Breast CancerPhase 3NCT00004935
Herceptin Followed by Chemotherapy in Treating Women With Metastatic Breast Cancer That Overexpresses HER2
A Phase 3 study testing Herceptin™ (Her) and Herceptin™ (Her) + chemo in people with Breast Cancer, run by Swiss Cancer Institute at 17 sites in 2 countries.
Trial summary
RATIONALE: To compare efficacy, toxicity and quality of life of the sequential administration of Her alone followed, at PD, by the combination with Chemotherapy (Arm A) vs. the upfront combination of Her and Chemotherapy (Arm B) in patients with advanced/metastatic breast cancer. Read more about this study
- Who is it for?
- Ages 18 to 70 years, women only
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Herceptin™ (Her) and Herceptin™ (Her) + chemo
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 175 participants
- Where
- 17 sitesin 2 countries
- Study dates
- 30 Aug 1999to 31 Mar 2022
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- Women only
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically confirmed HER2-overexpressing metastatic breast carcinoma
- Clinically or radiologically measurable or evaluable disease
- Bidimensionally or unidimensionally measurable lesions
- No ascitic, pleural, or pericardial effusions, osteoblastic bone metastases, or carcinomatous lymphangitis of the lung as only indicator lesion
- No known clinical brain or meningeal involvement
- Hormone receptor status:
- Not specified
PATIENT CHARACTERISTICS:
Age:
- 18 to 70
Sex:
- Female
Menopausal status:
- Not specified
Performance status:
- ECOG 0-1 OR
- SAKK 0-1
Life expectancy:
- At least 12 weeks
Hematopoietic:
- Hemoglobin at least 10 g/dL
- Platelet count at least 100,000/mm^3
- Absolute neutrophil count at least 2,000/mm^3
Hepatic:
- Bilirubin normal
- SGOT and/or SGPT no greater than 2 times upper limit of normal (ULN) (3 times ULN if proven liver metastases) OR
- No SGOT and/or SGPT greater than 1.5 times ULN if alkaline phosphatase greater than 2.5 times ULN
Renal:
- Creatinine no greater than 1.25 times ULN
Cardiovascular:
- LVEF normal
- No history of atrial ventricular arrhythmia, congestive heart failure, or angina pectoris, even if medically controlled
- No history of second or third-degree heart blocks
- No uncontrolled hypertension
Other:
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No pre-existing motor or sensory neuropathy grade 2 or greater
- No psychiatric disorder that would preclude informed consent
- No other prior malignancy except curatively treated nonmelanoma skin cancer or carcinoma in situ of the cervix
- No definite contraindications for use of corticosteroids
- No other concurrent serious illness or medical condition
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- Prior adjuvant or neoadjuvant chemotherapy allowed
- No more than 2 prior chemotherapy regimens for metastatic disease
- No prior cumulative dose of doxorubicin greater than 240 mg/m^2
- No prior cumulative dose of epirubicin greater than 360 mg/m^2
- No prior taxanes
Endocrine therapy:
- Prior hormonal therapy as adjuvant treatment or for metastatic disease allowed
- No concurrent corticosteroids unless started more than 6 months prior to study and at low doses (i.e., no greater than 20 mg methylprednisolone or equivalent)
Radiotherapy:
- Not specified
Surgery:
- Not specified
Other:
- No other concurrent anticancer drugs
- No other concurrent experimental drugs
- No concurrent bisphosphonates unless initiated more than 3 months prior to study
- Chronic use allowed provided bone metastases are not sole indicator lesions
Trial locations and contacts
17 sites in 2 countries.
17 sites in 2 countries
Switzerland15 sites
Kantonsspital Aarau
Aarau, CH-5001
Kantonsspital Baden
Baden, CH-5404
Universitaetsspital-Basel
Basel, CH-4031
Istituto Oncologico della Svizzera Italiana - Ospedale Regionale Bellinzona e Valli
Bellinzona, 6500
Inselspital Bern
Bern, CH-3010
Kantonsspital Graubuenden
Chur, 7000
Hopital Cantonal Universitaire de Geneve
Geneva, CH-1211
Centre Hospitalier Universitaire Vaudois
Lausanne, CH-1011
Ospedale Regionale di Lugano
Lugano, 6900
Praxis Dr. Beretta
Rheinfelden, CH-4310
Kantonsspital - St. Gallen
Sankt Gallen, CH-9007
Regionalspital
Thun, 3600
Onkozentrum
Zurich, 8038
City Hospital Triemli
Zurich, 8063
UniversitaetsSpital Zuerich
Zurich, CH-8091
Italy2 sites
European Institute of Oncology
Milan, 20141
Ospedale di Circolo e Fondazione Macchi
Varese, 21100
About this study
Official title: Randomized Phase III Trial of Herceptin® Followed by Chemotherapy Plus Herceptin® Versus the Combination of Herceptin® and Chemotherapy as Palliative Treatment in Patients With HER2- Overexpressing Advanced/Metastatic Breast Cancer.
