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Pharmacokinetics and Safety of Epidiferphane and Taxanes in Breast Cancer Patients

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Epidiferphane
Taxane Chemotherapy
Sponsored by
University of Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring breast cancer, taxanes, Epidiferphane

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Must be at least 18 years of age
  • Subjects on the phase I portion must have a clinical diagnosis of metastatic breast cancer. Subjects on the phase II portion must have a clinical diagnosis of breast cancer of any stage and histology.
  • Must be about to start a new treatment regimen containing either paclitaxel given weekly or docetaxel given every 3 weeks or nab-paclitaxel given weekly or every 3 weeks at UF Health, at one of the following doses:

    • Paclitaxel weekly at 80-90 mg/m2
    • Nab-paclitaxel weekly at 75-125 mg/m2 or every three weekly at 260 mg/m2
    • Docetaxel every three weeks at 75-100 mg/m2
  • An ECOG Performance Status less than or equal to 3 based on treating physician assessment
  • Must continue cancer therapy at UF Health for at least the next three months
  • Must not have more than one active malignancy at the time of enrollment (Subjects with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen [as determined by the treating physician and approved by the PI] may be included.
  • A functioning digestive tract with no obstruction
  • Subjects must be willing to avoid regular consumption of green tea and curcumin supplements for the duration of trial participation.
  • Written informed consent obtained from the subject and the ability for the subject to comply with all the study-related procedures.
  • Subjects of childbearing potential (SOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study.
  • Subjects with partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) throughout the study.

Exclusion Criteria:

  • Must not be receiving any other investigational agents
  • Subjects of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and following completion of taxane therapy for an additional 6 months for subjects of child bearing potential and 3 months for subjects with partners of child bearing potential.
  • Subjects who are pregnant or breastfeeding
  • Active systemic infection considered to be opportunistic, life threatening or clinically significant at the time of treatment.
  • Psychiatric illness or social situation that would limit compliance with trial requirements.
  • Known allergy to turmeric, broccoli, or green tea.
  • Subjects must not be on treatment with strong CYP3A4 inhibitors such as tacrolimus or on verapamil during the trial.
  • History of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding (e.g. hemoglobin < 10 mg/dL, CTCAE v 5.0 grade 3 or higher neutropenia or thrombocytopenia) giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications, in the opinion of the treating physician.
  • Prisoners or subjects who are involuntarily incarcerated.
  • Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.
  • Subjects demonstrating an inability to comply with the study and/or follow-up procedures.
  • CTCAE v 5.0 grade 2 or higher peripheral sensory or motor neuropathy
  • CTCAE v 5.0 grade 1 or higher paresthesia
  • Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST) >2.5 × the upper limit of normal (ULN)
  • Total bilirubin (TBL) >1.5 × ULN or >3 × ULN in the presence of documented Gilbert's Syndrome (unconjugated hyperbilirubinemia)
  • Glomerular filtration rate (GFR) <50 mL/min
  • Red blood cell infusions < 30 days prior to treatment

Sites / Locations

  • University of FloridaRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Epidiferphane + taxane chemotherapy

Arm Description

Outcomes

Primary Outcome Measures

Cmax of Epidiferphane's components
The Cmax of each of Epidiferphane's components will be based on blood concentration measured prior to taxane chemotherapy administration, as well as at 1, 2 and 24 hours after taxane chemotherapy administration. The Cmax of each of Epidiferphane's components will be the blood concentration measured prior to taxane chemotherapy administration, as well as at 1, 2 and 24 hours after taxane chemotherapy administration.
Cmax of taxanes
The Cmax of the taxane chemotherapy agents given will be based on blood concentrations measured prior to taxane chemotherapy administration, as well as at 1, 2 and 24 hours after taxane chemotherapy administration.
Concentration at 24 hours (C24 hours) of Epidiferphane's components
The C24 hours of each of Epidiferphane's components will be based on blood concentration measured 24 hours after taxane chemotherapy administration.
Concentration at 24 hours (C24 hours) of taxanes
The C24 hours of the taxanes given will be based on blood concentration measured 24 hours after taxane chemotherapy administration.
Maximum tolerated dose of Epidiferphane in patients with breast cancer who are being treated with taxanes
Rate of Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade 2 or higher neuropathy
Rate of Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade 1 or higher anemia

Secondary Outcome Measures

Effect of Epidiferphane on quality of life, as measured by the EORTC QLQ-C30 scale
The EORTC QLQ-C30 measures ability to perform everyday activities and whether the subject has experienced select physical symptoms on a scale of 1-4 (with 1 meaning "Not at all" and 4 meaning "Very much"), as well as overall quality of life and overall healt over the past week on a scale from 1-7 (with 1 meaning "Very Poor" and 7 meaning "Excellent").
Effect of Epidiferphane on quality of life, as measured by the FACT-Taxane scale
The FACT-Taxane measures various aspects of physical, social, emotional, and functional well-being, as well as whether the subject has experienced select physical symptoms over the past 7 days, on a scale of 0-4 (with 0 meaning "Not at all" and 4 meaning "Very much").
Objective response rate
Determine the objective response rate, defined as the percentage of subjects with a complete or partial response, as measured by RECIST 1.1 criteria, or descriptive statistics if RECIST measurements are not possible due to modality of imaging.
Concentration of the neuropathy marker NF-kB, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)
Concentration of the neuropathy marker VEGFA, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)
Concentration of the neuropathy marker Nrf2, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)
Concentration of the neuropathy marker IL18, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)

Full Information

First Posted
September 29, 2021
Last Updated
April 3, 2023
Sponsor
University of Florida
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1. Study Identification

Unique Protocol Identification Number
NCT05074290
Brief Title
Pharmacokinetics and Safety of Epidiferphane and Taxanes in Breast Cancer Patients
Official Title
Pharmacokinetics and Safety of Epidiferphane and Taxanes in Breast Cancer Patients
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 22, 2023 (Actual)
Primary Completion Date
January 2026 (Anticipated)
Study Completion Date
January 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Florida

4. Oversight

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

5. Study Description

Brief Summary
Patients with breast cancer are commonly treated with taxane chemotherapy. Some very common side effects of taxanes, such as anemia and peripheral neuropathy, are often as not well addressed during treatment, resulting in dose reductions, dose delays and early discontinuation (collectively called relative dose intensity) of these chemotherapy agents in 15-80 % of patients on these drugs. This reduction in relative dose intensity (RDI) results in worse clinical outcomes such as progression free and overall survival. Pre-clinical studies in mouse models subjected to standardized chemotherapy regimens containing paclitaxel or oxaliplatin have shown that the nutritional supplement Epidiferphane reduces both neuropathy and anemia. This study will investigate whether the use of Epidiferphane in patients with breast cancer receiving taxane chemotherapy results in an attenuation of the side effects experienced, as well as an improvement in tumor response rate. The safety and maximum tolerated dose of Epidiferphane in this patient population will also be determined in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
breast cancer, taxanes, Epidiferphane

