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    Clinical Trial Results:
    Capecitabine in combination with Bendamustine in women with pretreated locally advanced or metastatic Her2-negative breast cancer, a Phase II Trial

    Summary
    EudraCT number
    2012-005593-64
    Trial protocol
    AT  
    Global end of trial date
    15 Mar 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    23 Mar 2019
    First version publication date
    23 Mar 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AGMT_MBC-6
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01891277
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AGMT
    Sponsor organisation address
    Gentzgasse 60/20, Vienna, Austria, 1180
    Public contact
    Daniela Wolkersdorfer, AGMT, 0043 (0)66264044411, d.wolkersdorfer@agmt.at
    Scientific contact
    Richard Greil, AGMT, 0043 (0)5785585801, r.greil@salk.at
    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
    16 Apr 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    15 Mar 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Mar 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The efficacy of a capecitabine plus bendamustine combination regimen in the treatment of Her2-negative advanced metastatic breast cancer, in terms of overall response rates (complete or partial Response)
    Protection of trial subjects
    Safety assessments were scheduled 3-weekly during treatment until 28 days after end of study treatment. Recommendations for dose modifications in case of toxicity were done in protocol. Only patients with adequate haematology, liver and renal function could have been included. Patients with known hypersensitivity to the study drugs capecitabine and bendamustine or their excipients were excluded from study participation.
    Background therapy
    Capecitabine was dosed at 1000mg/m2 twice daily for 14 days, followed by a 7-day rest period for a total cycle time of 21 days (until disease progression or unacceptable toxic effects).
    Evidence for comparator
    None.
    Actual start date of recruitment
    09 Aug 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Austria: 40
    Worldwide total number of subjects
    40
    EEA total number of subjects
    40
    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)
    26
    From 65 to 84 years
    14
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    In stage 1 of AGMT MBC-6, 20 patients were recruited from September 2013 to July 2014 in Austria. Fulfilling the efficacy criterion, the study was continued enrolling another 20 patients from October 2014 to May 2015 (Stage 2). A total of 40 patients were recruited in eight Austrian centers.

    Pre-assignment
    Screening details
    Female patients, age ≥ 18 years were screened. The patients had to have advanced or metastatic Her2-negative breast cancer, histologically confirmed and had to be progredient after anthracycline and/or taxane treatment (palliative or neoadjuvant or adjuvant).

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

    Arms
    Arm title
    Bendamustin/Capecitabine
    Arm description
    Bendamustin in addition to backbone capecitabine, followed by capecitabine monotherapy.
    Arm type
    Experimental

    Investigational medicinal product name
    Bendamustin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for concentrate for solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Bendamustine 80mg/m2 were administered on day 1 and 8 of a three week cycle (for a maximum of eight cycles).

    Investigational medicinal product name
    Capecitabine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Capecitabine was dosed at 1000mg/m2 twice daily for 14 days, followed by a 7-day rest period for a total cycle time of 21 days (until disease progression or unacceptable toxic effects).

    Number of subjects in period 1
    Bendamustin/Capecitabine
    Started
    40
    Completed
    27
    Not completed
    13
         Adverse event, serious fatal
    1
         Consent withdrawn by subject
    5
         Physician decision
    3
         Therapy paused for more than 2 cylces
    1
         Adverse event, non-fatal
    3

    Baseline characteristics

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

    Reporting group values
    Overall trial Total
    Number of subjects
    40 40
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (full range (min-max))
    60 (29 to 77) -
    Gender categorical
    Units: Subjects
        Female
    40 40
        Male
    0 0

    End points

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    End points reporting groups
    Reporting group title
    Bendamustin/Capecitabine
    Reporting group description
    Bendamustin in addition to backbone capecitabine, followed by capecitabine monotherapy.

