Study of Apatinib in Metastatic Triple-Negative Breast Cancer Patients
Primary Purpose
Metastatic Breast Cancer
Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Apatinib
Sponsored by
About this trial
This is an interventional treatment trial for Metastatic Breast Cancer focused on measuring Apatinib, Triple-Negative Breast Cancer, Metastatic Breast Cancer, ER/PR Negative, Her2/Neu Negative
Eligibility Criteria
Inclusion Criteria:
- ≥ 18 and ≤ 70 years of age.
- ECOG performance status of 0-1.
- Women diagnosed with triple negative breast cancer (breast cancer is estrogen receptor negative (ER-), progesterone receptor negative (PgR-) and human epidermal growth factor receptor negative (HER2-). HER2- is defined as 0 or 1+ staining on immunohistochemistry or FISH/CISH negative for gene amplification.
- Metastatic breast cancer, confirmed by histological analysis.
- Have failed for at least one chemotherapy regimen, but at most three regimens(including adjuvant and neo-adjuvant setting).
- Duration from the last therapy (chemotherapy, radiotherapy, target therapy and operation) is more than 4 weeks (Duration for nitroso or mitomycin is 6 weeks).
- Have at least one extracranial measurable site of disease according to RECIST 1.1 criteria that has not been previously irradiated. If the patient has had previous radiation to the marker lesion(s), there must be evidence of disease progression since the radiation.
- Life expectancy of more than 3 months.
- If the patients have brain or meninges metastases, the lesions must have been controlled at least 8 weeks.
- Adequate hepatic, renal, heart, and hematologic functions (hemoglobin ≥ 9.0g/dl, neutrophils ≥ 1.5×10^9/L, platelets ≥ 80×10^9/L , ALT ≤ 2.5 x upper limit of normal (ULN), AST ≤ 2.5 x ULN, serum bilirubin ≤ 1.5 x ULN, serum creatine ≤ 1.5 x ULN, creatinine clearance rate ≥ 50ml/min, PT, APTT, TT, Fbg normal).
- Written informed consent prior to study specific screening procedures, with the understanding that the patient has the right to withdraw from the study at any time without prejudice.
Exclusion Criteria:
- Pregnant or lactating women.
- Less than 4 weeks from the last clinical trial.
- Have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as: Congestive heart failure: New York Heart Association Class III/IV, Unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction within 6 months of start of study drug, serious uncontrolled cardiac arrhythmia or any other clinically significant cardiac disease.
- Any factors that influence the usage of oral administration.
- Receiving the therapy of thrombolysis or anticoagulation.
- Unhealed wound or bone fracture.
- Urine protein ≥++ and confirmed >1.0 g by the 24h quantity.
- Previous or present history of pulmonary fibrosis,interstitial pneumonia,pneumoconiosis,radiation pneumonitis,drug-related pneumonitis or greatly-impaired pulmonary function.
- Disability of serious uncontrolled intercurrence infection.
- Abuse of alcohol or drugs.
- Have received prior treatment with a VEGFR, PDGFR or s-SRC TKI (Bevacizumab is permitted).
- History of other malignancies except cured basal cell carcinoma of skin and carcinoma in-situ of uterine cervix.
Sites / Locations
- Fudan University Cancer Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Apatinib
Arm Description
Outcomes
Primary Outcome Measures
DCR(Disease control rate) for IIa
PFS(Progression free survival) for IIb
Secondary Outcome Measures
PFS(Progression free survival) for IIa
OS (Overall survival)
ORR (Objective response rate)
Number of Participants with Adverse Events as a Measure of Safety and Tolerability
QoL (Quality of life)
DCR(Disease control rate) for IIb
Full Information
NCT ID
NCT01176669
First Posted
July 20, 2010
Last Updated
September 8, 2015
Sponsor
Fudan University
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT01176669
Brief Title
Study of Apatinib in Metastatic Triple-Negative Breast Cancer Patients
Official Title
A Single-Institutional Phase IIa Trial and A Multi-Institutional Phase IIb Trial of Apatinib in Metastatic Triple-Negative Breast Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
September 2015
Overall Recruitment Status
Completed
Study Start Date
June 2010 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
September 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fudan University
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The hypothesis of this clinical research study is to discover if the study drug apatinib can shrink or slow the growth of pretreated metastatic triple-negative breast cancer.
Detailed Description
Apatinib is a tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor (VEGFR), and its anti-angiogenesis effect has been viewed in preclinical tests. The investigators' phase I study has shown that the drug's toxicity is manageable and the maximum tolerable daily dose is 850 mg. The hypothesis of this clinical research study is to discover if the study drug apatinib can shrink or slow the growth of triple-negative breast cancer. The safety of apatinib will also be studied. Patients physical state, symptoms, changes in the size of the tumor, and laboratory findings obtained while on-study will help the research team decide if apatinib is safe and effective in pretreated metastatic triple-negative breast cancer patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer
Keywords
Apatinib, Triple-Negative Breast Cancer, Metastatic Breast Cancer, ER/PR Negative, Her2/Neu Negative
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Apatinib
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Apatinib
Other Intervention Name(s)
Target therapy
Intervention Description
Apatinib was administratered at 750 mg/d in Phase IIa. The actual average dose intensity delivered was 525 mg/d due to toxicities. So, in Phase IIb, the starting dose of apatinib will be 500mg/d. Two dose reductions will be allowed to 375 and then 250 mg/d.
Primary Outcome Measure Information:
Title
DCR(Disease control rate) for IIa
Time Frame
8 Weeks
Title
PFS(Progression free survival) for IIb
Time Frame
8 Weeks
Secondary Outcome Measure Information:
Title
PFS(Progression free survival) for IIa
Time Frame
8 Weeks
Title
OS (Overall survival)
Time Frame
8 Weeks
Title
ORR (Objective response rate)
Time Frame
8 Weeks
Title
Number of Participants with Adverse Events as a Measure of Safety and Tolerability
Time Frame
8 weeks
Title
QoL (Quality of life)
Time Frame
8 Weeks
Title
DCR(Disease control rate) for IIb
Time Frame
8 Weeks
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
≥ 18 and ≤ 70 years of age.
ECOG performance status of 0-1.
Women diagnosed with triple negative breast cancer (breast cancer is estrogen receptor negative (ER-), progesterone receptor negative (PgR-) and human epidermal growth factor receptor negative (HER2-). HER2- is defined as 0 or 1+ staining on immunohistochemistry or FISH/CISH negative for gene amplification.
Metastatic breast cancer, confirmed by histological analysis.
Have failed for at least one chemotherapy regimen, but at most three regimens(including adjuvant and neo-adjuvant setting).
Duration from the last therapy (chemotherapy, radiotherapy, target therapy and operation) is more than 4 weeks (Duration for nitroso or mitomycin is 6 weeks).
Have at least one extracranial measurable site of disease according to RECIST 1.1 criteria that has not been previously irradiated. If the patient has had previous radiation to the marker lesion(s), there must be evidence of disease progression since the radiation.
Life expectancy of more than 3 months.
If the patients have brain or meninges metastases, the lesions must have been controlled at least 8 weeks.
Adequate hepatic, renal, heart, and hematologic functions (hemoglobin ≥ 9.0g/dl, neutrophils ≥ 1.5×10^9/L, platelets ≥ 80×10^9/L , ALT ≤ 2.5 x upper limit of normal (ULN), AST ≤ 2.5 x ULN, serum bilirubin ≤ 1.5 x ULN, serum creatine ≤ 1.5 x ULN, creatinine clearance rate ≥ 50ml/min, PT, APTT, TT, Fbg normal).
Written informed consent prior to study specific screening procedures, with the understanding that the patient has the right to withdraw from the study at any time without prejudice.
Exclusion Criteria:
Pregnant or lactating women.
Less than 4 weeks from the last clinical trial.
Have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as: Congestive heart failure: New York Heart Association Class III/IV, Unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction within 6 months of start of study drug, serious uncontrolled cardiac arrhythmia or any other clinically significant cardiac disease.
Any factors that influence the usage of oral administration.
Receiving the therapy of thrombolysis or anticoagulation.
Unhealed wound or bone fracture.
Urine protein ≥++ and confirmed >1.0 g by the 24h quantity.
Previous or present history of pulmonary fibrosis,interstitial pneumonia,pneumoconiosis,radiation pneumonitis,drug-related pneumonitis or greatly-impaired pulmonary function.
Disability of serious uncontrolled intercurrence infection.
Abuse of alcohol or drugs.
Have received prior treatment with a VEGFR, PDGFR or s-SRC TKI (Bevacizumab is permitted).
History of other malignancies except cured basal cell carcinoma of skin and carcinoma in-situ of uterine cervix.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xichun Hu, Doctorship
Organizational Affiliation
Fudan University
Official's Role
Study Chair
Facility Information:
Facility Name
Fudan University Cancer Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
12. IPD Sharing Statement
Citations:
PubMed Identifier
24292957
Citation
Fan M, Zhang J, Wang Z, Wang B, Zhang Q, Zheng C, Li T, Ni C, Wu Z, Shao Z, Hu X. Phosphorylated VEGFR2 and hypertension: potential biomarkers to indicate VEGF-dependency of advanced breast cancer in anti-angiogenic therapy. Breast Cancer Res Treat. 2014 Jan;143(1):141-51. doi: 10.1007/s10549-013-2793-6. Epub 2013 Dec 1.
Results Reference
derived
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Study of Apatinib in Metastatic Triple-Negative Breast Cancer Patients
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