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Capecitabine and Pegylated Interferon Alfa-2a in Treating Patients With Recurrent or Progressive Brain Metastases Due to Breast Cancer

Primary Purpose

Breast Cancer, Metastatic Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PEG-interferon alfa-2a
Capecitabine
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring stage IV breast cancer, recurrent breast cancer, male breast cancer, tumors metastatic to brain

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically or cytologically confirmed breast cancer that metastasized to the brain, meeting all of the following criteria: Must have ≥ 1 inoperable brain metastases, meeting 1 of the following criteria: Progressive or recurrent disease after prior whole-brain or stereotactic radiotherapy Ineligible for OR unwilling to be treated with radiotherapy At least 1 unidimensionally measurable brain metastasis by enhanced MRI within the past 21 days No progression or development of central nervous system (CNS) metastasis during prior treatment with capecitabine, fluorouracil, interferon alfa, or interferon beta Systemic (i.e., outside the CNS system) cancer must be stable No progressive disease (e.g., liver, lymphangitic, or lung metastases) Hormone receptor status: Not specified PATIENT CHARACTERISTICS: Age 18 and over Sex Male or female Menopausal status Not specified Performance status Karnofsky 70-100% Life expectancy More than 12 weeks Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 10 mg/dL No history of idiopathic thrombocytopenic purpura No known uncontrolled coagulopathy No increased risk for anemia (e.g., thalassemia or spherocytosis) No medically problematic anemia Hepatic aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT) ≤ 2.5 times upper limit of normal (ULN) (5 times ULN for patients with concurrent liver metastases ) Bilirubin ≤ 1.5 times ULN Alkaline phosphatase ≤ 2.5 times ULN (5 times ULN for patients with concurrent liver metastases; 10 times ULN for patients with concurrent bone metastases) Renal Creatinine ≤ 1.5 times ULN OR Creatinine clearance ≥ 30 mL/min Cardiovascular No congestive heart failure No symptomatic coronary artery disease No medically uncontrolled arrhythmia No other clinically significant cardiac disease No myocardial infarction within the past 12 months Gastrointestinal No history of inflammatory bowel disease Must have intact upper gastrointestinal tract Able to swallow tablets No malabsorption syndrome No history of gastrointestinal bleeding Immunologic No prior unanticipated severe reaction to fluoropyrimidine therapy, interferon, pegylated interferon, or a pegylated moiety No known sensitivity to fluorouracil No serious uncontrolled infection No history of immunologically mediated disease Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 6 months after completion of study treatment No known dihydropyrimidine dehydrogenase deficiency No history of depression characterized by a suicide attempt No history of hospitalization for psychiatric disease No history of other severe psychiatric disease No prior disability as a result of psychiatric disease No history of clinically significant psychiatric disability that would preclude study compliance No other malignancy within the past 5 years except cured nonmelanoma skin cancer or treated carcinoma in situ of the cervix No uncontrolled thyroid dysfunction (e.g., thyroid-stimulating hormone not in normal range) No evidence of severe retinopathy (e.g., Cytomegalovirus (CMV) retinitis or macular degeneration) No clinically relevant ophthalmologic disorders due to diabetes or hypertension No other serious uncontrolled medical conditions that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics At least 3 months since prior interferon alfa or interferon beta Chemotherapy See Disease Characteristics At least 3 months since prior capecitabine or fluorouracil Endocrine therapy Concurrent hormonal agents (e.g., tamoxifen, raloxifene, or anastrazole) for breast cancer allowed Radiotherapy See Disease Characteristics Surgery More than 4 weeks since prior major surgery and recovered Other More than 4 weeks since prior participation in another investigational drug study At least 4 weeks since prior and no concurrent brivudine or sorivudine No concurrent cimetidine No other concurrent investigational or commercial agents or therapies for this malignancy

Sites / Locations

  • CCOP - Wichita
  • CCOP - Grand Rapids
  • Cancer Research for the Ozarks
  • University of Texas M.D. Anderson CCOP Research Base

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Capecitabine + PEG-interferon alfa-2a

Arm Description

Capecitabine 1000 mg/m2 orally twice daily during the first 14 days of each 3-week cycle (2 weeks on, 1 week rest), and PEG-interferon alfa-2a subcutaneously beginning at 180 mcg per week for 21 days.

