T-DM1 vs Paclitaxel/Trastuzumab for Breast (ATEMPT Trial)

Completed · Phase 2

Conditions studied: Breast Cancer

In brief

This research study is a Phase II clinical trial. Phase II clinical trials test the effectiveness of an investigational drug to learn whether the drug works in treating a specific cancer. "Investigational" means that the drug is still being studied and that research doctors are trying to find out more about it-such as the safest dose to use, the side effects it may cause, and if the drug is effective for treating different types of cancer. It also means that the FDA has not approved this drug for use patients undergoing adjuvant treatment for HER2+ breast cancer. Trastuzumab emtansine (T-DM1) is a drug that may stop cancer cells from growing. This drug has been used in other research studies and information from those other research studies suggests that this drug may help to prevent the recurrence of breast cancer in this research study. The use of T-DM1 in this research study is experimental, which means it is not approved by any regulatory authority for the adjuvant treatment of HER2-positive breast cancer. However, it FDA-approved for metastatic HER2-positive breast cancer. T-DM1 has caused cancer cells to die in laboratory studies. In preclinical studies, this drug has prevented or slowed the growth of breast cancer. The breast cancer treatments (paclitaxel and Trastuzumab) used in this study are considered part of standard-of-care regimens in early breast cancer. A standard treatment means that this is a treatment that would be accepted by the majority of the medical community as a suitable treatment for your type of breast cancer. In this research study, the investigators are looking to see if the study drug T-DM1 will have less side effects than traditional HER2-positive breast cancer treatment of trastuzumab and paclitaxel. The investigators are also hoping to learn about the long term benefits and disease-free survival of participants who take the study drug T-DM1 in comparison to those participants to take the combination of trastuzumab and paclitaxel.

Key facts

Study ID

NCT01853748

Run by

Dana-Farber Cancer Institute

People needed

512

Starts

2013-05-01

Expected to finish

2022-06-15

Last updated by the study team

2026-02-19

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• HER2-positive Stage I histologically confirmed invasive carcinoma of the breast
• ER/PR determination is required
• HER2 positive, confirmed by central testing: IHC 3+, FISH HER2/CEP17 <2.0 with an average HER2 copy number >/=6.0, or FISH HER2/CEP17 >/= 2.0
• Bilateral breast cancers that individually meet eligibility criteria are allowed
• Subjects with multifocal or multicentric disease are eligible as long as each tumor individually meets eligibility criteria
• Subjects with a history of ipsilateral DCIS are eligible if they were treated with wide-excision alone, without radiation therapy; Patients with a history of contralateral DCIS are not eligible.
• Should have tumor tissue available and a tissue block of sufficient size to make 15 slides, which must be sent to a DFCI site for testing
• Less than or equal to 90 days since most recent breast surgery for this breast cancer
• All tumor should be removed by either a modified radical mastectomy or a segmental mastectomy (lumpectomy) with either a sentinel node biopsy or axillary dissection
• All margins should be clear of invasive cancer or DCIS
• May have received up to 4 weeks of tamoxifen therapy or other hormonal therapy, for adjuvant therapy for this cancer
• Prior oophorectomy for cancer prevention is allowed
• Subjects who have undergone partial breast radiation (duration </= 7 days) prior to registration are eligible. Partial breast radiation must be completed prior to 2 weeks before starting protocol therapy.
• Must have discontinued any investigational drug at least 2 weeks prior to participation
• Willing to use one highly effective from of nonhormonal contraception or two effective forms of nonhormonal contraception while on study and for 7 months after end of study treatment
• Subjects undergoing lumpectomy must have no contraindications to radiation therapy

You may not qualify if…

• Pregnant or breastfeeding
• Use of potent CYP3A4 inhibitors during the study treatment period
• Excessive alcohol intake (more than 3 alcoholic beverages per day)
• Locally advanced tumors at diagnosis
• History of previous invasive breast cancer
• History of prior chemotherapy in the past 5 years
• History of prior trastuzumab or prior paclitaxel therapy
• Active, unresolved infection
• Active liver disease
• History of a different malignancy except for the following: disease free for at least 5 years and at low risk for recurrence; cervical cancer in situ, basal or squamous cell carcinoma of the skin
• Active cardiac disease

Where it is running

• University of California San Francisco — San Francisco, California, United States
• Hartford Hospital — Hartford, Connecticut, United States
• Midstate Medical Center — Meriden, Connecticut, United States
• Hartford Healthcare Cancer Institute at The Hospital of Central Connecticut — New Britain, Connecticut, United States
• William W Backus Hospital — Norwich, Connecticut, United States
• Georgetown Hospital — Washington D.C., District of Columbia, United States
• Washington Cancer Institute at Medstar Washington Hospital Center — Washington D.C., District of Columbia, United States
• Sibley Memorial Hospital — Washington D.C., District of Columbia, United States
• Florida Cancer Specialists — Fort Myers, Florida, United States
• Florida Cancer Specialists — St. Petersburg, Florida, United States
• Mountain States Tumor Institute — Boise, Idaho, United States
• Mountain States Tumor Institute — Fruitland, Idaho, United States
• Mountain States Tumor Institute — Meridian, Idaho, United States
• Mountain States Tumor Institute — Nampa, Idaho, United States
• Mountain States Tumor Institute — Twin Falls, Idaho, United States
• Loyola University Medical Center — Maywood, Illinois, United States
• University of Chicago Comprehensive Cancer Center at Silver Cross Hospital — New Lenox, Illinois, United States
• University of Chicago Medical Center for Advanced Care Orland Park — Orland Park, Illinois, United States
• Indiana University - Wishard Hospital — Indianapolis, Indiana, United States
• Indiana University Health - Melvin and Bren Simon Cancer Center — Indianapolis, Indiana, United States
• Indiana University Health - University Hospital — Indianapolis, Indiana, United States
• Indiana University - Springmill Medical Clinic — Indianapolis, Indiana, United States
• Eastern Maine Medical Center's Cancer Care — Brewer, Maine, United States
• Johns Hopkins - Sidney Kimmel Comprehensive Cancer Center — Baltimore, Maryland, United States
• University of Alabama Birmingham — Birmingham, Alabama, United States

Full record on ClinicalTrials.gov

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