prior Taxane Therapy) Abraxane (No Prior Taxane Therapy)

Percentage of Participants With Objective Confirmed Complete or Partial Overall Response According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.0 Based on Investigator and Independent Reviewers

Overall response rate (ORR) is complete response (CR) + partial response (PR). Complete response (CR): The disappearance of all known disease and no new sites or disease related symptoms confirmed at least 4 weeks after initial documentation. All sites must be assessed, including non-measurable sites, such as effusions, or markers. Disappearance of all non-target lesions. The normalization of tumor marker level confirmed at least 4 weeks after initial documentation. Partial response (PR): At least a 30% decrease in the sum of the longest diameters of target lesions, taking as a reference the baseline sum of the longest diameters confirmed at least 4 weeks after initial documentation. PR is also recorded when all measurable disease has completely disappeared, but a non-measurable component (i.e., ascites) is still present but not progressing. As well as persistence of one or more non-target lesion(s) and/or the maintenance of tumor marker level above the normal limits

Abraxane (Prior Taxane Therapy)

Independent Reviewer Assessment

32.0
percentage of participants
95% Confidence Interval: 18.6 to 45.2

Investigator Assessment

30.0
percentage of participants
95% Confidence Interval: 16.7 to 42.9

Abraxane (No Prior Taxane Therapy)

Independent Reviewer Assessment

32.0
percentage of participants
95% Confidence Interval: 21.1 to 42.0

Investigator Assessment

28.0
percentage of participants
95% Confidence Interval: 17.6 to 37.7

Percentage of Participants With Disease Control

Disease control was defined as stable disease (SD) for ≥ 16 weeks or complete response (CR) or partial response (PR). Response was evaluated by the Investigator and by an independent reviewer using Response Evaluation Criteria in Solid Tumors (RECIST) guidelines version 1.0. See Outcome #1 for definitions of CR and PR. RECIST defines SD for target lesions as neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease, no occurrence of progression disease for non-target lesions, and no new lesions.

Abraxane (Prior Taxane Therapy)

Independent Reviewer Assessment

55.0
percentage of participants
95% Confidence Interval: 41.1 to 69.5

Investigator Assessment

51.0
percentage of participants
95% Confidence Interval: 36.8 to 65.4

Abraxane (No Prior Taxane Therapy)

Independent Reviewer Assessment

57.0
percentage of participants
95% Confidence Interval: 45.4 to 67.7

Investigator Assessment

57.0
percentage of participants
95% Confidence Interval: 45.4 to 67.7

Progression-free Survival (PFS)

PFS was defined as the time from the first dose of study drug to the start of progression or patient death (any cause), whichever occurred first. Participants who did not have progression or did not die were censored at the last known time the participant was progression free. Participants who initiated other anticancer therapy prior to progression were censored at the time when new anticancer therapy was initiated.

Abraxane (Prior Taxane Therapy)

Independent Reviewer Assessment

5.3
months (Median)
95% Confidence Interval: 3.3 to 7.3

Investigator Assessment

6.0
months (Median)
95% Confidence Interval: 3.5 to 8.8

Abraxane (No Prior Taxane Therapy)

Independent Reviewer Assessment

5.3
months (Median)
95% Confidence Interval: 3.5 to 6.6

Investigator Assessment

6.7
months (Median)
95% Confidence Interval: 5.3 to 7.3

Duration of Response Based on Independent Reviewer Assessment

Duration of response was defined as progression-free survival in responders, i.e. as the time between the start of a complete response (CR) or partial response (PR) and the start of progressive disease (PD) or patient death from any cause, whichever occurred first. Participants who did not have progression or had not died were censored at the last known time the participant was progression free. Participants who had initiated other anticancer therapy prior to progression were censored at the time when new anticancer therapy was initiated. CR and PR were defined in outcome #1. Progressive disease was defined as at least a 20% increase in the sum of the longest diameters of target lesions; or the appearance of one or more new lesions; or the unequivocal progression of a non-target lesion. Response was evaluated using Response Evaluation Criteria in Solid Tumors (RECIST).

