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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Withdrawn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
Conjupro Biotherapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Breast Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria

Subjects are eligible to participate in the study only if all the following criteria apply:

  1. Women aged ≥18 and ≤75 years.
  2. Pathologically confirmed metastatic breast cancer.
  3. Are candidates for initial therapy with nab-paclitaxel, at a dose of >260 mg/m2 every 3 weeks for 4 planned cycles.
  4. Concomitant antitumor drugs used to treat the underlying malignancy, including immunotherapies, other than nab-paclitaxel will be allowed.
  5. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0 - 2.
  6. Life expectancy ≥6 months.
  7. 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).
  8. Able to complete study questionnaires by themselves or with assistance.
  9. Capable of understanding the purpose and risks of the study and able to provide informed consent by signing the informed consent form.
  10. Able to swallow softgel capsules as determined by the investigator.
  11. Able to comply with all study requirements. Exclusion Criteria

Subjects are excluded from the study if any of the following criteria apply:

  1. Non-metastatic breast cancer.
  2. Subjects who are pregnant, lactating/breast-feeding, or plan to become pregnant within the next 3 months.
  3. History of poorly controlled diabetes mellitus (hemoglobin A1C >8.0 at the time of the Screening visit).
  4. History of fibromyalgia.
  5. History of any signs or symptoms suggestive of neuropathy within 30 days of Screening as determined by the investigator based on the neurological examination.
  6. History of taking any neurotoxic drugs within 6 months of Screening.
  7. Current use of drugs that are used to treat neuropathic pain (eg, gabapentin, pregabalin, and duloxetine) within 30 days of Screening.
  8. Current diagnosis of malignancy other than breast cancer.
  9. Absolute neutrophil count <1.5 x 109 cells/L.
  10. Platelet count <100,000 x 109/L.
  11. Hemoglobin level <9 g/dL at Screening without transfusion (transfusion independent).
  12. Corrected QTcF >470 msec (single tracing) at Screening and prior to randomization.
  13. Chronic renal or hepatic disease.
  14. Clinically significant renal dysfunction including serum creatinine level >1.5 mg/dL or calculated creatinine clearance ≥50 mL/minute at Screening.
  15. 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.
  16. History of HIV, hepatitis B, hepatitis C, or tuberculosis.
  17. Major surgical procedures ≤30 days prior to starting study drug, or minor surgical procedures ≤7 days prior to starting study drug.
  18. History of alcohol or drug dependence or is known to have abused alcohol within 30 days prior to screening.
  19. Unwilling to abstain from alcohol and recreational drugs (with exception for medical marijuana) throughout the duration of participation in the study.
  20. Positive urine drug screen at Screening (with exception for medical marijuana which is allowed).
  21. Known hypersensitivity to celery or soybeans.
  22. Known serious hypersensitivity to paclitaxel
  23. 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
  24. 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

    First Posted
    November 20, 2020
    Last Updated
    June 7, 2023
    Sponsor
    Conjupro Biotherapeutics, Inc.
    Collaborators
    CSPC-NBP Pharmaceutical Co., Ltd.
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    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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