Breast Cancer, Breast Neoplasms, Cancer of the Breast
Conditions
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
1000 mg/m2, intravenous (IV) day 1 and day 8 every 21 days until disease progression
75 mg/m2, intravenous (IV), every 21 days until disease progression
1000 mg/m2, by mouth (PO) twice a day (BID), days 1-14, every 21 days until disease progression
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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 Survival | Date 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
| Arm | Count |
|---|---|
| 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 |
| Total | 475 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Crossover Treatment | Adverse Event | 8 | 8 |
| Crossover Treatment | Lost to Follow-up | 2 | 1 |
| Crossover Treatment | Other | 4 | 3 |
| Crossover Treatment | Physician Decision | 7 | 7 |
| Crossover Treatment | Withdrawal by Subject | 6 | 9 |
| Initial Treatment | Adverse Event | 43 | 67 |
| Initial Treatment | Lost to Follow-up | 0 | 6 |
| Initial Treatment | Other | 18 | 21 |
| Initial Treatment | Physician Decision | 40 | 31 |
| Initial Treatment | Withdrawal by Subject | 40 | 28 |
Baseline characteristics
| Characteristic | Gemcitabine Plus Docetaxel | Docetaxel Plus Capecitabine | Total |
|---|---|---|---|
| Age Continuous | 55.8 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 scale | 75 units on a scale | 149 units on a scale |
| Karnofsky Performance Status-Baseline <=60 Needs increasing assistance up to Death (0) | 0 units on a scale | 0 units on a scale | 0 units on a scale |
| Karnofsky Performance Status-Baseline 70 - Unable to carry on normal activity | 16 units on a scale | 15 units on a scale | 31 units on a scale |
| Karnofsky Performance Status-Baseline 80 - Activity with effort; some signs of disease | 44 units on a scale | 40 units on a scale | 84 units on a scale |
| Karnofsky Performance Status-Baseline 90 - Normal activity; minor signs of disease | 101 units on a scale | 101 units on a scale | 202 units on a scale |
| Karnofsky Performance Status-Baseline Missing | 4 units on a scale | 5 units on a scale | 9 units on a scale |
| Race/Ethnicity African Descent | 23 participants | 12 participants | 35 participants |
| Race/Ethnicity Caucasian | 160 participants | 158 participants | 318 participants |
| Race/Ethnicity Hispanic | 26 participants | 36 participants | 62 participants |
| Race/Ethnicity Oriental | 28 participants | 30 participants | 58 participants |
| Race/Ethnicity Other | 2 participants | 0 participants | 2 participants |
| Region of Enrollment Argentina | 11 participants | 13 participants | 24 participants |
| Region of Enrollment Australia | 11 participants | 12 participants | 23 participants |
| Region of Enrollment Brazil | 1 participants | 1 participants | 2 participants |
| Region of Enrollment Korea, Republic of | 10 participants | 10 participants | 20 participants |
| Region of Enrollment Mexico | 14 participants | 15 participants | 29 participants |
| Region of Enrollment Puerto Rico | 4 participants | 1 participants | 5 participants |
| Region of Enrollment Taiwan | 15 participants | 18 participants | 33 participants |
| Region of Enrollment United States | 173 participants | 166 participants | 339 participants |
| Sex: Female, Male Female | 237 Participants | 1 Participants | 238 Participants |
| Sex: Female, Male Male | 2 Participants | 235 Participants | 237 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 233 / 237 | 221 / 226 |
| serious Total, serious adverse events | 72 / 237 | 55 / 226 |
Outcome results
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Capecitabine | Time to Disease Progression (Initial Treatment) | 9.28 months |
| Gemcitabine | Time to Disease Progression (Initial Treatment) | 8.88 months |
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.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Capecitabine | Best Overall Response (Crossover Treatment) | Partial Response (confirmed) | 10 participants |
| Capecitabine | Best Overall Response (Crossover Treatment) | Progressive Disease | 34 participants |
| Capecitabine | Best Overall Response (Crossover Treatment) | Stable Disease | 19 participants |
| Capecitabine | Best Overall Response (Crossover Treatment) | Unknown | 13 participants |
| Capecitabine | Best Overall Response (Crossover Treatment) | Complete Response (confirmed) | 1 participants |
| Gemcitabine | Best Overall Response (Crossover Treatment) | Unknown | 18 participants |
| Gemcitabine | Best Overall Response (Crossover Treatment) | Complete Response (confirmed) | 1 participants |
| Gemcitabine | Best Overall Response (Crossover Treatment) | Partial Response (confirmed) | 6 participants |
| Gemcitabine | Best Overall Response (Crossover Treatment) | Stable Disease | 20 participants |
| Gemcitabine | Best Overall Response (Crossover Treatment) | Progressive Disease | 36 participants |
