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Hepatic Artery Infusion With FOLFOX in Liver Metastasis From Breast Cancer

Primary Purpose

Metastatic Breast Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HAI with FOLFOX
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. Performance status ECOG 0-2 and a life expectancy of >3 months.
  2. Patients were required to have measurable disease in the liver, defined as lesions measuring >1 cm in largest diameter on spiral-computed tomography (CT) or magnetic resonance imaging (MRI)
  3. Histologically confirmed metastatic advanced solid tumors involving the liver, liver replacement less than 70%
  4. No bevacizumab (avastin) use within 4 weeks prior to enrollment.
  5. Absence of portal vein thrombosis
  6. Not a surgical candidate or patients refuge surgery at the time of enrollment
  7. Loss of response to at least 1 line of systemic chemotherapy in metastatic setting
  8. An asymptomatic extra-hepatic disease is allowed, provided that the extent of the metastatic disease in the liver represented the bulk of the metastatic disease.
  9. History of liver-directed therapy is eligible at the investigator's discretion.
  10. Adequate renal function with a calculated creatinine clearance greater than 60 mL/min.
  11. Hepatic function as follows: Total Bilirubin ≤3 mg/dL, AST ≤5 times upper normal reference value, or ALT ≤ 5 times upper normal reference value.
  12. Adequate bone marrow function (ANC ≥1500 cells/uL; PLT ≥ 100,000 cells/uL) before each therapy.
  13. At least three weeks from previous immunotherapy, chemotherapy or radiotherapy before being enrolled in this study.
  14. All females in childbearing age MUST have a negative serum HCG test unless patients have prior hysterectomy.

Exclusion Criteria:

  1. Clinical or radiographic evidence of moderate amount of ascites.
  2. History of cirrhosis with Child-Pugh class B or C.
  3. Pregnant or lactating females.
  4. Inability to complete informed consent process and adhere to protocol treatment plan and follow-up requirements.
  5. Patients receiving any other investigational agents.
  6. Patients with bleeding diathesis (clinical bleeding, prothrombin time =/> 1.5 X upper institutional normal value, INR =/> 1.5, activated partial thromboplastin time aPTT =/> 1.5 X upper institutional normal value), active gastric or duodenal ulcer.
  7. History of thrombophilia, recurrent DVTs, diagnosis of phospholipid syndrome.
  8. Past or current history of malignancy other than breast cancer with the exception of treated non-melanoma skin cancer or carcinoma in situ of the cervix, or other cancers cured by local therapy alone and a DFS ≥5 years.
  9. Concurrent severe illness such as active infection, or psychiatric illness/social situations that would limit safety and compliance with study requirements.
  10. Patients with clinically significant cardiovascular disease: myocardial infarction or unstable angina within 6 months, New York Heart Association Grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication, unstable angina pectoris, clinically significant peripheral vascular disease
  11. Patients have untreated brain metastasis requiring or leptomeningeal metastases.

Sites / Locations

  • Western Regional Medical Center Inc

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

HAI with FOLFOX

Arm Description

Hepatic Artery Infusion with Oxaliplatin, 5FU, and Folinic Acid

Outcomes

Primary Outcome Measures

Determine Response Rate (RR) of HAI With Oxaliplatin/5-FU Every Three Weeks in Heavily Pre-treated Patients With Advanced Breast Cancer With Metastasis to the Liver.
To determine response rate (RR) of HAI with oxaliplatin/5-FU every three weeks in heavily pre-treated patients with advanced breast cancer with metastasis to the liver.
Determine Time to Intra-hepatic Progression (TIP) of HAI With Oxaliplatin/5-FU Every Three Weeks in Heavily Pre-treated Patients With Advanced Breast Cancer With Metastasis to the Liver.
To determine time to intra-hepatic progression (TIP) of HAI with oxaliplatin/5-FU every three weeks in heavily pre-treated patients with advanced breast cancer with metastasis to the liver.
Extra-hepatic Progression (TEP) of HAI With Oxaliplatin/5-FU
To determine time to extra-hepatic progression (TEP) of HAI with oxaliplatin/5-FU every three weeks in heavily pre-treated patients with advanced breast cancer with metastasis to the liver.

Secondary Outcome Measures

To Document the Toxicity, Tolerability of the Therapy in This Population.
Document the toxicity and tolerability of the therapy using the following CBC with differential, BUN, creatinine, liver function tests,CA 15-3, CA 27.29, Circulating tumor cells (CTCs)and Restaging radiographic studies (MRI or CT liver protocol).

Full Information

First Posted
June 24, 2013
Last Updated
January 11, 2018
Sponsor
Western Regional Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01937507
Brief Title
Hepatic Artery Infusion With FOLFOX in Liver Metastasis From Breast Cancer
Official Title
Pilot Study of Hepatic Arterial Infusion (HAI) With Oxaliplatin, Folinic Acid and 5 Fluorouracil (FOLFOX) in Heavily Pre-Treated Patients With Liver-Predominant Metastasis From Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Terminated
Why Stopped
PI Decision
Study Start Date
December 2012 (undefined)
Primary Completion Date
July 2014 (Actual)
Study Completion Date
July 2014 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Deliver oxliplatin and 5-FU via HAI to breast cancer patients with liver-only or liver-predominant metastases who have failed at least one line of systemic chemotherapy in metastatic setting.
Detailed Description
In this pilot study, the investigators will deliver oxliplatin and 5-FU via HAI to breast cancer patients with liver-only or liver-predominant metastases who have failed at least one line of systemic chemotherapy in metastatic setting. The investigators hypothesize that HAI chemotherapy will be able to convert some patients to surgical resection candidates, or/and to overcome chemo-resistance of liver metastases to systemic i.v. chemotherapy for some clinically fit, heavily pre-treated patients.

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
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
HAI with FOLFOX
Arm Type
Experimental
Arm Description
Hepatic Artery Infusion with Oxaliplatin, 5FU, and Folinic Acid
Intervention Type
Drug
Intervention Name(s)
HAI with FOLFOX
Other Intervention Name(s)
Hepatic Artery Infusion
Intervention Description
HAI with FOLFOX q 3 weeks
Primary Outcome Measure Information:
Title
Determine Response Rate (RR) of HAI With Oxaliplatin/5-FU Every Three Weeks in Heavily Pre-treated Patients With Advanced Breast Cancer With Metastasis to the Liver.
Description
To determine response rate (RR) of HAI with oxaliplatin/5-FU every three weeks in heavily pre-treated patients with advanced breast cancer with metastasis to the liver.
Time Frame
One year
Title
Determine Time to Intra-hepatic Progression (TIP) of HAI With Oxaliplatin/5-FU Every Three Weeks in Heavily Pre-treated Patients With Advanced Breast Cancer With Metastasis to the Liver.
Description
To determine time to intra-hepatic progression (TIP) of HAI with oxaliplatin/5-FU every three weeks in heavily pre-treated patients with advanced breast cancer with metastasis to the liver.
Time Frame
One year
Title
Extra-hepatic Progression (TEP) of HAI With Oxaliplatin/5-FU
Description
To determine time to extra-hepatic progression (TEP) of HAI with oxaliplatin/5-FU every three weeks in heavily pre-treated patients with advanced breast cancer with metastasis to the liver.
Time Frame
One year
Secondary Outcome Measure Information:
Title
To Document the Toxicity, Tolerability of the Therapy in This Population.
Description
Document the toxicity and tolerability of the therapy using the following CBC with differential, BUN, creatinine, liver function tests,CA 15-3, CA 27.29, Circulating tumor cells (CTCs)and Restaging radiographic studies (MRI or CT liver protocol).
Time Frame
one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Performance status ECOG 0-2 and a life expectancy of >3 months. Patients were required to have measurable disease in the liver, defined as lesions measuring >1 cm in largest diameter on spiral-computed tomography (CT) or magnetic resonance imaging (MRI) Histologically confirmed metastatic advanced solid tumors involving the liver, liver replacement less than 70% No bevacizumab (avastin) use within 4 weeks prior to enrollment. Absence of portal vein thrombosis Not a surgical candidate or patients refuge surgery at the time of enrollment Loss of response to at least 1 line of systemic chemotherapy in metastatic setting An asymptomatic extra-hepatic disease is allowed, provided that the extent of the metastatic disease in the liver represented the bulk of the metastatic disease. History of liver-directed therapy is eligible at the investigator's discretion. Adequate renal function with a calculated creatinine clearance greater than 60 mL/min. Hepatic function as follows: Total Bilirubin ≤3 mg/dL, AST ≤5 times upper normal reference value, or ALT ≤ 5 times upper normal reference value. Adequate bone marrow function (ANC ≥1500 cells/uL; PLT ≥ 100,000 cells/uL) before each therapy. At least three weeks from previous immunotherapy, chemotherapy or radiotherapy before being enrolled in this study. All females in childbearing age MUST have a negative serum HCG test unless patients have prior hysterectomy. Exclusion Criteria: Clinical or radiographic evidence of moderate amount of ascites. History of cirrhosis with Child-Pugh class B or C. Pregnant or lactating females. Inability to complete informed consent process and adhere to protocol treatment plan and follow-up requirements. Patients receiving any other investigational agents. Patients with bleeding diathesis (clinical bleeding, prothrombin time =/> 1.5 X upper institutional normal value, INR =/> 1.5, activated partial thromboplastin time aPTT =/> 1.5 X upper institutional normal value), active gastric or duodenal ulcer. History of thrombophilia, recurrent DVTs, diagnosis of phospholipid syndrome. Past or current history of malignancy other than breast cancer with the exception of treated non-melanoma skin cancer or carcinoma in situ of the cervix, or other cancers cured by local therapy alone and a DFS ≥5 years. Concurrent severe illness such as active infection, or psychiatric illness/social situations that would limit safety and compliance with study requirements. Patients with clinically significant cardiovascular disease: myocardial infarction or unstable angina within 6 months, New York Heart Association Grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication, unstable angina pectoris, clinically significant peripheral vascular disease Patients have untreated brain metastasis requiring or leptomeningeal metastases.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jiaxin Niu, MD
Organizational Affiliation
Western Regional Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Western Regional Medical Center Inc
City
Goodyear
State/Province
Arizona
ZIP/Postal Code
85338
Country
United States

12. IPD Sharing Statement

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Hepatic Artery Infusion With FOLFOX in Liver Metastasis From Breast Cancer

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