A Phase II Randomized Study of Docetaxel With or Without NINTEDANIB (BIBF-1120) in Patient Receiving a Second-line of Chemotherapy for HER Negative Metastatic or Locally Recurrent Breast Cancer
Inclusion Criteria:
- Age ≥ 18 years old
- Histologically or cytologically confirmed adenocarcinoma of the breast
- Locally recurrent or metastatic disease
- HER 2 negative status
- Prior first line chemotherapy not containing Docetaxel
- Relapsing after a first line chemotherapy for locally recurrent or metastatic disease
- Measurable or evaluable disease according to RECIST criteria
- Prior chemotherapy as follows :
- Docetaxel in the neoadjuvant or adjuvant setting is allowed provided that
relapse has been observed more than 12 months after the end of docetaxel
treatment
- Bevacizumab in 1st line is allowed with a wash-out of 3 months
- ECOG performance status 0-1
- Adequate bone marrow, hepatic and renal functions as evidence by the following:
- Hemoglobin ≥ 10 G/100 mL
- Neutrophils count ≥ 1500 /mm3
- Platelets ≥ 100 000 /mm3
- Total bilirubin ≤ ULN (ULN:Upper Limit of Normal)
- SGOT/SGPT ≤ 1.5 x ULN (≤ 2.5 x ULN in case of hepatic metastasis)
- Creatinin clearance ≥ 45 ml/min or creatinin ≤ 1.5 x ULN
- Proteinuria < CTCAE grade 2
- Coagulation parameters: International normalised ratio (INR) ≤ 2, prothrombin time
(PT) and partial thromboplastin time (PTT) ≤ 50% of deviation of institutional ULN
- Effective contraception for patients (male and female) of reproductive potential
during their entire participation in the study and during 3 months after the last
administration of Nintedanib or Docetaxel
- Negative pregnancy test (serum beta-HCG) within 1 week prior to start of study
treatment in females of reproductive potential
- Patient covered by government health insurance
- Signed and dated written informed consent prior to admission to the study in
accordance with ICH-GCP guidelines and to the local legislation
Exclusion Criteria:
- Symptomatic brain metastasis
- Concomitant hormone therapy for metastatic breast cancer
- Patients with dysphagia, or inability to swallow the tablets
- Other serious illness or medical conditions: Cardiac disease
- Unstable diabetes
- Uncontrolled hypercalcemia
- Clinically significant active infections
- Pregnancy or breast feeding woman
- Unable for medical follow-up (geographic, social or mental reasons)
- Prior treatment with Nintedanib or any other VEGFR inhibitor or stratify if trial
aims to establish anti-angiogenic retreatment
- Known hypersensitivity to the trial drugs , to their excipients or to contrast media
- Contra indication to the use of the backbone treatment and to the comparator
- Active brain metastases (e.g. stable for <4 weeks, no adequate previous treatment
with radiotherapy, symptomatic, requiring treatment with anti-convulsants;
dexamethasone therapy will be allowed if administered as stable dose for at least one
month before randomisation)
- Leptomeningeal disease
- Radiographic evidence of cavitary or necrotic tumors
- Centrally located tumors with radiographic evidence (CT or MRI) of local invasion of
major blood vessels
- History of clinically significant haemorrhagic or thromboembolic event in the past 6
months
- Known inherited predisposition to bleeding or thrombosis
- Significant cardiovascular diseases ( i.e. uncontrolled hypertension, unstable
angina, history of infarction within the past 12 months prior to start of study
treatment, congestive heart failure > NYHA II, serious cardiac arrhythmia,
pericardial effusion)
- Other malignancies within the past 5 years other than basal cell skin cancer or
carcinoma in situ of the cervix
- Active serious infections in particular if requiring systemic antibiotic or
antimicrobial therapy
- Active or chronic hepatitis C and/or B infection
- Active alcohol or drug abuse
- Significant weight loss (> 10% of BW) within past 6 months prior to inclusion into
the trial