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.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Capecitabine | Best Overall Response (Initial Treatment) | Partial Response (confirmed) | 71 participants |
| Capecitabine | Best Overall Response (Initial Treatment) | Stable Disease | 96 participants |
| Capecitabine | Best Overall Response (Initial Treatment) | Progressive Disease | 32 participants |
| Capecitabine | Best Overall Response (Initial Treatment) | Unknown | 34 participants |
| Capecitabine | Best Overall Response (Initial Treatment) | Complete Response (confirmed) | 6 participants |
| Gemcitabine | Best Overall Response (Initial Treatment) | Complete Response (confirmed) | 6 participants |
| Gemcitabine | Best Overall Response (Initial Treatment) | Unknown | 34 participants |
| Gemcitabine | Best Overall Response (Initial Treatment) | Partial Response (confirmed) | 79 participants |
| Gemcitabine | Best Overall Response (Initial Treatment) | Stable Disease | 90 participants |
| Gemcitabine | Best Overall Response (Initial Treatment) | Progressive Disease | 27 participants |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Capecitabine | Duration of Response (Crossover Treatment) | 25.89 months |
| Gemcitabine | Duration of Response (Crossover Treatment) | 42.50 months |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Capecitabine | Duration of Response (Initial Treatment) | 9.11 months |
| Gemcitabine | Duration of Response (Initial Treatment) | 10.39 months |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Capecitabine | Overall Survival | 22.99 months |
| Gemcitabine | Overall Survival | 23.29 months |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Capecitabine | Progression-Free Survival (Crossover Treatment) | 4.51 months |
| Gemcitabine | Progression-Free Survival (Crossover Treatment) | 2.34 months |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Capecitabine | Progression-Free Survival (Initial Treatment) | 9.01 months |
| Gemcitabine | Progression-Free Survival (Initial Treatment) | 8.88 months |
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
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Capecitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment) | Baseline | 89.09 units on a scale | Standard Deviation 7.174 |
| Capecitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment) | Change from Baseline | -0.30 units on a scale | Standard Deviation 7.839 |
| Gemcitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment) | Baseline | 87.94 units on a scale | Standard Deviation 9.36 |
| Gemcitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Crossover Treatment) | Change from Baseline | -1.27 units on a scale | Standard Deviation 9.068 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Capecitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment) | Baseline | 90.85 units on a scale | Standard Deviation 8.159 |
| Capecitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment) | Change from Baseline | -3.30 units on a scale | Standard Deviation 9.259 |
| Gemcitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment) | Baseline | 90.09 units on a scale | Standard Deviation 8.335 |
| Gemcitabine | Summary of Changes in Karnofsky Performance Status (KPS) by Treatment (Initial Treatment) | Change from Baseline | -3.27 units on a scale | Standard Deviation 9.118 |
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
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Capecitabine | Summary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment) | Baseline | 75.00 units on a scale | Standard Deviation 20.876 |
| Capecitabine | Summary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment) | Change from Baseline | -2.78 units on a scale | Standard Deviation 21.029 |
| Gemcitabine | Summary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment) | Baseline | 76.39 units on a scale | Standard Deviation 17.663 |
| Gemcitabine | Summary of Changes in Rotterdam Symptom Checklist by Treatment (Crossover Treatment) | Change from Baseline | -0.69 units on a scale | Standard Deviation 27.133 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Capecitabine | Summary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment) | Baseline | 68.09 units on a scale | Standard Deviation 25.103 |
| Capecitabine | Summary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment) | Change from Baseline | 2.42 units on a scale | Standard Deviation 27.093 |
| Gemcitabine | Summary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment) | Baseline | 72.32 units on a scale | Standard Deviation 23.693 |
| Gemcitabine | Summary of Changes in Rotterdam Symptom Checklist (RSCL) by Treatment (Initial Treatment) | Change from Baseline | -2.68 units on a scale | Standard Deviation 26.685 |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Capecitabine | Time to Disease Progression (Crossover Treatment) | 4.51 months |
| Gemcitabine | Time to Disease Progression (Crossover Treatment) | 2.34 months |