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Trial to Compare the Efficacy and Safety of Pegfilgrastim Biosimilar in Subjects With High Risk Stage Breast Cancer Receiving Chemotherapy

Primary Purpose

Breast Cancer

Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Eurofarma's pegfilgrastim
Neulastim
Sponsored by
Eurofarma Laboratorios S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring Breast Cancer High risk Stage II or Stage III / IV

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed written informed consent
  2. Males or females ≥ 18 years of age (at the time of signing consent)
  3. Breast cancer high-risk Stage II, or Stage III, or Stage IV (classification according to American Joint Committee on Cancer)
  4. Eligible to receive 4 cycles of docetaxel and doxorubicin combination CTX for the treatment of high-risk stage II, III, or IV breast cancer
  5. CTX-naïve
  6. ECOG performance status ≤ 2
  7. Adequate bone marrow function:

    • Leucocyte count < 50 x 109/L
    • ANC ≥ 1.5 x 109/L
    • Platelet count ≥ 100 x 109/L
    • Haemoglobin ≥ 10 x g/dL
  8. Left Ventricular Ejection Fraction (LVEF) ≥ 50% by echocardiography or equivalent method (e.g. Multi Gated Acquisition scan) within 4 weeks prior to administration of the first dose of trial medication
  9. Alanine aminotransferase and aspartate aminotransferase < 2.5 x upper limit of normal (ULN), alkaline phosphatase < 5 x ULN
  10. Total bilirubin ≤ ULN
  11. Creatinine ≤ 1.5 x ULN
  12. Female subjects of childbearing potential must have a negative serum pregnancy test within 14 days of first dose of trial treatment and agree to use highly effective contraception (e.g. hormonal contraception or intra-uterine device [which should be established prior to the start of the trial], plus usage by at least 1 of the partners of an additional spermicide-containing barrier method of contraception) from 2 weeks prior to administration of the first dose of trial medication until trial completion, and for 30 days after the last dose of trial drug
  13. Female subjects of non-childbearing potential must have a documented tubal ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea. A male subject with a female partner of childbearing potential must have either had a prior vasectomy or agree to use effective contraception from 2 weeks prior to administration of the first dose of trial medication until trial completion, and for 30 days after the last dose of trial drug
  14. Able to comply with the trial Protocol.

Exclusion Criteria:

  1. Severe chronic neutropenia
  2. History of chronic myeloid leukaemia or myelodysplastic syndrome
  3. History of sickle cell disease
  4. Previous or concurrent malignancy except non-invasive non-melanomatous skin cancer, in situ carcinoma of the cervix, or other solid tumour treated curatively, and without evidence of recurrence for at least 10 years prior to trial entry
  5. Active uncontrolled infection
  6. Known human immunodeficiency virus seropositivity; active hepatitis B or hepatitis C at the Screening Visit
  7. Clinically significant impairment of LVEF
  8. Severe valvular heart disease, myocardial infarction, heart failure, unstable angina pectoris, uncontrolled hypertension, or uncontrolled arrhythmias within 6 months of the Screening Visit
  9. Significant neurologic or psychiatric disorders including psychotic disorders, dementia, or seizures that would prohibit the understanding and giving of informed consent
  10. Concurrent or prior radiotherapy within 4 weeks of the Screening Visit
  11. Tumour surgery within 4 weeks prior to administration of the first dose of trial medication
  12. Concurrent or prior anti-cancer treatment for breast cancer such as endocrine therapy, immunotherapy, monoclonal antibodies, and/or biological therapy
  13. Concurrent prophylactic antibiotics or antibiotic treatment within 72 hours before CTX
  14. Prior bone marrow or stem cell transplant
  15. Previous therapy with any recombinant human granulocyte colony stimulating factor (G CSF) product
  16. Known hypersensitivity to docetaxel, doxorubicin, pegfilgrastim, filgrastim, Escherichia coli proteins, or any of the excipients used in the trial medication
  17. Treatment with lithium at randomization
  18. Known controlled drug addiction, including alcoholism
  19. Participation in a clinical trial within 30 days prior to the Screening Visit
  20. Pregnant or nursing women, women planning to become pregnant, or women of childbearing potential who do not agree to use highly effective contraception (e.g. hormonal contraception or intra-uterine device [which should be established prior to the start of the trial], plus usage by at least 1 of the partners of an additional spermicide-containing barrier method of contraception) from 2 weeks prior to administration of the first dose of trial medication until trial completion and for 30 days after the last dose of trial drug
  21. Male subjects with a female partner of childbearing potential who have not had a prior vasectomy and do not agree to use highly effective contraception from 2 weeks prior to administration of the first dose of trial medication until trial completion and for 30 days after the last dose of trial drug
  22. Any severe concurrent disease or condition, which in the judgment of the Investigator would make the subject inappropriate for trial participation.
  23. Peripheral neuropathy (sensory/motor) Grade 2 or higher (CTCAE, Version 4.03)
  24. Chronic use of corticosteroids.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Eurofarma's pegfilgrastim

