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A Phase II Trial of Capecitabine in Combination With the Farnesyltransferase Inhibitor, R115777 (Tipifarnib, Zarnestra) in Patients With Metastatic Breast Cancer


Phase 2
18 Years
N/A
Not Enrolling
Female
Recurrent Breast Cancer, Stage IV Breast Cancer

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Trial Information

A Phase II Trial of Capecitabine in Combination With the Farnesyltransferase Inhibitor, R115777 (Tipifarnib, Zarnestra) in Patients With Metastatic Breast Cancer


PRIMARY OBJECTIVES:

I. The primary objective of this study is to determine the response rate in patients with
taxane-resistant metastatic breast cancer treated with capecitabine plus tipifarnib.

SECONDARY OBJECTIVES:

I. To evaluate toxicity in patients with taxane-resistant metastatic breast cancer treated
with capecitabine plus tipifarnib.

II. To evaluate progression free survival, time to treatment failure, and overall survival
in patients with taxane-resistant metastatic breast cancer treated with capecitabine plus
tipifarnib.

OUTLINE: This is a multicenter study.

Patients receive oral tipifarnib twice daily and oral capecitabine twice daily on days 1-14.
Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Patients achieving a complete response (CR) receive 4 additional courses beyond
documentation of CR.

Patients are followed every 3 months for 2 years and then every 6 months for 1 year.


Inclusion Criteria:



- Female patients with histologically confirmed adenocarcinoma of the breast with
manifestations of metastatic progression

- Patients must have at least one objective measurable disease parameter as defined by
RECIST criteria; tumor measurements and evaluation of non-measurable sites must be
performed within 4 weeks prior to registration

- ECOG performance status 0-2

- In order to be eligible for inclusion, patients must meet all of the following
criteria with regard to prior cytotoxic therapy: (1) prior treatment with an
anthracycline (e.g., doxorubicin, epirubicin) either in the adjuvant/neoadjuvant
setting and/or for metastatic disease, (2) prior treatment with a taxane (i.e.
paclitaxel, docetaxel) for metastatic disease, or relapse while receiving adjuvant
taxane therapy (3) progressive disease while receiving taxane therapy or up to 30
days after receiving the last taxane dose, (4) no more than three prior cytotoxic
regimens for metastatic disease, (5) no prior treatment with capecitabine or
5-flourouracil for metastatic disease

- Prior hormonal therapy in either the metastatic or adjuvant/neoadjuvant setting is
allowed, but patients must have been off such therapy for greater than or equal to 1
week prior to registration

- No prior radiotherapy other than to the conserved breast, to the postmastectomy chest
wall or to a limited field involving less than 25% of marrow - containing bone

- Previously irradiated tumors cannot be used to assess a clinical response;
patients will not be eligible for this study if the previously irradiated tumors
constitute the only site of measurable disease

- Patients must not have previously received tipifarnib or other farnesyl transferase
inhibitors

- Patients must be disease-free of prior malignancies for > 5 years with the exception
of curatively treated basal or squamous cell carcinomas of the skin or carcinoma in
situ of the cervix

- Patients must have serum creatinine =< 1.5 mg/dl or measured (or calculated)
creatinine clearance >= 60 mL/minute

- Granulocytes > 1500/mm^3

- Platelets > 100,000/mm^3

- Total bilirubin =< 1.5 x upper limit of normal

- SGOT (AST) and SGPT (ALT) =< 3 x upper limit of normal (unless liver is involved by
tumor, in which case SGOT (AST) and SGPT (ALT) can be =< 5 x upper limit of normal)

- Patients must not be pregnant or breastfeeding since there is no information
regarding the use of these agents in this population; a negative serum or urine
pregnancy test is required within 14 days prior to registration if pre- or
perimenopausal (i.e., last menstrual period within one year of registration)

- Women of childbearing potential are strongly advised to use an accepted and effective
method of contraception

- Patients with current or previously treated brain metastases are ineligible; patients
who are taking enzyme inducing anticonvulsant medications are also not eligible
(e.g., phenobarbital, phenytoin)

- Patients must not have had prior organ allograft or received immunosuppressive
therapy

- Patients must not have any uncontrolled intercurrent illness including, but not
limited to, chronic nausea/vomiting, complete or partial bowel obstruction,
dysphagia/odynophagia with inability to swallow pills, ongoing or active infection,
symptomatic cardiovascular disease, or other chronic medical or psychiatric
conditions that would impair compliance or would substantially increase the risk of
participating in this study

- Patients must not have received previous treatment with cytotoxic drugs, and/or
radiotherapy < 4 weeks prior to registration; concurrent radiation therapy is not
permitted

- Because of the potential for a drug interaction between warfarin and both tipifarnib
and capecitabine, patients taking warfarin adjusted to an elevated INR are not
eligible; patients taking prophylactic low-dose warfarin (i.e., 1 mg daily) are
eligible, but a PT and INR are required within 2 weeks of registration and must be
normal

- Patients with CTC v 3.0 grade 2-4 neuropathy are not eligible

Type of Study:

Interventional

Study Design:

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Objective response rate (PR+CR)

Outcome Time Frame:

Up to 5 years

Safety Issue:

No

Principal Investigator

William Gradishar

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2012-02973

NCT ID:

NCT00077363

Start Date:

May 2004

Completion Date:

Related Keywords:

  • Recurrent Breast Cancer
  • Stage IV Breast Cancer
  • Breast Neoplasms

Name

Location

Eastern Cooperative Oncology Group Boston, Massachusetts  02215