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Clinical Study of Mitoxantrone Hydrochloride Liposome Injection Combined With Capecitabine Versus Capecitabine Monotherapy in Patients With Recurrent Metastatic Nasopharyngeal Carcinoma Who Failed Platinum-containing Treatment

Primary Purpose

Recurrent Metastatic Nasopharyngeal Carcinoma

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Mitoxantrone hydrochloride liposome injection
Capecitabine
Sponsored by
CSPC Zhongnuo Pharmaceutical (Shijiazhuang) Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Metastatic Nasopharyngeal Carcinoma

Eligibility Criteria

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

Inclusion Criteria: Willing to participate in the study and sign the informed consent form (ICF). Age ≥ 18 years. Nasopharyngeal carcinoma confirmed by histopathology. Recurrent metastatic nasopharyngeal carcinoma that has previously failed treatment with first-line platinum-containing standard regimens and/or second-line standard regimens. At least one evaluable lesion at baseline according to RECIST 1.1 criteria; The area should not have received previous radiotherapy, or there is evidence that the lesion has made definite progress after radiotherapy. Eastern Cooperative Oncology Group (ECOG) score 0-1. Toxic reaction caused by any previous antitumor treatment has recovered to grade 1 or below (except for alopecia, pigmentation, or other toxicities deemed by the investigator to pose no safety risk to the patient). Adequate main organ function. Female patients must have a negative blood HCG test (except for menopause and hysterectomy), Female patients of childbearing age and their partners must use effective contraception (For example: combination hormones [containing estrogen and progesterone] to suppress ovulation, progestogen contraception to suppress ovulation, intrauterine device, intrauterine hormone release system, bilateral tubal ligation, vasectomy, avoidance of sexual activity, etc) during the trial and within 6 months of the end of the last dose. Male patients and their partners agree to use one of the contraceptive measures described in Article 9. Exclusion Criteria: Severe allergy to mitoxantrone or liposome; Previous severe, unexpected reactions to fluorouracil or known allergy to fluorouracil or to any excipients of capecitabine. Previous treatment regimens containing capecitabine for recurrent or metastatic nasopharyngeal carcinoma; Patients with locally advanced nasopharyngeal carcinoma have previously experienced disease recurrence or metastasis during or within 6 months of use of capecitabine. Patients with brain or meningeal metastasis. Expected lifetime < 3 months. Patients with active hepatitis B, hepatitis C or HIV. Active bacterial infection, fungal infection, viral infection, or interstitial pneumonia requiring systemic therapy within 1 week prior to the first administration of the study drug. Antitumor therapy such as chemotherapy, small-molecule inhibitors, immunotherapy (such as interleukin, interferon, or thymosin) within 4 weeks or 5 half-lives (whichever is shorter but at least 2 weeks) prior to initial administration of the study drug; Received Chinese patent drugs with antitumor activity within 14 days prior to administration. Have received other investigational drugs within 4 weeks prior to initial administration. Patients had major surgery within 3 months prior to initial dosing or plan to have major surgery during the study period. Severe embolic events, such as cerebrovascular accidents (including transient ischemic attacks) and pulmonary embolism, occurred within 6 months prior to screening. Other active malignant tumors within 2 years prior to the first study drug administration. Abnormal heart function, including: Long QTc syndrome or QTc interval >480 ms; Complete left bundle branch block, second-degree or third-degree atrioventricular block; Severe, uncontrolled arrhythmias requiring medication; History of chronic congestive heart failure with NYHA ≥ grade 3; Cardiac ejection fraction less than 50% or lower than the lower limit of the laboratory test range within 6 months prior to screening; CTCAE version 5.0 ≥ grade 3 valvular heart disease; Uncontrolled hypertension (defined as measuring systolic blood pressure >160 mmHg or diastolic blood pressure >90 mmHg when medically controlled); Myocardial infarction, unstable angina, history of severe pericardial disease, ECG evidence of acute ischemic or active conduction system abnormalities within 6 months prior to screening. Prior treatment with doxorubicin or other anthracyclines and the cumulative doxorubicin doses greater than 350 mg/m^2 (anthracycline equivalent: 1 mg doxorubicin = 2 mg epirubicin = 2 mg daunorubicin = 0.5 mg normethoxydaunorubicin = 0.45 mg mitoxantrone). Pregnant or lactating women. Have any serious and/or uncontrollable medical conditions that, as determined by the investigator, may affect the patient's participation in the study. Have severe gastrointestinal disorders that affect the ingestion, transport, or absorption of medications. Other situations that the investigator determines to be inappropriate for participation.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Experimental group

    Control group

    Arm Description

    Patients will receive mitoxantrone hydrochloride liposome injection combined with capecitabine therapy

    Patients will receive capecitabine monotherapy.

