415 Participants Needed

Platinum Chemotherapy for Triple-Negative Breast Cancer

Recruiting at 1023 trial locations
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: ECOG-ACRIN Cancer Research Group
Stay on Your Current MedsYou can continue your current medications while participating
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. However, adjuvant chemotherapy other than specified in the protocol is not allowed, but certain medications like LHRH agonists and bisphosphonates are permitted. It's best to discuss your current medications with the trial team.

What evidence supports the effectiveness of the drug Carboplatin for treating triple-negative breast cancer?

Research shows that adding Carboplatin to chemotherapy for triple-negative breast cancer can improve the rate at which the cancer completely disappears from the breast and lymph nodes before surgery, known as pathological complete response (pCR). Some studies also suggest it may help with long-term survival, although this is still being studied.12345

What safety data exists for platinum chemotherapy drugs like cisplatin and carboplatin?

Cisplatin can cause severe kidney damage, nausea, vomiting, nerve damage, and hearing loss, while carboplatin is less harmful to the kidneys and causes less nausea but can lead to blood-related issues like low platelet counts. Both drugs have been used safely in humans, but they have different side effects that need to be managed during treatment.678910

How is the drug Carboplatin or Cisplatin unique for treating triple-negative breast cancer?

Carboplatin and Cisplatin are unique for treating triple-negative breast cancer because they are platinum-based drugs that damage the DNA of cancer cells, which can be particularly effective in this aggressive cancer type. Unlike other treatments, they show a good initial response in triple-negative breast cancer, especially in cases with BRCA mutations, and are used when other therapies are not effective.1112131415

What is the purpose of this trial?

This randomized phase III trial studies how well cisplatin or carboplatin (platinum based chemotherapy) works compared to capecitabine in treating patients with remaining (residual) basal-like triple-negative breast cancer following chemotherapy after surgery (neoadjuvant). Drugs used in chemotherapy, such as cisplatin, carboplatin and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether cisplatin or carboplatin is more effective than capecitabine in treating patients with residual triple negative basal-like breast cancer.

Research Team

IM

Ingrid Mayer

Principal Investigator

ECOG-ACRIN Cancer Research Group

Eligibility Criteria

This trial is for adults with triple-negative breast cancer that remains after initial chemotherapy and surgery. Participants must have completed neoadjuvant taxane +/- anthracycline therapy, not received cisplatin, carboplatin, or capecitabine as part of this regimen, and meet certain health criteria like specific blood cell counts and liver function.

Inclusion Criteria

I can receive radiotherapy before or after the trial treatment as per standard guidelines.
I completed a specific chemotherapy regimen without cisplatin, carboplatin, or capecitabine.
I have not received any chemotherapy after surgery that is not listed in this study.
See 6 more

Exclusion Criteria

I had triple-negative breast cancer within the last 5 years and no other cancers.
I do not have any serious infections.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either cisplatin or carboplatin intravenously every 3 weeks for 4 courses, or capecitabine orally twice daily for up to 6 courses

12-18 weeks
4-6 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

10 years
Every 3 months for 2 years, then every 6 months for 3 years

Treatment Details

Interventions

  • Carboplatin
  • Cisplatin
Trial Overview The study compares the effectiveness of platinum-based chemotherapy (cisplatin or carboplatin) versus capecitabine in patients with residual basal-like triple-negative breast cancer post-surgery. It aims to determine which treatment better stops tumor growth by killing cells or preventing their spread.
Participant Groups
3Treatment groups
Experimental Treatment
Active Control
Group I: Arm B (cisplatin or carboplatin)Experimental Treatment2 Interventions
Patients receive cisplatin IV or carboplatin IV on day 1. Treatment repeats every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Group II: Arm A (observation) (closed to accrual 05/16/2016)Active Control1 Intervention
Patients undergo observation.
Group III: Arm C (capecitabine)Active Control1 Intervention
Patients receive capecitabine PO BID on days 1-14. Treatment repeats every 3 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Carboplatin is already approved in United States, European Union, Canada for the following indications:

🇺🇸
Approved in United States as Paraplatin for:
  • Ovarian cancer
  • Testicular cancer
  • Lung cancer
  • Head and neck cancer
  • Brain cancer
🇪🇺
Approved in European Union as Carboplatin for:
  • Ovarian cancer
  • Small cell lung cancer
🇨🇦
Approved in Canada as Carboplatin for:
  • Ovarian cancer
  • Small cell lung cancer
  • Testicular cancer

Find a Clinic Near You

Who Is Running the Clinical Trial?

ECOG-ACRIN Cancer Research Group

Lead Sponsor

Trials
122
Recruited
160,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Findings from Research

In a clinical trial involving 90 patients with triple negative breast cancer (TNBC), the optimal chemotherapy regimen combined carboplatin with standard dose-dense ACT, resulting in the lowest grade 3 or 4 toxicities and no delays or dose reductions for carboplatin.
The study identified reduced protein levels of androgen receptor and PD-L1 as potential indicators of treatment response, with Stage I patients showing a zero relapse rate, suggesting the effectiveness of the carboplatin-based regimen.
A prospective phase II clinical trial identifying the optimal regimen for carboplatin plus standard backbone of anthracycline and taxane-based chemotherapy in triple negative breast cancer.Hamm, C., Fifield, BA., Kay, A., et al.[2022]
In a study of 190 patients with stage I-III triple-negative breast cancer (TNBC), the neoadjuvant regimen of carboplatin and docetaxel (CbD) achieved a high pathologic complete response (pCR) rate of 55%, indicating effective tumor reduction before surgery.
The CbD regimen was well tolerated, with only 21% of patients experiencing grade 3 or 4 adverse events, suggesting it is a safe treatment option comparable to traditional chemotherapy combinations that include anthracyclines.
Efficacy of Neoadjuvant Carboplatin plus Docetaxel in Triple-Negative Breast Cancer: Combined Analysis of Two Cohorts.Sharma, P., López-Tarruella, S., García-Saenz, JA., et al.[2022]
A phase I trial involving 33 patients tested the combination of cisplatin and carboplatin, revealing that while the combination is feasible, it can lead to unexpectedly severe thrombocytopenia (low platelet count) when using specific doses, particularly 280 mg/m2 carboplatin with 25 mg/m2 cisplatin.
Despite the risk of thrombocytopenia, the combination therapy showed promising responses in tumors known to be responsive to platinum-based treatments, suggesting that further investigation into this combination is warranted.
Platinum analogue combination chemotherapy: cisplatin and carboplatin--a phase I trial with pharmacokinetic assessment of the effect of cisplatin administration on carboplatin excretion.Trump, DL., Grem, JL., Tutsch, KD., et al.[2017]

References

Association of Immunophenotype With Pathologic Complete Response to Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Secondary Analysis of the BrighTNess Phase 3 Randomized Clinical Trial. [2023]
A prospective phase II clinical trial identifying the optimal regimen for carboplatin plus standard backbone of anthracycline and taxane-based chemotherapy in triple negative breast cancer. [2022]
Moment of truth-adding carboplatin to neoadjuvant/adjuvant chemotherapy in triple negative breast cancer improves overall survival: An individual participant data and trial-level Meta-analysis. [2022]
Long-term survival analysis of addition of carboplatin to neoadjuvant chemotherapy in HER2-negative breast cancer. [2020]
Efficacy of Neoadjuvant Carboplatin plus Docetaxel in Triple-Negative Breast Cancer: Combined Analysis of Two Cohorts. [2022]
Platinum analogue combination chemotherapy: cisplatin and carboplatin--a phase I trial with pharmacokinetic assessment of the effect of cisplatin administration on carboplatin excretion. [2017]
Combined carboplatin and cisplatin therapy in patients with advanced non-small cell lung cancer. [2019]
Comparative adverse effect profiles of platinum drugs. [2018]
Results of NCI-sponsored phase I trials with carboplatin. [2019]
10.United Statespubmed.ncbi.nlm.nih.gov
Single-agent carboplatinum for advanced seminoma. A phase II study. [2019]
[Platinum-based chemotherapy in triple negative breast cancer]. [2013]
Neoadjuvant, anthracycline-free chemotherapy with carboplatin and docetaxel in triple-negative, early-stage breast cancer: a multicentric analysis of rates of pathologic complete response and survival. [2022]
Pathological complete response following cisplatin or carboplatin-based neoadjuvant chemotherapy for triple-negative breast cancer: A systematic review and meta-analysis. [2021]
14.United Statespubmed.ncbi.nlm.nih.gov
Role of Platinums in Triple-Negative Breast Cancer. [2022]
Cisplatin plus gemcitabine versus paclitaxel plus gemcitabine as first-line therapy for metastatic triple-negative breast cancer (CBCSG006): a randomised, open-label, multicentre, phase 3 trial. [2022]
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