NBP in Women With Metastatic Breast Cancer to Prevent Nab-paclitaxel Induced Toxic Neuropathy
Primary Purpose
Breast Cancer, Peripheral Neuropathy
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Placebo
NBP Softgel Capsules
Sponsored by
About this trial
This is an interventional prevention trial for Breast Cancer
Eligibility Criteria
Inclusion Criteria
Subjects are eligible to participate in the study only if all the following criteria apply:
- Women aged ≥18 and ≤75 years.
- Pathologically confirmed metastatic breast cancer.
- Are candidates for initial therapy with nab-paclitaxel, at a dose of >260 mg/m2 every 3 weeks for 4 planned cycles.
- Concomitant antitumor drugs used to treat the underlying malignancy, including immunotherapies, other than nab-paclitaxel will be allowed.
- Eastern Cooperative Oncology Group (ECOG) performance status scores of 0 - 2.
- Life expectancy ≥6 months.
- Women of childbearing potential (WOCBP) must have a negative serum human chorionic gonadotropin (HCG) pregnancy test at Screening and be practicing a medically acceptable method of contraception with an annual failure rate of less than 1% until the completion of the trial or 30 days after discontinuation of study treatment. Women are considered not childbearing if they are >1 year postmenopausal or surgically sterile (ie, hysterectomy, bilateral oophorectomy, or bilateral salpingectomy tubal ligation).
- Able to complete study questionnaires by themselves or with assistance.
- Capable of understanding the purpose and risks of the study and able to provide informed consent by signing the informed consent form.
- Able to swallow softgel capsules as determined by the investigator.
- Able to comply with all study requirements. Exclusion Criteria
Subjects are excluded from the study if any of the following criteria apply:
- Non-metastatic breast cancer.
- Subjects who are pregnant, lactating/breast-feeding, or plan to become pregnant within the next 3 months.
- History of poorly controlled diabetes mellitus (hemoglobin A1C >8.0 at the time of the Screening visit).
- History of fibromyalgia.
- History of any signs or symptoms suggestive of neuropathy within 30 days of Screening as determined by the investigator based on the neurological examination.
- History of taking any neurotoxic drugs within 6 months of Screening.
- Current use of drugs that are used to treat neuropathic pain (eg, gabapentin, pregabalin, and duloxetine) within 30 days of Screening.
- Current diagnosis of malignancy other than breast cancer.
- Absolute neutrophil count <1.5 x 109 cells/L.
- Platelet count <100,000 x 109/L.
- Hemoglobin level <9 g/dL at Screening without transfusion (transfusion independent).
- Corrected QTcF >470 msec (single tracing) at Screening and prior to randomization.
- Chronic renal or hepatic disease.
- Clinically significant renal dysfunction including serum creatinine level >1.5 mg/dL or calculated creatinine clearance ≥50 mL/minute at Screening.
- Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level >2.0 x upper limits of normal (ULN), or a bilirubin >1.5 x ULN unless in the setting of known Gilbert's disease at Screening.
- History of HIV, hepatitis B, hepatitis C, or tuberculosis.
- Major surgical procedures ≤30 days prior to starting study drug, or minor surgical procedures ≤7 days prior to starting study drug.
- History of alcohol or drug dependence or is known to have abused alcohol within 30 days prior to screening.
- Unwilling to abstain from alcohol and recreational drugs (with exception for medical marijuana) throughout the duration of participation in the study.
- Positive urine drug screen at Screening (with exception for medical marijuana which is allowed).
- Known hypersensitivity to celery or soybeans.
- Known serious hypersensitivity to paclitaxel
- Received treatment with any other investigational drug within 30 days before screening, was previously treated with NBP, is currently taking celery seed extract, or is currently participating in another clinical study
- Any other reasons that in the opinion of the investigator make the subject unsuitable for enrollment.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Active Comparator
Arm Label
Placebo
NBP
Arm Description
Interventions: Placebo (NBP placebo softgel capsules, 0 mg NBP, BID)
Interventions: 800 mg NBP softgel capsules daily (400 mg BID)
Outcomes
Primary Outcome Measures
Mean Change from Baseline in EORTC Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy (EORTC QLQ-CIPN20) Sensory Subscale
Change from baseline in the mean EORTC QLQ-CIPN20 sensory subscale (converted to a 0-100 scale) collected during the treatment period at weeks 5, 8, 11 and 15.
Secondary Outcome Measures
Number of Participants Requiring Rescue Medication
The number and percentage of participants requiring oxycodone of any amount anytime during the 15 week treatment period.
Days Free of Rescue Medication
The mean cumulative number of days free of oxycodone of any amount anytime for each participant during the 15 week treatment period.
Mean Change from Baseline in the Brief Pain Inventory Short Form (mBPI-SF) score.
The mean change from baseline (mean days 2-7 after first dose of NBP or Placebo) in the mBPI-SF total score to mean of all post-nab-paclitaxel mBPI-SF scores collected on days 2-7 after each of 4 nab-paclitaxel administration at days 7, 28, 49 and 70 during the 15 week treatment period.
