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Protocol Fast Facts
NSABP, SWOG, CALGB& RTOG

NSABP, SWOG & CALGB Click here for RTOG
•  Breast Protocols: Neoadjuvant
•  Breast Protocols: Stages 0-II
•  Breast Protocols: Stages I-IIIA
•  Breast Protocols: Locally
Advanced/Recurrent Metastatic
•  Breast Protocols: Surgical
•  Cancer Control/
Symptom Management
•  GI Protocols: Colon-Rectal
•  GI Protocols: Pancreas
•  GU Protocols: Prostate
GU Protocols: Renal
Head & Neck Protocols
  Lung Protocols: Non-small Cell
  Lung Protocols: Small Cell
  Melanoma Protocols
  Breast Protocols
  CNS Protocols
  GU Protocols: Prostate
  Head & Neck Protocols
  Lung Protocols: Non-Small Cell
  Lung Protocols: Small Cell
  Miscellaneous Protocols

BREAST PROTOCOLS: Neoadjuvant

1.  ACOSOG Z1031 (Temporarily closed 08/15/09)
Neoadjuvant Hormonal Therapy

Eligibility: clinical stage T2-T4c, any N, M0; ER+ tumor with Allred score of 6, 7 or 8; postmenopausal; surgical resection is the goal; performance status 0-2: RX: Exemestane 25 mg/day vs Letrozole 2.5 mg/day vs Anastrozole 1 mg/day  for 16 -18 weeks followed by surgery.  Continue post – op Anastrozole or Tamoxifen X 5 years.  Post-op chemo and/or RT at physician’s discretion. (NO DRUG SUPPLIED)

2. CALGB 40601
Clinical Stage II-III; HER2 Positive

Eligibility: breast tumor must be at least 1 cm by clinical  or radiographic msmt; multicentric or bilateral dz is OK; no prior treatment for this cancer; performance status 0-1; men OK: Rx: Taxol/Herceptin weekly + Lapatinib po qd x 16 weeks versus Taxol/Herceptin weekly x 16 weeks versus Taxol weekly + Lapatinib po qd x 16 weeks. (LAPATINIB SUPPLIED)

3. CALGB 40603
Clinical Stage IIA-IIIA; Triple Negative (ER/PR/HER2)

Eligibility: histologic dx by core or incisional bx; measurable dz >/= 1 cm; pt must agree to pretreatment research biopsies; no prior chemo, hormonal therapy or RT for this cancer;  performance status 0-1: Rx: Paclitaxel à ddAC +/- Bevacizumab vs Paclitaxel + Carboplatin à ddAC +/- Bevacizumab (BEVACIZUMAB/PLACEBO SUPPLIED) 

4. NSABP B-40
Neoadjuvant Chemotherapy

Eligibility: dx by core needle biopsy; tumor palpable and >/= 2.0 cm; tumor cannot be strongly HER2 positive; performance status 0 - 1; LVEF >/= LLN: RX: 6 arm study: Docetaxel  Q 3swks X 4  versus Docetaxel/Capecitabine Q 3 wks X 4 versus Docetaxel/Gemcitabine Q 3 wks X 4 ( each arm +/- Bevacizumab) and each  followed by AC Q 3wks X 4 (+/- Bevacizumab). (CAPECITABINE, GEMCITABINE & BEVACIZUMAB SUPPLIED)

BREAST PROTOCOLS: Stages 0-II

1.  NSABP B-39: (RTOG 0413)
Stages 0 - II Treated by Lumpectomy (Closed to the following low risk groups: women >/= 50 yrs with DCIS only or with node negative, hormone positive invasive cancer)
Eligibility: tumor < 3.0 cm; no more than 3 positive nodes; no bilateral dz; must enroll prior to start of adj chemo and within 42 days of last surgery for breast cancer: RX: Whole breast irradiation versus partial breast irradiation (approved for use at Doctors Medical Center and East Bay Radiation Oncology Center only) .