    Outcomes

    Primary Outcome Measures

    Progression-free survival (PFS) assessed by the independent review committee (IRC)
    Progression-Free Survival PFS is defined as the time from randomization to progression or death
    Overall survival (OS)
    Overall survival (OS) is defined as the duration from the date of diagnosis to death or last follow-up, with no restriction on the cause of death.

    Secondary Outcome Measures

    Objective response rate (ORR) assessed by the investigator and IRC
    Objective response rate (ORR) is defined as the proportion of patients with a complete response or partial response to treatment
    Disease control rate (DCR) assessed by the investigator and IRC
    Disease Control Rate (DCR) is defined as the percentage of patients who have achieved complete response, partial response and stable disease to a therapeutic intervention in clinical trials of anticancer agents
    Duration of Response (DOR) assessed by the investigator and IRC
    Duration of Response (DOR) is defined as time from the first assessment of CR or PR until the date of the first occurrence of PD, or until the date of death
    Progression-free survival (PFS) assessed by the investigator
    Progression-Free Survival PFS is defined as the time from randomization to progression or death
    Frequency and severity of AE (NCI CTCAE 5.0)
    Blood concentrations of total and free mitoxantrone

    Full Information

    First Posted
    January 11, 2023
    Last Updated
    January 29, 2023
    Sponsor
    CSPC Zhongnuo Pharmaceutical (Shijiazhuang) Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05717764
    Brief Title
    Clinical Study of Mitoxantrone Hydrochloride Liposome Injection Combined With Capecitabine Versus Capecitabine Monotherapy in Patients With Recurrent Metastatic Nasopharyngeal Carcinoma Who Failed Platinum-containing Treatment
    Official Title
    A Randomized, Open-label, Positive-controlled, Multicenter Phase Ш Study Comparing Mitoxantrone Hydrochloride Liposome Injection Combined With Capecitabine Versus Capecitabine Monotherapy in Patients With Recurrent Metastatic Nasopharyngeal Carcinoma Who Failed Platinum-containing Therapy
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    February 2023 (Anticipated)
    Primary Completion Date
    September 2026 (Anticipated)
    Study Completion Date
    September 2027 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    CSPC Zhongnuo Pharmaceutical (Shijiazhuang) Co., Ltd.

