Title

Efficacy and Safety of Bevacizumab in the Neodjuvant Treatment of Inflammatory Breast Cancer
Efficacy & Safety of Bevacizumab as Neoadjuvant Treatment in Patients With Locally Advanced Inflammatory Breast Cancer, a Pilot Study.
  • Phase

    Phase 1
  • Study Type

    Interventional
  • Status

    Unknown status
  • Study Participants

    30
Multi-center, non randomised, open label, non controlled pilot study. Evaluating the treatment of bevacizumab in association with pre-operative chemotherapy, followed by surgery, adjuvant chemotherapy and radiotherapy in Patients with inflammatory breast cancer.
Pilot study evaluating the safety and efficacy of adding Bevacizumab to neoadjuvant chemotherapy in patients presenting non metastatic inflammatory breast cancer (IBC). Patients will receive 4 cycles of chemotherapy FEC100 associating Fluorouracil (500 mg/m2), Epirubicin (100 mg/m2), Cyclophosphamide (500 mg/m2) and Bevacizumab 15 mg/kg every at day 1 of ecah 21 days cycle for 4 cycles. Six weeks after the end of neoadjuvant chemotherapy, patients will undergo mastectomy and 4 cycles of Docetaxel (100 mg/m2)as adjuvant chemotherapy +/-Trastuzumab 8 mg/kg for the first cycle then 6mg/kg every 3 weeks for 17 cycles if tumor overexpress Human Epidermal Growth Factor Receptor 2 (HER2).

The primary objective of this study is to evaluate the safety and the efficacy, i.e. pathologic complete response (pCR) after 4 cycles of FEC100+Bevacizumab in IBC
Study Started
Mar 31
2011
Primary Completion
Sep 30
2013
Anticipated
Study Completion
Apr 30
2017
Anticipated
Last Update
Jun 19
2013
Estimate

Biological Bevacizumab

During neoadjuvant phase: 15 mg/kg, d1 q3w, 4 cycles

  • Other names: Avastin

Drug Cyclophosphamide

Neoadjuvant: 500 mg/m2 d1 q3w, 4 cycles

Drug epirubicin hydrochloride

Neoadjuvant: 100 mg/m2, d1 q3w, 4 cycles

Drug fluorouracil

Neoadjuvant: 500 mg/m2, d1 q3w, 4 cycles

Drug Docetaxel

Adjuvant: 100 mg/m2 q3w, 4 cycles

Biological Trastuzumab

Adjuvant: 8 mg/kg d1 in the 1st cycle then 6 mg/kg for d1 q3w, 17 cycles if tumor overexpress HER2

bevacizumab, inflammatory breast cancer Experimental

Neoadjuvant therapy associating bevacizumab, cyclophosphamide, fluorouracil and epirubicin hydrochloride q3w, 4 cycles Adjuvant therapy by docetaxel q3w, 4 cycles +/- trastuzumab q3w, 18 cycles if tumors overexpress HER2

Criteria

Inclusion Criteria:

• Patients must have signed a written informed consent form prior to any study specific procedures,

Women,
20 years or older,
Performance status < 2 (ECOG),
Histologically confirmed inflammatory breast cancer T4d any N,
hormonal Status known,
no metastases according to the last TNM classification,

adequate hematologic function :

absolute neutrophil count ≥ 1 500/mm3
Platelets ≥ 100 000/mm3
Hemoglobin ≥ 9 g/dL

adequate liver function :

ASAT and ALAT < à 3 ULN
Alkaline Phosphatase < 5 ULN
Total bilirubin < 1,5 ULN, o

adequate kidney function :

creatinine < 1,5 x normal or creatinine Clearance ≥ 50ml/min (according to the cockcroft and Gault formula)
Urine Dipstick for proteinuria < 2+ patients who have proteinuria ≥ 2 + on dipstick urinalysis at baseline should undergo a 24 hours urine collection and must demonstrate ≤ 1 g of protein in 24 hours,

adequate coagulation and cardiac function :

Prothrombin ratio ≥ 70 % and,
Prothrombin time ≤ 1,5 upper limit of normal (ULN) within 7 days prior to enrolment
Left Ventricular ejection fraction (LVEF) ≥ 55 %

Exclusion Criteria:

Patients of childbearing potential with a positive pregnancy test (serum or urine) prior to enrollment
Patients who are either not post-menopausal, or surgically sterile, not using "effective contraception" (the definition of "effective contraception" will be based on the judgment of the investigator)
Patients who are pregnant or breastfeeding
Patient considered socially or psychological unable to comply with the treatment and the required medial follow-up,
Concurrent participation in another clinical trial or treatment with any other anticancer agent during the protocol specified period
Patients unwilling or unable to sign and date an Ethics Committee (EC)/ Institutional Review Board (IRB)-approved patient informed consent form
Patients unwilling or unable to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures
Non inflammatory breast cancer with lymphatic skin permeation, Metastases,
Bilateral breast cancer
Distant metastases (stage IV)
History of another cancer other than adequately treated carcinoma in situ of the cervix uteri, basal or squamous cell skin cancer
Prior anti tumor therapy (surgery, radiotherapy, chemotherapy, hormonal treatment and targeted therapy) except treatments given for carcinoma in situ of the cervix uteri, basal or squamous cell skin cancer
History or evidence of inherited bleeding diathesis or coagulopathy,
History of thrombotic disorders within the last 6 months prior to enrollment (i.e. cerebrovascular accident, transient ischemic attacks, subarachnoid hemorrhage),
Uncontrolled hypertension (systolic > 150 mmHg and/or diastolic > 100 mmHg)with or without any anti-hypertensive medication ; patients with high initial blood pressure are eligible if entry criteria are met after initiation or adjustment of anti-hypertensive medication,
Any of the following within 6 months prior to enrollment:

myocardial infarction, severe/unstable angina, or coronary/peripheral artery bypass graft surgery, clinically symptomatic and uncontrolled cardiovascular disease, or clinically significant cardiac arrhythmias (grade 3-4)

Severe resting dyspnea due to complications or oxygen dependency,
Diabetic patient treated with oral anti-diabetics or insulin with an underlying cardiopathy at ultrasound,
Any other severe acute illness such as active uncontrolled infections that would preclude the safe administration of study therapy at the time of the enrolment
Other severe underlying medical conditions, which could impair the ability to participate in the study
Major surgery, significant traumatic injury within 28 days prior to study treatment start or anticipation of the need for major surgery during study treatment,
Minor surgery, including insertion of an indwelling catheter, within 24 hours prior to the first bevacizumab infusion,
Non-healing wound, active peptic ulcer or bone fracture,
History of abdominal fistula, diagnosed with a trachea-oesophageal fistula or any grade 4 non gastro-intestinal fistula, gastrointestinal perforation or intra-abdominal abscess within 6 months of enrolment,
No Results Posted