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    Clinical Trial Results:
    Multicentric, open-label, phase II clinical trial with pegylated liposomal doxorubicin (Caelyx®) as primary treatment in patients with breast cancer and a history of heart disease or over 65 years (CAPRICE).

    Summary
    EudraCT number
    2007-001428-11
    Trial protocol
    ES  
    Global end of trial date
    27 Apr 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    25 May 2022
    First version publication date
    25 May 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    50SOLTI-0702
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00563953
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    SOLTI
    Sponsor organisation address
    C/ Balmes 89 3-7, Barcelona, Spain, 08008
    Public contact
    INVESTIGACION CLINICA, SOLTI, +34 933436302, regsolti@gruposolti.org
    Scientific contact
    INVESTIGACION CLINICA, SOLTI, +34 933436302, regsolti@gruposolti.org
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    25 Sep 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    27 Apr 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    • To assess the frequency of complete pathological response (CRp) at the time of surgery in patients at risk of developing anthracycline cardiotoxicity and who started a primary chemotherapy regimen with pegylated liposomal doxorubicin and cyclophosphamide followed by paclitaxel.
    Protection of trial subjects
    The investigator provided all details of the study verbally, in writing, or both, and obtained the written informed consent of each subject before participating in the study. Patients (or their legal representative and / or witness, as applicable) personally signed and dated the informed consent form; also signed by the person who provided the information to the patients. In providing this information, it was emphasized that participation in the study was voluntary and that the patient could withdraw from it at any time and for any reason. All patients were given the opportunity to ask questions about the study and were given sufficient time to decide whether they wanted to participate in it. All patients and / or legal representative were given a copy of the informed consent. The consent included information that the data were registered, collected and processed in accordance with Organic Law 15/1999, of December 13, on the protection of personal data. According to this law, the data was treated in such a way that the information that had been obtained could not be associated with an identified or identifiable person.
    Background therapy
    Anthracyclines and taxanes are the most effective drugs against non-hormone-dependent breast cancer. Due to its toxicity, its use is limited in elderly patients or patients with a history of heart disease. DLP has shown similar efficacy to doxorubicin in metastatic breast cancer with less cardiotoxicity. The combination of DLP and CFM in QTP has shown promising results in a phase II study. The most effective regimen in primary chemotherapy is the sequential administration of anthracyclines and taxanes. Doxorubicin administration is contraindicated in cardiac or elderly patients. This study aims to demonstrate that the administration of DLP, in a scheme with CFM followed by paclitaxel in QTP, maintains the efficacy of conventional anthracyclines, in terms of pCR, without increasing cardiotoxicity, in a sample of patients that otherwise would not be known. You may benefit from anthracycline treatment.
    Evidence for comparator
    -
    Actual start date of recruitment
    10 Oct 2007
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 50
    Worldwide total number of subjects
    50
    EEA total number of subjects
    50
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    6
    From 65 to 84 years
    34
    85 years and over
    10

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    -

    Pre-assignment period milestones
    Number of subjects started
    50
    Number of subjects completed
    50

    Period 1
    Period 1 title
    Baseline (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    surgeried
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Caelyx pegylated liposoma
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    35 mg/m2

    Investigational medicinal product name
    cyclophosphamide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Concentrate for solution for infusion
    Dosage and administration details
    600 mg/m2

    Investigational medicinal product name
    Paclitaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    80 mg/m2 por 12

    Arm title
    non surgied
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Caelyx pegylated liposoma
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    35 mg/m2

    Investigational medicinal product name
    cyclophosphamide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Concentrate for solution for infusion
    Dosage and administration details
    600 mg/m2

    Investigational medicinal product name
    Paclitaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    80 mg/m2 por 12

    Number of subjects in period 1
    surgeried non surgied
    Started
    46
    4
    Completed
    46
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Baseline
    Reporting group description
    -