    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 randomized, open-label, positive-controlled, multicenter Phase Ш study to evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection combined with capecitabine versus capecitabine monotherapy in patients with recurrent metastatic nasopharyngeal carcinoma.
    Detailed Description
    Five hundred patients with recurrent metastatic nasopharyngeal carcinoma will be randomly assigned to the experimental group or the control group. The experimental group will receive mitoxantrone hydrochloride liposome injection combined with capecitabine, and the control group will receive capecitabine alone. All patients will be treated until disease progression as determined by the investigator based on RECIST 1.1 criteria, intolerable toxicity, subject withdrawal of informed consent, initiation of new antitumor therapy, loss of follow-up, death, or study completion, whichever occurs first. Regular visits and imaging examinations will be conducted to compare the efficacy and safety of the two groups.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Recurrent Metastatic Nasopharyngeal Carcinoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    500 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Experimental group
    Arm Type
    Experimental
    Arm Description
    Patients will receive mitoxantrone hydrochloride liposome injection combined with capecitabine therapy
    Arm Title
    Control group
    Arm Type
    Active Comparator
    Arm Description
    Patients will receive capecitabine monotherapy.
    Intervention Type
    Drug
    Intervention Name(s)
    Mitoxantrone hydrochloride liposome injection
    Intervention Description
    Mitoxantrone hydrochloride liposome injection will be administered by intravenous infusion on day 1 in a 3-week treatment cycle.
    Intervention Type
    Drug
    Intervention Name(s)
    Capecitabine
    Intervention Description
    Capecitabine will be administered orally in a 3-week treatment cycle, twice a day from day 1 to day 14 of each cycle.
    Primary Outcome Measure Information:
    Title
    Progression-free survival (PFS) assessed by the independent review committee (IRC)
    Description
    Progression-Free Survival PFS is defined as the time from randomization to progression or death
    Time Frame
    Throughout the study period, up to approximately 2 years
    Title
    Overall survival (OS)
    Description
    Overall survival (OS) is defined as the duration from the date of diagnosis to death or last follow-up, with no restriction on the cause of death.
    Time Frame
    Throughout the study period, up to approximately 2 years
    Secondary Outcome Measure Information:
    Title
    Objective response rate (ORR) assessed by the investigator and IRC
    Description
    Objective response rate (ORR) is defined as the proportion of patients with a complete response or partial response to treatment
    Time Frame
    Throughout the study period, up to approximately 2 years
    Title
    Disease control rate (DCR) assessed by the investigator and IRC
    Description
    Disease Control Rate (DCR) is defined as the percentage of patients who have achieved complete response, partial response and stable disease to a therapeutic intervention in clinical trials of anticancer agents
    Time Frame
    Throughout the study period, up to approximately 2 years
    Title
    Duration of Response (DOR) assessed by the investigator and IRC
    Description
    Duration of Response (DOR) is defined as time from the first assessment of CR or PR until the date of the first occurrence of PD, or until the date of death
    Time Frame
    Throughout the study period, up to approximately 2 years
    Title
    Progression-free survival (PFS) assessed by the investigator
    Description
    Progression-Free Survival PFS is defined as the time from randomization to progression or death
    Time Frame
    Throughout the study period, up to approximately 2 years
    Title
    Frequency and severity of AE (NCI CTCAE 5.0)
    Time Frame
    Throughout the study period, up to approximately 2 years
    Title
    Blood concentrations of total and free mitoxantrone
    Time Frame
    At the end of Cycle 4 (each cycle is 28 days)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Willing to participate in the study and sign the informed consent form (ICF). Age ≥ 18 years. Nasopharyngeal carcinoma confirmed by histopathology. Recurrent metastatic nasopharyngeal carcinoma that has previously failed treatment with first-line platinum-containing standard regimens and/or second-line standard regimens. At least one evaluable lesion at baseline according to RECIST 1.1 criteria; The area should not have received previous radiotherapy, or there is evidence that the lesion has made definite progress after radiotherapy. Eastern Cooperative Oncology Group (ECOG) score 0-1. Toxic reaction caused by any previous antitumor treatment has recovered to grade 1 or below (except for alopecia, pigmentation, or other toxicities deemed by the investigator to pose no safety risk to the patient). Adequate main organ function. Female patients must have a negative blood HCG test (except for menopause and hysterectomy), Female patients of childbearing age and their partners must use effective contraception (For example: combination hormones [containing estrogen and progesterone] to suppress ovulation, progestogen contraception to suppress ovulation, intrauterine device, intrauterine hormone release system, bilateral tubal ligation, vasectomy, avoidance of sexual activity, etc) during the trial and within 6 months of the end of the last dose. Male patients and their partners agree to use one of the contraceptive measures described in Article 9. Exclusion Criteria: Severe allergy to mitoxantrone or liposome; Previous severe, unexpected reactions to fluorouracil or known allergy to fluorouracil or to any excipients of capecitabine. Previous treatment regimens containing capecitabine for recurrent or metastatic nasopharyngeal carcinoma; Patients with locally advanced nasopharyngeal carcinoma have previously experienced disease recurrence or metastasis during or within 6 months of use of capecitabine. Patients with brain or meningeal metastasis. Expected lifetime < 3 months. Patients with active hepatitis B, hepatitis C or HIV. Active bacterial infection, fungal infection, viral infection, or interstitial pneumonia requiring systemic therapy within 1 week prior to the first administration of the study drug. Antitumor therapy such as chemotherapy, small-molecule inhibitors, immunotherapy (such as interleukin, interferon, or thymosin) within 4 weeks or 5 half-lives (whichever is shorter but at least 2 weeks) prior to initial administration of the study drug; Received Chinese patent drugs with antitumor activity within 14 days prior to administration. Have received other investigational drugs within 4 weeks prior to initial administration. Patients had major surgery within 3 months prior to initial dosing or plan to have major surgery during the study period. Severe embolic events, such as cerebrovascular accidents (including transient ischemic attacks) and pulmonary embolism, occurred within 6 months prior to screening. Other active malignant tumors within 2 years prior to the first study drug administration. Abnormal heart function, including: Long QTc syndrome or QTc interval >480 ms; Complete left bundle branch block, second-degree or third-degree atrioventricular block; Severe, uncontrolled arrhythmias requiring medication; History of chronic congestive heart failure with NYHA ≥ grade 3; Cardiac ejection fraction less than 50% or lower than the lower limit of the laboratory test range within 6 months prior to screening; CTCAE version 5.0 ≥ grade 3 valvular heart disease; Uncontrolled hypertension (defined as measuring systolic blood pressure >160 mmHg or diastolic blood pressure >90 mmHg when medically controlled); Myocardial infarction, unstable angina, history of severe pericardial disease, ECG evidence of acute ischemic or active conduction system abnormalities within 6 months prior to screening. Prior treatment with doxorubicin or other anthracyclines and the cumulative doxorubicin doses greater than 350 mg/m^2 (anthracycline equivalent: 1 mg doxorubicin = 2 mg epirubicin = 2 mg daunorubicin = 0.5 mg normethoxydaunorubicin = 0.45 mg mitoxantrone). Pregnant or lactating women. Have any serious and/or uncontrollable medical conditions that, as determined by the investigator, may affect the patient's participation in the study. Have severe gastrointestinal disorders that affect the ingestion, transport, or absorption of medications. Other situations that the investigator determines to be inappropriate for participation.

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Clinical Study of Mitoxantrone Hydrochloride Liposome Injection Combined With Capecitabine Versus Capecitabine Monotherapy in Patients With Recurrent Metastatic Nasopharyngeal Carcinoma Who Failed Platinum-containing Treatment

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