Preoperative Bevacizumab and Trastuzumab With ABI-007 and Carboplatin in HER2+ Breast Cancer

Study Overview
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Brief Summary
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This trial combines trastuzumab and bevacizumab monoclonal antibodies, with ABI-007 and carboplatin, as neoadjuvant therapy in previously untreated locally advanced breast cancers demonstrating HER2 gene amplification. It is hoped that this novel combination will result in increased pathologic response rates that will translate into long term outcome improvements in HER2 positive patients with locally advanced breast cancer.

Detailed Description
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All eligible patients will receive induction chemotherapy prior to consideration of primary surgical intervention. If surgical intervention is deemed not to be in the best interest of the patient, patient will go off study at the time of evaluation for surgery. Upon completion of chemotherapy and surgery, all ER + and/or PR + patients will be placed on Tamoxifen 20 mg/qd or an aromatase inhibitor. Induction preoperative therapy: Bevacizumab Trastuzumab ABI-007 Carboplatin Postoperative Adjuvant Therapy: Bevacizumab Trastuzumab

Official Title
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Phase II Study of Preoperative Bevacizumab and Trastuzumab Administered With ABI-007 and Carboplatin in HER2 Overexpressing Breast Cancer

Conditions
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Breast Cancer

Intervention / Treatment
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* Drug: nab-paclitaxel
* Drug: Bevacizumab
* Drug: Trastuzumab


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female patients with histologically confirmed adenocarcinoma of the breast or inflammatory breast cancer Clinical stage T 1-4, N 0-3, M0 FISH+ HER2 gene amplified breast cancer 18 years or older Normal cardiac function Performance status 0-2 Cannot have received any prior chemotherapy for this disease or cannot have received chemotherapy for any other cancer in the past 5 years. Previous diagnosis of noninvasive breast cancer is OK. Must have adequate bone marrow, renal and liver function. Pregnant or lactating females not allowed. Preexisting peripheral neuropathy must be equal to or less than grade 1 Must have archived tumor tissue for tissue testing. Exclusion Criteria: You cannot be in this study if you any of the following: History of cardiac disease, with New York Heart Association Class II or greater with congestive heart failure Any heart attack, stroke or TIAs within the last 6 months or serious arrhythmias needing medication; no bleeding diathesis or coagulopathy. No prior investigational drug within the last 30 days No prior trastuzumab or bevacizumab therapy There are additional inclusion/exclusion criteria. The study center will determine if you meet all of the criteria. If you do not qualify for the trial, study personnel will explain the reasons.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Patients received treatment with nab-paclitaxel (100 mg/m2 IV days 1, 8, 15) and carboplatin (AUC 6 IV day 1) every 28 days for 6 cycles. Trastuzumab (4 mg/kg loading dose, followed by 2 mg/kg) and bevacizumab (5 mg/kg IV) were administered weekly for 23 weeks, beginning concurrently with chemotherapy. Patients then underwent either mastectomy or breast conserving surgery and pathologic treatment responses were assessed. After surgery, trastuzumab 6 mg/kg and bevacizumab 15 mg/kg were administered at 3 week intervals for a total of 52 weeks. | Drug: nab-paclitaxel<br>* ABI-007<br>* Other names: ABI-007;Drug: Bevacizumab<br>* Bevacizumab<br>* Other names: Avastin;Drug: Trastuzumab<br>* Trastuzumab<br>* Other names: Herceptin;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pathologic Complete Response Rate (PCRR), the Percentage of Patients Who Have No Evidence of Cancer in the Breast or Lymph Nodes Following Surgery | Pathologic complete response was defined as the absence of residual invasive cancer in the breast (pT0) and axillary lymph nodes (pN0). | 18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Breast Cancer