2.  NSABP B-43
HER2-positive DCIS

Eligibility: tumors must be HER2 positive by centralized testing (pts must agree to centralized HER2 testing pre-entry); tumor completely removed by lumpectomy; axillary staging not required but if done must be node-negative; enroll </= 120 post-op; no multicentric disease: Rx: RT +/- Trastuzumab (TRASTUZUMAB SUPPLIED)

3.  PACCT-1 (TAILORx)
Stage I-II, ER and/or PR Positive, Node-negative

Eligibility: Tumor size 1.1 - 5.0 cm or:  5 mm - 1 cm with unfavorable histologic features; HER2 neg by FISH or IHC; pt agreeable to standard adj chemo and hormonal therapy; pre-register within 84 days post-op; submit tissue for determination of recurrence score (RS) within 3 days of pre-registration (uninsured pts will not be billed for Oncotype Dx assay)" : RX:  RS < 11 will be assigned hormonal Rx only; RS > 25 will be assigned Chemo + hormonal Rx; RS 11-25 will be randomized to hormonal Rx only versus Chemo + hormonal Rx. (NO DRUG SUPPLIED)

BREAST PROTOCOLS: Stages I-III

1.  CALGB 40101
High-risk, 0-3 Positive Nodes
Eligibility: If node-negative, tumor must be  > 1 cm or ER or PR negative; < 84 days since last breast surgery; sentinel node dissection is adequate if negative; no prior anthracycline; no prior chemo for this cancer; no more than 4 wks of Tam for this cancer; no inflammatory ca; no prior Evista/Raloxifene; bilat dz OK: RX: AC (4 versus 6 cycles) or Taxol (4 versus 6 cycles). (NO DRUG SUPPLIED)

2.  CTSU E5103 ( Accrual suspended 09/24/09)
Node Positive and High-risk Node Negative 

Eligibility: node pos or node neg with one of the following- ER neg tumor >/= 1 cm; or ER pos tumor >/= 5 cm; or ER pos tumor between 1 & 5 cm with recurrence score >/= 11; must be </= 84 days post-op; HER+ not eligible; men OK: RX: AC + placebo > T + placebo versus AC + Bev > T + Bev versus AC + Bev > T + Bev > Bev. (BEV/PLACEBO SUPPLIED)

3.  CTSU N063D (ALTTO) (Design 1 is closed)
Adequately Resected, HER-2 Positive 

Eligibility: Node positive or node negative if tumor >/= 1.0 cm; performance status </= 1; must have completed at least 4 cycles of anthracycline-based chemo (adj or neoadj); no prior anti HER-2 therapy; If docetaxel is indicated, must be given prior to enrollment (Design 1); If a taxane is indicated rando prior to start (Design 2); RT may be given concurrent with protocol therapy; men OK: RX: Herceptin versus Lapatinib versus Herceptin followed by Lapatinib versus Herceptin plus concurrent Lapatinib. (LAPATINIB SUPPLIED)

4.  IBCSG 24-02 (SOFT)
Premenopausal Women with ER and/or PR Positive Tumors

Eligibility: completely resected breast cancer; bilat dz OK; pts not receiving chemo must enroll within 12 wks of surgery; pts receiving chemo must enroll within 8 months after last dose of chemo; hormonal therapy allowed up to 8 months after diagnosis: RX: Tamoxifen vs Tamoxifen + ovarian function suppression vs Exemestane + ovarian function suppression. (TRIPTORELIN & EXEMESTANE SUPPLIED)

5. SWOG 0221
Node Positive and High-risk Node Negative (see protocol for risk criteria)

Eligibility: Stage I-III, synchronous bilat dz OK(w/in 1 month); T4 tumors not OK; HER2-positive tumors OK; men OK; no CHF or active angina; enroll w/in 84 days of surgery: RX: AC + PEG-G x 6 followed by q 2 wk T + PEG-G x 6 versus AC + PEG-G x 6 followed by weekly T x 12 versus AC + G x15 followed by q 2 wk T + PEG-G x 6 versus AC + G x15 followed by weekly T x 12. (G-CSF SUPPLIED- contact Amgen for financial assistance with PEG-G if needed)

6. SWOG 0307
Bisphosphonates for Stage I -III
Eligibility: Resected primary tumor; (pos margins OK); multifocal dz OK; pts must receive adjuvant Rx (chemo, hormonal or combo); can be registered prior to, during or up to 8 weeks after chemo; if hormonal Rx only register within 12 weeks of surgery; RX: Zoledronic Acid vs Clodronate vs Ibandronate. Must start w/in 5 days of rando.  Can do w/C40101, E5103, SOFT (if on S0307 first), but not B-39. (ALL 3 DRUGS SUPPLIED)

BREAST PROTOCOLS: Locally Advanced/Recurrent/Metastatic

1. CALGB 40302
Postmenopausal Women with ER and/or PR Positive Tumors
Eligibility: At least 1 and up to 2 prior hormone therapies; Tumor expression of HER2 (IHC 1+, 2+ , 3+ levels OR FISH positive OR serum HER@ ECD >/= 15 ng/ml); measurable dz required except for pts with bone mets only; no symptomatic CNS mets: RX: Fulvestrant + Placebo vs Fulvestrant + Lapatanib. (LAPATINIB/PLACEBO SUPPLIED; FULVESTRANT SUPPLIED FOR CYCLE 1 ONLY)

2. CALGB 40502
Stage IV or IIIB not Amenable to Local Therapy

Eligibility: measurable disease; no prior chemo for stg IV or IIIB disease; prior neoadj, adj Rx allowed; prior bevacizumab allowed; HER2 pos pts must have rec'd Herceptin or Lapatinib; ECOG performance status 0-1; men OK: Rx: Paclitaxel + bevacizumab vs Nab-paclitaxel + bevacizumab vs Ixabepilone + bevacizumab. (NAB-PACLITAXEL, BEVACIZUMAB AND IXABEPILONE SUPPLIED)

3. CALGB 40503
Unresectable Stage IIIB or Stage IV
Eligibility: ER and/or PR positive; measurable or non-measurable dz; no prior chemo for met dz; no hormonal Rx for met dz unless initiated within 4 wks of registration; prior adj/neoadj chemo and/or hormonal Rx allowed; performance status </= 1: RX: Endocrine therapy (Tam or Letrozole) plus Bevacizumab or Placebo q 21 days (ovarian suppression is required for premenopausal pts). (BEVACIZUMAB/PLACEBO & LETROZOLE SUPPLIED)

4.  SWOG 0622
Stage IV, Bone Metastasis Predominant DZ

Eligibility: the number of bone mets must be = or > than the number of non-bone, measurable lesions; if nonmeasurable dz only, pt must have rising CA 15-3 or CA 27-29; 1 prior chemo for met dz allowed; if ER/PR+, must have had at least 1 hormonal Rx for met dz; men OK: RX: Dasatinib, 100 mg PO QD versus Dasatinib, 70 mg PO BID. (DASATINIB SUPPLIED)

BREAST PROTOCOLS: Surgical

1.  ACOSOG Z1071
Node Positive Breast Cancer (T1-4, N1-2, M0)

Eligibility: positive FNA or core bx of axillary node (prior to neoadj Rx); planned or completed neoadj chemo; no prior ipsilateral axillary surgery or/excisional biopsy or treatment of hidradenitis; performance status 0-1: Surgery:  SLN and ALND

CANCER CONTROL/SYMPTOM MANAGEMENT PROTOCOLS

1. CALGB 170601
Treatment of Chemo Induced Peripheral Neuropathy (PN)

Eligibility: >/= grade 2 peripheral sensory neuropathy (interfering with function); past Rx with taxol or oxaliplatin (not both); >/= 3 months since completion of Rx; no pre-existing PN; no use of vitamin supplements above recommended daily allowances; no antidepressants or anticonvulsants; no warfarin or heparin; stable doses of analgesics for PN okay: Rx: duloxetine/placebo (DULOXETINE/PLACEBO SUPPLIED)

2.  CALGB 70305
Prevention of Lymphedema

Eligibility- step 1: Newly diagnosed clinical stage I-III breast cancer; no hx LCIS, DCIS or invasive breast cancer; planned neoadj Rx is okay; arm circumference </= 17 inches measured pre-op and, if applicable, pre neoadj RX: step 2: full axillary node dissection including 10 or more nodes. Intervention: LEAP (lymphedema education with a comprehensive exercise program).

