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Phase II Clinical Trial Of 6-Mercaptopurine (6MP) and Low-Dose Methotrexate In Patients With Known BRCA Defective Tumours

Phase 2
18 Years
Open (Enrolling)
Breast Cancer, Ovarian Cancer

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Trial Information

Phase II Clinical Trial Of 6-Mercaptopurine (6MP) and Low-Dose Methotrexate In Patients With Known BRCA Defective Tumours

Inclusion Criteria:

1. Patients with proven BRCA1 or BRCA2 mutations and after appropriate exposure to
standard treatment, as defined by:

Breast Cancer

- Patients with initially histologically or cytologically proven locally advanced
or metastatic breast cancer who may have received up to 3 previous lines of
chemotherapy in the locally advanced or metastatic breast cancer setting.

- Patients must have previously had a taxane and an anthracycline in either the
adjuvant or metastatic setting, provided that these were not contraindicated.

- Patients with hormone responsive disease should have had at least 1 line of
hormone therapy for metastatic disease.

- Prior treatment with a PARP inhibitor is permissible. OR Ovarian Cancer

- Patients with initially histologically or cytologically proven ovarian cancer.

- Patients must have disease that is platinum resistant or in whom further
platinum based therapy is inappropriate.

- Prior treatment with a PARP inhibitor is permissible.

2. Patients must have measurable disease on computerized tomography (CT) or MRI scan as
defined by RECIST criteria.

3. Age ≥18 years.

4. ECOG performance score of 0-2.

5. Life expectancy >12 weeks.

6. Written informed consent.

7. Patient willing and able to comply with all protocol requirements.

8. No prior anti-cancer treatment in previous 4 weeks, other than palliative RT.

9. Haematological and biochemical indices within the ranges shown below.

- Lab Test Value required

- Haemoglobin (Hb) > 10g/dL

- White Blood Count (WBC) > 3x109/L

- Platelet count > 100,000/μL

- Absolute Neutrophil count > 1.5x109/L;

- Serum bilirubin ≤ 2 x Upper limit normal (ULN)

- AST (SGOT) or ALT ≤ 5 x ULN (liver mets)

- or ≤ 3 x ULN (no liver mets)

- Alk Phos ≤ 5 x ULN

- Serum creatinine ≤ 1.5 x ULN

10. Ascites and pleural effusions must be drained prior to therapy.

Exclusion Criteria:

1. Patients with any of the following contra-indications to thiopurines (6MP or 6TG) or

- family history of severe liver failure;

- alcoholism;

- porphyria;

- diffuse infiltrative pulmonary or pericardial disease;

- known hypersensitivity to either trial agent.

2. Patients found to have a Low/Low genotype on TPMT testing will be excluded.

3. Pregnant or breast-feeding women or women of childbearing potential unless highly
effective methods of contraception are used (see section 7.2.3).

4. Other active malignancy, with the exception of adequately treated in situ carcinoma
of the cervix uteri and basal or squamous cell carcinoma of the skin.

5. Patients known or tested to be serologically positive for Hepatitis B, Hepatitis C or

6. Patients with active CNS lesions are excluded (i.e., those with radiographically
unstable, symptomatic lesions). However, patients treated with stereotactic therapy
or surgery and/or whole brain radiotherapy are eligible if the patient remains
without evidence of disease progression in brain ≥ 3 months prior to registration
date . They must also be off corticosteroid therapy for ≥ 3 weeks prior to
registration date.

7. Patients who have received anticancer agent(s) or an investigational agent within 28
days prior to study drug administration.

8. Subjects who have not recovered to within one grade level (not to exceed grade 2) of
their baseline following a significant adverse event or toxicity attributed to
previous anticancer treatment are excluded.

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

To determine the objective response rate to 6MP/MTX in this patient population.

Outcome Description:

1st stage: If less than 3/30 evaluable patients respond at 8 weeks the trial will be stopped for futility. If 3 or more out of 30 evaluable patients respond then a further 35 patients will be recruited (2nd stage). The proportion of patients responding to treatment will be presented, together with 95% confidence intervals, for Stage 1 and overall, if applicable. This will be repeated separately for patients previously treated with/without PARP inhibitors.

Outcome Time Frame:

Up to 24 weeks after the 30th (65th) patient has been recruited.

Safety Issue:


Principal Investigator

Shibani Nicum

Investigator Role:

Principal Investigator

Investigator Affiliation:

University of Oxford


United Kingdom: Medicines and Healthcare Products Regulatory Agency

Study ID:




Start Date:

May 2011

Completion Date:

May 2015

Related Keywords:

  • Breast Cancer
  • Ovarian Cancer
  • BRCA defective
  • Breast Neoplasms
  • Ovarian Neoplasms