Outcomes

Primary Outcome Measures

Neurologic progression-free survival rate at 6 months

Secondary Outcome Measures

Time to neurologic progression
Overall survival
Tumor response (complete response and partial response)
Response Evaluation Criteria in Solid Tumors (RECIST) criteria for Target (Brain Metastasis) Lesions where Complete Response (CR): Disappearance of all target lesions; and Partial Response (PR): At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.
Toxicity
Toxicity defined as grade 3 or 4 hematologic, skin (hand and foot syndrome), or fatigue/myalgia/flu debilitation-syndrome (interferon-related) toxicities.

Full Information

First Posted
September 26, 2005
Last Updated
December 10, 2012
Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00227656
Brief Title
Capecitabine and Pegylated Interferon Alfa-2a in Treating Patients With Recurrent or Progressive Brain Metastases Due to Breast Cancer
Official Title
Phase II Trial of Capecitabine (Xeloda®) and Pegylated Interferon Alfa-2A(Pegasys®) for Recurrent or Progressive Brain Metastasis From Breast Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2012
Overall Recruitment Status
Terminated
Why Stopped
Study slow to accrue.
Study Start Date
September 2005 (undefined)
Primary Completion Date
November 2006 (Actual)
Study Completion Date
November 2006 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Pegylated interferon alfa-2a may interfere with the growth of tumor cells. Giving capecitabine together with pegylated interferon alfa-2a may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving capecitabine together with pegylated interferon alfa-2a works in treating patients with recurrent or progressive brain metastases due to breast cancer.
Detailed Description
OBJECTIVES: Primary Determine the efficacy of capecitabine and pegylated interferon alfa-2a, in terms of 6-month neurologic progression-free rate, in patients with recurrent or progressive brain metastases secondary to breast cancer. Secondary Determine the toxicity spectrum of this regimen in these patients. Determine the time to neurologic progression and overall survival of patients treated with this regimen. OUTLINE: This is an open-label, multicenter study. Patients receive oral capecitabine twice daily on days 1-14 and pegylated interferon alfa-2a subcutaneously on days 1, 8, and 15. Treatment repeats every 3 weeks for at least 6 months in the absence of disease progression or unacceptable toxicity. PROJECTED ACCRUAL: A total of 38-98 patients will be accrued for this study within 2 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Metastatic Cancer
Keywords
stage IV breast cancer, recurrent breast cancer, male breast cancer, tumors metastatic to brain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Capecitabine + PEG-interferon alfa-2a
Arm Type
Experimental
Arm Description
Capecitabine 1000 mg/m2 orally twice daily during the first 14 days of each 3-week cycle (2 weeks on, 1 week rest), and PEG-interferon alfa-2a subcutaneously beginning at 180 mcg per week for 21 days.
Intervention Type
Biological
Intervention Name(s)
PEG-interferon alfa-2a
Other Intervention Name(s)
PEGSYS, Interferon-alfa-2a, Interferon alpha 2a recombinant, Pegylated interferon alfa-2a
Intervention Description
Once a week subcutaneous injection for 21 days, beginning at 180 mcg per week. Repeated for additional 21 days to begin at the same time as repeat 21 day Capecitabine cycle.
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Other Intervention Name(s)
Xeloda
Intervention Description
1000 mg/m^2 twice daily during first 14 days of each 3-week cycle (2 weeks on, 1 week rest).
Primary Outcome Measure Information:
Title
Neurologic progression-free survival rate at 6 months
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Time to neurologic progression
Time Frame
6 months or until disease progression
Title
Overall survival
Time Frame
Up to 2 years
Title
Tumor response (complete response and partial response)
Description
Response Evaluation Criteria in Solid Tumors (RECIST) criteria for Target (Brain Metastasis) Lesions where Complete Response (CR): Disappearance of all target lesions; and Partial Response (PR): At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.
Time Frame
6 months
Title
Toxicity
Description
Toxicity defined as grade 3 or 4 hematologic, skin (hand and foot syndrome), or fatigue/myalgia/flu debilitation-syndrome (interferon-related) toxicities.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed breast cancer that metastasized to the brain, meeting all of the following criteria: Must have ≥ 1 inoperable brain metastases, meeting 1 of the following criteria: Progressive or recurrent disease after prior whole-brain or stereotactic radiotherapy Ineligible for OR unwilling to be treated with radiotherapy At least 1 unidimensionally measurable brain metastasis by enhanced MRI within the past 21 days No progression or development of central nervous system (CNS) metastasis during prior treatment with capecitabine, fluorouracil, interferon alfa, or interferon beta Systemic (i.e., outside the CNS system) cancer must be stable No progressive disease (e.g., liver, lymphangitic, or lung metastases) Hormone receptor status: Not specified PATIENT CHARACTERISTICS: Age 18 and over Sex Male or female Menopausal status Not specified Performance status Karnofsky 70-100% Life expectancy More than 12 weeks Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 10 mg/dL No history of idiopathic thrombocytopenic purpura No known uncontrolled coagulopathy No increased risk for anemia (e.g., thalassemia or spherocytosis) No medically problematic anemia Hepatic aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT) ≤ 2.5 times upper limit of normal (ULN) (5 times ULN for patients with concurrent liver metastases ) Bilirubin ≤ 1.5 times ULN Alkaline phosphatase ≤ 2.5 times ULN (5 times ULN for patients with concurrent liver metastases; 10 times ULN for patients with concurrent bone metastases) Renal Creatinine ≤ 1.5 times ULN OR Creatinine clearance ≥ 30 mL/min Cardiovascular No congestive heart failure No symptomatic coronary artery disease No medically uncontrolled arrhythmia No other clinically significant cardiac disease No myocardial infarction within the past 12 months Gastrointestinal No history of inflammatory bowel disease Must have intact upper gastrointestinal tract Able to swallow tablets No malabsorption syndrome No history of gastrointestinal bleeding Immunologic No prior unanticipated severe reaction to fluoropyrimidine therapy, interferon, pegylated interferon, or a pegylated moiety No known sensitivity to fluorouracil No serious uncontrolled infection No history of immunologically mediated disease Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 6 months after completion of study treatment No known dihydropyrimidine dehydrogenase deficiency No history of depression characterized by a suicide attempt No history of hospitalization for psychiatric disease No history of other severe psychiatric disease No prior disability as a result of psychiatric disease No history of clinically significant psychiatric disability that would preclude study compliance No other malignancy within the past 5 years except cured nonmelanoma skin cancer or treated carcinoma in situ of the cervix No uncontrolled thyroid dysfunction (e.g., thyroid-stimulating hormone not in normal range) No evidence of severe retinopathy (e.g., Cytomegalovirus (CMV) retinitis or macular degeneration) No clinically relevant ophthalmologic disorders due to diabetes or hypertension No other serious uncontrolled medical conditions that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics At least 3 months since prior interferon alfa or interferon beta Chemotherapy See Disease Characteristics At least 3 months since prior capecitabine or fluorouracil Endocrine therapy Concurrent hormonal agents (e.g., tamoxifen, raloxifene, or anastrazole) for breast cancer allowed Radiotherapy See Disease Characteristics Surgery More than 4 weeks since prior major surgery and recovered Other More than 4 weeks since prior participation in another investigational drug study At least 4 weeks since prior and no concurrent brivudine or sorivudine No concurrent cimetidine No other concurrent investigational or commercial agents or therapies for this malignancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Morris D. Groves, MD, JD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
CCOP - Wichita
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214-3882
Country
United States
Facility Name
CCOP - Grand Rapids
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49503
Country
United States
Facility Name
Cancer Research for the Ozarks
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65807
Country
United States
Facility Name
University of Texas M.D. Anderson CCOP Research Base
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-4009
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Capecitabine and Pegylated Interferon Alfa-2a in Treating Patients With Recurrent or Progressive Brain Metastases Due to Breast Cancer

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