Capecitabine in Metastatic Breast and GI Cancers

NCT02595320 | Unknown Phase 2 DMC

• 1 other identifier: 2015-IIT-X7-7
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 15

Brief Summary

The purpose of this study is compare different doses of capecitabine to see if one is better than the other in terms of efficacy and toxicity.

Conditions

Breast Cancer; Gastrointestinal Cancer

Keywords

breast, gastrointestinal,capecitabine, cancer, metastatic

Outcome Measures

Primary Outcomes (1)

• Twelve-week Progression Free Survival (cohort 1 only)

  As the percentage of patients with progression from the date of registration to 12 weeks from that date

  12 weeks from the date of registration into the study

Secondary Outcomes (1)

• Grade 3 or higher toxicity (cohorts 1 and 2)

  From Day 1 of treatment, throughout treatment, up to 2 years from Day 1 of treatment

Other Outcomes (1)

• Objective response rate (cohorts 1 and 2)

  From Day 1 of treatment, throughout treatment, up to 2 years from Day 1 of treatment

Study Arms (2)

Group A

EXPERIMENTAL

capecitabine, 1500 mg, twice a day for 7 days on then 7 days off

Drug: Capecitabine

Group B

ACTIVE COMPARATOR

capecitabine, 1250 mg/m2 OR 1000 mg/m2, twice a day for 14 days on then 7 days off

Drug: Capecitabine

Interventions

Capecitabine DRUG

Capecitabine will be given to participants in Arm A at 1500 mg PO BID for 7 days, followed by a 7 day rest (7-7). Capecitabine will be given to participants in group B at 1250 mg/m2 OR 1000 mg/m2 PO BID for 14 days, followed by a 7 day rest (14-7).

Also known as: Xeloda®

Group A; Group B

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Women with metastatic breast cancer OR men and women with metastatic gastrointestinal (GI) cancer
• There is no limit to the number of prior chemotherapy or endocrine therapy regimens received. Use of a previous fluoropyrimidine-containing regimen in advanced / metastatic setting is permitted as long as the subject discontinued the regimen for reasons other than progression.
• No restriction on the use of fluoropyrimidine-containing regimen in the neoadjuvant or adjuvant setting
• For metastatic colorectal cancers, patients starting maintenance capecitabine after a course of oxaliplatin or irinotecan based chemotherapy are eligible.
• Measurable or non-measurable disease per RECIST criteria 1.1
• Must have completed prior chemotherapy or radiation therapy at least 2 weeks prior to registration
• Pathologic confirmation of respective malignancies. Biopsy of metastatic disease is preferred but not mandatory.
• Performance Status: Eastern Cooperative Oncology Group (ECOG) Performance Score (PS) 0-2
• Adequate organ and marrow function as defined below:
• Absolute neutrophil count ≥ 1,000/ microLiter (uL)
• hemoglobin ≥ 7 g/L
• platelets ≥ 50,000/uL
• total bilirubin ≤ 2 X the Institutional Upper Limit of Normal (IULN)
• o Aspartate Aminotransferase (AST) ( Serum Glutamic Oxaloacetic Transaminase \[SGOT\]) ≤ 5 X IULN
• Alanine Aminotransferase (ALT) (Serum Pyruvic Glutamic Transaminase \[SPGT\]) ≤ 5 X IULN

You may not qualify if:

• Patient has used Capecitabine in a past regimen for metastatic disease.
• Patient is currently using, or planning to use another investigational agent.
• Patient with known Dihydropyrimidine Dehydrogenase (DPD) deficiency
• Patient has symptomatic brain or CNS metastases.
• Patient has leptomeningeal disease
• Patient is pregnant or nursing
• Subjects must have no barriers to taking oral medications, for example uncontrolled nausea, vomiting, diarrhea at baseline, lack of physical integrity of the upper gastrointestinal tract, or malabsorption syndrome.
• No recent (≤ 3months) of partial or complete bowel obstruction unless surgically corrected.

Sponsors & Collaborators

• Qamar Khan: lead

Study Sites (15)

University of Kansas Cancer Center - CRC

Fairway, Kansas, 66205, United States

Location

St. Catherine Hospital - Central Care Cancer Center

Garden City, Kansas, 67846, United States

Location

Heartland Cancer Center - Central Care Cancer Center

Great Bend, Kansas, 67530, United States

Location

Hays Medical Center Dreiling-Schmidt Cancer Institute

Hays, Kansas, 67601, United States

Location

University of Kansas Cancer Center - West

Kansas City, Kansas, 66112, United States

Location

Olathe Medical Center

Olathe, Kansas, 66061, United States

Location

University of Kansas Cancer Center - Overland Park

Overland Park, Kansas, 66210, United States

Location

Via Christi Cancer Center

Pittsburg, Kansas, 66762, United States

Location

Salina Regional Health

Salina, Kansas, 67401, United States

Location

St. Francis Comprehensive Cancer Center

Topeka, Kansas, 66606, United States

Location

University of Kansas Cancer Center - Westwood

Westwood, Kansas, 66205, United States

Location

Truman Medical Center

Kansas City, Missouri, 64108, United States

Location

University of Kansas Cancer Center - South

Kansas City, Missouri, 64131, United States

Location

University of Kansas Cancer Center - North

Kansas City, Missouri, 64154, United States

Location

University of Kansas Cancer Center - Lee's Summit

Lee's Summit, Missouri, 64064, United States

Location

Related Publications (32)

• Chia SK, Speers CH, D'yachkova Y, Kang A, Malfair-Taylor S, Barnett J, Coldman A, Gelmon KA, O'reilly SE, Olivotto IA. The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer. 2007 Sep 1;110(5):973-9. doi: 10.1002/cncr.22867.

  PMID: 17647245 BACKGROUND

• Liu G, Franssen E, Fitch MI, Warner E. Patient preferences for oral versus intravenous palliative chemotherapy. J Clin Oncol. 1997 Jan;15(1):110-5. doi: 10.1200/JCO.1997.15.1.110.

  PMID: 8996131 BACKGROUND

• Hofheinz RD, Wenz F, Post S, Matzdorff A, Laechelt S, Hartmann JT, Muller L, Link H, Moehler M, Kettner E, Fritz E, Hieber U, Lindemann HW, Grunewald M, Kremers S, Constantin C, Hipp M, Hartung G, Gencer D, Kienle P, Burkholder I, Hochhaus A. Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol. 2012 Jun;13(6):579-88. doi: 10.1016/S1470-2045(12)70116-X. Epub 2012 Apr 13.

  PMID: 22503032 BACKGROUND

• Kopf B, De Giorgi U, Zago S, Carminati O, Rosti G, Marangolo M. Innovative therapy for patients with brain metastases: oral treatments. J Chemother. 2004 Nov;16 Suppl 5:94-7. doi: 10.1080/1120009x.2004.11782396.

  PMID: 15675490 BACKGROUND

• Fumoleau P, Largillier R, Clippe C, Dieras V, Orfeuvre H, Lesimple T, Culine S, Audhuy B, Serin D, Cure H, Vuillemin E, Morere JF, Montestruc F, Mouri Z, Namer M. Multicentre, phase II study evaluating capecitabine monotherapy in patients with anthracycline- and taxane-pretreated metastatic breast cancer. Eur J Cancer. 2004 Mar;40(4):536-42. doi: 10.1016/j.ejca.2003.11.007.

  PMID: 14962720 BACKGROUND

• Oshaughnessy JA, Blum J, Moiseyenko V, Jones SE, Miles D, Bell D, Rosso R, Mauriac L, Osterwalder B, Burger HU, Laws S. Randomized, open-label, phase II trial of oral capecitabine (Xeloda) vs. a reference arm of intravenous CMF (cyclophosphamide, methotrexate and 5-fluorouracil) as first-line therapy for advanced/metastatic breast cancer. Ann Oncol. 2001 Sep;12(9):1247-54. doi: 10.1023/a:1012281104865.

  PMID: 11697835 BACKGROUND

• Blum JL, Dieras V, Lo Russo PM, Horton J, Rutman O, Buzdar A, Osterwalder B. Multicenter, Phase II study of capecitabine in taxane-pretreated metastatic breast carcinoma patients. Cancer. 2001 Oct 1;92(7):1759-68. doi: 10.1002/1097-0142(20011001)92:73.0.co;2-a.

  PMID: 11745247 BACKGROUND

• Blum JL, Jones SE, Buzdar AU, LoRusso PM, Kuter I, Vogel C, Osterwalder B, Burger HU, Brown CS, Griffin T. Multicenter phase II study of capecitabine in paclitaxel-refractory metastatic breast cancer. J Clin Oncol. 1999 Feb;17(2):485-93. doi: 10.1200/JCO.1999.17.2.485.

  PMID: 10080589 BACKGROUND

• Mackean M, Planting A, Twelves C, Schellens J, Allman D, Osterwalder B, Reigner B, Griffin T, Kaye S, Verweij J. Phase I and pharmacologic study of intermittent twice-daily oral therapy with capecitabine in patients with advanced and/or metastatic cancer. J Clin Oncol. 1998 Sep;16(9):2977-85. doi: 10.1200/JCO.1998.16.9.2977.

  PMID: 9738566 BACKGROUND

• Leonard R, O'Shaughnessy J, Vukelja S, Gorbounova V, Chan-Navarro CA, Maraninchi D, Barak-Wigler N, McKendrick JJ, Harker WG, Bexon AS, Twelves C. Detailed analysis of a randomized phase III trial: can the tolerability of capecitabine plus docetaxel be improved without compromising its survival advantage? Ann Oncol. 2006 Sep;17(9):1379-85. doi: 10.1093/annonc/mdl134.

  PMID: 16966367 BACKGROUND

• Norton L. Conceptual and practical implications of breast tissue geometry: toward a more effective, less toxic therapy. Oncologist. 2005 Jun-Jul;10(6):370-81. doi: 10.1634/theoncologist.10-6-370.

  PMID: 15967831 BACKGROUND

• Traina TA, Dugan U, Higgins B, Kolinsky K, Theodoulou M, Hudis CA, Norton L. Optimizing chemotherapy dose and schedule by Norton-Simon mathematical modeling. Breast Dis. 2010;31(1):7-18. doi: 10.3233/BD-2009-0290.

  PMID: 20519801 BACKGROUND

• Traina TA, Theodoulou M, Feigin K, Patil S, Tan KL, Edwards C, Dugan U, Norton L, Hudis C. Phase I study of a novel capecitabine schedule based on the Norton-Simon mathematical model in patients with metastatic breast cancer. J Clin Oncol. 2008 Apr 10;26(11):1797-802. doi: 10.1200/JCO.2007.13.8388.

  PMID: 18398145 BACKGROUND

• Gajria D, Feigin K, Tan LK, Patil S, Geneus S, Theodoulou M, Norton L, Hudis CA, Traina TA. Phase 2 trial of a novel capecitabine dosing schedule in combination with bevacizumab for patients with metastatic breast cancer. Cancer. 2011 Sep 15;117(18):4125-31. doi: 10.1002/cncr.25992. Epub 2011 Mar 8.

  PMID: 21387266 BACKGROUND

• Ou SH, Holcombe RF. Capecitabine in advanced gastric or oesophagogastric cancer: a viewpoint by Sai-Hong Ignatius Ou and Randall F. Holcombe. Drugs. 2007;67(4):611-2. doi: 10.2165/00003495-200767040-00011. No abstract available.