    Neulastim

    Arm Description

    A single 6 mg dose on Day 2 of each chemotherapy cycle of Eurofarma's pegfilgrastim (subcutaneous injection)

    A single 6 mg dose on Day 2 of each chemotherapy cycle of Neulastim (subcutaneous injection)

    Outcomes

    Primary Outcome Measures

    Duration of severe neutropenia (grade 4) in days during chemotherapy cycle 1.

    Secondary Outcome Measures

    Duration of severe neutropenia (grade 4) in days during chemotherapy Cycles 2, 3, and 4
    Incidence of febril neutropenia during chemotherapy cycles 1, 2, 3, and 4 and across all chemotherapy cycles.
    Incidence of infections during chemotherapy cycles 1, 2, 3, and 4 and for all chemotherapy cycles combined.
    Use of IV antibiotics to treat febril neutropenia or associated infections
    Overall survival

    Full Information

    First Posted
    May 9, 2016
    Last Updated
    September 14, 2017
    Sponsor
    Eurofarma Laboratorios S.A.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02768714
    Brief Title
    Trial to Compare the Efficacy and Safety of Pegfilgrastim Biosimilar in Subjects With High Risk Stage Breast Cancer Receiving Chemotherapy
    Official Title
    A Randomized, Assessor-blind, Parallel Group, Multicentre Phase III Trial to Compare the Efficacy and Safety of Eurofarma's Pegfilgrastim to Neulastim® in Subjects With High Risk Stage II or Stage III / IV Breast Cancer Receiving Chemotherapy.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2017
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Strategic changes regarding the product development
    Study Start Date
    January 2018 (Anticipated)
    Primary Completion Date
    October 2019 (Anticipated)
    Study Completion Date
    October 2019 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Eurofarma Laboratorios S.A.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is a Phase III, randomised, assessor-blind, parallel group, multicentre trial. At least 180 adult subjects with high-risk Stage II or Stage III / IV breast cancer will be randomised (1:1) to receive either Eurofarma's pegfilgrastim (n = 90) or Neulastim (n = 90) in 8 to 10 sites in Brazil. Subjects will undergo a maximum of 4 cycles of myelosuppressive chemotherapy (21 days per cycle).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Breast Cancer
    Keywords
    Breast Cancer High risk Stage II or Stage III / IV

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    Investigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Eurofarma's pegfilgrastim
    Arm Type
    Experimental
    Arm Description
    A single 6 mg dose on Day 2 of each chemotherapy cycle of Eurofarma's pegfilgrastim (subcutaneous injection)
    Arm Title
    Neulastim
    Arm Type
    Active Comparator
    Arm Description
    A single 6 mg dose on Day 2 of each chemotherapy cycle of Neulastim (subcutaneous injection)
    Intervention Type
    Drug
    Intervention Name(s)
    Eurofarma's pegfilgrastim
    Intervention Description
    Eurofarma's pegfilgrastim is a clear, colourless solution for injection (6 mg/0.6 mL) provided in a single use prefilled syringe. Subjects randomised to Eurofarma's pegfilgrastim will receive 6 mg administered as a single SC injection in the abdomen, upper arm, or thigh on Day 2 of each CTX cycle, approximately 24 hours after
    Intervention Type
    Drug
    Intervention Name(s)
    Neulastim
    Intervention Description
    Eurofarma's pegfilgrastim is a clear, colourless solution for injection (6 mg/0.6 mL) provided in a single use prefilled syringe. Subjects randomised to Eurofarma's pegfilgrastim will receive 6 mg administered as a single SC injection in the abdomen, upper arm, or thigh on Day 2 of each CTX cycle, approximately 24 hours after
    Primary Outcome Measure Information:
    Title
    Duration of severe neutropenia (grade 4) in days during chemotherapy cycle 1.
    Time Frame
    Within the 21 Days of the first chemotherapy cycle
    Secondary Outcome Measure Information:
    Title
    Duration of severe neutropenia (grade 4) in days during chemotherapy Cycles 2, 3, and 4
    Time Frame
    Four months
    Title
    Incidence of febril neutropenia during chemotherapy cycles 1, 2, 3, and 4 and across all chemotherapy cycles.
    Time Frame
    Four months
    Title
    Incidence of infections during chemotherapy cycles 1, 2, 3, and 4 and for all chemotherapy cycles combined.
    Time Frame
    Four months
    Title
    Use of IV antibiotics to treat febril neutropenia or associated infections
    Time Frame
    Four months
    Title
    Overall survival
    Time Frame
    one year after the last chemotherapy cycle