3. CALGB 70501
Pt Reported Symptoms via the Internet

Eligibility: concurrent enrollment in CALGB 30607, 300704, 40502, 40503, 40601, 40603, 70604, 80405 or 90401; must be enrolled in 70501 prior to 2nd cycle of treatment; must read and comprehend English; must be able to see computer screen: Intervention: pt uses dedicated computer to report symptoms on day 1 of cycles 2-6. (HAND-HELD COMPUTER SCREENS SUPPLIED)

4.  CALGB 70604
Zoledronic Acid for Bone Metastases

Eligibility:  adenocarcinoma of breast or prostate; multiple myeloma; at least 1 bone met by radiographic imaging; no brain mets; no prior IV bisphosphonate; no prior radiopharmaceuticals; no current investigational agents; performance status 0-2: RX: Zoledronic acid q 4 weeks versus q 12 weeks (NO DRUG SUPPLIED)

5. CCCWFU 97405
Treatment of Vasomotor Symptoms of Men with Prostate Cancer

Eligibility: histologic diagnosis of prostate cancer; prior or current androgen deprivation (orchiectomy, LHRH agonist, chemo or RT to prostate and/or pelvis); mod to severe hot flashes at least 4 times per day; no current use of SSRIs, SNRIs or MAOIs; no uncontrolled HTN: Rx: Effexor + soy/casein protein powder (BOTH AGENTS SUPPLIED)

6. HLMCC 0501
Stress Management for Chemotherapy Patients (Closed to non-Hispanic patients)

Eligibility: new diagnosis of cancer; scheduled to receive at least 4 cycles of chemo; no concurrent RT; no severe depression: RX: Usual care only versus Stress Mgmt Training kit + usual care. (STRESS MGMT KIT SUPPLIED)

7. SWOG 0702
ONJ Associated with Zoledronic Acid Treatment

Eligibility: bone metastases from multiple myeloma or solid tumor for which IV bisphosphonate treatment is indicated; plans to receive Zoledronic acid w/in 30 days; prior oral bisphosphonate OK; prior IV bisphos for bone mets allowed w/in 90 days of rando; 3 prior doses of IV bisphos w/in 3 yrs allowed for low bone mass; no prior RT to maxillofacial area; no preexisting ONJ; performance status 0-3: Intervention: dental evaluation q 6 mos (NO DRUG SUPPLIED)

8. SWOG 0715
Prevention of Taxane Induced Neuropathy

Eligibility: women with resected stg I-IIIa breast cancer; plans to receive one of 5 std taxane regimens; concurrent biologic therapy OK; other therapeutic trials OK; performance status 0-2: RX: Acetyl-L Carnitine (ALC) or Placebo po daily x 24 wks (ALC/PLACEBO SUPPLIED)

GI PROTOCOLS: Colo-Rectal

1. CALGB 80405
Locally Advanced (unresectable) or Metastatic Disease
Eligibility: Must have wild type K-ras gene as determined by central lab. No prior treatment for advanced dz; no prior Bevacizumab or Cetuximab; no history of significant bleeding ; no pleural effusion or grade 2 dyspnea; no CNS metastases; no periperal neuropathy =/> grade 2: RX: FOLFOX or FOLFIRI (physician's choice) + Bevacizumab versus FOLFOX or FORFIRI + Cetuximab versus FOLFOX or FOLFIRI + Bevacizumab and Cetuximab. (CETUXIMAB SUPPLIED)

2.  CTSU E5202
Stage II Colon Cancer; High Risk versus Low Risk for Recurrence (must submit tumor block to ECOG to determine risk for recurrence)

Eligibility: T3 or T4, N0, M0; at least 8 nodes evaluated; perforation or complete obstruction not allowed; no history of bleeding, TIA, thromboembolic events, peripheral vascular dz or NYHA Class III/IV cardiac dz; no active GI ulcer  RX: low risk pts are registered to observation only; high risk pts are randomized to FOLFOX +/- Bevacizumab. (BEVACIZUMAB & OXALIPLATIN SUPPLIED)

