Review Article

Triple-Negative Breast Cancer: Adjuvant Therapeutic Options

Table 2

Neoadjuvant/Adjuvant clinical trials for patients with triple-negative breast cancer*.

NCI IDStatusPrimary locationStudy typeSetting adjuvantStageRegimen

Chemotherapy
NCT00861705RecruitingMiriam Hospital (Providence, RI)Phase IINeoadjuvantII-IIIArm A: Paclitaxel D1 weekly × 12 weekly → ddAC D1 × 4 cycles
Arm B: Arm A + Bevacizumab q2wks (weeks 1, 3, 5, 7, 9, 10, 11, 13, 15, 17)
Arm C: Arm A + Carboplatin q3wks (wks 1, 4, 7, 10
Arm D: Arm A + Bevacizumab as in Arm B + Carboplatin as in Arm C.
NCT00912444RecruitingShanghai Jiao Tong University School of Medicine (Shanghai, China)Phase IIINeoadjuvantT2N1 OR T3-4/N0-3 OR T0-4/N2-3Arm A: Docetaxel 75 mg/m2 & Doxorubicin 50 mg/m2 OR Epirubicin 60 mg/m2 & Cyclophosphamide 500 mg/m2 D1 × 6 cycles (cycle = 21 days)
Arm B: Docetaxel 75 mg/m2 & Cyclophosphamide 500 mg/m2 D1 × 6 cycles (cycle = 21 days)
NCT01112826RecruitingSun Yat-sen University Cancer Center (Guangzhou, China)Phase IIIAdjuvantT1c-T3, pN0-2Arm A: Standard adjuvant chemotherapy followed by capecitabine 650 mg/m2 BID × 1 yr
Arm B: standard adjuvant chemotherapy
NCT00789581Active/Not recruitingSarah Cannon Research Institute (Nashville, TN)Phase IIIAdjuvantNode negative T1c-T3 OR Node positive pN1mi -N2b)Arm A: Doxorubicin 60 mg/m2 & Cyclophosphamide 600 mg/m2 D1 × 4 cycles (cycle = 21 days) → Ixabepilone at 40 mg/m2 D1 × 4 cycles (cycle = 21 days)
Arm B: Doxorubicin 60 mg/m2 & Cyclophosphamide 600 mg/m2 D1 × 4 cycles (cycle = 21 days) → Paclitaxel at 80 mg/m2 D1 weekly × 12 weeks
NCT00630032Active/Not recruitingCentre Regional Rene Gauducheau (Nantes-Saint Herblain, France)Phase IIIAdjuvantNode-positive disease OR node-negative disease: II-III OR pT1-4Arm A: Epirubicin & 5-Fluorouracil & Cyclophosphamide D1 × 3 cycles (cycle = 21 days) → Docetaxel D1 × 3 cycles (cycles = 21 days)
Arm B: Epirubicin & 5-Fluorouracil & Cyclophosphamide D1 × 3 cycles (cycle = 21 days) → Ixabepilone D1 × 3 cycles (cycles = 21 days)
NCT01216111AvailableFudan University (Shanghai, China)Expanded AccessAdjuvantI-IIIAPaclitaxel 100 mg/m2 & Cisplatin AUC = 2 D1, 8, 15 × 6 cycles (cycle = 28 days)
NCT01276769RecruitingCancer Institute Hospital/Chinese Academy of Medical Sciences (Beijing, China)Phase IINeoadjuvantIIa-IIIc (no T4 disease)Arm A: Paclitaxel 175 mg/m2 D3 & Epirubicin 75 mg/m2 D 1, 2 × 2–6 cycles (cycle = 21 days)
Arm B: Paclitaxel 175 mg/m2 D1 & Carboplatin AUC = 5 D2 × 2–6 cycles (cycle = 21 days)
NCT01216124AvailableFudan University (Shanghai, China)Expanded AccessNeoadjuvantI-IIIADocetaxel 75 mg/m2 D1 & Oxaliplatin 130 mg/m2 D2 × 6 cycles (cycle = 21 days)
NCT01238133RecruitingArthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center (Columbus, OH)Phase INeoadjuvantII-IIIRO4929097 D1-3, 8-10, 15-17 & Paclitaxel D1, 8, 15 & Carboplatin D1 × 6 cycles (cycle = 21 days)
NCT01167192RecruitingWashington University School of Medicine (St. Louis, MO)Phase IINeoadjuvantT2-T4, any NCisplatin 75 mg/m2 IV or Carboplatin AUC = 6 IV, at physician discretion) + XRT × 6 weeks (50–60 Gy to breast/CW; 45–50 Gy to internal mammary nodes, supraclavicular fossa nodes and axillary nodal basins)

Antiangiogenic agents
NCT00861705RecruitingMiriam Hospital (Providence, RI)Phase IINeoadjuvantII-IIIArm A: Paclitaxel D1 weekly × 12 weekly → dd AC D1 × 4 cycles
Arm B: Arm A + Bevacizumab q2wks (weeks 1, 3, 5, 7, 9, 10, 11, 13, 15, 17)
Arm C: Arm A + Carboplatin q3wks (wks 1, 4, 7, 10
Arm D: Arm A + Bevacizumab as in Arm B + Carboplatin as in Arm C.
NCT01208480RecruitingSeverance Hospital (Seoul, Korea)Phase IINeoadjuvantII-IIIBevacizumab & Docetaxel & Carboplatin D1 × 5 cycles (cycle = 21 days → Docetaxel & Carboplatin C6D1
NCT00777673RecruitingUniversity of Tennessee Cancer Institute (Memphis, TN)Phase IINeoadjuvantT2-T3, cN1-cN2aNab-paclitaxel D1, 8, 15 & Carboplatin D1 & Bevacizumab D1,15 × 4 cycles (cycle = 28 days) → ddAC × 4 cycles (cycle = 14 days) & Bevacizumab D1 × 2 cycles (cycle = 14 days)
>4 weeks postoperative: Bevacizumab D1, 15 × 8 cycles (cycle = 28 days)
NCT00528567RecruitingHoffmann-La Roche; InternationalPhase IIIAdjuvantOperable primary invasive breast cancerArm A: Standard adjuvant chemotherapy (anthracycline ± taxane or taxane only) & 1 yr of Bevacizumab 5 mg/kg/week dosing equivalent
Arm B: Standard adjuvant chemotherapy (anthracycline ± taxane or taxane only)
NCT00887575RecruitingTennessee Oncology, PLLC (Nashville, TN)Phase I/IINeoadjuvantT1-3, any N (excluding T1N0)Paclitaxel D1, 8, 15 & Carboplatin D1 & Sunitinib D1-21 × 6 cycles (cycle = 28 days)
NCT01194869RecruitingEmory University (Atlanta, GA)Phase IINeoadjuvantI-IIIASorafenib 400 mg BID throughout the study: single agent for weeks 1–4, then in combination with cisplatin followed by dose dense paclitaxel
Poly(ADP-ribose) polymerase (PARP) inhibitors
NCT00813956RecruitingStanford Comprehensive Cancer Center (Stanford, CA)Phase IINeoadjuvantI-IIIAGemcitabine & Carboplatin & BSI-201 q3wks
NCT01204125RecruitingGrupo Espanol de Estudio Tratamiento y Otras Estrategias Experimentales en Tumores Solidos (France/Spain)Phase IINeoadjuvantII-IIIAArm A: Iniparib 5.6 mg/kg D1, 4 &Paclitaxel 80 mg/m2 D1 weekly × 12 weeks
Arm B: Iniparib 11.2 mg/kg D1 &Paclitaxel 80 mg/m2 D1 weekly × 12 weeks
Arm C: Paclitaxel 80 mg/2 D1 weekly × 12 weeks
NCT01074970RecruitingIndiana University Melvin and Bren Simon Cancer Center (Indianapolis, IN)Phase IIAdjuvantResidual disease post neoadjuvant chemotherapy (I-III)Arm A: PF-01367338 D1-3 C1: 30mg C2-4: 24 mg & Cisplatin 75 mg/m2 D1 × 4 cycles (cycle = 21 days)
Arm B: Cisplatin 75 mg/m2 D1 × 4 cycles (cycle = 21 days)

EGFR inhibitors
NCT01097642RecruitingThe Methodist Hospital Research Institute (Houston, TX)Phase IINeoadjuvantT1N1-3M0 or T2-4 N0-3M0Arm A: Cetuximab 400 mg/m2 D1 then weekly 250 mg/m2 & Ixabepilone 40 mg/m2 D1 1 × 4 cycles (cycle = 21 days)
Arm B: Ixabepilone 40 mg/m2 D1 1 × 4 cycles (cycle = 21 days)
NCT00600249RecruitingCentre Jean Perrin (Clermont-Ferrand, France)Phase IINeoadjuvantII-IIIaCetuximab Wk1D1 400 mg/m2 → 250 mg/m2 D1 weeks 2–18. & Docetaxel 100 mg/m2 D1 × 6 cycles (cycle = 21 days)
NCT00491816Active/Not recruitingUniversity of Kansas Medical Center (Kansas City, KS)Phase IINeoadjuvantII-III (T2-4, N1-2)Erlotinib150 mg orally D3-14 with cycles 1 to 6 or 3 to 6 of neoadjuvant chemotherapy. Adjuvant chemotherapy given at the discretion of treating physician followed by 1 yr of maintenance erlotinib 150 mg daily

Other targeted agents
NCT00930930RecruitingVanderbilt-Ingram Cancer Center (Nashville, TN)Phase IINeoadjuvantII-IIIArm A: Cisplatin & Everolimus D1 weekly × 12 weeks & Paclitaxel D1 weekly in weeks 4–12
Arm B: Cisplatin & Placebo D1 weekly × 12 weeks & Paclitaxel D1 weekly in weeks 4–12
NCT00499603Active/Not recruitingM.D. Anderson Cancer Center (Houston, TX)Phase IINeoadjuvantIIa-IIIcArm A: Drug: Paclitaxel 80 mg/m2 D1 weekly & RAD001 30 mg D1, 8, 15 × 12 cycles (cycle = 21 days) → 5-Fluorouracil 500 mg/m2 & Epirubicin100 mg/m2 & Cyclophosphamide 500 mg/m2 D1 × 4 cycles (cycle = 21 days)
Arm B: Paclitaxel 80 mg/m2 D1 weekly × 12 cycles (cycle = 21 days) → 5-Fluorouracil 500 mg/m2 & Epirubicin100 mg/m2 & Cyclophosphamide 500 mg/m2 D1 × 4 cycles (cycle = 21 days)

*Details outlined above as per http://clinicaltrials.gov/; accessed February 28th, 2011.