Abraxane (Prior Taxane Therapy)

10.9
months (Median)
95% Confidence Interval: 7.3 to 18.9

Abraxane (No Prior Taxane Therapy)

9.2
months (Median)
95% Confidence Interval: 7.4 to 14.2

Duration of Response Based on Investigator Assessment

Duration of response was defined as progression-free survival in responders, i.e. as the time between the start of a complete response (CR) or partial response (PR) and the start of progressive disease (PD) or patient death from any cause, whichever occurred first. Participants who did not have progression or had not died were censored at the last known time the participant was progression free. Participants who had initiated other anticancer therapy prior to progression were censored at the time when new anticancer therapy was initiated. Complete response (CR) and partial response (PR) were defined in outcome #1. Progressive disease was defined as at least a 20% increase in the sum of the longest diameters of target lesions; or the appearance of one or more new lesions; or the unequivocal progression of a non-target lesion. Response was evaluated using Response Evaluation Criteria in Solid Tumors (RECIST).

Abraxane (Prior Taxane Therapy)

10.5
months (Median)
95% Confidence Interval: 8.8 to 25.4

Abraxane (No Prior Taxane Therapy)

10.8
months (Median)
95% Confidence Interval: 8.7 to 22.4

Patient Survival

Participant survival was the time from the first dose of study drug to participant death from any cause. Participants who did not die were censored at the last known time the participant was alive.

Abraxane (Prior Taxane Therapy)

20.9
months (Median)
95% Confidence Interval: 14.3 to 28.0

Abraxane (No Prior Taxane Therapy)

20.0
months (Median)
95% Confidence Interval: 13.8 to 28.6

Number of Participants Experiencing Dose Reductions, Interruptions, or Dose Delays of Study Drug

The number of participants with dose reductions, dose interruptions and dose delays that occurred during the treatment period. Dose reductions, interruptions and delays are typically caused by clinically significant laboratory abnormalities and /or treatment emergent adverse events/toxicities.

Abraxane (Prior Taxane Therapy)

Patients with at Least One Dose Delay/Not Given

20.0
participants

Patients with at Least One Dose Interruption

3.0
participants

Patients with at Least One Dose Reduction

11.0
participants

Abraxane (No Prior Taxane Therapy)

Patients with at Least One Dose Delay/Not Given

39.0
participants

Patients with at Least One Dose Interruption

2.0
participants

Patients with at Least One Dose Reduction

19.0
participants

Number of Participants With Treatment-Emergent Adverse Events

Count of study participants who had at least one treatment-emergent adverse event (TEAE) defined as any adverse event that began or worsened in grade after the start of study drug through 30 days after the last dose of study drug. The National Cancer Institute (NCI)'s Common Terminology Criteria for AEs (CTCAE) was used to grade AE severity: severity grade 3= severe and undesirable AE. Severity grade 4= life-threatening or disabling AE. Severity grade 5 = death.

Abraxane (Prior Taxane Therapy)

≥1 Adverse Event (AE)

46.0
participants

≥1 AE leading to death

≥1 AE leading to dose delay of study drug

15.0
participants

≥1 AE leading to dose interruption of study drug

2.0
participants

≥1 AE leading to dose reduction of study drug

11.0
participants

≥1 AE leading to treatment discontinuation

2.0
participants

≥1 One Grade 3/4 Adverse Event

25.0
participants

≥1 One Grade 3 or Higher Adverse Event

25.0
participants

≥ 1 Serious Adverse Event

5.0
participants

≥1 Treatment related Adverse Event

41.0
participants

Treatment related Serious Adverse Event

2.0
participants

Abraxane (No Prior Taxane Therapy)

≥1 Adverse Event (AE)

75.0
participants

≥1 AE leading to death

2.0
participants

≥1 AE leading to dose delay of study drug

29.0
participants

≥1 AE leading to dose interruption of study drug

≥1 AE leading to dose reduction of study drug

18.0
participants

≥1 AE leading to treatment discontinuation

16.0
participants

≥1 One Grade 3/4 Adverse Event

36.0
participants

≥1 One Grade 3 or Higher Adverse Event

36.0
participants

≥ 1 Serious Adverse Event

14.0
participants

≥1 Treatment related Adverse Event

74.0
participants

Treatment related Serious Adverse Event

7.0
participants

Total

123
Participants

Age, Continuous

57.2
years (Mean)
Standard Deviation: 10.54

Eastern Cooperative Oncology Group (ECOG) Performance Status

Menopausal Status

Physician Assessment of Peripheral Neuropathy] [2]

Race/Ethnicity, Customized

Sex: Female, Male

Stage at Primary Diagnosis

Overall Study

Abraxane (Prior Taxane Therapy)

Abraxane (No Prior Taxane Therapy)

Drop/Withdrawal Reasons

Abraxane (Prior Taxane Therapy)

Abraxane (No Prior Taxane Therapy)