Number of Participants with Treatment-Emergent Adverse Events
The number and percentage of participants with treatment-emergent adverse events according to MedDRA system organ class and preferred term with onset during the 15 week treatment period or 4 week follow-up.
Area Under the Curve (AUC) for NBP
The AUC (h*ng/mL) be calculated using Phoenix WinNonlin software
Cmax for NBP
Cmax (ng/mL) be calculated using Phoenix WinNonlin software
Tmax for NBP
Tmax (hr) be calculated using Phoenix WinNonlin software
Area Under the Curve for Paclitaxel
AUC (h*ng/mL) be calculated using Phoenix WinNonlin software
Cmax for Paclitaxel
Cmax (ng/mL) be calculated using Phoenix WinNonlin software
Tmax for Paclitaxel
Tmax (hr) be calculated using Phoenix WinNonlin software
Full Information
NCT ID
NCT04675450
First Posted
November 20, 2020
Last Updated
June 7, 2023
Sponsor
Conjupro Biotherapeutics, Inc.
Collaborators
CSPC-NBP Pharmaceutical Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT04675450
Brief Title
NBP in Women With Metastatic Breast Cancer to Prevent Nab-paclitaxel Induced Toxic Neuropathy
Official Title
A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Multiple Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of n-Butylphthalide (NBP) Softgel Capsules Administered to Patients With Metastatic Breast Cancer to Prevent Nab-paclitaxel Induced Toxic Neuropathy
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Further preclinical development activities required to proceed
Study Start Date
June 30, 2023 (Anticipated)
Primary Completion Date
December 30, 2024 (Anticipated)
Study Completion Date
January 30, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Conjupro Biotherapeutics, Inc.
Collaborators
CSPC-NBP Pharmaceutical Co., Ltd.
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
Phase 2, randomized, double-blind, Placebo-Controlled, Multiple Dose Study for the treatment of Patients with Metastatic Breast Cancer.
Detailed Description
This is a multiple center, randomized, double-blind, Phase 2 study of NBP administered to women with metastatic breast cancer who receive nab-paclitaxel as therapy. Nab-paclitaxel will be administered at a dose >260 mg/m2 every 3 weeks for 4 planned cycles. Subjects will begin receiving NBP orally at a dose of 400 mg administered every 12-hours (BID) or matching placebo 5 days (10 doses) prior to starting nab-paclitaxel therapy and continue to self-administer it BID until Visit 6/Day 100/Week 15. The primary objective is to evaluate the efficacy of NBP relative to placebo at preventing or reducing symptoms associated with nab-paclitaxel induced toxic neuropathy (CIPN). The secondary objectives include an evaluation the efficacy of NBP relative to placebo at preventing or attenuating taxane induced acute pain syndrome (TAPS), the evaluation of the safety and tolerability of NBP relative to placebo and to determine if NBP administration impacts the pharmacokinetics of nab-paclitaxel or if nab-paclitaxel affects the pharmacokinetics of NBP.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Peripheral Neuropathy
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Interventions: Placebo (NBP placebo softgel capsules, 0 mg NBP, BID)
Arm Title
NBP
Arm Type
Active Comparator
Arm Description
Interventions: 800 mg NBP softgel capsules daily (400 mg BID)
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
NBP Placebo Softgel Capsules
Intervention Description
Take 4 capsules BID on an empty stomach at least 1 hour before food intake, and remain fasting at least 1 hour after dosing
Intervention Type
Drug
Intervention Name(s)
NBP Softgel Capsules
Other Intervention Name(s)
NBP
Intervention Description
Take 4 capsules BID on an empty stomach at least 1 hour before food intake, and remain fasting at least 1 hour after dosing.
Primary Outcome Measure Information:
Title
Mean Change from Baseline in EORTC Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy (EORTC QLQ-CIPN20) Sensory Subscale
Description
Change from baseline in the mean EORTC QLQ-CIPN20 sensory subscale (converted to a 0-100 scale) collected during the treatment period at weeks 5, 8, 11 and 15.
Time Frame
Baseline and weeks 5, 8, 11 and 15
Secondary Outcome Measure Information:
Title
Number of Participants Requiring Rescue Medication
Description
The number and percentage of participants requiring oxycodone of any amount anytime during the 15 week treatment period.
Time Frame
15 weeks
Title
Days Free of Rescue Medication
Description
The mean cumulative number of days free of oxycodone of any amount anytime for each participant during the 15 week treatment period.
Time Frame
15 weeks
Title
Mean Change from Baseline in the Brief Pain Inventory Short Form (mBPI-SF) score.
Description
The mean change from baseline (mean days 2-7 after first dose of NBP or Placebo) in the mBPI-SF total score to mean of all post-nab-paclitaxel mBPI-SF scores collected on days 2-7 after each of 4 nab-paclitaxel administration at days 7, 28, 49 and 70 during the 15 week treatment period.
Time Frame
15 weeks
Title
Number of Participants with Treatment-Emergent Adverse Events
Description
The number and percentage of participants with treatment-emergent adverse events according to MedDRA system organ class and preferred term with onset during the 15 week treatment period or 4 week follow-up.
