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A Study to Evaluate the Efficacy and Safety of Oral Navelbine in Female Patients With HER2-Negative Metastatic Breast Cancer

Primary Purpose

Human Epidermal Growth Factor 2 Negative Carcinoma of Breast

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Oral NVB Metronomic
Oral NVB Weekly
Sponsored by
Chinese Academy of Medical Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Human Epidermal Growth Factor 2 Negative Carcinoma of Breast focused on measuring oral Navelbine, Metastasis Breast Cancer, metronomic chemotherapy

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Female patients with life expectancy ≥ 3 months, age ≥ 18 years at the time informed consent is signed.
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 as assessed within 21 days prior to randomization (Appendix ).
  • Subjects with HER2 negative metastasis breast cancer, source documented, defined as per American Society of Clinical Oncology - College of American Pathologists (ASCO/CAP) guidelines (Appendix ).
  • Subjects with measurable metastatic disease defined by Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) guidelines (Appendix ) .
  • Subjects may previously exposed to anthracyclines (e.g. doxorubicin, epirubicin) and/or taxanes (e.g., paclitaxel, docetaxel) including:

    • Subject has been pretreated in the adjuvant or neoadjuvant setting with anthracyclines and/or taxanes before breast cancer relapsing;
    • Subjects has experienced treatment failure while receiving or after completing anthracycline- and/or taxane- based chemotherapy;
    • Subjects who are not suitable for the choice of anthracycline- and/or taxane- based chemotherapy as first-line treatment in the judgment of investigator.
  • Prior radiotherapy must have completed before randomization, with full recovery from acute radiation side effects. An interval of less than 4 weeks after radiotherapy was not allowed.Concurrent limited field radiation therapy (RT) is allowed. At least one measurable lesion must be completely outside the radiation portal in accordance with RECIST 1.1 guidelines;
  • At least 30 days from major surgery before randomization, with full recovery;
  • Adequate bone marrow function as evidenced by the following:

    • Absolute Neutrophil Count (ANC) ≥ 1500/mm2;
    • Platelets ≥ 100,000/mm2;
    • Hemoglobin (Hb) ≥ 10 g/dL.
  • Adequate liver function as evidenced by the following:

    • Total serum bilirubin ≤ 1.5 times upper limit of normal range (ULN);
    • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≤ 2.5 times ULN (if hepatic metastases present ≤ 5.0 times ULN);
    • Alkaline phosphatase < 5 x ULN.
  • Adequate renal function as evidenced by the following:

    -Creatinine clearance > 40 mL/min (by Cockcroft-Gault).

  • Women of child-bearing potential must have a negative pregnancy test (urine or serum) within 7 days of randomization and agree to take an adequate contraceptive measure.
  • Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted.
  • Able to adhere to the study visit schedule and other protocol requirements.

Exclusion Criteria:

  • History of, or current active cancer other than breast cancer, with the exception of curatively resected non-melanomatous skin cancer, curatively treated cervical carcinoma in situ, or other primary solid tumors curatively treated with no known active disease present and no curative treatment administered for the last 3 years.
  • Patients with medical conditions that the only manifestation is hydrothorax, ascites, bone lesions or other un-measurable diseases.
  • Subjects with visceral crisis in the judgment of investigator. Visceral crisis is defined as severe organ dysfunction as assessed by signs and symptoms, laboratory studies, and rapid progression of disease. Visceral crisis is not the mere presence of disease of visceral metastases, but implies important visceral compromise leading to a clinical indication for a more rapidly efficacious therapy, particularly since chemotherapy option at progression will probably not be possible.
  • Malabsorption syndrome or disease significantly affecting gastro-intestinal function or major resection of the stomach or proximal small bowel that could affect absorption of Oral NVB.
  • Subjects with dysphagia, or inability to swallow the tablets.
  • Subjects with symptoms suggesting central nervous system (CNS) involvement or leptomeningeal metastases, any suspicious sins or symptoms of CNS involvement or leptomeningeal metastases should be excluded by CT or MRI scans.
  • Other serious illness or medical conditions by the investigator during screening:

    • Clinically significant cardiac disease;
    • Unstable diabetes;
    • Uncontrolled hypercalcemia;
    • Clinically significant active infections (current or in the last two weeks).
  • Previous organ allograft.
  • Current peripheral neuropathy ≥grade 2 according to NCI version 4.0 criteria.
  • More than one previous line of chemotherapy in advanced setting.
  • Concomitant hormonal therapy for MBC.
  • Ongoing anti-coagulation therapy.
  • Subjects of reproductive potential who are pregnant, breast feeding or not willing to use effective contraceptive precautions during the study and for at least one month after the last dose of investigational product in the judgment of the investigator.
  • Patients with psychiatric disorder or other disease leading to incompliance to the therapy.
  • Known hypersensitivity to any ingredient of the study drug.
  • An interval of less than 3 weeks between the last dose of previous chemotherapy and randomization.
  • Previous treated by oral NVB.
  • Treatment with any investigational drug within 30 days before the beginning of treatment with study drug. Less than 30 days since receipt of any other investigational product or device.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Oral NVB Metronomic

    Oral NVB Weekly

    Arm Description

    50mg three times weekly on Mondays (or Tuesdays), Wednesdays (or Thursdays) and Friday (or Saturdays). A cycle is a 3 weeks period.

    60mg/m2 weekly for cycle 1 and 80mg/m2 weekly for subsequent cycles in the absence of grade 3 or 4 toxicity. A cycle is a 3 weeks period.

    Outcomes

    Primary Outcome Measures

    Disease Control Rate
    Disease Control Rate (DCR) is the proportion of subjects who have best overall response of CR + PR + SD with duration of ≥6 weeks.

    Secondary Outcome Measures

    Time to Tumor Progression
    Time to Tumor Progression (TTP) is defined as the time from randomization to time of progressive disease.
    Time to Treatment Failure
    Time to Treatment Failure (TTF) is defined as the time from randomization to treatment discontinuation for any reason, including disease progression, treatment toxicity, patient toxicity, patient preference, or death.
    Progression free survival
    Progression free survival (PFS) is the time from the date of randomization to the date of first documentation of disease progression, or to the date of death from any case, whichever occurs first.
    Overall survival
    Overall survival (OS) will be measured from the date of randomization until the date of death from any case.
    Adverse events
    Adverse events including Serious AEs and non-serious AEs (since ICF signed and until 30 days after last intake of study medication)
    Quality of Life (QoL)
    The FACT-B +4 (Version 4) (Appendix ) QoL questionnaires will be filled in at baseline before randomization, then every 6 weeks during the Randomization Treatment Period and at EoTV. Changes of the scores from baseline of the parameters will be provided from baseline.

    Full Information

    First Posted
    February 19, 2019
    Last Updated
    February 23, 2019
    Sponsor
    Chinese Academy of Medical Sciences
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03854617
    Brief Title
    A Study to Evaluate the Efficacy and Safety of Oral Navelbine in Female Patients With HER2-Negative Metastatic Breast Cancer
    Official Title
    A Randomized, Open-label, Parallel Study to Evaluate the Efficacy and Safety of Oral Navelbine in Female Patients With HER2-Negative Metastatic Breast Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2019
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    February 20, 2019 (Anticipated)
    Primary Completion Date
    December 20, 2021 (Anticipated)
    Study Completion Date
    December 20, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Chinese Academy of Medical Sciences

    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

    5. Study Description

    Brief Summary
    This is a randomized, open-label, parallel, multi-center study, aims to evaluate the efficacy and safety of metronomic chemotherapy with oral Navelbine versus intermittent oral Navelbine in female patients with HER2 negative Metastasis Breast Cancer.
    Detailed Description
    The significant efficacy and good safety profile of Vinorelbine in the treatment of advanced breast cancer are accepted. Oral NVB presents absolute bioavailability of 40% and oral availability allows to use different schedules and the endothelial cell functionality and motility are interfered at very low drug concentration Oral NVB at 50 mg three times a week (Monday-Wednesday-Friday) has been tested in phase Ia/Ib/II trials, highlighting the excellent safety of this scheme combined with an interesting activity in various European countries. The study aims to evaluate the efficacy and safety of metronomic chemotherapy with oral Navelbine versus intermittent oral Navelbine in female patients with HER2 negative Metastasis Breast Cancer.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Human Epidermal Growth Factor 2 Negative Carcinoma of Breast
    Keywords
    oral Navelbine, Metastasis Breast Cancer, metronomic chemotherapy

