Pixantrone Dimaleate in Treating Patients With HER2-Negative Metastatic Breast Cancer

OBJECTIVES: Primary * To assess the proportion of confirmed tumor responses at each dose level of pixantrone Secondary * To describe the distribution of progression-free survival (PFS) times of patients receiving pixantrone * To assess the 6-month PFS rate in patients receiving each dose level of pixantrone * To describe the overall survival distribution of patients receiving pixantrone * To assess the adverse event profile of pixantrone in the treatment of patients with metastatic breast cancer. * To evaluate the quality of life and patient-reported symptoms of patients receiving the study regimen OUTLINE: This is a multicenter study. Patients are randomized according to prior doxorubicin treatment ( yes vs no). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive pixantrone dimaleate IV over 1 hour on day 1. Treatment repeats every 21 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. * Arm II: Patients receive pixantrone dimaleate IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. Some patients undergo blood sample collection at baseline and periodically during study for circulating tumor cells analysis by CellSearch System and mRNA isolation assays. Patients complete quality-of-life questionnaires using the Linear Analogue Self Assessment (LASA6) and the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) at baseline and periodically during study. After completion of study therapy, patients are followed up every 3-6 months for up to 5 years.