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
74 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Epidiferphane + taxane chemotherapy
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Epidiferphane
Intervention Description
During the phase I portion of the study, subjects will be assigned to take either two (half target dose) or four (full target dose) Epidiferphane tablets orally three times daily following a 3 + 3 design. Three subjects will be sequentially enrolled at each of the 2 dose levels (beginning with the half target dose) until at least one dose-limiting toxicity (DLT) occurs. Dosing escalation will be stopped if two or more DLTs occur at either dose level. The maximum tolerated dose will be one dose level lower than the dose level at which 2 or more DLTs occur. Dose escalation will occur separately for each taxane regimen (docetaxel or paclitaxel). All subjects in the phase II portion of the study will receive the maximum tolerated dose determined in the phase I portion of the study for their taxane regimen. Subjects in both portions of the study will receive treatment with Epidiferphane for a maximum of three months.
Intervention Type
Drug
Intervention Name(s)
Taxane Chemotherapy
Intervention Description
All subjects on both phases of the study will be concurrently treated with a taxane regimen containing either paclitaxel given weekly, nab-paclitaxel given weekly or every 3 weeks or docetaxel given every 3 weeks. The choice of taxane regimen will be determined by the treating physician prior to consenting to participate in this trial.
Primary Outcome Measure Information:
Title
Cmax of Epidiferphane's components
Description
The Cmax of each of Epidiferphane's components will be based on blood concentration measured prior to taxane chemotherapy administration, as well as at 1, 2 and 24 hours after taxane chemotherapy administration. The Cmax of each of Epidiferphane's components will be the blood concentration measured prior to taxane chemotherapy administration, as well as at 1, 2 and 24 hours after taxane chemotherapy administration.
Time Frame
24 hours
Title
Cmax of taxanes
Description
The Cmax of the taxane chemotherapy agents given will be based on blood concentrations measured prior to taxane chemotherapy administration, as well as at 1, 2 and 24 hours after taxane chemotherapy administration.
Time Frame
24 hours
Title
Concentration at 24 hours (C24 hours) of Epidiferphane's components
Description
The C24 hours of each of Epidiferphane's components will be based on blood concentration measured 24 hours after taxane chemotherapy administration.
Time Frame
24 hours
Title
Concentration at 24 hours (C24 hours) of taxanes
Description
The C24 hours of the taxanes given will be based on blood concentration measured 24 hours after taxane chemotherapy administration.
Time Frame
24 hours
Title
Maximum tolerated dose of Epidiferphane in patients with breast cancer who are being treated with taxanes
Time Frame
4 months
Title
Rate of Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade 2 or higher neuropathy
Time Frame
4 months
Title
Rate of Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade 1 or higher anemia
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Effect of Epidiferphane on quality of life, as measured by the EORTC QLQ-C30 scale
Description
The EORTC QLQ-C30 measures ability to perform everyday activities and whether the subject has experienced select physical symptoms on a scale of 1-4 (with 1 meaning "Not at all" and 4 meaning "Very much"), as well as overall quality of life and overall healt over the past week on a scale from 1-7 (with 1 meaning "Very Poor" and 7 meaning "Excellent").
Time Frame
3 months
Title
Effect of Epidiferphane on quality of life, as measured by the FACT-Taxane scale
Description
The FACT-Taxane measures various aspects of physical, social, emotional, and functional well-being, as well as whether the subject has experienced select physical symptoms over the past 7 days, on a scale of 0-4 (with 0 meaning "Not at all" and 4 meaning "Very much").
Time Frame
3 months
Title
Objective response rate
Description
Determine the objective response rate, defined as the percentage of subjects with a complete or partial response, as measured by RECIST 1.1 criteria, or descriptive statistics if RECIST measurements are not possible due to modality of imaging.
Time Frame
3 months
Title
Concentration of the neuropathy marker NF-kB, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)
Time Frame
3 months
Title
Concentration of the neuropathy marker VEGFA, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)
Time Frame
3 months
Title
Concentration of the neuropathy marker Nrf2, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)
Time Frame
3 months
Title
Concentration of the neuropathy marker IL18, as measured by multiplex cytokine bead analysis or ELISA (enzyme-linked immunosorbent assay)
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must be at least 18 years of age Subjects on the phase I portion must either be initiating neoadjuvant chemotherapy or have a clinical diagnosis of metastatic breast cancer. Subjects on the phase II portion must have a clinical diagnosis of breast cancer of any stage and histology. Must be about to start a new treatment regimen containing either paclitaxel given weekly or docetaxel given every 3 weeks or nab-paclitaxel given weekly or every 3 weeks at UF Health, at one of the following doses: Paclitaxel weekly at 80-90 mg/m2 Nab-paclitaxel weekly at 75-125 mg/m2 or every three weekly at 260 mg/m2 Docetaxel every three weeks at 75-100 mg/m2 An ECOG Performance Status less than or equal to 3 based on treating physician assessment Must continue cancer therapy at UF Health for at least the next three months Must not have more than one active malignancy at the time of enrollment (Subjects with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen [as determined by the treating physician and approved by the PI] may be included. A functioning digestive tract with no obstruction Subjects must be willing to avoid regular consumption of green tea and curcumin supplements for the duration of trial participation. Written informed consent obtained from the subject and the ability for the subject to comply with all the study-related procedures. Subjects of childbearing potential (SOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study. Subjects with partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) throughout the study. Exclusion Criteria: Must not be receiving any other investigational agents Subjects of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and following completion of taxane therapy for an additional 6 months for subjects of child bearing potential and 3 months for subjects with partners of child bearing potential. Subjects who are pregnant or breastfeeding Active systemic infection considered to be opportunistic, life threatening or clinically significant at the time of treatment. Psychiatric illness or social situation that would limit compliance with trial requirements. Known allergy to turmeric, broccoli, or green tea. Subjects must not be on treatment with strong CYP3A4 inhibitors such as tacrolimus or on verapamil during the trial. History of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding (e.g. hemoglobin < 10 mg/dL, CTCAE v 5.0 grade 3 or higher neutropenia or thrombocytopenia) giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications, in the opinion of the treating physician. Prisoners or subjects who are involuntarily incarcerated. Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness. Subjects demonstrating an inability to comply with the study and/or follow-up procedures. CTCAE v 5.0 grade 2 or higher peripheral sensory or motor neuropathy CTCAE v 5.0 grade 1 or higher paresthesia Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST) >2.5 × the upper limit of normal (ULN) Total bilirubin (TBL) >1.5 × ULN or >3 × ULN in the presence of documented Gilbert's Syndrome (unconjugated hyperbilirubinemia) Glomerular filtration rate (GFR) <50 mL/min Red blood cell infusions < 30 days prior to treatment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Priya Gurjar
Phone
352-273-6772
Email
PMO@cancer.ufl.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Coy Heldermon
Organizational Affiliation
University of Florida
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Danielle Ogden
Phone
352-733-0488
Email
d.ogden@ufl.edu
First Name & Middle Initial & Last Name & Degree
Coy Heldermon, MD, PhD

12. IPD Sharing Statement

Learn more about this trial

Pharmacokinetics and Safety of Epidiferphane and Taxanes in Breast Cancer Patients

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