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    172 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Oral NVB Metronomic
    Arm Type
    Experimental
    Arm Description
    50mg three times weekly on Mondays (or Tuesdays), Wednesdays (or Thursdays) and Friday (or Saturdays). A cycle is a 3 weeks period.
    Arm Title
    Oral NVB Weekly
    Arm Type
    Active Comparator
    Arm Description
    60mg/m2 weekly for cycle 1 and 80mg/m2 weekly for subsequent cycles in the absence of grade 3 or 4 toxicity. A cycle is a 3 weeks period.
    Intervention Type
    Drug
    Intervention Name(s)
    Oral NVB Metronomic
    Other Intervention Name(s)
    Oral Navelbine Metronomic
    Intervention Description
    50mg three times weekly on Mondays (or Tuesdays), Wednesdays (or Thursdays) and Friday (or Saturdays). A cycle is a 3 weeks period.
    Intervention Type
    Drug
    Intervention Name(s)
    Oral NVB Weekly
    Other Intervention Name(s)
    Oral Navelbine Weekly
    Intervention Description
    60mg/m2 weekly for cycle 1 and 80mg/m2 weekly for subsequent cycles in the absence of grade 3 or 4 toxicity. A cycle is a 3 weeks period
    Primary Outcome Measure Information:
    Title
    Disease Control Rate
    Description
    Disease Control Rate (DCR) is the proportion of subjects who have best overall response of CR + PR + SD with duration of ≥6 weeks.
    Time Frame
    12 weeks
    Secondary Outcome Measure Information:
    Title
    Time to Tumor Progression
    Description
    Time to Tumor Progression (TTP) is defined as the time from randomization to time of progressive disease.
    Time Frame
    up to 36 months
    Title
    Time to Treatment Failure
    Description
    Time to Treatment Failure (TTF) is defined as the time from randomization to treatment discontinuation for any reason, including disease progression, treatment toxicity, patient toxicity, patient preference, or death.
    Time Frame
    up to 36 months
    Title
    Progression free survival
    Description
    Progression free survival (PFS) is the time from the date of randomization to the date of first documentation of disease progression, or to the date of death from any case, whichever occurs first.
    Time Frame
    up to 36 months
    Title
    Overall survival
    Description
    Overall survival (OS) will be measured from the date of randomization until the date of death from any case.
    Time Frame
    up to 60 months
    Title
    Adverse events
    Description
    Adverse events including Serious AEs and non-serious AEs (since ICF signed and until 30 days after last intake of study medication)
    Time Frame
    up to 36 months
    Title
    Quality of Life (QoL)
    Description
    The FACT-B +4 (Version 4) (Appendix ) QoL questionnaires will be filled in at baseline before randomization, then every 6 weeks during the Randomization Treatment Period and at EoTV. Changes of the scores from baseline of the parameters will be provided from baseline.
    Time Frame
    up to 36 months

