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Multi-Cycle High-Dose Chemotherapy Versus Optimized Conventionally-Dosed Chemotherapy in Patients With Metastatic Breast Cancer: A Phase II Prospective Randomized Trial
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. It is not yet known if chemotherapy followed by peripheral stem cell transplantation is more effective than chemotherapy alone in treating metastatic breast cancer. PURPOSE: Randomized phase II trial to compare the effectiveness of combination chemotherapy plus peripheral stem cell transplantation with that of chemotherapy alone in treating women who have stage IV breast cancer.
OBJECTIVES: I. Compare the efficacy of multi-course high-dose chemotherapy with autologous peripheral blood stem cell transplantation versus standard-dose chemotherapy in women with metastatic breast cancer. II. Compare the five year event-free survival, in terms of time to progression or time to death due to toxic effects, in patients treated with these regimens. III. Compare the response rate and overall survival of patients treated with these regimens. IV. Compare the toxicity of these regimens in this patient population. OUTLINE: This is a randomized, multicenter study. Patients are randomized to one of two treatment arms. Arm I: Patients receive docetaxel and doxorubicin once followed by filgrastim (G-CSF) daily for approximately 1 week. Treatment repeats approximately every 3 weeks for 4 courses. Patients then receive cyclophosphamide, methotrexate, and fluorouracil on days 7 and 8 every 4 weeks for 4 courses. Arm II: Patients receive docetaxel, doxorubicin, and G-CSF as in arm I for 3 courses. Patients undergo leukapheresis daily for 3 or 4 days. Patients then receive 1 course of ifosfamide, etoposide, and carboplatin daily for 4 days when blood counts recover, followed by 1 course of cyclophosphamide and thiotepa daily for 4 days. Patients undergo peripheral blood stem cell reinfusion following each course. PROJECTED ACCRUAL: A total of 264 patients (132 per arm) will be accrued for this study.
Age
18 - 59 years
Sex
FEMALE
Healthy Volunteers
No
Herbert Irving Comprehensive Cancer Center
New York, New York, United States
Start Date
January 1, 2000
Last Updated
January 6, 2014
filgrastim
BIOLOGICAL
CMF regimen
DRUG
carboplatin
DRUG
cyclophosphamide
DRUG
docetaxel
DRUG
doxorubicin hydrochloride
DRUG
etoposide
DRUG
fluorouracil
DRUG
ifosfamide
DRUG
methotrexate
DRUG
thiotepa
DRUG
peripheral blood stem cell transplantation
PROCEDURE
Lead Sponsor
Herbert Irving Comprehensive Cancer Center
Collaborators
NCT05673200
NCT05372640
Data Source & Attribution
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