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Capecitabine and Pegylated Interferon Alfa-2a in Treating Patients With Recurrent or Progressive Brain Metastases Due to Breast Cancer

Phase II Trial of Capecitabine (Xeloda®) and Pegylated Interferon Alfa-2A(Pegasys®) for Recurrent or Progressive Brain Metastasis From Breast Carcinoma

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00227656
Enrollment
2
Registered
2005-09-28
Start date
2005-09-30
Completion date
2006-11-30
Last updated
2012-12-11

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

Conditions

Breast Cancer, Metastatic Cancer

Keywords

stage IV breast cancer, recurrent breast cancer, male breast cancer, tumors metastatic to brain

Brief summary

RATIONALE: Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Pegylated interferon alfa-2a may interfere with the growth of tumor cells. Giving capecitabine together with pegylated interferon alfa-2a may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving capecitabine together with pegylated interferon alfa-2a works in treating patients with recurrent or progressive brain metastases due to breast cancer.

Detailed description

OBJECTIVES: Primary * Determine the efficacy of capecitabine and pegylated interferon alfa-2a, in terms of 6-month neurologic progression-free rate, in patients with recurrent or progressive brain metastases secondary to breast cancer. Secondary * Determine the toxicity spectrum of this regimen in these patients. * Determine the time to neurologic progression and overall survival of patients treated with this regimen. OUTLINE: This is an open-label, multicenter study. Patients receive oral capecitabine twice daily on days 1-14 and pegylated interferon alfa-2a subcutaneously on days 1, 8, and 15. Treatment repeats every 3 weeks for at least 6 months in the absence of disease progression or unacceptable toxicity. PROJECTED ACCRUAL: A total of 38-98 patients will be accrued for this study within 2 years.

Interventions

Once a week subcutaneous injection for 21 days, beginning at 180 mcg per week. Repeated for additional 21 days to begin at the same time as repeat 21 day Capecitabine cycle.

DRUGCapecitabine

1000 mg/m\^2 twice daily during first 14 days of each 3-week cycle (2 weeks on, 1 week rest).

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
M.D. Anderson Cancer Center
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed breast cancer that metastasized to the brain, meeting all of the following criteria: * Must have ≥ 1 inoperable brain metastases, meeting 1 of the following criteria: * Progressive or recurrent disease after prior whole-brain or stereotactic radiotherapy * Ineligible for OR unwilling to be treated with radiotherapy * At least 1 unidimensionally measurable brain metastasis by enhanced MRI within the past 21 days * No progression or development of central nervous system (CNS) metastasis during prior treatment with capecitabine, fluorouracil, interferon alfa, or interferon beta * Systemic (i.e., outside the CNS system) cancer must be stable * No progressive disease (e.g., liver, lymphangitic, or lung metastases) * Hormone receptor status: * Not specified PATIENT CHARACTERISTICS: Age * 18 and over Sex * Male or female Menopausal status * Not specified Performance status * Karnofsky 70-100% Life expectancy * More than 12 weeks Hematopoietic * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * Hemoglobin ≥ 10 mg/dL * No history of idiopathic thrombocytopenic purpura * No known uncontrolled coagulopathy * No increased risk for anemia (e.g., thalassemia or spherocytosis) * No medically problematic anemia Hepatic * aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT) ≤ 2.5 times upper limit of normal (ULN) (5 times ULN for patients with concurrent liver metastases ) * Bilirubin ≤ 1.5 times ULN * Alkaline phosphatase ≤ 2.5 times ULN (5 times ULN for patients with concurrent liver metastases; 10 times ULN for patients with concurrent bone metastases) Renal * Creatinine ≤ 1.5 times ULN OR * Creatinine clearance ≥ 30 mL/min Cardiovascular * No congestive heart failure * No symptomatic coronary artery disease * No medically uncontrolled arrhythmia * No other clinically significant cardiac disease * No myocardial infarction within the past 12 months Gastrointestinal * No history of inflammatory bowel disease * Must have intact upper gastrointestinal tract * Able to swallow tablets * No malabsorption syndrome * No history of gastrointestinal bleeding Immunologic * No prior unanticipated severe reaction to fluoropyrimidine therapy, interferon, pegylated interferon, or a pegylated moiety * No known sensitivity to fluorouracil * No serious uncontrolled infection * No history of immunologically mediated disease Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for 6 months after completion of study treatment * No known dihydropyrimidine dehydrogenase deficiency * No history of depression characterized by a suicide attempt * No history of hospitalization for psychiatric disease * No history of other severe psychiatric disease * No prior disability as a result of psychiatric disease * No history of clinically significant psychiatric disability that would preclude study compliance * No other malignancy within the past 5 years except cured nonmelanoma skin cancer or treated carcinoma in situ of the cervix * No uncontrolled thyroid dysfunction (e.g., thyroid-stimulating hormone not in normal range) * No evidence of severe retinopathy (e.g., Cytomegalovirus (CMV) retinitis or macular degeneration) * No clinically relevant ophthalmologic disorders due to diabetes or hypertension * No other serious uncontrolled medical conditions that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy * See Disease Characteristics * At least 3 months since prior interferon alfa or interferon beta Chemotherapy * See Disease Characteristics * At least 3 months since prior capecitabine or fluorouracil Endocrine therapy * Concurrent hormonal agents (e.g., tamoxifen, raloxifene, or anastrazole) for breast cancer allowed Radiotherapy * See Disease Characteristics Surgery * More than 4 weeks since prior major surgery and recovered Other * More than 4 weeks since prior participation in another investigational drug study * At least 4 weeks since prior and no concurrent brivudine or sorivudine * No concurrent cimetidine * No other concurrent investigational or commercial agents or therapies for this malignancy

Design outcomes

Primary

MeasureTime frame
Neurologic progression-free survival rate at 6 months6 months

Secondary

MeasureTime frameDescription
Time to neurologic progression6 months or until disease progression
Overall survivalUp to 2 years
Tumor response (complete response and partial response)6 monthsResponse Evaluation Criteria in Solid Tumors (RECIST) criteria for Target (Brain Metastasis) Lesions where Complete Response (CR): Disappearance of all target lesions; and Partial Response (PR): At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.
Toxicity6 monthsToxicity defined as grade 3 or 4 hematologic, skin (hand and foot syndrome), or fatigue/myalgia/flu debilitation-syndrome (interferon-related) toxicities.

Countries

United States

Outcome results

None listed

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