Interest of Intrathecal Chemotherapy With Liposomal Cytarabine (DepoCyte®) in Meningeal Metastasis of Breast Cancer
DEPOSEIN
Role of Intrathecal Chemotherapy With Liposomal Cytarabine (DepoCyte®) in Patients Wih Leptomeningeal Metastasis of Breast Cancer. A Randomized Phase III Study.
The purpose of this study is to evaluate the impact of Depocyte® IT combined with the systemic standard treatment in terms of clinical and/or radiological neuromeningeal progression free survival (SSPN)
Registry Overview
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
Recruitment status
completed
Actual enrollment (reported)
74 participants
Study completion date
March 1, 2019
Actual (reported)
Listed locations
1 countries · 10 sites
Trial Relationships
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Some registry-reported names shown below are not yet linked in this graph.
Related Scientific Literature
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Study Timeline
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
time between randomization and date of first leptomeningeal progression (defined according to clinical-neurological or imaging criteria) or date of death (death from any cause) whatever occurs first. Patients alive without neurological progression at the time of the last follow-up will be censored at the date of the last visit.
At baseline, then every 2 weeks for 2 months, after 2 months from baseline once a month until progression (up to 6 months) and at the end of the study (up to 6 months)
Secondary Outcomes (5)
Response of leptomeningeal metastases
At baseline, then every 2 weeks for 2 months, after 2 months from baseline once a month until progression (up to 6 months) and at the end of the study (up to 6 months)
Progression free survival (PFS)
At baseline, then every 2 weeks for 2 months, after 2 months from baseline once a month until progression (up to 6 months) and at the end of the study (up to 6 months)
Overall survival
Until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 6 months.
Tolerance to DepoCyte® according to NCI CTCAE V4.0
Up to 30 days after the last administration of the study treatment
Q-TWiST
Calculated at the end of study
Other Outcomes (5)
Quality of life (questionnaire QLQ C30, BN20 and C15)
At baseline, then every 2 weeks for 2 months, after 2 months from baseline once a month until progression (up to 6 months) and at the end of the study (up to 6 months)
Autonomy in daily life (questionnaire Instrumental Activities in Daily Living)
At baseline, then every 2 weeks for 2 months, after 2 months from baseline once a month until progression (up to 6 months) and at the end of the study (up to 6 months)
Emotional state of the patient assessed by the psychological distress score
At baseline
+2 more other outcomes
Study Arms (2)
Systemic treatment with Depocyte
EXPERIMENTAL
Intrathecal injection of Liposomal Cytarabine (Depocyte®) every 14 ± 2 days for a total of 5 cycles and then every 28 ± 4 days until progression.
Drug: Liposomal Cytarabine
Systemic treatment without Depocyte
NO INTERVENTION
No intrathecal injection.
Interventions
Liposomal CytarabineDrug
50mg (5 mL) by slow intrathecal injection (1-5 minutes) directly into the cerebrospinal fluid (CSF) via a ventricular catheter directly into the lumbar sac during a lumbar puncture.
Also known as: Depocyte, Aracytine
Systemic treatment with Depocyte
Registry-reported names are shown in full. Names without a link have not yet been matched to a Syfrah profile.
Registry intervention entries
These entries preserve how the registry describes the intervention. Their treatment roles are shown separately from molecular identities.
Formulated product
Liposomal Cytarabine
The registry describes a specific formulation. Its exact chemical ingredients and approval status require separate evidence.
New diagnosis of leptomeningeal metastasis confirmed by CSF cytology, or by the combination of typical clinical symptoms or signs with typical MRI abnormalities
Le Rhun E, Wallet J, Mailliez A, Le Deley MC, Rodrigues I, Boulanger T, Lorgis V, Barriere J, Robin YM, Weller M, Bonneterre J. Intrathecal liposomal cytarabine plus systemic therapy versus systemic chemotherapy alone for newly diagnosed leptomeningeal metastasis from breast cancer. Neuro Oncol. 2020 Apr 15;22(4):524-538. doi: 10.1093/neuonc/noz201.
Neoplasms by SiteNeoplasmsBreast DiseasesSkin DiseasesSkin and Connective Tissue DiseasesMeningeal NeoplasmsCentral Nervous System NeoplasmsNervous System NeoplasmsNervous System Diseases
Intervention Hierarchy (Ancestors)
Cytidine
Study Officials
Emilie LERHUN, MD
Centre Oscar Lambret
PRINCIPAL INVESTIGATOR
Enrollment
74 participants (actual enrollment reported by the registry).
Cerebrospinal MRI criteria: no visible lesion, or meningeal metastases \<0.5 cm, or \>0.5 cm largest diameter if focal radiotherapy planned
Indication for systemic treatment (chemotherapy and/or targeted therapy and/or hormonal therapy) at the time of enrollment. Systemic treatment is at the discretion of the investigator (in collaboration with the treating oncologist if different) according to cancer characteristics, previous treatments, and clinical and biological disease characteristics. Focal radiotherapy is permitted.
Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
Patients unable to walk due to a palsy but able to use a wheelchair are considered as ambulatory patients
Expected survival of at least 2 months. Patients with rapidly progressive systemic disease are not eligible for this trial
Co-existing asymptomatic brain metastases are permitted
In case of suspicion of CSF flow block, or after focal radiotherapy for the treatment of a CSF flow block, a CSF flow study will be performed (isotopic method) to confirm the absence of CSF block
Patients must have recovered from acute adverse events of other anticancer treatments previously administered
Adequate bone marrow, renal, and hepatic function with the following range: bilirubin ≤ 3 x upper limit of normal (ULN), ASAT ≤ 2.5 x ULN or ≤ 5 x ULN in presence of liver metastases
Adequate contraception (CPMP/ICH/286/95) for patients of reproductive potential (e.g., barrier method, vasectomy of partner, abstinence) (hormonal contraception not permitted)
Patient affiliated to the French Social Security
Able to understand the requirements of the study, date and sign written informed consent
You may not qualify if:
Leptomeningeal metastasis related to other primary tumors than breast cancer
History of other cancer (\<5 years) except adequately treated cervical cancer, or basocellular or spinocellular skin cancer
Contra-indication to MRI (including claustrophobia)
MRI criteria: CSF flow obstruction (hydrocephalus on brain MRI or obstacle on spinal MRI)
Contra-indication to lumbar puncture and to implantation of a ventricular device
Progressive brain metastases thought to require whole brain radiotherapy
Prior cranio-spinal irradiation (prior brain focal radiotherapy or whole brain radiotherapy for brain metastases permitted)
Prior intrathecal chemotherapy or targeted therapy
Prior systemic cytarabine treatment or prior systemic high-dose methotrexate treatment
Patient presenting with other severe non-controlled disease which could compromise the participation in the study (infection, cardio-vascular disease, gastro-intestinal disease, renal disease, pulmonary disease)
Enrollment into another study evaluating a drug within 30 days before the screening visit
+2 more criteria
Contact the study team to confirm eligibility.
Centre Hospitalier Universitaire de Nice
Nice, 06002, France
Centre Antoine Lacassagne
Nice, 06189, France
Hôpital Salpétrière
Paris, 75013, France
Pyrimidine Nucleosides
Pyrimidines
Heterocyclic Compounds, 1-Ring
Heterocyclic Compounds
Arabinonucleosides
Nucleosides
Nucleic Acids, Nucleotides, and Nucleosides
August 2018
Actual (reported)
Study Completion
March 1, 2019
Actual (reported)
Last Updated
June 12, 2019
Record last verified: 2019-06
Data Sharing
IPD Sharing
Will not share
Source record
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Source: ClinicalTrials.gov.
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