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Signed written informed consent Males or females ≥ 18 years of age (at the time of signing consent) Breast cancer high-risk Stage II, or Stage III, or Stage IV (classification according to American Joint Committee on Cancer) Eligible to receive 4 cycles of docetaxel and doxorubicin combination CTX for the treatment of high-risk stage II, III, or IV breast cancer CTX-naïve ECOG performance status ≤ 2 Adequate bone marrow function: Leucocyte count < 50 x 109/L ANC ≥ 1.5 x 109/L Platelet count ≥ 100 x 109/L Haemoglobin ≥ 10 x g/dL Left Ventricular Ejection Fraction (LVEF) ≥ 50% by echocardiography or equivalent method (e.g. Multi Gated Acquisition scan) within 4 weeks prior to administration of the first dose of trial medication Alanine aminotransferase and aspartate aminotransferase < 2.5 x upper limit of normal (ULN), alkaline phosphatase < 5 x ULN Total bilirubin ≤ ULN Creatinine ≤ 1.5 x ULN Female subjects of childbearing potential must have a negative serum pregnancy test within 14 days of first dose of trial treatment and agree to use highly effective contraception (e.g. hormonal contraception or intra-uterine device [which should be established prior to the start of the trial], plus usage by at least 1 of the partners of an additional spermicide-containing barrier method of contraception) from 2 weeks prior to administration of the first dose of trial medication until trial completion, and for 30 days after the last dose of trial drug Female subjects of non-childbearing potential must have a documented tubal ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea. A male subject with a female partner of childbearing potential must have either had a prior vasectomy or agree to use effective contraception from 2 weeks prior to administration of the first dose of trial medication until trial completion, and for 30 days after the last dose of trial drug Able to comply with the trial Protocol. Exclusion Criteria: Severe chronic neutropenia History of chronic myeloid leukaemia or myelodysplastic syndrome History of sickle cell disease Previous or concurrent malignancy except non-invasive non-melanomatous skin cancer, in situ carcinoma of the cervix, or other solid tumour treated curatively, and without evidence of recurrence for at least 10 years prior to trial entry Active uncontrolled infection Known human immunodeficiency virus seropositivity; active hepatitis B or hepatitis C at the Screening Visit Clinically significant impairment of LVEF Severe valvular heart disease, myocardial infarction, heart failure, unstable angina pectoris, uncontrolled hypertension, or uncontrolled arrhythmias within 6 months of the Screening Visit Significant neurologic or psychiatric disorders including psychotic disorders, dementia, or seizures that would prohibit the understanding and giving of informed consent Concurrent or prior radiotherapy within 4 weeks of the Screening Visit Tumour surgery within 4 weeks prior to administration of the first dose of trial medication Concurrent or prior anti-cancer treatment for breast cancer such as endocrine therapy, immunotherapy, monoclonal antibodies, and/or biological therapy Concurrent prophylactic antibiotics or antibiotic treatment within 72 hours before CTX Prior bone marrow or stem cell transplant Previous therapy with any recombinant human granulocyte colony stimulating factor (G CSF) product Known hypersensitivity to docetaxel, doxorubicin, pegfilgrastim, filgrastim, Escherichia coli proteins, or any of the excipients used in the trial medication Treatment with lithium at randomization Known controlled drug addiction, including alcoholism Participation in a clinical trial within 30 days prior to the Screening Visit Pregnant or nursing women, women planning to become pregnant, or women of childbearing potential who do not agree to use highly effective contraception (e.g. hormonal contraception or intra-uterine device [which should be established prior to the start of the trial], plus usage by at least 1 of the partners of an additional spermicide-containing barrier method of contraception) from 2 weeks prior to administration of the first dose of trial medication until trial completion and for 30 days after the last dose of trial drug Male subjects with a female partner of childbearing potential who have not had a prior vasectomy and do not agree to use highly effective contraception from 2 weeks prior to administration of the first dose of trial medication until trial completion and for 30 days after the last dose of trial drug Any severe concurrent disease or condition, which in the judgment of the Investigator would make the subject inappropriate for trial participation. Peripheral neuropathy (sensory/motor) Grade 2 or higher (CTCAE, Version 4.03) Chronic use of corticosteroids.

    12. IPD Sharing Statement

    Learn more about this trial

    Trial to Compare the Efficacy and Safety of Pegfilgrastim Biosimilar in Subjects With High Risk Stage Breast Cancer Receiving Chemotherapy

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