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Capecitabine With Digoxin for Metastatic Breast Cancer

Primary Purpose

Metastatic Breast Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Capecitabine
Digoxin
Sponsored by
Western Regional Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Breast Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients ≥ 18 years of age with histologically confirmed, metastatic breast cancer resistant to anthracyclines and taxanes
  2. Anthracycline resistance is defined as tumor progression during treatment or within 3 months of last dose in the metastatic setting, or recurrence within 6 months in the neoadjuvant or adjuvant setting. Alternatively, a minimum cumulative dose of anthracycline of 240 mg/m^2 (doxorubicin) or 360 mg/m^2 (epirubicin) has been reached, or there is contraindication to use anthracycline, the patient is also eligible
  3. Taxane resistance is defined as recurrence within 4 months of the last dose in the metastatic setting or within 12 months in the adjuvant setting
  4. Having progressed on anti-HER2 or hormonal therapy if they have HER2 positive or hormone-receptor positive breast cancer
  5. Eastern Cooperative Oncology Group (ECOG) performance status score ≤ 2 and a life expectancy >3 months.
  6. Participants must have at least one target lesion as defined by RECIST 1.1 that allows for evaluation of tumor response
  7. Absolute neutrophil count ≥ 1500 mm3, platelet count ≥ 100×109 L, hemoglobin ≥ 8.5 g/dL
  8. Serum creatinine ≤1.5 times the upper limit of the normal range, total bilirubin ≤ 2 mg/dL, AST/ALT ≤ 5 times the upper limit of normal range
  9. No remaining grade 2 or higher toxicity from prior cancer therapies unless judged to be clinically insignificant by the Principal Investigator
  10. At least three (3) weeks from prior chemotherapy
  11. Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must be willing to use an acceptable contraceptive method (abstinence, oral contraceptive or double barrier method) for the duration of the study and for 30 days following the last dose of study drug, and must have a negative urine or serum pregnancy test within 2 weeks prior to beginning treatment on this trial.

Exclusion Criteria:

  1. Inadequate renal function with a calculated creatinine clearance less than 51 mL/min.
  2. History of ventricular fibrillation, sinus node or AV nodal disease, Wolff Parkinson White Syndrome, hemodynamically significant or life threatening cardiac arrhythmia.
  3. Uncontrolled cardiac disease, congestive heart failure, angina or hypertension.
  4. Myocardial infarction or unstable angina within 2 months of treatment.
  5. Known human immunodeficiency virus (HIV) infection or chronic active Hepatitis B or C (patients are NOT required to be tested for the presence of such viruses prior to therapy on this protocol).
  6. Active clinically serious infection > CTCAE (version 4.03) Grade 2.
  7. Thrombotic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months.
  8. Pulmonary hemorrhage/bleeding event ≥ CTCAE Grade 2 within 4 weeks of first dose of study drug.
  9. Any other hemorrhage/bleeding event ≥ CTCAE Grade 3 within 4 weeks of first dose of study drug.
  10. Serious non-healing wound, ulcer, or bone fracture.
  11. Major surgery or significant traumatic injury within 2 weeks of first study drug.
  12. Inability to complete informed consent process and adhere to the protocol treatment plan and follow-up requirements.
  13. Concurrent severe illness such as active infection, or psychiatric illness/social situations that would limit safety and compliance with study requirements.
  14. Currently on anti-coagulation therapy with Coumadin, and cannot be switched other forms of anti-coagulation.
  15. Patients have symptomatic untreated brain metastasis or leptomeningeal metastases or treated but still symptomatic requiring the use of steroid within the past two weeks.
  16. Patients receiving any other investigational agents. Pregnant or Lactating females.

Sites / Locations

  • Western Regional Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Capecitabine with Digoxin

Arm Description

Capecitabine PO daily b.i.d., no breaks, starts at day 1 of the first cycle; Digoxin: once daily, starts at day -7 of the first cycle (1 cycle - 4 weeks)

Outcomes

Primary Outcome Measures

Metronomic Capecitabine With Oral Digoxin
Evaluate the Growth Modulation Index (GMI) of the combination of metronomic capecitabine with oral digoxin in metastatic breast cancer

Secondary Outcome Measures

Combination Overall Clinical Benefit by RECIST 1.1
Assess the activity of this combination in terms of overall clinical benefit rates (CBR), including complete response (CR), partial response (PR) or stable disease (SD) as defined by Response Evaluation Criteria in Solid Tumors (RECIST 1.1)

Full Information

First Posted
June 24, 2013
Last Updated
January 22, 2018
Sponsor
Western Regional Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01887288
Brief Title
Capecitabine With Digoxin for Metastatic Breast Cancer
Official Title
Metronomic Capecitabine With Digoxin for Metastatic Breast Cancer Progressing After Anthracycline and Taxane Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Terminated
Why Stopped
PI Leaving Site
Study Start Date
April 2013 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Western Regional Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
To evaluate the Growth Modulation Index (GMI) of the combination of metronomic capecitabine with oral digoxin in metastatic breast cancer
Detailed Description
In this phase II study, the Investigators will combine metronomic capecitabine with digoxin to treat metastatic breast cancer patients who have progressed on both anthracyclines and taxanes. We hypothesize that the combination of digoxin with metronomic capecitabine may lead to increased efficacy and duration of treatment without progression with decreased side effects than standard regimen.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Capecitabine with Digoxin
Arm Type
Experimental
Arm Description
Capecitabine PO daily b.i.d., no breaks, starts at day 1 of the first cycle; Digoxin: once daily, starts at day -7 of the first cycle (1 cycle - 4 weeks)
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Other Intervention Name(s)
Xeloda®
Intervention Description
650 mg/m^2 PO b.i.d.
Intervention Type
Drug
Intervention Name(s)
Digoxin
Other Intervention Name(s)
Cardoxin®, Digitek®, Lanoxicaps®, Lanoxin®
Intervention Description
0.25 mg once daily
Primary Outcome Measure Information:
Title
Metronomic Capecitabine With Oral Digoxin
Description
Evaluate the Growth Modulation Index (GMI) of the combination of metronomic capecitabine with oral digoxin in metastatic breast cancer
Time Frame
One year
Secondary Outcome Measure Information:
Title
Combination Overall Clinical Benefit by RECIST 1.1
Description
Assess the activity of this combination in terms of overall clinical benefit rates (CBR), including complete response (CR), partial response (PR) or stable disease (SD) as defined by Response Evaluation Criteria in Solid Tumors (RECIST 1.1)
Time Frame
One year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients ≥ 18 years of age with histologically confirmed, metastatic breast cancer resistant to anthracyclines and taxanes Anthracycline resistance is defined as tumor progression during treatment or within 3 months of last dose in the metastatic setting, or recurrence within 6 months in the neoadjuvant or adjuvant setting. Alternatively, a minimum cumulative dose of anthracycline of 240 mg/m^2 (doxorubicin) or 360 mg/m^2 (epirubicin) has been reached, or there is contraindication to use anthracycline, the patient is also eligible Taxane resistance is defined as recurrence within 4 months of the last dose in the metastatic setting or within 12 months in the adjuvant setting Having progressed on anti-HER2 or hormonal therapy if they have HER2 positive or hormone-receptor positive breast cancer Eastern Cooperative Oncology Group (ECOG) performance status score ≤ 2 and a life expectancy >3 months. Participants must have at least one target lesion as defined by RECIST 1.1 that allows for evaluation of tumor response Absolute neutrophil count ≥ 1500 mm3, platelet count ≥ 100×109 L, hemoglobin ≥ 8.5 g/dL Serum creatinine ≤1.5 times the upper limit of the normal range, total bilirubin ≤ 2 mg/dL, AST/ALT ≤ 5 times the upper limit of normal range No remaining grade 2 or higher toxicity from prior cancer therapies unless judged to be clinically insignificant by the Principal Investigator At least three (3) weeks from prior chemotherapy Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must be willing to use an acceptable contraceptive method (abstinence, oral contraceptive or double barrier method) for the duration of the study and for 30 days following the last dose of study drug, and must have a negative urine or serum pregnancy test within 2 weeks prior to beginning treatment on this trial. Exclusion Criteria: Inadequate renal function with a calculated creatinine clearance less than 51 mL/min. History of ventricular fibrillation, sinus node or AV nodal disease, Wolff Parkinson White Syndrome, hemodynamically significant or life threatening cardiac arrhythmia. Uncontrolled cardiac disease, congestive heart failure, angina or hypertension. Myocardial infarction or unstable angina within 2 months of treatment. Known human immunodeficiency virus (HIV) infection or chronic active Hepatitis B or C (patients are NOT required to be tested for the presence of such viruses prior to therapy on this protocol). Active clinically serious infection > CTCAE (version 4.03) Grade 2. Thrombotic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months. Pulmonary hemorrhage/bleeding event ≥ CTCAE Grade 2 within 4 weeks of first dose of study drug. Any other hemorrhage/bleeding event ≥ CTCAE Grade 3 within 4 weeks of first dose of study drug. Serious non-healing wound, ulcer, or bone fracture. Major surgery or significant traumatic injury within 2 weeks of first study drug. Inability to complete informed consent process and adhere to the protocol treatment plan and follow-up requirements. Concurrent severe illness such as active infection, or psychiatric illness/social situations that would limit safety and compliance with study requirements. Currently on anti-coagulation therapy with Coumadin, and cannot be switched other forms of anti-coagulation. Patients have symptomatic untreated brain metastasis or leptomeningeal metastases or treated but still symptomatic requiring the use of steroid within the past two weeks. Patients receiving any other investigational agents. Pregnant or Lactating females.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jiaxin Niu, MD, PhD
Organizational Affiliation
Western Regional Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Western Regional Medical Center
City
Goodyear
State/Province
Arizona
ZIP/Postal Code
85338
Country
United States

12. IPD Sharing Statement

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Capecitabine With Digoxin for Metastatic Breast Cancer

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