    Primary: Overall Response Rate

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    End point title
    Overall Response Rate [1]
    End point description
    Overall tumor response rates (complete response (CR) or partial response (PR), determined by radiologic evaluation according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1))
    End point type
    Primary
    End point timeframe
    Best response evaluated from start of study therapy until end of study participation (progression or withdrawal).
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis is provided as this is a one armed, open label, non-comperative study. According to the pre-specified design, the regimen was concluded to be efficacious since 18 responses were observed in the study exceeding the efficacy criterion of 13 or more responses out of 40 at the end of trial.
    End point values
    Bendamustin/Capecitabine
    Number of subjects analysed
    40
    Units: Patients
        CR
    1
        PR
    17
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All patients having received at least one dose of the study medication were followed for (serious) adverse events for 28 days after discontinuing study treatment or completion of study treatment.
    Adverse event reporting additional description
    Progression of disease (including death due to the underlying malignant disease) was not to be regarded as SAE. Due to the seriousness of the disease, certain conditions defined as SAEs were excluded from expedited reporting i.e.: elective hospitalization and surgery for treatment of disease or to simplify treatment or study procedures.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21
    Reporting groups
    Reporting group title
    Safety population
    Reporting group description
    All patients having received at least one dose of the study medication were followed for (serious) adverse events for 28 days after discontinuing study treatment or completion of study treatment.

    Serious adverse events
    Safety population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    26 / 40 (65.00%)
         number of deaths (all causes)
    5
         number of deaths resulting from adverse events
    1
    Vascular disorders
    Embolism
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Overdose
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiomyopathy
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Nervous system disorders
    Peripheral motor neuropathy
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia macrocytic
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ascites
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Faecaloma
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Toothache
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatic failure
         subjects affected / exposed
    1 / 40 (2.50%)
         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 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal chest pain
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile infection
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tooth infection
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Viral infection
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 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
    37 / 40 (92.50%)
    Vascular disorders
    Lymphoedema
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    4
    Thrombosis
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Hot flush
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    29 / 40 (72.50%)
         occurrences all number
    58
    Oedema peripheral
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    8
    Pain
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    4
    Pyrexia
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Influenza like illness
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Chills
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    3
    Non-cardiac chest pain
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Feeling cold
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    General physical health deterioration
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    9 / 40 (22.50%)
         occurrences all number
    10
    Dyspnoea
         subjects affected / exposed
    7 / 40 (17.50%)
         occurrences all number
    12
    Psychiatric disorders
    Depression
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Investigations
    Weight decreased
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Platelet count decreased
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    5
    White blood cell count decreased
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    7
    Neutrophil count decreased
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Lymphocyte count decreased
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Nervous system disorders
    Peripheral sensory neuropathy
         subjects affected / exposed
    7 / 40 (17.50%)
         occurrences all number
    9
    Dysgeusia
         subjects affected / exposed
    7 / 40 (17.50%)
         occurrences all number
    7
    Polyneuropathy
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    6
    Headache
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    9
    Dizziness
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    9
    Presyncope
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Paraesthesia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Neuropathy peripheral
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    15 / 40 (37.50%)
         occurrences all number
    36
    Leukopenia
         subjects affected / exposed
    13 / 40 (32.50%)
         occurrences all number
    35
    Anaemia
         subjects affected / exposed
    9 / 40 (22.50%)
         occurrences all number
    13
    Thrombocytopenia
         subjects affected / exposed
    8 / 40 (20.00%)
         occurrences all number
    11
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    7
    Eye disorders
    Eyelid oedema
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    19 / 40 (47.50%)
         occurrences all number
    34
    Diarrhoea
         subjects affected / exposed
    14 / 40 (35.00%)
         occurrences all number
    31
    Stomatitis
         subjects affected / exposed
    7 / 40 (17.50%)
         occurrences all number
    7
    Constipation
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    11
    Vomiting
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    11
    Toothache
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    5
    Abdominal pain upper
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    7
    Dry mouth
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Dyspepsia
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    4
    Haematochezia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Abdominal pain
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Flatulence
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Abdominal distension
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    22 / 40 (55.00%)
         occurrences all number
    54
    Night sweats
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Alopecia
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    4
    Rash
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    4
    Erythema
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Pruritus
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Dry skin
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Skin fissures
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    5
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    5
    Arthralgia
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Back pain
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Musculoskeletal chest pain
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Bone pain
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Musculoskeletal pain
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    3
    Infections and infestations
    Oral herpes
         subjects affected / exposed
    10 / 40 (25.00%)
         occurrences all number
    16
    Nasopharyngitis
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    7
    Bronchitis
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    4
    Upper respiratory tract infection
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    4
    Rhinitis
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Urinary tract infection
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    8 / 40 (20.00%)
         occurrences all number
    10
    Hypokalaemia
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3

    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.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    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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