  PMID: 17352521 BACKGROUND

• Evans TR, Pentheroudakis G, Paul J, McInnes A, Blackie R, Raby N, Morrison R, Fullarton GM, Soukop M, McDonald AC. A phase I and pharmacokinetic study of capecitabine in combination with epirubicin and cisplatin in patients with inoperable oesophago-gastric adenocarcinoma. Ann Oncol. 2002 Sep;13(9):1469-78. doi: 10.1093/annonc/mdf243.

  PMID: 12196374 BACKGROUND

• Hong YS, Song SY, Lee SI, Chung HC, Choi SH, Noh SH, Park JN, Han JY, Kang JH, Lee KS, Cho JY. A phase II trial of capecitabine in previously untreated patients with advanced and/or metastatic gastric cancer. Ann Oncol. 2004 Sep;15(9):1344-7. doi: 10.1093/annonc/mdh343.

  PMID: 15319239 BACKGROUND

• Koizumi W, Saigenji K, Ujiie S, Terashima M, Sakata Y, Taguchi T; Clinical Study Group of Capecitabine. A pilot phase II study of capecitabine in advanced or recurrent gastric cancer. Oncology. 2003;64(3):232-6. doi: 10.1159/000069313.

  PMID: 12697963 BACKGROUND

• Lee JL, Kang YK, Kang HJ, Lee KH, Zang DY, Ryoo BY, Kim JG, Park SR, Kang WK, Shin DB, Ryu MH, Chang HM, Kim TW, Baek JH, Min YJ. A randomised multicentre phase II trial of capecitabine vs S-1 as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer. Br J Cancer. 2008 Aug 19;99(4):584-90. doi: 10.1038/sj.bjc.6604536. Epub 2008 Jul 29.

  PMID: 18665164 BACKGROUND

• Qiu MZ, Wei XL, Zhang DS, Jin Y, Zhou YX, Wang DS, Ren C, Bai L, Luo HY, Wang ZQ, Wang FH, Li YH, Yang DJ, Xu RH. Efficacy and safety of capecitabine as maintenance treatment after first-line chemotherapy using oxaliplatin and capecitabine in advanced gastric adenocarcinoma patients: a prospective observation. Tumour Biol. 2014 May;35(5):4369-75. doi: 10.1007/s13277-013-1574-5. Epub 2014 Feb 11.

  PMID: 24515655 BACKGROUND

• Ajani J. Review of capecitabine as oral treatment of gastric, gastroesophageal, and esophageal cancers. Cancer. 2006 Jul 15;107(2):221-31. doi: 10.1002/cncr.21986.

  PMID: 16770784 BACKGROUND

• Cartwright TH, Cohn A, Varkey JA, Chen YM, Szatrowski TP, Cox JV, Schulz JJ. Phase II study of oral capecitabine in patients with advanced or metastatic pancreatic cancer. J Clin Oncol. 2002 Jan 1;20(1):160-4. doi: 10.1200/JCO.2002.20.1.160.

  PMID: 11773165 BACKGROUND

• Boeck S, Wilkowski R, Bruns CJ, Issels RD, Schulz C, Moosmann N, Laessig D, Haas M, Golf A, Heinemann V. Oral capecitabine in gemcitabine-pretreated patients with advanced pancreatic cancer. Oncology. 2007;73(3-4):221-7. doi: 10.1159/000127413. Epub 2008 Apr 17.

  PMID: 18424886 BACKGROUND

• Saadati H, Saif MW. Capecitabine as salvage therapy for a pancreatic cancer patient with extensive liver metastases and associated impairment of liver function. JOP. 2008 May 8;9(3):354-6. No abstract available.

  PMID: 18469454 BACKGROUND

• Patt YZ, Hassan MM, Aguayo A, Nooka AK, Lozano RD, Curley SA, Vauthey JN, Ellis LM, Schnirer II, Wolff RA, Charnsangavej C, Brown TD. Oral capecitabine for the treatment of hepatocellular carcinoma, cholangiocarcinoma, and gallbladder carcinoma. Cancer. 2004 Aug 1;101(3):578-86. doi: 10.1002/cncr.20368.

