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Ph3 Study To Determine Safety,Tolerability&Tumor Response Of Oraxol Compared To Taxol In Metastatic Breast Cancer

Primary Purpose

Metastatic Breast Cancer

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Oraxol
IV paclitaxel
Sponsored by
Athenex, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed written informed consent
  2. Women ≥18 years of age
  3. Histologically- or cytologically-confirmed breast cancer for whom IV paclitaxel (as Taxol or generic) monotherapy has been recommended by their oncologist
  4. Measurable metastatic target lesion disease measurable by CT scan as per RECIST v1.1 criteria
  5. Adequate hematological status as demonstrated by not requiring granulocyte-colony stimulating factor (G-CSF) or transfusion support to achieve the following at Screening:

    • Absolute neutrophil count (ANC) ≥1.5 x 109/L
    • Platelet count ≥100 x 109/L
    • Hemoglobin ≥10 g/dL
  6. Adequate liver function as demonstrated by:

    • Total bilirubin within normal limits (WNL)
    • Alanine aminotransferase and aspartate aminotransferase ≤3 x upper limit of normal (ULN)
    • Alkaline phosphatase ≤3 x ULN or ≤5 x ULN if bone metastasis is present
    • Gamma glutamyl transferase (GGT) ≤5 x ULN
  7. Adequate renal function as demonstrated by serum creatinine ≤1.5 x ULN
  8. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  9. Life expectancy of at least 6 months, in the judgement of the investigator
  10. Subjects must be postmenopausal (≥12 months without menses) or surgically sterile (ie, by hysterectomy and/or bilateral oophorectomy) or must be using effective contraception and agree to used of contraception for 30 days after their last dose of assigned study treatment.
  11. Subjects who are of childbearing potential must have a negative screening serum pregnancy test.

Exclusion Criteria:

  1. Have not recovered to ≤ Grade 1 toxicity from previous anticancer treatments or previous investigational products
  2. If previously treated with a taxane (paclitaxel or docetaxel) as part of anthracycline-based adjuvant chemotherapy or for metastatic disease, the subject relapsed less than 1 year following treatment
  3. Only evidence of metastatic disease is to bone or other nontarget or nonmeasurable lesions (including, for example, ascites or plural effusion) according to RECIST v1.1 criteria
  4. Central nervous system metastasis, including leptomeningeal involvement
  5. Received IPs within 14 days or 5 half-lives of the first study dosing day, whichever is longer
  6. Are currently receiving other medications intended for the treatment of their malignancy
  7. Received radiation therapy within 2 weeks prior to signing informed consent and those for whom radiation therapy is planned within 6 months from the time of signing informed consent
  8. Women who are pregnant or breastfeeding
  9. Taking a medication known to be a strong P-gp inhibitor or inducer within 14 days of starting treatment
  10. Taking an oral medication with a narrow therapeutic index known to be a P-gp substrate within 24 hours prior to start of treatment
  11. Taking a medication known to be a strong cytochrome P450 (CYP) 3A4 inhibitor (eg, ketoconazole) or inducer (eg, rifampin or St. John's Wort) within 14 days of starting treatment
  12. Taking a medication known to be a strong inhibitor (eg, gemfibrozil) or inducer (eg, rifampin) of CYP2C8 within 14 days of starting treatment
  13. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, myocardial infarction within the last 6 months, unstable angina pectoris, cardiac arrhythmia, chronic pulmonary disease requiring oxygen, known bleeding disorders, or any concomitant illness or social situation that would limit compliance with study requirements
  14. Major surgery to the upper GI tract, or have a history of GI disease or other medical condition that, in the opinion of the Investigator may interfere with oral drug absorption
  15. History of significant hypersensitivity-type reactions to paclitaxel or Cremophor EL (polyoxyl 35 castor oil, NF) that would contraindicate the use of IV paclitaxel formulated with Cremophor EL
  16. Known allergic reaction or intolerance to contrast media
  17. Documented history of true systemic allergic reaction to 3 or more medications
  18. For whom the Investigator believes that participation in this study would not be acceptable
  19. Known chronic hepatitis or cirrhosis

Sites / Locations

  • Centro de Investigacion Pergamino SA
  • IONC
  • Clinica Universitaria Privada Reina Fabiola
  • Centro Oncologico Infinito
  • Fundación Koriza
  • Clinica Viedma
  • COIBA
  • CEMEDIC
  • Fundación Investigar
  • Fundación Centro Oncológico Riojano Integral (CORI)
  • Hospital Provincial del Centenario
  • Instituto de Oncologia de Rosario
  • Sanatorio Britanico
  • Centro Medico San Roque
  • CAIPO
  • Fundación Arturo López Pérez
  • Hospital de Referencia de Salud Cordillera Unidad de Patología Mamaria
  • Hospital San Borja Arriarán
  • IRAM
  • Clínica Alemana Temuco
  • Instituto Nacional de Cancerología E.S.E.
  • Fundación Colombiana de Cancerología Clinica Vida
  • Fundación Hospitalaria San Vicente de Paúl
  • Hemato Oncologos S.A.
  • Hospital Metropolitano de Santiago (HOMS)
  • Clinical Research
  • Hospital General de la Plaza de la Salud
  • Hospital SOLCA
  • Hospital Carlos Andrade Martín
  • Hospital SOLCA
  • Espemedic
  • Hospital Diagnotico Clinica Oncologica & Cancer Research
  • American Cancer Center
  • CELAN Clínica Médica
  • Clinica Privada
  • Clínica Privada
  • Grupo Angeles, S.A.
  • Oncomedica en Guatemala
  • CRESEM
  • Excel Medica
  • Tecnología en Investigación
  • Centro Hemato Oncológico Panamá
  • Clínica Oncológica Miraflores
  • Hospital Cayetano Heredia
  • Hospital Nacional del Arzobispo Loayza

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Oraxol (paclitaxel + HM30181AK-US)

IV paclitaxel

Arm Description

Oraxol paclitaxel - supplied as 30-mg capsules Oraxol HM30181 methansulfonate monohydrate - supplied as 15-mg HM30181AK-US tablets

IV paclitaxel - supplied as Taxol or generic

Outcomes

Primary Outcome Measures

Tumor response as determined by response criteria
Tumor response is evaluated using the response evaluation criteria in solid tumors (RECIST v1.1 criteria).
Safety and tolerability assessments of Oraxol compared with IV paclitaxel, as determined by laboratory, adverse event (AE) and serious adverse event (SAE) information
Safety assessments will consist of determining and recording all AEs and SAEs; laboratory evaluation of hematology, blood chemistry, and urine analyses; periodic measurement of vital signs and electrocardiograms (ECGs); and the performance of physical examinations, as detailed in the schedule of procedures and assessments of the protocol

Secondary Outcome Measures

Progression-free survival (PFS)
The endpoint of progression-free survival is defined as not having died or progression of disease. Lost to follow-up will be considered as censored.
Overall survival (OS)
The endpoint of overall survival is defined as death, confirmed alive, and lost to follow-up. Alive and lost to follow-up will be considered as censored.

Full Information

First Posted
October 28, 2015
Last Updated
August 2, 2022
Sponsor
Athenex, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02594371
Brief Title
Ph3 Study To Determine Safety,Tolerability&Tumor Response Of Oraxol Compared To Taxol In Metastatic Breast Cancer
Official Title
An Open-Label, Randomized, Multicenter, Phase 3 Study to Determine the Safety, Tolerability, and Tumor Response of Oraxol and Its Comparability to IV Taxol or Generic IV Paclitaxel in Subjects With Metastatic Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
December 2, 2015 (Actual)
Primary Completion Date
July 25, 2019 (Actual)
Study Completion Date
June 30, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Athenex, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To determine the safety and tolerability of Oraxol as compared to IV paclitaxel in metastatic breast cancer
Detailed Description
This is a Phase 3, open-label, randomized, multicenter study in approximately 360 adult female subjects with histologically- or cytologically-confirmed breast cancer that is metastatic for whom treatment with IV paclitaxel monotherapy has been recommended by their oncologist. Approximately 400 subjects will be enrolled to provide 360 evaluable subjects. The subjects must have measurable metastatic target lesion disease as per RECIST v1.1 criteria. Subjects will be randomized in a 2:1 ratio to either Oraxol or IV paclitaxel (as Taxol or generic).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Oraxol (paclitaxel + HM30181AK-US)
Arm Type
Experimental
Arm Description
Oraxol paclitaxel - supplied as 30-mg capsules Oraxol HM30181 methansulfonate monohydrate - supplied as 15-mg HM30181AK-US tablets
Arm Title
IV paclitaxel
Arm Type
Active Comparator
Arm Description
IV paclitaxel - supplied as Taxol or generic
Intervention Type
Drug
Intervention Name(s)
Oraxol
Other Intervention Name(s)
HM30181 methanesulfonate monohydrate, Oral paclitaxel capsules
Intervention Type
Drug
Intervention Name(s)
IV paclitaxel
Primary Outcome Measure Information:
Title
Tumor response as determined by response criteria
Description
Tumor response is evaluated using the response evaluation criteria in solid tumors (RECIST v1.1 criteria).
Time Frame
19 to 22 weeks
Title
Safety and tolerability assessments of Oraxol compared with IV paclitaxel, as determined by laboratory, adverse event (AE) and serious adverse event (SAE) information
Description
Safety assessments will consist of determining and recording all AEs and SAEs; laboratory evaluation of hematology, blood chemistry, and urine analyses; periodic measurement of vital signs and electrocardiograms (ECGs); and the performance of physical examinations, as detailed in the schedule of procedures and assessments of the protocol
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, up to ~48 months (expected end of study).]
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
The endpoint of progression-free survival is defined as not having died or progression of disease. Lost to follow-up will be considered as censored.
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, up to ~48 months (expected end of study).
Title
Overall survival (OS)
Description
The endpoint of overall survival is defined as death, confirmed alive, and lost to follow-up. Alive and lost to follow-up will be considered as censored.
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, up to ~48 months (expected end of study).

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed written informed consent Women ≥18 years of age Histologically- or cytologically-confirmed breast cancer for whom IV paclitaxel (as Taxol or generic) monotherapy has been recommended by their oncologist Measurable metastatic target lesion disease measurable by CT scan as per RECIST v1.1 criteria Adequate hematological status as demonstrated by not requiring granulocyte-colony stimulating factor (G-CSF) or transfusion support to achieve the following at Screening: Absolute neutrophil count (ANC) ≥1.5 x 109/L Platelet count ≥100 x 109/L Hemoglobin ≥10 g/dL Adequate liver function as demonstrated by: Total bilirubin within normal limits (WNL) Alanine aminotransferase and aspartate aminotransferase ≤3 x upper limit of normal (ULN) Alkaline phosphatase ≤3 x ULN or ≤5 x ULN if bone metastasis is present Gamma glutamyl transferase (GGT) ≤5 x ULN Adequate renal function as demonstrated by serum creatinine ≤1.5 x ULN Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Life expectancy of at least 6 months, in the judgement of the investigator Subjects must be postmenopausal (≥12 months without menses) or surgically sterile (ie, by hysterectomy and/or bilateral oophorectomy) or must be using effective contraception and agree to used of contraception for 30 days after their last dose of assigned study treatment. Subjects who are of childbearing potential must have a negative screening serum pregnancy test. Exclusion Criteria: Have not recovered to ≤ Grade 1 toxicity from previous anticancer treatments or previous investigational products If previously treated with a taxane (paclitaxel or docetaxel) as part of anthracycline-based adjuvant chemotherapy or for metastatic disease, the subject relapsed less than 1 year following treatment Only evidence of metastatic disease is to bone or other nontarget or nonmeasurable lesions (including, for example, ascites or plural effusion) according to RECIST v1.1 criteria Central nervous system metastasis, including leptomeningeal involvement Received IPs within 14 days or 5 half-lives of the first study dosing day, whichever is longer Are currently receiving other medications intended for the treatment of their malignancy Received radiation therapy within 2 weeks prior to signing informed consent and those for whom radiation therapy is planned within 6 months from the time of signing informed consent Women who are pregnant or breastfeeding Taking a medication known to be a strong P-gp inhibitor or inducer within 14 days of starting treatment Taking an oral medication with a narrow therapeutic index known to be a P-gp substrate within 24 hours prior to start of treatment Taking a medication known to be a strong cytochrome P450 (CYP) 3A4 inhibitor (eg, ketoconazole) or inducer (eg, rifampin or St. John's Wort) within 14 days of starting treatment Taking a medication known to be a strong inhibitor (eg, gemfibrozil) or inducer (eg, rifampin) of CYP2C8 within 14 days of starting treatment Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, myocardial infarction within the last 6 months, unstable angina pectoris, cardiac arrhythmia, chronic pulmonary disease requiring oxygen, known bleeding disorders, or any concomitant illness or social situation that would limit compliance with study requirements Major surgery to the upper GI tract, or have a history of GI disease or other medical condition that, in the opinion of the Investigator may interfere with oral drug absorption History of significant hypersensitivity-type reactions to paclitaxel or Cremophor EL (polyoxyl 35 castor oil, NF) that would contraindicate the use of IV paclitaxel formulated with Cremophor EL Known allergic reaction or intolerance to contrast media Documented history of true systemic allergic reaction to 3 or more medications For whom the Investigator believes that participation in this study would not be acceptable Known chronic hepatitis or cirrhosis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Cutler, MD
Organizational Affiliation
Kinex Pharmaceuticals Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Centro de Investigacion Pergamino SA
City
Pergamino
State/Province
Buenos Aires
Country
Argentina
Facility Name
IONC
City
Ciudad de Córdoba
State/Province
Cordoba
Country
Argentina
Facility Name
Clinica Universitaria Privada Reina Fabiola
City
Córdoba
State/Province
Cordoba
Country
Argentina
Facility Name
Centro Oncologico Infinito
City
Santa Rosa
State/Province
La Pampa
Country
Argentina
Facility Name
Fundación Koriza
City
Santa Rosa
State/Province
La Pampa
Country
Argentina
Facility Name
Clinica Viedma
City
Viedma
State/Province
Rio Negro
Country
Argentina
Facility Name
COIBA
City
Buenos Aires
Country
Argentina
Facility Name
CEMEDIC
City
Ciudad Autónoma de Buenos Aires
Country
Argentina
Facility Name
Fundación Investigar
City
Ciudad Autónoma de Buenos Aires
Country
Argentina
Facility Name
Fundación Centro Oncológico Riojano Integral (CORI)
City
La Rioja
Country
Argentina
Facility Name
Hospital Provincial del Centenario
City
Santa Fe
Country
Argentina
Facility Name
Instituto de Oncologia de Rosario
City
Santa Fe
Country
Argentina
Facility Name
Sanatorio Britanico
City
Santa Fe
Country
Argentina
Facility Name
Centro Medico San Roque
City
Tucuman
Country
Argentina
Facility Name
CAIPO
City
Tucumán
Country
Argentina
Facility Name
Fundación Arturo López Pérez
City
Santiago de Chile
Country
Chile
Facility Name
Hospital de Referencia de Salud Cordillera Unidad de Patología Mamaria
City
Santiago de Chile
Country
Chile
Facility Name
Hospital San Borja Arriarán
City
Santiago de Chile
Country
Chile
Facility Name
IRAM
City
Santiago de Chile
Country
Chile
Facility Name
Clínica Alemana Temuco
City
Temuco
Country
Chile
Facility Name
Instituto Nacional de Cancerología E.S.E.
City
Bogota
Country
Colombia
Facility Name
Fundación Colombiana de Cancerología Clinica Vida
City
Medellín
Country
Colombia
Facility Name
Fundación Hospitalaria San Vicente de Paúl
City
Medellín
Country
Colombia
Facility Name
Hemato Oncologos S.A.
City
Valle
Country
Colombia
Facility Name
Hospital Metropolitano de Santiago (HOMS)
City
Santiago de los Caballeros
Country
Dominican Republic
Facility Name
Clinical Research
City
Santo Domingo
Country
Dominican Republic
Facility Name
Hospital General de la Plaza de la Salud
City
Santo Domingo
Country
Dominican Republic
Facility Name
Hospital SOLCA
City
Guayaquil
Country
Ecuador
Facility Name
Hospital Carlos Andrade Martín
City
Quito
Country
Ecuador
Facility Name
Hospital SOLCA
City
Quito
Country
Ecuador
Facility Name
Espemedic
City
San Salvador
Country
El Salvador
Facility Name
Hospital Diagnotico Clinica Oncologica & Cancer Research
City
San Salvador
Country
El Salvador
Facility Name
American Cancer Center
City
Guatemala City
Country
Guatemala
Facility Name
CELAN Clínica Médica
City
Guatemala City
Country
Guatemala
Facility Name
Clinica Privada
City
Guatemala city
Country
Guatemala
Facility Name
Clínica Privada
City
Guatemala City
Country
Guatemala
Facility Name
Grupo Angeles, S.A.
City
Guatemala City
Country
Guatemala
Facility Name
Oncomedica en Guatemala
City
Guatemala City
Country
Guatemala
Facility Name
CRESEM
City
Quetzaltenango
Country
Guatemala
Facility Name
Excel Medica
City
Cortés
Country
Honduras
Facility Name
Tecnología en Investigación
City
Cortés
Country
Honduras
Facility Name
Centro Hemato Oncológico Panamá
City
Panama city
Country
Panama
Facility Name
Clínica Oncológica Miraflores
City
Lima
Country
Peru
Facility Name
Hospital Cayetano Heredia
City
Lima
Country
Peru
Facility Name
Hospital Nacional del Arzobispo Loayza
City
Lima
Country
Peru

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
35858154
Citation
Rugo HS, Umanzor GA, Barrios FJ, Vasallo RH, Chivalan MA, Bejarano S, Ramirez JR, Fein L, Kowalyszyn RD, Kramer ED, Wang H, Kwan MR, Cutler DL; Oraxol Study Consortium Investigators. Open-Label, Randomized, Multicenter, Phase III Study Comparing Oral Paclitaxel Plus Encequidar Versus Intravenous Paclitaxel in Patients With Metastatic Breast Cancer. J Clin Oncol. 2023 Jan 1;41(1):65-74. doi: 10.1200/JCO.21.02953. Epub 2022 Jul 20.
Results Reference
derived

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Ph3 Study To Determine Safety,Tolerability&Tumor Response Of Oraxol Compared To Taxol In Metastatic Breast Cancer

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