Time Frame
19 weeks
Title
Area Under the Curve (AUC) for NBP
Description
The AUC (h*ng/mL) be calculated using Phoenix WinNonlin software
Time Frame
0, 1.5, 3, 4, 6, 8 and 24 hours - Days 6 and 7
Title
Cmax for NBP
Description
Cmax (ng/mL) be calculated using Phoenix WinNonlin software
Time Frame
Time Frame: 0, 1.5, 3, 4, 6, 8 and 24 hours - Days 6 and 7
Title
Tmax for NBP
Description
Tmax (hr) be calculated using Phoenix WinNonlin software
Time Frame
0, 1.5, 3, 4, 6, 8 and 24 hours - Days 6 and 7
Title
Area Under the Curve for Paclitaxel
Description
AUC (h*ng/mL) be calculated using Phoenix WinNonlin software
Time Frame
0, 1.5, 3, 4, 6, 8 and 24 hours - Days 6 and 7
Title
Cmax for Paclitaxel
Description
Cmax (ng/mL) be calculated using Phoenix WinNonlin software
Time Frame
0, 1.5, 3, 4, 6, 8 and 24 hours - Days 6 and 7
Title
Tmax for Paclitaxel
Description
Tmax (hr) be calculated using Phoenix WinNonlin software
Time Frame
Time Frame: 0, 1.5, 3, 4, 6, 8 and 24 hours - Days 6 and 7
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria
Subjects are eligible to participate in the study only if all the following criteria apply:
Women aged ≥18 and ≤75 years.
Pathologically confirmed metastatic breast cancer.
Are candidates for initial therapy with nab-paclitaxel, at a dose of >260 mg/m2 every 3 weeks for 4 planned cycles.
Concomitant antitumor drugs used to treat the underlying malignancy, including immunotherapies, other than nab-paclitaxel will be allowed.
Eastern Cooperative Oncology Group (ECOG) performance status scores of 0 - 2.
Life expectancy ≥6 months.
Women of childbearing potential (WOCBP) must have a negative serum human chorionic gonadotropin (HCG) pregnancy test at Screening and be practicing a medically acceptable method of contraception with an annual failure rate of less than 1% until the completion of the trial or 30 days after discontinuation of study treatment. Women are considered not childbearing if they are >1 year postmenopausal or surgically sterile (ie, hysterectomy, bilateral oophorectomy, or bilateral salpingectomy tubal ligation).
Able to complete study questionnaires by themselves or with assistance.
Capable of understanding the purpose and risks of the study and able to provide informed consent by signing the informed consent form.
Able to swallow softgel capsules as determined by the investigator.
Able to comply with all study requirements. Exclusion Criteria
Subjects are excluded from the study if any of the following criteria apply:
Non-metastatic breast cancer.
Subjects who are pregnant, lactating/breast-feeding, or plan to become pregnant within the next 3 months.
History of poorly controlled diabetes mellitus (hemoglobin A1C >8.0 at the time of the Screening visit).
History of fibromyalgia.
History of any signs or symptoms suggestive of neuropathy within 30 days of Screening as determined by the investigator based on the neurological examination.
History of taking any neurotoxic drugs within 6 months of Screening.
Current use of drugs that are used to treat neuropathic pain (eg, gabapentin, pregabalin, and duloxetine) within 30 days of Screening.
Current diagnosis of malignancy other than breast cancer.
Absolute neutrophil count <1.5 x 109 cells/L.
Platelet count <100,000 x 109/L.
Hemoglobin level <9 g/dL at Screening without transfusion (transfusion independent).
Corrected QTcF >470 msec (single tracing) at Screening and prior to randomization.
Chronic renal or hepatic disease.
Clinically significant renal dysfunction including serum creatinine level >1.5 mg/dL or calculated creatinine clearance ≥50 mL/minute at Screening.
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level >2.0 x upper limits of normal (ULN), or a bilirubin >1.5 x ULN unless in the setting of known Gilbert's disease at Screening.
History of HIV, hepatitis B, hepatitis C, or tuberculosis.
Major surgical procedures ≤30 days prior to starting study drug, or minor surgical procedures ≤7 days prior to starting study drug.
History of alcohol or drug dependence or is known to have abused alcohol within 30 days prior to screening.
Unwilling to abstain from alcohol and recreational drugs (with exception for medical marijuana) throughout the duration of participation in the study.
Positive urine drug screen at Screening (with exception for medical marijuana which is allowed).
Known hypersensitivity to celery or soybeans.
Known serious hypersensitivity to paclitaxel
Received treatment with any other investigational drug within 30 days before screening, was previously treated with NBP, is currently taking celery seed extract, or is currently participating in another clinical study
Any other reasons that in the opinion of the investigator make the subject unsuitable for enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Qingxi Wang, PhD
Organizational Affiliation
Conjupro Biotherapeutics, Inc.
Official's Role
Study Director
12. IPD Sharing Statement
Learn more about this trial
NBP in Women With Metastatic Breast Cancer to Prevent Nab-paclitaxel Induced Toxic Neuropathy
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