    Reporting group values
    Baseline Total
    Number of subjects
    50 50
    Age categorical
    Units: Subjects
        <60 years
    6 6
        60-64 years
    2 2
        65-69 years
    11 11
        70-74 years
    11 11
        75-79 years
    14 14
        >79 years
    6 6
    Age continuous
    Units: years
        geometric mean (full range (min-max))
    73 (35 to 84) -
    Gender categorical
    Units: Subjects
        Female
    0 0
        Male
    50 50
    ECOG
    Units: Subjects
        zero
    43 43
        one
    7 7
    Menopausal status
    Units: Subjects
        Premenopausal
    4 4
        Postmenopausal
    46 46
    Tumor Grading
    Units: Subjects
        G1
    4 4
        G2
    10 10
        G3
    36 36
    Tumor stadium
    Units: Subjects
        II
    24 24
        III
    26 26
    Her2/neu
    Units: Subjects
        Negative
    49 49
        Positive
    1 1
    Stadium
    Units: Subjects
        II
    24 24
        III
    26 26
    Clinic T
    Units: Subjects
        T2-3
    29 29
        T4a-c
    14 14
        T4d
    7 7
    Clinic N
    Units: Subjects
        N0
    23 23
        N1
    14 14
        N2
    11 11
        N3
    2 2
    Type of surgery
    Units: Subjects
        Mastectomy
    37 37
        Conservative surgery
    13 13
    Tumor size
    Units: millimeter(s)
        geometric mean (full range (min-max))
    33.7 (5 to 123) -

    End points

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    End points reporting groups
    Reporting group title
    surgeried
    Reporting group description
    -

    Reporting group title
    non surgied
    Reporting group description
    -

    Subject analysis set title
    Surgied
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Patients Surgied

    Subject analysis set title
    Total
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    total

    Subject analysis set title
    PCR breast
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Pathologic Complete Response in Surgical Breast Specimens

    Subject analysis set title
    CPR breast and armpit
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Pathologic Complete Response in Breast and Axillary Surgical Specimens

    Primary: Complete pathological response

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    End point title
    Complete pathological response
    End point description
    Breast surgical specimens were evaluated for evaluation according to the NSABP guidelines. Patients were considered to have CRp if there was no evidence of invasive breast cancer or there was only non-invasive cancer in situ in the breast specimen. The NSABP guidelines do not take into account the histological status of the nodes to define CRP. The CRp rate is summarized as the percentage (%) of patients meeting the criterion, with the exact 95% confidence interval.
    End point type
    Primary
    End point timeframe
    until progression
    End point values
    PCR breast CPR breast and armpit
    Number of subjects analysed
    50
    50
    Units: percent
        geometric mean (confidence interval 95%)
    32 (19.5 to 46.7)
    24 (12.1 to 35.8)
    Statistical analysis title
    ITT RCp
    Comparison groups
    PCR breast v CPR breast and armpit
    Number of subjects included in analysis
    100
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority
    P-value
    ≥ 0.05
    Method
    t-test, 2-sided
    Parameter type
    Hazard ratio (HR)
    Point estimate
    32
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    19.5
         upper limit
    46.7
    Variability estimate
    Standard deviation
    Dispersion value
    18

    Secondary: Radiological Response Rate

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    End point title
    Radiological Response Rate
    End point description
    End point type
    Secondary
    End point timeframe
    Until progression
    End point values
    Total
    Number of subjects analysed
    50
    Units: percent
    geometric mean (confidence interval 95%)
        PLD- cyclofosfamide
    2 (0.05 to 10.6)
        PLD- cyclofosfamide-paclitaxel
    6 (1.25 to 16.5)
    No statistical analyses for this end point

    Secondary: Relapse-free survival at 5 years

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    End point title
    Relapse-free survival at 5 years
    End point description
    End point type
    Secondary
    End point timeframe
    Until death
    End point values
    Total
    Number of subjects analysed
    50
    Units: percent
    geometric mean (confidence interval 95%)
        RFS 5 years
    54.4 (38.3 to 67.9)
    No statistical analyses for this end point

    Secondary: Overall survival -5 years

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    End point title
    Overall survival -5 years
    End point description
    End point type
    Secondary
    End point timeframe
    Until death
    End point values
    Surgied
    Number of subjects analysed
    46
    Units: percent
        geometric mean (confidence interval 95%)
    56 (41.2 to 68.4)
    No statistical analyses for this end point