3. NSABP R-04
Rectal Cancer: Neoadjuvant

Biopsy confirmed adenocarcinoma.  Clinical stage II or III.  Eligibility:  Measurable disease. Zubrod 0-2. No prior RT or chemo. Arm 1: Pre-op RT + 5-FU followed by Surgery. Arm 2: Pre-op RT + 5-FU/Oxaliplatin followed by surgery; Arm 3: Pre-op RT + Capecitabine followed by surgery; Arm 4: Pre-op RT + Capeticabine/Oxaliplatin followed by surgery. (CAPECITABINE & OXALIPLATIN SUPPLIED)

4.  SWOG 0600
Stage IV Colorectal Cancer; 2nd Line Therapy

Eligibility: pts must have progressed on 1st line Rx with bevacizumab + FOLFOX, OPTIMOX or XELOX; progression must be within 90 days of last dose of bevacizumab; measurable or non-measurable dz;  no prior irinotecan, cetuximab or other VEGF/EGFR targeting agents; prior RT and/or surgery allowed:  RX: FOLFIRI or irinotecan + cetuximab versus FOLFIRI or irinotecan + cetuximab + lower dose bevacizumab versus FOLFIRI or irinotecan + cetuximab + higher dose bevacizumab. (BEVACIZUMAB & CETUXIMAB SUPPLIED)

GI PROTOCOLS: Pancreas

1.  SWOG 0727
Pancreatic Adenocarcinoma; Stage IV (unresectable) Disease

Eligibility:  no prior chemo, hormonal or immunotherapy for adv or met pancreatic ca; no prior gemcitabine; prior adj chemo and palliative RT okay; performance status 0-1; no known brain mets: Rx: Erlotinib and Gemcitabine +/- IMC-A12  (ERLOTINIB & IMC-A12 SUPPLIED)

GU PROTOCOLS: Prostate

1. SWOG 0421
Advanced Hormone Refractory

Eligibility: adenocarcinoma of prostate, any T, any N, M1b; must have evidence of bone mets on bone scan; refractory to hormone Rx; no prior chemo for met dz; prior RT and/or surgery allowed; bisphosphonates permitted; RX: Docetaxel/Prednisone + Atrasentan/Placebo X 12 cycles followed by Atrasentan/Placebo for a total of 52 weeks. (ATRASENTAN/PLACEBO SUPPLIED)

GU PROTOCOLS: Renal

1.  CTSU E2804
Advanced Renal Cell; Clear Cell Variant with < 25% Other Histologies

Eligibility: measurable metastatic disease not curable by std RT or surgery; no CNS disease; 1 prior immunotherapy regimen for advanced dz allowed; no prior anti-angiogenic therapy; prior RT allowed; Rx: Bevacizumab versus Bevacizumab + Temsirolimus versus Bevacizumab + Sorafenib versus Temsirolimus + Sorafenib. (ALL 3 DRUGS SUPPLIED)

2.  CTSU E 2805
Unfavorable Renal Cell Carcinoma

Eligibility: T1b-T4, N0-2, M0 ; no prior treatment other than surgery; no clinically significant cardiovascular dz or uncontrolled HTN; baseline LVEF above LLN; randomize 3-10 weeks post-op: RX: Sunitinib + placebo versus Sorafenib + placebo versus placebo + placebo. (SUNITINIB/PLACEBO & SORAFENIB/PLACEBO SUPPLIED)

HEAD & NECK PROTOCOLS

1.  CTSU E1305
Recurrent or Netastatic Disease

Eligibility: SCC of H&N, any primary; recurrent and incurable by surgery or metastatic; no prior chemo or bio therapy for rec/met dz; 1 prior regimen of induction or adj chem and/or RT with curative intent allowed; must be > 6 months since last chemo and/or RT; palliative RT to H&N allowed but must be > 8 wks since last dose; no prior Bev; no brain mets; Rx: physician choice of Docetaxel/Cisplatin or Cisplatin/5FU; pt then randomized to chemo +/- bevacizumab. (BEVACIZUMAB SUPPLIED)

LUNG PROTOCOLS: Non-small Cell

1.  CALGB 30605
Poor Risk Stage III NSCLC

Eligibility: Unresectable Stage IIIA or IIIB; measurable dz; no prior chemo or RT for NSCLC; performance status = 2 OR performance status 0-1 and >/= 10% wt loss: RX: Abraxane + Carbo X 2 cycles followed by RT + concurrent Erlotinib 150 mg PO QD. (ERLOTINIB & ABRAXANE SUPPLIED)

2. CALGB 30607
Stage IIIB/IV; Maintenance Therapy

Eligibility:  pts must have received 4 cycles platinum based doublet therapy +/- bevacizumab; no evidence of progression; no prior adj chemo for stg I-III resected dz or combined modality Rx for stage III NSCLC; Rx:  Sunitinib, 37.5 mg po daily versus Placebo.  (SUNITINIB/PLACEBO SUPPLIED)

3.  CALGB 30704
Second Line Treatment of Advanced NSCLC

Eligibility: stage IIIB or IV with evidence of progression during/following 1st line Rx; only one prior regimen for advance dz; no prior VEGFR inhibitors; no prior pemetrexed; measurable or non-measurable dz; performance status 0 -1; Rx: Pemetrexed versus Sunitinib versus Pemetrexed + Sunitinib. (SUNITINIB SUPPLIED)

4.  CTSU E1505
Completely Resected NSCLC

Eligibility: Stage IB – IIIA (If IB, tumor >/= 4 cm); wedge resection or segmentectomy NOT allowed; mediastinal lymph node sampling expected; no prior chemo; performance status 0-1; 6-12 weeks post-op: RX: One of 3 chemo regimens +/- Bevacizumab (Investigator may choose Cisplat/Vinorelbine or Cisplat/docetaxel or Cisplat/gemcitabine). (BEVACIZUMAB SUPPLIED)

5.  SWOG 0819
Stage IV Newly Diagnosed or Recurrent

Eligibility:  measurable or non-measurable dz; performance status 0-1; no prior chemo, cetuximab, gefitinib, erlotinib or agents that target EGFR pathway; no VEGF related agents; no chimerized or muring monoclonal antibody therapy; nodules in an ipsilateral non-primary lobe with no other M1 dz will not be considered stage IV: Rx: Chemo +/- Bevacizumab versus Chemo with Cetuximab +/- Bevacizumab (CETUXIMAB SUPPLIED)

LUNG PROTOCOLS: Small Cell

1. CALGB 30610
Limited Stage

Eligibility: No prior resection; no prior chemo or RT for SCLC; no prior thoracic RT; measurable or non-measurable dz; performance status 0-2; RX: Cisplatin/Etoposide X 4 cycles plus one of three radiotherapy regimens (3 arm study).  (NO DRUG SUPPLIED)

MELANOMA PROTOCOLS

1. SWOG 0826
Stage IV Disease of Cutaneous or Mucosal Origin

Eligibility: measurable or non-measurable dz; unknown primary okay; performance status 0-1; up to 1 prior systemic Rx for stage IV dz; any number of adj system therapies allowed; prior RT and prior surgery allowed: Rx: SCH 727965 iv q 21 days (SCH 727965 SUPPLIED)

 

These Protocols are Approved for Use at the Following Hospitals
Alameda County Medical Center
Alta Bates Summit Medical Center
Contra Costa Regional Medical Center
Doctors Medical Center
El Camino Hospital

Abbreviations
ACOSOG = American College of Surgeons Oncology Group
CALGB = Cancer and Leukemia Group B
CCCWFU = Comprehensive Cancer Center at Wake Forest University
CTSU = Cancer Trials Support Unit
ECOG = Eastern Cooperative Oncology Group
HLMCC = H. Lee Moffitt Cancer Center
IBCSG = International Breast Cancer Study Group
NCI = National Cancer Institute
NSABP = National Surgical Adjunct Breast and Bowel Project
PACCT = Program for the Assessment of Clinical Cancer Tests
RTOG = Radiation Therapy Oncology Group
SWOG = Southwest Oncology Group

REVISED 2/12/10

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		Bay Area Tumor Institute, 
		400 30th Street,
		Suite 301, Oakland, California 94609-3305,
		Tel (510) 465-2242, Fax (510) 465-8588