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    85 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Female patients with life expectancy ≥ 3 months, age ≥ 18 years at the time informed consent is signed. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 as assessed within 21 days prior to randomization (Appendix ). Subjects with HER2 negative metastasis breast cancer, source documented, defined as per American Society of Clinical Oncology - College of American Pathologists (ASCO/CAP) guidelines (Appendix ). Subjects with measurable metastatic disease defined by Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) guidelines (Appendix ) . Subjects may previously exposed to anthracyclines (e.g. doxorubicin, epirubicin) and/or taxanes (e.g., paclitaxel, docetaxel) including: Subject has been pretreated in the adjuvant or neoadjuvant setting with anthracyclines and/or taxanes before breast cancer relapsing; Subjects has experienced treatment failure while receiving or after completing anthracycline- and/or taxane- based chemotherapy; Subjects who are not suitable for the choice of anthracycline- and/or taxane- based chemotherapy as first-line treatment in the judgment of investigator. Prior radiotherapy must have completed before randomization, with full recovery from acute radiation side effects. An interval of less than 4 weeks after radiotherapy was not allowed.Concurrent limited field radiation therapy (RT) is allowed. At least one measurable lesion must be completely outside the radiation portal in accordance with RECIST 1.1 guidelines; At least 30 days from major surgery before randomization, with full recovery; Adequate bone marrow function as evidenced by the following: Absolute Neutrophil Count (ANC) ≥ 1500/mm2; Platelets ≥ 100,000/mm2; Hemoglobin (Hb) ≥ 10 g/dL. Adequate liver function as evidenced by the following: Total serum bilirubin ≤ 1.5 times upper limit of normal range (ULN); Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≤ 2.5 times ULN (if hepatic metastases present ≤ 5.0 times ULN); Alkaline phosphatase < 5 x ULN. Adequate renal function as evidenced by the following: -Creatinine clearance > 40 mL/min (by Cockcroft-Gault). Women of child-bearing potential must have a negative pregnancy test (urine or serum) within 7 days of randomization and agree to take an adequate contraceptive measure. Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted. Able to adhere to the study visit schedule and other protocol requirements. Exclusion Criteria: History of, or current active cancer other than breast cancer, with the exception of curatively resected non-melanomatous skin cancer, curatively treated cervical carcinoma in situ, or other primary solid tumors curatively treated with no known active disease present and no curative treatment administered for the last 3 years. Patients with medical conditions that the only manifestation is hydrothorax, ascites, bone lesions or other un-measurable diseases. Subjects with visceral crisis in the judgment of investigator. Visceral crisis is defined as severe organ dysfunction as assessed by signs and symptoms, laboratory studies, and rapid progression of disease. Visceral crisis is not the mere presence of disease of visceral metastases, but implies important visceral compromise leading to a clinical indication for a more rapidly efficacious therapy, particularly since chemotherapy option at progression will probably not be possible. Malabsorption syndrome or disease significantly affecting gastro-intestinal function or major resection of the stomach or proximal small bowel that could affect absorption of Oral NVB. Subjects with dysphagia, or inability to swallow the tablets. Subjects with symptoms suggesting central nervous system (CNS) involvement or leptomeningeal metastases, any suspicious sins or symptoms of CNS involvement or leptomeningeal metastases should be excluded by CT or MRI scans. Other serious illness or medical conditions by the investigator during screening: Clinically significant cardiac disease; Unstable diabetes; Uncontrolled hypercalcemia; Clinically significant active infections (current or in the last two weeks). Previous organ allograft. Current peripheral neuropathy ≥grade 2 according to NCI version 4.0 criteria. More than one previous line of chemotherapy in advanced setting. Concomitant hormonal therapy for MBC. Ongoing anti-coagulation therapy. Subjects of reproductive potential who are pregnant, breast feeding or not willing to use effective contraceptive precautions during the study and for at least one month after the last dose of investigational product in the judgment of the investigator. Patients with psychiatric disorder or other disease leading to incompliance to the therapy. Known hypersensitivity to any ingredient of the study drug. An interval of less than 3 weeks between the last dose of previous chemotherapy and randomization. Previous treated by oral NVB. Treatment with any investigational drug within 30 days before the beginning of treatment with study drug. Less than 30 days since receipt of any other investigational product or device.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Binghe Xu, MD
    Phone
    86-10-87788826
    Ext
    86-10-87715711
    Email
    xubinghe@medmail.com.cn
    First Name & Middle Initial & Last Name or Official Title & Degree
    Fei Ma, MD
    Phone
    86-10-87788060
    Ext
    86-10-87715711
    Email
    drmafei@126.com

    12. IPD Sharing Statement

    Learn more about this trial

    A Study to Evaluate the Efficacy and Safety of Oral Navelbine in Female Patients With HER2-Negative Metastatic Breast Cancer

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