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A Phase III Trial For Patients With Metastatic Breast Cancer

Randomized Trial of Gemcitabine Plus Docetaxel vs. Docetaxel Plus Capecitabine in Metastatic Breast Cancer in 1st and 2nd

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00191152
Enrollment
475
Registered
2005-09-19
Start date
2002-02-28
Completion date
2008-11-30
Last updated
2009-12-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer, Breast Neoplasms, Cancer of the Breast

Brief summary

This is a phase III randomized study between the docetaxel/gemcitabine and docetaxel/ capecitabine doublets, with crossover to the alternate agent. The experimental arm will receive gemcitabine 1000 mg/m2 intravenous (IV) over 30 minutes days 1 and 8 and docetaxel 75 mg/m2 IV day 1 over 1 hour repeated every three weeks. The comparator arm will receive docetaxel 75 mgm/m2 IV day 1 over 1 hour and oral capecitabine 1000 mg/m2 twice daily, days 1 through 14 repeated every three weeks. Patients who progress on the experimental arm, will be treated with capecitabine as dosed on the comparator arm. Patients who progress on the comparator arm will be treated with gemcitabine as dosed on the experimental arm.

Interventions

DRUGgemcitabine

1000 mg/m2, intravenous (IV) day 1 and day 8 every 21 days until disease progression

DRUGdocetaxel

75 mg/m2, intravenous (IV), every 21 days until disease progression

DRUGcapecitabine

1000 mg/m2, by mouth (PO) twice a day (BID), days 1-14, every 21 days until disease progression

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Histologic or cytologic confirmation of breast cancer with locally advanced and/or metastatic disease * Patients may have received prior neo-adjuvant or adjuvant taxane regimen as long as it has been greater than or equal to 6 months since completion of the regimen * Patients may have had 0-1, but no more than one prior course of chemotherapy for metastatic disease * Patients must have either measurable or non-measurable (evaluable) disease * Prior radiation therapy allowed of less than 25% of the bone marrow

Exclusion criteria

* Second primary malignancy (except in situ carcinoma of the cervix or adequately treated nonmelanomatous carcinoma of the skin or other malignancy treated at least 5 years previously with no evidence of recurrence) * Parenchymal or leptomeningeal brain metastases * Peripheral neuropathy greater than or equal to grade 2 * Prior treatment with gemcitabine and capecitabine will not be allowed. Prior treatment with a taxane in the metastatic setting will not be allowed. Prior taxane therapy in the neo-adjuvant or adjuvant setting is allowed if completion of therapy greater than or equal to 6 months prior to enrollment. * Active cardiac disease not controlled by therapy and/or myocardial infarction within the preceding 6 months. * Concomitant Herceptin is not allowed

Design outcomes

Primary

MeasureTime frameDescription
Time to Disease Progression (Initial Treatment)Randomization date to the earliest date of first documented disease progression date or the date of death if the participant died due to study disease (up to 82 months)Time to disease progression (TTDP) at initial treatment was defined as the number of months between date of randomization and the date of first documented disease progression or the date of death due to disease under study, whichever came first. TTDP censored at earliest of: 1) date of death not due to disease; or 2) date of last contact for participants alive without disease progression; or 3) start date of other anti-tumor therapy; or 4) first dose date of crossover treatment.

Secondary

MeasureTime frameDescription
Progression-Free Survival (Initial Treatment)Date of randomization until the date of first documented progression or date of death from any cause, whichever came first (up to 82 months)For initial treatment, progression-free survival (PFS) was defined as the number of months between the date of randomization and the date of first documented disease progression or the date of death due to any cause, whichever came first. Time to PFS was censored at the earliest of: 1) date of last contact for participants alive without disease progression; or 2) start date of other anti-tumor therapy for progression; or 3) first dose date of crossover treatment.
Progression-Free Survival (Crossover Treatment)First dose date of crossover treatment to date of first-documented progression after receiving crossover treatment or date of death due to any cause, whichever came first (up to 82 months)For crossover treatment, progression-free survival (PFS) was defined as the number of months between first dose date of crossover treatment and date of documented disease progression or date of death due to any cause, whichever came first. PFS for crossover treatment only applied to those participants who crossed over from initial treatment to crossover treatment. PFS was censored at the earliest of: 1) date of last contact for participants alive without disease progression; or 2) start date of other anti-tumor therapy for participants with documented disease progression.
Duration of Response (Initial Treatment)Date of response (CR or PR) until the first date of documented progression or death from any cause (up to 82 months)Among tumor responders, duration of tumor response was measured from the date of response (complete response \[CR\] or partial response \[PR\] until the first date of documented progression or death from any cause. Duration of response was censored at the earliest of: 1) date of last contact for participants alive without disease progression (DP); or 2) start date of other anti-tumor therapy for DP; or 3) dose date of crossover treatment.
Duration of Response (Crossover Treatment)Date of CR or PR until first date of recurrent or progressive disease after receiving crossover treatment was objectively documented or date of date due to any cause, whichever came first (up to 82 months)At crossover treatment, duration of response was measured from the time criteria were met for complete response (CR) or partial response (PR), until first date that recurrent or progressive disease was objectively documented or date of death due to any cause, whichever came first. This definition only applied to those who crossed over & achieved CR or PR in crossover treatment. Duration of response censored at earliest of: 1) date of last contact for those alive without disease progression; or 2) start date of other anti-tumor therapy for documented disease progression.
Overall SurvivalDate of randomization to date of death from any cause (up to 82 months)Overall survival time was defined as the number of months between the date of randomization and the date of death due to any cause. The overall survival time was censored at the date of last contact for participants who were still alive.
Time to Disease Progression (Crossover Treatment)Date of first dose of crossover treatment to date of first-documented disease progression after receiving first crossover treatment or date of death due to study disease, whichever came first (up to 82 months)For crossover treatment, time to disease progression (TTDP) was defined as the number of months between the first dose date of crossover treatment and the date of disease progression or the date of death due to disease under study, whichever came first. TTDP for crossover treatment only applied to those participants who crossed over from initial treatment to crossover treatment. TTDP censored at earliest of: 1)date of death not due to disease; or 2)date of last contact for participants alive without disease progression; or 3)start date of other anti-tumor therapy due to progression.
Best Overall Response (Crossover Treatment)Best response from start of treatment until disease progression/recurrence (up to 82 months)Best overall response was the best response recorded from the start of treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). Response assessed using RECIST criteria. Complete Response=disappearance of all target lesions; Partial Response=30% decrease in sum of longest diameter of target lesions; Progressive Disease=20% increase in sum of longest diameter of target lesions; Stable Disease=small changes that did not meet above criteria.
Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment)Baseline until crossover treatment began (up to 82 months)KPS ranges from 0 to 100, subdivided into three categories: incapacitated (0-40), self-care (50-70), and normal activity (80-100).
Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment)First day of crossover treatment until end of crossover treatment at trial discontinuation (up to 82 moths)KPS ranges from 0 to 100, subdivided into three categories: incapacitated (0-40), self-care (50-70), and normal activity (80-100).
Summary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment)Baseline until crossover treatment began (up to 82 months)RSCL includes 4 scales to assess quality of life (QOL) endpoints: 1) a 23-item physical distress level with scale score ranges from 23 to 92 \[low score represents better QOL\] 2)a 7-item psychological distress level with scale score ranges from 7 to 28\[low score represents better QOL\] 3)8-item activity level with scale score ranges from 8 to 32 \[high score represents better QOL\]; 1-item overall valuation of life with score range from 1 to 7 \[low score represents better QOL\].
Summary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment)First day of crossover treatment until end of crossover treatment at trial discontinuation (up to 82 months)RSCL includes 4 scales to assess quality of life (QOL) endpoints: 1) a 23-item physical distress level with scale score ranges from 23 to 92 \[low score represents better QOL\] 2)a 7-item psychological distress level with scale score ranges from 7 to 28\[low score represents better QOL\] 3)8-item activity level with scale score ranges from 8 to 32 \[high score represents better QOL\]; 1-item overall valuation of life with score range from 1 to 7 \[low score represents better QOL\].
Best Overall Response (Initial Treatment)Best response from start of treatment until disease progression/recurrence (up to 82 months)Best overall response was the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). Response was assessed using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Complete Response=disappearance of all target lesions; Partial Response=30% decrease in sum of longest diameter of target lesions; Progressive Disease=20% increase in sum of longest diameter of target lesions; Stable Disease=small changes that did not meet above criteria.

Countries

Argentina, Australia, Brazil, Mexico, Puerto Rico, South Korea, Taiwan, United States

Participant flow

Pre-assignment details

Not all participants who completed initial treatment went on to crossover treatment. Per protocol, participants had the option to go off study without receiving crossover treatment.

Participants by arm

ArmCount
Gemcitabine Plus Docetaxel
Initial treatment: Gemcitabine 1000 milligrams per meter squared (mg/m2), intravenous (IV) on Days 1 and 8 every 21 days plus docetaxel 75 mg/m2 IV on Day 1 every 21 days. This treatment continues until progression of disease (PD), at which time crossover treatment begins. Crossover treatment: capecitabine 1000 mg/m2 by mouth (PO)twice a day (BID), Days 1-14, every 21 days until progressive disease (PD) at which time all treatment is discontinued.
239
Docetaxel Plus Capecitabine
Initial treatment: Docetaxel 75 milligrams per meter squared (mg/m2), intravenous (IV) on Day 1 every 21 days plus capecitabine 1000 mg/m2, by mouth (PO), twice a day (BID),Days 1-14, every 21 days. This treatment continues until progression of disease (PD), at which time crossover treatment begins. Crossover treatment: gemcitabine 1000 mg/m2, IV, Days 1 and 8, every 21 days. This treatment continues until PD at which time all treatment is discontinued.
236
Total475

Withdrawals & dropouts

PeriodReasonFG000FG001
Crossover TreatmentAdverse Event88
Crossover TreatmentLost to Follow-up21
Crossover TreatmentOther43
Crossover TreatmentPhysician Decision77
Crossover TreatmentWithdrawal by Subject69
Initial TreatmentAdverse Event4367
Initial TreatmentLost to Follow-up06
Initial TreatmentOther1821
Initial TreatmentPhysician Decision4031
Initial TreatmentWithdrawal by Subject4028

Baseline characteristics

CharacteristicGemcitabine Plus DocetaxelDocetaxel Plus CapecitabineTotal
Age Continuous55.8 years
STANDARD_DEVIATION 11.77
54.6 years
STANDARD_DEVIATION 11.6
55.2 years
STANDARD_DEVIATION 11.69
Karnofsky Performance Status-Baseline
100 - Normal no complaints; no evidence of disease
74 units on a scale75 units on a scale149 units on a scale
Karnofsky Performance Status-Baseline
<=60 Needs increasing assistance up to Death (0)
0 units on a scale0 units on a scale0 units on a scale
Karnofsky Performance Status-Baseline
70 - Unable to carry on normal activity
16 units on a scale15 units on a scale31 units on a scale
Karnofsky Performance Status-Baseline
80 - Activity with effort; some signs of disease
44 units on a scale40 units on a scale84 units on a scale
Karnofsky Performance Status-Baseline
90 - Normal activity; minor signs of disease
101 units on a scale101 units on a scale202 units on a scale
Karnofsky Performance Status-Baseline
Missing
4 units on a scale5 units on a scale9 units on a scale
Race/Ethnicity
African Descent
23 participants12 participants35 participants
Race/Ethnicity
Caucasian
160 participants158 participants318 participants
Race/Ethnicity
Hispanic
26 participants36 participants62 participants
Race/Ethnicity
Oriental
28 participants30 participants58 participants
Race/Ethnicity
Other
2 participants0 participants2 participants
Region of Enrollment
Argentina
11 participants13 participants24 participants
Region of Enrollment
Australia
11 participants12 participants23 participants
Region of Enrollment
Brazil
1 participants1 participants2 participants
Region of Enrollment
Korea, Republic of
10 participants10 participants20 participants
Region of Enrollment
Mexico
14 participants15 participants29 participants
Region of Enrollment
Puerto Rico
4 participants1 participants5 participants
Region of Enrollment
Taiwan
15 participants18 participants33 participants
Region of Enrollment
United States
173 participants166 participants339 participants
Sex: Female, Male
Female
237 Participants1 Participants238 Participants
Sex: Female, Male
Male
2 Participants235 Participants237 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
233 / 237221 / 226
serious
Total, serious adverse events
72 / 23755 / 226

Outcome results

Primary

Time to Disease Progression (Initial Treatment)

Time to disease progression (TTDP) at initial treatment was defined as the number of months between date of randomization and the date of first documented disease progression or the date of death due to disease under study, whichever came first. TTDP censored at earliest of: 1) date of death not due to disease; or 2) date of last contact for participants alive without disease progression; or 3) start date of other anti-tumor therapy; or 4) first dose date of crossover treatment.

Time frame: Randomization date to the earliest date of first documented disease progression date or the date of death if the participant died due to study disease (up to 82 months)

Population: Intent-to-treat (ITT) population: all randomized participants. Censored participants in initial treatment: 68 gemcitabine/docetaxel arm; 83 docetaxel/capecitabine arm.

ArmMeasureValue (MEDIAN)
CapecitabineTime to Disease Progression (Initial Treatment)9.28 months
GemcitabineTime to Disease Progression (Initial Treatment)8.88 months
p-value: 0.385Log Rank
Secondary

Best Overall Response (Crossover Treatment)

Best overall response was the best response recorded from the start of treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). Response assessed using RECIST criteria. Complete Response=disappearance of all target lesions; Partial Response=30% decrease in sum of longest diameter of target lesions; Progressive Disease=20% increase in sum of longest diameter of target lesions; Stable Disease=small changes that did not meet above criteria.

Time frame: Best response from start of treatment until disease progression/recurrence (up to 82 months)

Population: Only included participants who crossed over from initial treatment to crossover treatment.

ArmMeasureGroupValue (NUMBER)
CapecitabineBest Overall Response (Crossover Treatment)Partial Response (confirmed)10 participants
CapecitabineBest Overall Response (Crossover Treatment)Progressive Disease34 participants
CapecitabineBest Overall Response (Crossover Treatment)Stable Disease19 participants
CapecitabineBest Overall Response (Crossover Treatment)Unknown13 participants
CapecitabineBest Overall Response (Crossover Treatment)Complete Response (confirmed)1 participants
GemcitabineBest Overall Response (Crossover Treatment)Unknown18 participants
GemcitabineBest Overall Response (Crossover Treatment)Complete Response (confirmed)1 participants
GemcitabineBest Overall Response (Crossover Treatment)Partial Response (confirmed)6 participants
GemcitabineBest Overall Response (Crossover Treatment)Stable Disease20 participants
GemcitabineBest Overall Response (Crossover Treatment)Progressive Disease36 participants
p-value: 0.446Fisher Exact
Secondary

Best Overall Response (Initial Treatment)

Best overall response was the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). Response was assessed using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Complete Response=disappearance of all target lesions; Partial Response=30% decrease in sum of longest diameter of target lesions; Progressive Disease=20% increase in sum of longest diameter of target lesions; Stable Disease=small changes that did not meet above criteria.

Time frame: Best response from start of treatment until disease progression/recurrence (up to 82 months)

Population: ITT population.

ArmMeasureGroupValue (NUMBER)
CapecitabineBest Overall Response (Initial Treatment)Partial Response (confirmed)71 participants
CapecitabineBest Overall Response (Initial Treatment)Stable Disease96 participants
CapecitabineBest Overall Response (Initial Treatment)Progressive Disease32 participants
CapecitabineBest Overall Response (Initial Treatment)Unknown34 participants
CapecitabineBest Overall Response (Initial Treatment)Complete Response (confirmed)6 participants
GemcitabineBest Overall Response (Initial Treatment)Complete Response (confirmed)6 participants
GemcitabineBest Overall Response (Initial Treatment)Unknown34 participants
GemcitabineBest Overall Response (Initial Treatment)Partial Response (confirmed)79 participants
GemcitabineBest Overall Response (Initial Treatment)Stable Disease90 participants
GemcitabineBest Overall Response (Initial Treatment)Progressive Disease27 participants
p-value: 0.364Fisher Exact
Secondary

Duration of Response (Crossover Treatment)

At crossover treatment, duration of response was measured from the time criteria were met for complete response (CR) or partial response (PR), until first date that recurrent or progressive disease was objectively documented or date of death due to any cause, whichever came first. This definition only applied to those who crossed over & achieved CR or PR in crossover treatment. Duration of response censored at earliest of: 1) date of last contact for those alive without disease progression; or 2) start date of other anti-tumor therapy for documented disease progression.

Time frame: Date of CR or PR until first date of recurrent or progressive disease after receiving crossover treatment was objectively documented or date of date due to any cause, whichever came first (up to 82 months)

Population: ITT population: participants with CR or PR as best overall response at crossover treatment. Censored participants: 4 in capecitabine arm; 2 in gemcitabine arm.

ArmMeasureValue (MEDIAN)
CapecitabineDuration of Response (Crossover Treatment)25.89 months
GemcitabineDuration of Response (Crossover Treatment)42.50 months
p-value: 0.446Log Rank
Secondary

Duration of Response (Initial Treatment)

Among tumor responders, duration of tumor response was measured from the date of response (complete response \[CR\] or partial response \[PR\] until the first date of documented progression or death from any cause. Duration of response was censored at the earliest of: 1) date of last contact for participants alive without disease progression (DP); or 2) start date of other anti-tumor therapy for DP; or 3) dose date of crossover treatment.

Time frame: Date of response (CR or PR) until the first date of documented progression or death from any cause (up to 82 months)

Population: ITT population: participants with CR or PR as best overall response (initial treatment). Censored participants: 16 in gemcitabine/docetaxel arm; 30 in docetaxel/capecitabine arm.

ArmMeasureValue (MEDIAN)
CapecitabineDuration of Response (Initial Treatment)9.11 months
GemcitabineDuration of Response (Initial Treatment)10.39 months
p-value: 0.377Log Rank
Secondary

Overall Survival

Overall survival time was defined as the number of months between the date of randomization and the date of death due to any cause. The overall survival time was censored at the date of last contact for participants who were still alive.

Time frame: Date of randomization to date of death from any cause (up to 82 months)

Population: Intent to treat population: all randomized participant. Censored participants: 75 in gemcitabine/docetaxel arm; 72 in docetaxel/capecitabine arm.

ArmMeasureValue (MEDIAN)
CapecitabineOverall Survival22.99 months
GemcitabineOverall Survival23.29 months
p-value: 0.785Log Rank
Secondary

Progression-Free Survival (Crossover Treatment)

For crossover treatment, progression-free survival (PFS) was defined as the number of months between first dose date of crossover treatment and date of documented disease progression or date of death due to any cause, whichever came first. PFS for crossover treatment only applied to those participants who crossed over from initial treatment to crossover treatment. PFS was censored at the earliest of: 1) date of last contact for participants alive without disease progression; or 2) start date of other anti-tumor therapy for participants with documented disease progression.

Time frame: First dose date of crossover treatment to date of first-documented progression after receiving crossover treatment or date of death due to any cause, whichever came first (up to 82 months)

Population: ITT population: all randomized participants. Censored participants, crossover treatment: 13 in capecitabine arm; 10 in gemcitabine arm.

ArmMeasureValue (MEDIAN)
CapecitabineProgression-Free Survival (Crossover Treatment)4.51 months
GemcitabineProgression-Free Survival (Crossover Treatment)2.34 months
p-value: 0.145Log Rank
Secondary

Progression-Free Survival (Initial Treatment)

For initial treatment, progression-free survival (PFS) was defined as the number of months between the date of randomization and the date of first documented disease progression or the date of death due to any cause, whichever came first. Time to PFS was censored at the earliest of: 1) date of last contact for participants alive without disease progression; or 2) start date of other anti-tumor therapy for progression; or 3) first dose date of crossover treatment.

Time frame: Date of randomization until the date of first documented progression or date of death from any cause, whichever came first (up to 82 months)

Population: ITT: all randomized participants. Censored participants (initial treatment): 64 in gemcitabine/docetaxel arm; 80 in docetaxel/capecitabine arm.

ArmMeasureValue (MEDIAN)
CapecitabineProgression-Free Survival (Initial Treatment)9.01 months
GemcitabineProgression-Free Survival (Initial Treatment)8.88 months
p-value: 0.361Log Rank
Secondary

Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment)

KPS ranges from 0 to 100, subdivided into three categories: incapacitated (0-40), self-care (50-70), and normal activity (80-100).

Time frame: First day of crossover treatment until end of crossover treatment at trial discontinuation (up to 82 moths)

Population: Participants with KPS at baseline (conclusion of initial treatment) and end of crossover treatment

ArmMeasureGroupValue (MEAN)Dispersion
CapecitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment)Baseline89.09 units on a scaleStandard Deviation 7.174
CapecitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment)Change from Baseline-0.30 units on a scaleStandard Deviation 7.839
GemcitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment)Baseline87.94 units on a scaleStandard Deviation 9.36
GemcitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment)Change from Baseline-1.27 units on a scaleStandard Deviation 9.068
p-value: 0.117Mixed Models Analysis
Secondary

Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment)

KPS ranges from 0 to 100, subdivided into three categories: incapacitated (0-40), self-care (50-70), and normal activity (80-100).

Time frame: Baseline until crossover treatment began (up to 82 months)

Population: Intent-to-treat population, initial treatment, participants with KPS at baseline and end of initial treatment.

ArmMeasureGroupValue (MEAN)Dispersion
CapecitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment)Baseline90.85 units on a scaleStandard Deviation 8.159
CapecitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment)Change from Baseline-3.30 units on a scaleStandard Deviation 9.259
GemcitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment)Baseline90.09 units on a scaleStandard Deviation 8.335
GemcitabineSummary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment)Change from Baseline-3.27 units on a scaleStandard Deviation 9.118
p-value: 0.99Mixed Models Analysis
Secondary

Summary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment)

RSCL includes 4 scales to assess quality of life (QOL) endpoints: 1) a 23-item physical distress level with scale score ranges from 23 to 92 \[low score represents better QOL\] 2)a 7-item psychological distress level with scale score ranges from 7 to 28\[low score represents better QOL\] 3)8-item activity level with scale score ranges from 8 to 32 \[high score represents better QOL\]; 1-item overall valuation of life with score range from 1 to 7 \[low score represents better QOL\].

Time frame: First day of crossover treatment until end of crossover treatment at trial discontinuation (up to 82 months)

Population: Participants with RSCL at baseline (conclusion of initial treatment)and end of crossover treatment

ArmMeasureGroupValue (MEAN)Dispersion
CapecitabineSummary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment)Baseline75.00 units on a scaleStandard Deviation 20.876
CapecitabineSummary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment)Change from Baseline-2.78 units on a scaleStandard Deviation 21.029
GemcitabineSummary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment)Baseline76.39 units on a scaleStandard Deviation 17.663
GemcitabineSummary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment)Change from Baseline-0.69 units on a scaleStandard Deviation 27.133
p-value: 0.19Mixed Models Analysis
Secondary

Summary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment)

RSCL includes 4 scales to assess quality of life (QOL) endpoints: 1) a 23-item physical distress level with scale score ranges from 23 to 92 \[low score represents better QOL\] 2)a 7-item psychological distress level with scale score ranges from 7 to 28\[low score represents better QOL\] 3)8-item activity level with scale score ranges from 8 to 32 \[high score represents better QOL\]; 1-item overall valuation of life with score range from 1 to 7 \[low score represents better QOL\].

Time frame: Baseline until crossover treatment began (up to 82 months)

Population: Participants with RSCL at baseline and end of initial treatment.

ArmMeasureGroupValue (MEAN)Dispersion
CapecitabineSummary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment)Baseline68.09 units on a scaleStandard Deviation 25.103
CapecitabineSummary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment)Change from Baseline2.42 units on a scaleStandard Deviation 27.093
GemcitabineSummary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment)Baseline72.32 units on a scaleStandard Deviation 23.693
GemcitabineSummary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment)Change from Baseline-2.68 units on a scaleStandard Deviation 26.685
p-value: 0.801Mixed Models Analysis
Secondary

Time to Disease Progression (Crossover Treatment)

For crossover treatment, time to disease progression (TTDP) was defined as the number of months between the first dose date of crossover treatment and the date of disease progression or the date of death due to disease under study, whichever came first. TTDP for crossover treatment only applied to those participants who crossed over from initial treatment to crossover treatment. TTDP censored at earliest of: 1)date of death not due to disease; or 2)date of last contact for participants alive without disease progression; or 3)start date of other anti-tumor therapy due to progression.

Time frame: Date of first dose of crossover treatment to date of first-documented disease progression after receiving first crossover treatment or date of death due to study disease, whichever came first (up to 82 months)

Population: ITT population: all randomized participants. Censored participants in crossover treatment: 13 in capecitabine arm; 10 in gemcitabine arm.

ArmMeasureValue (MEDIAN)
CapecitabineTime to Disease Progression (Crossover Treatment)4.51 months
GemcitabineTime to Disease Progression (Crossover Treatment)2.34 months
p-value: 0.145Log Rank

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026