    Secondary: Conservative surgery rate

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    End point title
    Conservative surgery rate
    End point description
    End point type
    Secondary
    End point timeframe
    NA
    End point values
    Surgied
    Number of subjects analysed
    46
    Units: percent
    number (not applicable)
        conservative surgery
    58.7
        mastectomy
    41.3
        axillary lymphadenectomy
    84
    No statistical analyses for this end point

    Secondary: Complete response at the level of axillary nodes

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    End point title
    Complete response at the level of axillary nodes
    End point description
    End point type
    Secondary
    End point timeframe
    NA
    End point values
    Number of subjects analysed
    Units: percent
    geometric mean (confidence interval 95%)
        pCR in the breast and lymph nodes
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Until close study
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    13.0
    Reporting groups
    Reporting group title
    Safety population
    Reporting group description
    -

    Serious adverse events
    Safety population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 50 (16.00%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    3
    Vascular disorders
    Cerebrovascular accident
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematoma
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Angina pectoris
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Amyotrophic lateral sclerosis
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Partial seizures
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Convulsions local
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pneumonia aspiration
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Skin and subcutaneous tissue disorders
    Skin toxicity
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Infections and infestations
    Neutropenia
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Safety population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    38 / 50 (76.00%)
    General disorders and administration site conditions
    Alopecia
         subjects affected / exposed
    37 / 50 (74.00%)
         occurrences all number
    37
    Mucositis management
         subjects affected / exposed
    30 / 50 (60.00%)
         occurrences all number
    30
    Oedema peripheral
         subjects affected / exposed
    6 / 50 (12.00%)
         occurrences all number
    6
    Fever
         subjects affected / exposed
    6 / 50 (12.00%)
         occurrences all number
    6
    Seroma
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Immune system disorders
    Neutropenia
         subjects affected / exposed
    12 / 50 (24.00%)
         occurrences all number
    12
    Reproductive system and breast disorders
    Mastalgia
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Cough
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Catarrh
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Hyporexia
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Rhinorea
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Nervous system disorders
    Neuropathy peripheral
         subjects affected / exposed
    14 / 50 (28.00%)
         occurrences all number
    14
    Neurotoxicity
         subjects affected / exposed
    13 / 50 (26.00%)
         occurrences all number
    13
    Dysgeusia
         subjects affected / exposed
    9 / 50 (18.00%)
         occurrences all number
    9
    Dizziness
         subjects affected / exposed
    6 / 50 (12.00%)
         occurrences all number
    6
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    8 / 50 (16.00%)
         occurrences all number
    8
    Leukopenia
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Eye disorders
    Abdominal pain
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    18 / 50 (36.00%)
         occurrences all number
    18
    Diarrhoea
         subjects affected / exposed
    17 / 50 (34.00%)
         occurrences all number
    17
    Constipation
         subjects affected / exposed
    10 / 50 (20.00%)
         occurrences all number
    10
    Vomiting
         subjects affected / exposed
    9 / 50 (18.00%)
         occurrences all number
    9
    Epigastric discomfort
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    14 / 50 (28.00%)
         occurrences all number
    14
    Skin toxicity
         subjects affected / exposed
    11 / 50 (22.00%)
         occurrences all number
    11
    Rash
         subjects affected / exposed
    9 / 50 (18.00%)
         occurrences all number
    9
    Nail toxicity
         subjects affected / exposed
    8 / 50 (16.00%)
         occurrences all number
    8
    Redness facial
         subjects affected / exposed
    6 / 50 (12.00%)
         occurrences all number
    6
    Erythema
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Onychodystrophy
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Nail disorder
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Pruritus
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Dry skin
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Musculoskeletal and connective tissue disorders
    Artralxia
         subjects affected / exposed
    10 / 50 (20.00%)
         occurrences all number
    10
    Lumbar pain
         subjects affected / exposed
    7 / 50 (14.00%)
         occurrences all number
    7
    Infections and infestations
    Conjunctivitis
         subjects affected / exposed
    4 / 50 (8.00%)
         occurrences all number
    4
    Urinary tract infection
         subjects affected / exposed
    3 / 50 (6.00%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Anorexia nervosa
         subjects affected / exposed
    19 / 50 (38.00%)
         occurrences all number
    19

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    NA
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    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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