E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Female breast cancer patients with progression of brain metastasis following WBRT and at least one measurable lesion in the brain (defined as any lesion >1 cm in longest dimension at MRI). |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10006128 |
E.1.2 | Term | Brain metastases |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of capecitabine in terms of Progression Free Survival (PFS) rate at 4 months, reviewed by centralized independent expert, in treatment of brain metastases secondary to breast cancer in patients with CNS progression after whole brain radiotherapy (WBRT)
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E.2.2 | Secondary objectives of the trial |
To evaluate the following parameters: - Objective CNS response (CR+PR) - Duration of CNS response - CNS progression-free survival - Progression-free survival assessed by investigator - Disease control rate defined as Overall Response (CR+PR) + Stable Disease (SD) for overall disease - Overall survival - Safety according to CTC-AE v3.0 and with the Mini Mental Score (MMS) examination to evaluate the neurotoxicity
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E.2.3 | Trial contains a sub-study | No |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
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E.3 | Principal inclusion criteria |
• Patients must have signed a written informed consent form prior to any study specific screening procedures • Women • 18 years or older • ECOG Performance Status 0-2 • Life expectancy ≥ 3 months • Able to comply with the protocol • Patient affiliated to the national “Social Security” regimen or beneficiary of this regimen • Able to swallow oral medications • Histologically confirmed breast cancer • HER2 and hormone receptors status known • Brain metastasis progression after whole brain radiotherapy alone or radio-surgery + whole brain radiotherapy with at least one measurable lesion in the brain (defined as any lesion ≥1 cm on T1-weighted contrast enhanced MRI) • Stable extra-cranial disease • Patients could entered in the study regardless of previous treatment (included chemotherapy except capecitabine) for metastatic extracranial disease • No steroids or stable dose of steroids for at least 5 days before the MRI evaluation • Adequate hematologic function: Absolute neutrophil count ≥1.5 x 109/L and platelets ≥ 100 x 109/L and Hb ≥ 9 g/Dl • Adequate liver function: Total bilirubin ≤ 1.5 x ULN and AST or ALT ≤ 2.5 x ULN (≤ 5 x ULN in patients with liver metastases) • Adequate renal function: Serum creatinine ≤ 1.5 x ULN or Creatinine clearance ≥ 50 mL/min (Cockroft Gault formula)
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E.4 | Principal exclusion criteria |
• Prior treatment with capecitabine • Leptomeningeal disease • Previous history of cancer (other than curatively treated basal and squamous cell carcinoma of the skin and/or in-situ carcinoma of the cervix) within the 5 years before study entry • Pregnant or breast feeding women • Women with an intact uterus (unless amenorrhoeic for the last 24 months) not using effective means of contraception • Patient considered socially or psychologically unable to comply with the treatment and the required medical follow-up • Clinically significant malabsorption syndrome or inability to take oral medication • Clinically significant (i.e. active) cardiovascular disease, i.e. myocardial infarction within the last 6 months before inclusion, unstable angina, congestive heart failure NYHA Class ≥ II, serious cardiac arrhythmia requiring medication during the study which might interfere with regularity of the study treatment or not controlled by medication • Evidence of ongoing or active infection (requiring IV antibiotics), any other disease, neurological or metabolic dysfunction, physical examination finding or laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or increases the patient’s risk of treatment-related complications • Requirement for concurrent use of the antiviral agent sorivudine or chemically related analogue such as brivudine • Treatment with any other investigational agent within 30 days prior to enrolment • Prior unanticipated severe reaction to fluoropyrimidine therapy (with or without documented DPD deficiency) or known allergy to capecitabine, to 5-fluorouracil, to other study therapies or any of their excipients • Known DPD deficiency • History of immediate or delayed hypersensitivity reaction to gadolinium contrast agents or other contraindication to MRI (cardiac pacemaker, implanted cardiac defibrillator, brain aneurysm clips, cochlear implant, ocular foreign body, or shrapnel)
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary criterion is Progression Free Survival Rate at 4 months (16 weeks).
Progression Free Survival is defined as the time from the first administration of study treatment to CNS or extra-cranial disease progression according to RECIST criteria reviewed by centralized independent expert or death from any cause.
The CNS assessments will be realized by contrast-enhanced MRI and the extra-cranial disease assessments will be realized by CT Chest/Abdomen/Pelvis. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 15 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |