E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced, triple receptor negative breast cancer |
Carcinoma mammario metastatico ''triple negative'' |
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E.1.1.1 | Medical condition in easily understood language |
The combination cisplatin and cyclophosphamide will be offered to metastatic triple receptor negative breast cancer patients previously treated with anthracyclines and/or taxanes. |
pazienti affette da carcinoma mammario metastatico cosiddetto triple negative trattate con almeno una linea di chemioterapia per la malattia metastatica contenente antracicline e/o taxani. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10055113 |
E.1.2 | Term | Breast cancer metastatic |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 objective response rate (ORR), defined as the percentage of all patients who experienced a Complete Response (CR) or Partial Response (PR) of the combination cisplatin and metronomic cyclophosphamide in patients with previously treated, triple receptor negative (ER/PR and HER2/neu), locally recurrent or metastatic breast cancer. |
Valutare in tasso di risposta obiettiva (ORR) della combinazione di ciclofosfamide metronomica e del cisplatino nelle pazienti con carcinoma mammario “triple negative” localmente avanzato o metastatico, precedentemente trattate con taxani e/o antracicline. |
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E.2.2 | Secondary objectives of the trial |
To evaluate Time to Tumor Progression (TTP) of the combination cisplatin and metronomic cyclophosphamide in this patient population - To assess the safety of the combination cisplatin and metronomic cyclophosphamide - To examine the Health-Related Quality of Life (HRQoL) of the combination cisplatin and metronomic Cyclophosphamide |
Valutare il TTP della combinazione cisplatino e ciclofosfamide metronomica in questa popolazione - Determinare la safety della combinazione cisplatino e ciclofosfamide metronomica - Valutare la Qualità di vita (Health-Related Quality of Life) della combinazione di cisplatino e ciclofosfamide metronomica |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Histologically proven diagnosis of breast cancer with evidence of 1) unresectable, locally recurrent, or 2) metastatic disease. Locally recurrent disease must not be amenable to resection or radiation therapy with curative intent. • Documentation of Estrogen and Progestin Receptor (ER and PgR) negative status (immunohistochemistry 0%) and HER2/neu receptor negative status (i.e., FISH negative or immunohistochemistry 0 or +1). • Prior treatment with an anthracycline and/or a taxanes in the neoadjuvant, adjuvant or metastatic disease setting. • Measurable disease as per RECIST. Measurable lesions that have been previously radiated will not considered target lesions unless increase in size has been observed following completion of radiation therapy. • Female, 18 years of age or older. • ECOG performance status 0, 1 or 2. • Resolution of all acute toxic effects of prior therapy or surgical procedures to grade ≤ 1 (except alopecia). • The definitions of minimum adequacy for organ function required prior to study entry |
• Diagnosi istologica di carcinoma mammario dimostrata con evidenza di carcinoma mammario metastatico oppure localmente avanzato e non operabile • Carcinoma mammario “triple negative” (ER e PgR 0% ed assenza di sovraespressione determinata mediante immunoistochimica di c-erb B2 (o o 1+) o assenza di amplificazione genica (FISH negativo) • Precedente trattamento con antracicline e/o taxani nel setting neoadiuvante, adiuvante o metastatico • Malattia misurabile secondo criteri RECIST • Donne di età ≥ 18 anni • ECOG performance status ≤ 2 • Risoluzione di tutti gli effetti tossici acuti dell’eventuale precedente trattamento antineoplastico fino ad un grado ≤ 1 • Adeguata funzionalità epatica, renale e midollare |
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E.4 | Principal exclusion criteria |
• Major surgery, radiation therapy, or systemic therapy within 3 weeks of study enrollment except palliative radiotherapy to non-target metastatic lesions. • Uncontrolled brain metastases, spinal cord compression, carcinomatous meningitis, or leptomenigeal disease. Patients should have completed surgery or radiation therapy for existing brain metastases, should not have documented increase in size over the previous 3 months prior to first dose of treatment on study and should be asymptomatic. • Diagnosis of any second malignancy within the last 3 years, except for contralateral breast cancer also with triple negative receptor status, adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the cervic. • Any of the following within the 2 months prior to starting study treatment: myocardial infarction, severe/unstable angina, congestive heart failure, cerebrovascular accident including transient attack, or pulmonary embolus not correlated to the breast cancer. • Ongoing cardiac dysrhythmias of NCI CTCAE grade ≥ 2 or atrial fibrillation of any grade. • Current treatment with therapeutic doses of coumarin or oral anti-vitamin K agents such as warfarin and phenprocoumon derivates. Low molecular weight heparin is allowed at any dose level. • Known human immunodeficiency virus infection. • Female who is pregnant or nursing; female of child-bearing potential who is unwilling or unable to use adequate contraception to prevent pregnancy during the trial and for 3 months after the last dose of study treatment. All female patients with reproductive potential must have a negative pregnancy test (serum or urine) prior to randomization. Female patients must be surgically sterile or be in postmenopausal, or must agree to use effective contraception during the period of therapy and for 3 months after the last dose of study treatment. • Other severe acute or chronic medical or psychiatric condition, or laboratory abnormality that would impart, in the judgment of the investigator, excess risk associated with study participation or study drug administration, or which in the judgment of the investigator, would make the patient inappropriate for entry into this study. • Acute kidney injury or failure within 3 months prior to starting study treatment. • Current treatment with drug-related nephrotoxic effects. • Ongoing condition described as 'urethral' (or 'dysuria/frequency') syndrome. |
• Chirurgia maggiore, radioterapia o terapia antineoplasia sistemica entro 3 settimane dall’arruolamento ad eccezione di radioterapia sintomatica su una sede non target dolente. • Metastasi del S.N.C. non controllate dal punto di vista sintomatologico, compressione midollare conseguente alla neoplasia, carcinomatosi meningea. I pazienti con metastasi cerebrali sottoposte a chirurgia e/o radioterapia encefalica, dovrebbero avere una stazionarietà delle lesioni cerebrali negli ultimi 3 mesi prima dell’avvio del trattamento sperimentale • Diagnosi di una seconda neoplasia maligna entro gli ultimi 3 anni, ad eccezione di un carcinoma mammario controlaterale triple negative, carcinomi squamocellulari della pelle adeguatamente trattati o carcinoma in situ della cervice • Una delle seguenti comorbidità nei 3 mesi precedenti l’avvio del trattamento sperimentale: o Infarto del miocardio o Angina severa/instabile o Insufficienza cardiaca congestizia o Eventi cerebrovascolari, inclusi TIA o Embolia polmonare non oncologica o non correlata a accessi venosi centrali • Aritmie NCI CTCAE grado ≥ 2 in atto o una fibrillazione atriale di qualsiasi grado • Trattamento concomitante con dicumarolici o vitamina K orale o warfarin • HIV • Donne gravide • Donne in età fertile che non vogliono o non sono in grado di attuare adeguati metodi anticoncezionali per evitare una gravidanza durante il trattamento sperimentale e per 3 mesi dopo il termine del trattamento con cisplatino e ciclofosfamide • Altre malattie gravi acute o condizioni psichiatriche scompensate o anormalità di laboratorio che a giudizio dell’investigatore sono a rischio per la partecipazione della paziente allo studio • Insufficienza renale acuta o entro 3 mesi dall’inizio del trattamento sperimentale • Trattamenti medici concomitanti con potenziali rischi nefrotossici |
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E.5 End points |
E.5.1 | Primary end point(s) |
Objective response rate (ORR), defined as the percentage of all patients who experienced a Complete Response (CR) or Partial Response (PR). |
Determinare l’Overall Response Rate (ORR), definita come la percentuale di tutte le pazienti che ottengono una completa risposta (RC) o una risposta parziale (PR). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
time to progression |
tempo alla progressione |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | No |
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 | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
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.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
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 | No |
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 | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |