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    Clinical Trial Results:
    Phase II, open label, neoadjuvant study of Bevacizumab in patients with inflammatory or locally advanced breast cancer

    Summary
    EudraCT number
    2006-003291-35
    Trial protocol
    IT  
    Global end of trial date
    28 Jul 2015

    Results information
    Results version number
    v2(current)
    This version publication date
    17 Feb 2017
    First version publication date
    16 Nov 2016
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    Update to align with ClinicalTrials.gov registry posting.

    Trial information

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    Trial identification
    Sponsor protocol code
    ML 19884
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00559845
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.com
    Scientific contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    28 Jul 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    28 Jul 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    28 Jul 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine the rate of pathological complete responses (pCR) defined as absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy.
    Protection of trial subjects
    All study subjects were required to read and sign an informed consent form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    18 Feb 2008
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Efficacy, Safety
    Long term follow-up duration
    5 Years
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Italy: 56
    Worldwide total number of subjects
    56
    EEA total number of subjects
    56
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    52
    From 65 to 84 years
    4
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    56 subjects were enrolled in 8 centers in Italy.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Bevacizumab
    Arm description
    5-fluorouracil, epidoxorubicin and cyclophosphamide (FEC), followed by paclitaxel, given concomitantly with bevacizumab for approximately 3-12 months.
    Arm type
    Experimental

    Investigational medicinal product name
    5-fluorouracil
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous bolus use
    Dosage and administration details
    600 milligrams per metre squared (mg/m^2) as an intravenous (i.v.) bolus over ≤15 minutes every 3 weeks for 4 cycles.

    Investigational medicinal product name
    Epidoxorubicin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    90 mg/m^2 as an i.v. infusion over 1 hour every 3 weeks for 4 cycles.

    Investigational medicinal product name
    Cyclophosphamide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    600 mg/m^2 as an i.v. infusion over 1 hour every 3 weeks for 4 cycles.

    Investigational medicinal product name
    Paclitaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravascular use
    Dosage and administration details
    80 mg/m^2 i.v. over 1 hour weekly for 12 weeks.

    Investigational medicinal product name
    Bevacizumab
    Investigational medicinal product code
    Other name
    Avastin®
    Pharmaceutical forms
    Concentrate for emulsion for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    10 milligrams per kilogram (mg/kg) i.v. every 2 weeks for 6 cycles.

    Number of subjects in period 1
    Bevacizumab
    Started
    56
    Completed
    49
    Not completed
    7
         Did not attend cycle 6 hospital visit
    1
         Disease progression
    1
         Adverse event
    3
         Premature surgery-investigator decision
    1
         Withdrew consent
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Bevacizumab
    Reporting group description
    5-fluorouracil, epidoxorubicin and cyclophosphamide (FEC), followed by paclitaxel, given concomitantly with bevacizumab for approximately 3-12 months.

    Reporting group values
    Bevacizumab Total
    Number of subjects
    56 56
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    50 ( 9.279 ) -
    Gender categorical
    Units: Subjects
        Female
    56 56
        Male
    0 0

    End points

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    End points reporting groups
    Reporting group title
    Bevacizumab
    Reporting group description
    5-fluorouracil, epidoxorubicin and cyclophosphamide (FEC), followed by paclitaxel, given concomitantly with bevacizumab for approximately 3-12 months.

    Primary: Percentage of Subjects With Pathological Complete Response Following Principle Investigator Review

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    End point title
    Percentage of Subjects With Pathological Complete Response Following Principle Investigator Review [1]
    End point description
    Pathological complete response was defined as absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. Intention-to-Treat (ITT) population, defined as all subjects that were included in the trial and underwent surgery.
    End point type
    Primary
    End point timeframe
    Up to 7.5 years
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive data was planned to be reported.
    End point values
    Bevacizumab
    Number of subjects analysed
    56
    Units: percentage of subjects
        number (not applicable)
    23.2
    No statistical analyses for this end point

    Secondary: Objective Response Rate

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    End point title
    Objective Response Rate
    End point description
    Objective response rate was defined as the percentage of subjects with a Complete Response (CR) or Partial Response (PR) as defined by the Response Evaluation Criteria in Solid Tumors (RECIST). CR was defined as the disappearance of all target lesions; PR was defined as a 30% decrease in sum of longest diameter of target lesions. ITT population, defined as all subjects that were included in the trial and underwent surgery.
    End point type
    Secondary
    End point timeframe
    Up to 7.5 years
    End point values
    Bevacizumab
    Number of subjects analysed
    56
    Units: percentage of subjects
        number (not applicable)
    59
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Breast-Conserving Surgery

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    End point title
    Percentage of Subjects With Breast-Conserving Surgery
    End point description
    Categories breast-conserving procedure, and breast-conserving procedure plus axillary dissection are presented. ITT population, defined as all subjects that were included in the trial and underwent surgery.
    End point type
    Secondary
    End point timeframe
    Up to 7.5 years
    End point values
    Bevacizumab
    Number of subjects analysed
    56
    Units: percentage of subjects
    number (not applicable)
        Breast-conserving
    17
        Breast-conserving plus axillary
    13.2
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Disease-Free Interval at Specified Time Points

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    End point title
    Percentage of Subjects With Disease-Free Interval at Specified Time Points
    End point description
    Disease-free interval was defined as the time from enrollment until recurrence of tumor or death from any cause, and was estimated using the Kaplan-Meier method. The percentage of subjects without events at Months 12, 24, 36, 48, and 60 is presented. ITT population, defined as all subjects that were included in the trial and underwent surgery.
    End point type
    Secondary
    End point timeframe
    Months 12, 24, 36, 48, and 60
    End point values
    Bevacizumab
    Number of subjects analysed
    53 [2]
    Units: percentage of subjects
    number (confidence interval 95%)
        12 Months
    92.2 (85.1 to 99.8)
        24 Months
    84.3 (74.9 to 94.9)
        36 Months
    80.4 (70.2 to 92.1)
        48 Months
    76.5 (65.7 to 89.1)
        60 Months
    76.5 (65.7 to 89.1)
    Notes
    [2] - Number of subjects analyzed signifies those subjects who were evaluable for the endpoint.
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    Overall survival was defined as the time from enrollment of subject to death from any cause.
    End point type
    Secondary
    End point timeframe
    Up to 7.5 years
    End point values
    Bevacizumab
    Number of subjects analysed
    0 [3]
    Units: months
        median (full range (min-max))
    ( to )
    Notes
    [3] - Data for the outcome measure was not collected.
    No statistical analyses for this end point

    Secondary: Percentage of Subjects Experiencing Any Adverse Event

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    End point title
    Percentage of Subjects Experiencing Any Adverse Event
    End point description
    An adverse event was defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Safety population, defined as all subjects who received at least one infusion of Bevacizumab.
    End point type
    Secondary
    End point timeframe
    Up to 7.5 years
    End point values
    Bevacizumab
    Number of subjects analysed
    56
    Units: percentage of subjects
        number (not applicable)
    100
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 7.5 years
    Adverse event reporting additional description
    Safety population, defined as all subjects who received at least one infusion of Bevacizumab.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    13.0
    Reporting groups
    Reporting group title
    Bevacizumab
    Reporting group description
    5-fluorouracil, epidoxorubicin and cyclophosphamide (FEC), followed by paclitaxel, given concomitantly with bevacizumab for approximately 3-12 months.

    Serious adverse events
    Bevacizumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 54 (14.81%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Investigations
    Cardiac imaging procedure abnormal
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant melanoma in situ
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Postoperative wound complication
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    4 / 6
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Retinopathy hypertensive
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Suicide attempt
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Febrile infection
         subjects affected / exposed
    1 / 54 (1.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Bevacizumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    54 / 54 (100.00%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    6 / 54 (11.11%)
         occurrences all number
    8
    Ast increased
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    4
    Vascular disorders
    Hypertension
         subjects affected / exposed
    13 / 54 (24.07%)
         occurrences all number
    15
    Phlebitis
         subjects affected / exposed
    4 / 54 (7.41%)
         occurrences all number
    4
    Surgical and medical procedures
    Astringent therapy
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    3
    Nervous system disorders
    Paraesthesia
         subjects affected / exposed
    27 / 54 (50.00%)
         occurrences all number
    37
    Headache
         subjects affected / exposed
    10 / 54 (18.52%)
         occurrences all number
    16
    Dysgeusia
         subjects affected / exposed
    5 / 54 (9.26%)
         occurrences all number
    6
    Syncope
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    22 / 54 (40.74%)
         occurrences all number
    50
    Leukopenia
         subjects affected / exposed
    15 / 54 (27.78%)
         occurrences all number
    26
    Anaemia
         subjects affected / exposed
    12 / 54 (22.22%)
         occurrences all number
    15
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    30 / 54 (55.56%)
         occurrences all number
    83
    Mucosal inflammation
         subjects affected / exposed
    18 / 54 (33.33%)
         occurrences all number
    41
    Pyrexia
         subjects affected / exposed
    15 / 54 (27.78%)
         occurrences all number
    27
    Oedema
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    3
    Pain
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    4
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    9 / 54 (16.67%)
         occurrences all number
    17
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    38 / 54 (70.37%)
         occurrences all number
    66
    Diarrhea
         subjects affected / exposed
    17 / 54 (31.48%)
         occurrences all number
    27
    Vomiting
         subjects affected / exposed
    17 / 54 (31.48%)
         occurrences all number
    28
    Constipation
         subjects affected / exposed
    11 / 54 (20.37%)
         occurrences all number
    16
    Stomatitis
         subjects affected / exposed
    11 / 54 (20.37%)
         occurrences all number
    14
    Abdominal pain upper
         subjects affected / exposed
    7 / 54 (12.96%)
         occurrences all number
    8
    Dyspepsia
         subjects affected / exposed
    6 / 54 (11.11%)
         occurrences all number
    7
    Haemorrhoids
         subjects affected / exposed
    4 / 54 (7.41%)
         occurrences all number
    4
    Abdominal pain
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Epistaxis
         subjects affected / exposed
    33 / 54 (61.11%)
         occurrences all number
    47
    Cough
         subjects affected / exposed
    4 / 54 (7.41%)
         occurrences all number
    4
    Dyspnoea
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    6
    Oropharyngeal pain
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    3
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    36 / 54 (66.67%)
         occurrences all number
    36
    Nail disorder
         subjects affected / exposed
    10 / 54 (18.52%)
         occurrences all number
    10
    Rash
         subjects affected / exposed
    8 / 54 (14.81%)
         occurrences all number
    11
    Pruritus
         subjects affected / exposed
    4 / 54 (7.41%)
         occurrences all number
    5
    Erythema
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    3
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    4 / 54 (7.41%)
         occurrences all number
    4
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    18 / 54 (33.33%)
         occurrences all number
    35
    Bone Pain
         subjects affected / exposed
    13 / 54 (24.07%)
         occurrences all number
    24
    Arthralgia
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    7
    Pain in extremity
         subjects affected / exposed
    3 / 54 (5.56%)
         occurrences all number
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    20 Nov 2009
    1. Better define and specify the objectives of the study 2. Update the duration of the study according to the new definition of "Long-Term Follow-up" for a maximum of 5 years 3. Update the examinations to be performed during the "Long-Term Follow-up" according to the clinical practice

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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