  PMID: 15274071 BACKGROUND

• Hoff PM, Ansari R, Batist G, Cox J, Kocha W, Kuperminc M, Maroun J, Walde D, Weaver C, Harrison E, Burger HU, Osterwalder B, Wong AO, Wong R. Comparison of oral capecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase III study. J Clin Oncol. 2001 Apr 15;19(8):2282-92. doi: 10.1200/JCO.2001.19.8.2282.

  PMID: 11304782 BACKGROUND

• Van Cutsem E, Twelves C, Cassidy J, Allman D, Bajetta E, Boyer M, Bugat R, Findlay M, Frings S, Jahn M, McKendrick J, Osterwalder B, Perez-Manga G, Rosso R, Rougier P, Schmiegel WH, Seitz JF, Thompson P, Vieitez JM, Weitzel C, Harper P; Xeloda Colorectal Cancer Study Group. Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase III study. J Clin Oncol. 2001 Nov 1;19(21):4097-106. doi: 10.1200/JCO.2001.19.21.4097.

  PMID: 11689577 BACKGROUND

• Twelves CJ. Xeloda in Adjuvant Colon Cancer Therapy (X-ACT) trial: overview of efficacy, safety, and cost-effectiveness. Clin Colorectal Cancer. 2006 Nov;6(4):278-87. doi: 10.3816/CCC.2006.n.046.

  PMID: 17241512 BACKGROUND

• Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, Cassidy J, Cervantes A, Fagerberg J, Georgoulias V, Husseini F, Jodrell D, Koralewski P, Kroning H, Maroun J, Marschner N, McKendrick J, Pawlicki M, Rosso R, Schuller J, Seitz JF, Stabuc B, Tujakowski J, Van Hazel G, Zaluski J, Scheithauer W. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005 Jun 30;352(26):2696-704. doi: 10.1056/NEJMoa043116.

  PMID: 15987918 BACKGROUND

• Stockler M, S.T., Grimison P, et al, A randomized trial of capecitabine (C) given intermittently (IC) rather than continuously (CC) compared to classical CMF as first-line chemotherapy for advanced breast cancer (ABC). J Clin Oncol, 2007. 25(18S; June 20 suppl). Abstract 1031.

  BACKGROUND

• Soto C, T.L., Reyes S, et al., Capecitabine (X) and taxanes in patients (pts) with anthracycline-pretreated metastatic breast cancer (MBC): sequential vs. combined therapy results from a MOSG randomized phase III trial. J Clin Oncol., 2006. 24(18S; June 20 suppl). Abstract 570.

  BACKGROUND

• O'shaughnessy J, B.J., A retrospective evaluation of the impact of dose reduction in patients treated with Xeloda (capecitabine). Proc Am Soc Clin Oncol, 2000. 19: 104a. Abstract 400.

  BACKGROUND

MeSH Terms

Conditions

Breast Neoplasms; Gastrointestinal Neoplasms; Neoplasms; Neoplasm Metastasis

Interventions

Capecitabine

Condition Hierarchy (Ancestors)

Neoplasms by Site; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Neoplastic Processes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Deoxycytidine; Cytidine; Pyrimidine Nucleosides; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Fluorouracil; Uracil; Pyrimidinones; Deoxyribonucleosides; Nucleosides; Nucleic Acids, Nucleotides, and Nucleosides

Study Officials

• Qamar Khan, MD

  University of Kansas Cancer Center - CRC

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: October 2, 2015
• First Posted: November 3, 2015
• Study Start: October 5, 2015
• Primary Completion: December 1, 2022
• Study Completion: December 1, 2023
• Last Updated: December 20, 2021

Record last verified: 2021-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (15)