RATIONALE: To compare efficacy, toxicity and quality of life of the sequential administration of Her alone followed, at PD, by the combination with Chemotherapy (Arm A) vs. the upfront combination of Her and Chemotherapy (Arm B) in patients with advanced/metastatic breast cancer.
PURPOSE: Trial SAKK 22/99 addresses clinically relevant and currently unresolved questions regarding the optimal use of Herceptin in the treatment of patients with advanced/metastatic breast cancer.
Read the detailed description
In advanced HER2+ breast cancer the impact of combining Trastuzumab (T) and chemotherapy (chemo) versus T alone followed by the addition of chemo at disease progression has not been properly studied.
The trial compared efficacy, toxicity and quality of life of sequential administration of T followed, at progression, by combination with chemo (T>TChemo) versus the upfront combination of T and chemo (TChemo) in patients with HER2+ advanced breast cancer.
- Conditions
- Breast Cancer
- Being tested
- Herceptin™ (Her), Herceptin™ (Her) + chemo
- Keywords
- stage IV breast cancer, recurrent breast cancer
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Herceptin™ (Her)Drug
Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks; at time of progression add chemotherapy
Herceptin™ (Her) + chemoDrug
Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks, and chemotherapy
| Study group | Role | What they receive |
|---|---|---|
| Herceptin™ (Her) | Active comparator | Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks; at time of progression add chemotherapy Receives: Drug: Herceptin™ (Her) |
| Herceptin™+Chemo | Active comparator | Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks, and chemotherapy Receives: Drug: Herceptin™ (Her) + chemo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to progression on combined HerChemo (TTPHerChemo)
Measured: 8 weeks
Secondary outcomes (8)
Response rate
Measured: 8 weeks
Time to first progression
Measured: 8 weeks
Time to treatment failure
Measured: 8 weeks
Overall survival
Measured: 8 weeks
Adverse events
Measured: 8 weeks
Predictive value of serum HER2/neu ECD levels on clinical outcome
Measured: 8 weeks
Conversion rate of estrogen receptor status
Measured: 8 weeks
Association of immunoprofiles of erbB-1, erbB-2, erbB-3 and erbB-4 with clinical outcome
Measured: 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jan 2003 (estimated)
- Study start30 Aug 1999
- Primary completion6 Nov 2014
- Study completion31 Mar 2022
Why it stopped: Trial is Life long follow-up: to reduce ressources and costs - trial terminated prematurely.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Enrolment
- 175 participants (actual)
Sponsor and investigators
- Lead sponsor
- Swiss Cancer Institute
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Pagani Olivia, MD, Study chair, Istituto Oncologico della Svizzera Italiana IOSI
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00004935
- Sponsor's protocol ID
- SAKK 22/99
- Other IDs
- SWS-SAKK-22/99, EU-99028
- Status last verified
- Mar 2022
- First submitted
- 7 Mar 2000
- Last updated
- 18 Apr 2023
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Eppenberger-Castori S, Klingbiel D, Ruhstaller T, Dietrich D, Rufle DA, Rothgiesser K, Pagani O, Thurlimann B. Plasma HER2ECD a promising test for patient prognosis and prediction of response in HER2 positive breast cancer: results of a randomized study - SAKK 22/99. BMC Cancer. 2020 Feb 11;20(1):114. doi: 10.1186/s12885-020-6594-0.
PubMed 32046665Schmid S, Klingbiel D, Aebi S, Goldhirsch A, Mamot C, Munzone E, Nole F, Oehlschlegel C, Pagani O, Pestalozzi B, Rochlitz C, Thurlimann B, von Moos R, Weder P, Zaman K, Ruhstaller T. Long-term responders to trastuzumab monotherapy in first-line HER-2+ advanced breast cancer: characteristics and survival data. BMC Cancer. 2019 Sep 10;19(1):902. doi: 10.1186/s12885-019-6105-3.
PubMed 31500588
Study at a glance
From the registry record, last updated by the sponsor on 18 Apr 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Phase III Trial of Herceptin® Followed by Chemotherapy Plus Herceptin® Versus the Combination of Herceptin® and Chemotherapy as Palliative Treatment in Patients With HER2- Overexpressing Advanced/Metastatic Breast Cancer.
- ClinicalTrials.gov ID
- NCT00004935
- Acronym / sponsor ID
- SAKK 22/99
- Conditions
- Breast Cancer
- Keywords
- stage IV breast cancer, recurrent breast cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Trial is Life long follow-up: to reduce ressources and costs - trial terminated prematurely.
- Enrolment
- 175 participants (actual)
- Lead sponsor
- Swiss Cancer InstituteUniversity, hospital or other
- Study start
- 30 Aug 1999 (actual)
- Primary completion
- 6 Nov 2014 (actual)
- Study completion
- 31 Mar 2022 (actual)
- First posted
- 27 Jan 2003 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: To compare efficacy, toxicity and quality of life of the sequential administration of Her alone followed, at PD, by the combination with Chemotherapy (Arm A) vs. the upfront combination of Her and Chemotherapy (Arm B) in patients with advanced/metastatic breast cancer.
PURPOSE: Trial SAKK 22/99 addresses clinically relevant and currently unresolved questions regarding the optimal use of Herceptin in the treatment of patients with advanced/metastatic breast cancer.
Detailed description
In advanced HER2+ breast cancer the impact of combining Trastuzumab (T) and chemotherapy (chemo) versus T alone followed by the addition of chemo at disease progression has not been properly studied.
The trial compared efficacy, toxicity and quality of life of sequential administration of T followed, at progression, by combination with chemo (T>TChemo) versus the upfront combination of T and chemo (TChemo) in patients with HER2+ advanced breast cancer.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Herceptin™ (Her) | Active comparator | Drug: Herceptin™ (Her)Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks; at time of progression add chemotherapy |
| Herceptin™+Chemo | Active comparator | Drug: Herceptin™ (Her) + chemoHerceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks, and chemotherapy |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Herceptin™ (Her)Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks; at time of progression add chemotherapy | Drug | Herceptin™ (Her) |
| Herceptin™ (Her) + chemoHerceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks, and chemotherapy | Drug | Herceptin™+Chemo |
Primary outcome
Time to progression on combined HerChemo (TTPHerChemo)
Time frame: 8 weeks
8 secondary outcomes
Response rate
Time frame: 8 weeks
Time to first progression
Time frame: 8 weeks
Time to treatment failure
Time frame: 8 weeks
Overall survival
Time frame: 8 weeks
Adverse events
Time frame: 8 weeks
Predictive value of serum HER2/neu ECD levels on clinical outcome
Time frame: 8 weeks
Conversion rate of estrogen receptor status
Time frame: 8 weeks
Association of immunoprofiles of erbB-1, erbB-2, erbB-3 and erbB-4 with clinical outcome
Time frame: 8 weeks
Results and safety
The study was stopped early (reason given: Trial is Life long follow-up: to reduce ressources and costs - trial terminated prematurely.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Apr 2023.
- Derived from this study: PubMed 32046665Eppenberger-Castori S, Klingbiel D, Ruhstaller T, Dietrich D, Rufle DA, Rothgiesser K, Pagani O, Thurlimann B. Plasma HER2ECD a promising test for patient prognosis and prediction of response in HER2 positive breast cancer: results of a randomized study - SAKK 22/99. BMC Cancer. 2020 Feb 11;20(1):114. doi: 10.1186/s12885-020-6594-0.
- Derived from this study: PubMed 31500588Schmid S, Klingbiel D, Aebi S, Goldhirsch A, Mamot C, Munzone E, Nole F, Oehlschlegel C, Pagani O, Pestalozzi B, Rochlitz C, Thurlimann B, von Moos R, Weder P, Zaman K, Ruhstaller T. Long-term responders to trastuzumab monotherapy in first-line HER-2+ advanced breast cancer: characteristics and survival data. BMC Cancer. 2019 Sep 10;19(1):902. doi: 10.1186/s12885-019-6105-3.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Pagani Olivia, MD study chair
Istituto Oncologico della Svizzera Italiana IOSI
17 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Herceptin™ (Her) and Herceptin™ (Her) + chemo in people with Breast Cancer, run by Swiss Cancer Institute at 17 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 18 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 17 sites in Switzerland, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: Trial is Life long follow-up: to reduce ressources and costs - trial terminated prematurely.). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to progression on combined HerChemo (TTPHerChemo) (time frame: 8 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00004935, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Apr 2023.