The Efficacy and Safety of Mecobalamin in the Prevention of Capecitabine Induced Hand Foot Syndrome

The Efficacy and Safety of Mecobalamin in the Prevention of Capecitabine Induced Hand Foot Syndrome in Breast Cancer Patients: A Multicenter, Phase III, Randomized, Double-blind, Controlled Trial

A multicenter, randomized, placebo-controlled, double-blind, phase III clinical trial will be conducted to explore the efficacy and safety of mecobalamin in the prevention of 2/3 HFS in patients with early breast cancer. 234 patients will be enrolled and will be randomized into mecobalamin group and placebo group at the ration of 1:1. The incidence of grade 2 / 3 HFS in the experimental group and the control group will be observed. This study is expected to provide evidence for clinical prevention of hand foot syndrome, improve clinical treatment guidelines for early breast cancer, and provide reference for other antitumor drugs for hand foot syndrome.

Study Overview

• Status: Active, not recruiting
• Conditions: Hand-foot Syndrome
• Intervention / Treatment: Drug: Mecobalamin 5 MG Disintegrating Oral Tablet; Drug: placebo

Detailed Description

Capecitabine is a drug recommended for adjuvant therapy in early breast cancer. The key to improving the prognosis of early breast cancer is to ensure that adequate treatment is sufficient. Hand foot syndrome Hand foot syndrome (HFS) is the most common and specific side effect of capecitabine, in which the incidence of grade 2 / 3 HFS requiring treatment is as high as 17-36%. At present, there is no specific drug for the treatment of HFS, and capecitabine must be reduced or stopped in case of grade 2 / 3 HFS. The guidelines also do not recommend standard drugs for the prevention of HFS. Mecobalamin is a derivative of vitamin B12, which can improve autonomic nervous system After symptoms and repair of small neuropathy, its clinical indication is the treatment of peripheral neuropathy.

A multicenter, randomized, placebo-controlled, double-blind, phase III clinical trial will be conducted to explore the efficacy and safety of mecobalamin in the prevention of 2/3 HFS in patients with early breast cancer. 234 patients will be enrolled and will be randomized into mecobalamin group and placebo group at the ration of 1:1. The incidence of grade 2 / 3 HFS in the experimental group and the control group will be observed. This study is expected to provide evidence for clinical prevention of hand foot syndrome, improve clinical treatment guidelines for early breast cancer, and provide reference for other antitumor drugs for hand foot syndrome.

• Study Type: Interventional
• Enrollment (Estimated): 234
• Phase: Phase 3

Contacts and Locations

Study Locations

• China
  • Guangdong
    • Guangzhou, Guangdong, China, 510120
      • Sun Yat-sen Memorial Hospital of Sun Yat-sen University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Female, aged 18 to 75
2. Her-2 negative patients with non metastatic breast cancer.
3. patients with early breast cancer who did not receive PCR after neoadjuvant chemotherapy or patients with lymph node metastasis after breast cancer surgery.

4. Prepare to receive postoperative adjuvant single drug capecitabine or capecitabine combined with endocrine therapy and / or radiotherapy

   The Binbin dose is 1000mg / ㎡, bid (continuous oral administration for 14 days, stopping for 7 days, repeated every 21 days)

5. Eastern cancer cooperation group (ECoG) physical strength score 0-1;

6. During randomization, the toxicity related to previous treatment must be alleviated to NCI CTCAE (version 4.03) ≤ 1 degree (except hair loss or according to the research)

   Other toxicity judged by the investigator that there is no risk to the safety of the patient);

7. Blood routine examination was basically normal within 4 weeks before enrollment: A. white blood cell count (WBC) ≥ 3.0 × 10 ^ 9 / L, B. medium

   Sex granulocyte count (ANC) ≥ 1.5 × 10 ^ 9 / L, C. platelet count (PLT) ≥ 100 × 10^9／L;

8. The liver and kidney function tests were basically normal within 4 weeks before enrollment (based on the normal values in the laboratories of each research center): a

   Total bilirubin (TBIL) ≤ 1.5 × Upper limit of normal value (ULN), B. alanine aminotransferase and aspartate aminotransferase (ALT / AST)

   ≤2.5 × ULN (patients with liver metastasis) ≤ 5 × ULN), C. serum creatinine ≤ 1.5 × ULN or creatinine clearance (CCR)

   ≥60 ml/min；

9. Women of childbearing age must have a serum / urine pregnancy test 4 weeks before enrollment, and the result is negative, and are willing to participate in the study

   Use a medically recognized high-efficiency contraceptive during and within 6 months after the last administration of the drug;

10. Informed consent has been signed before joining the group;
11. There was no active infectious disease within 12 weeks of screening period

Exclusion Criteria:

1. in the first 5 years of randomised allocation, there was a history of malignancy except for breast cancer, but the risk of metastasis or death was negligible.

   Except for malignant tumors that can be cured after treatment (such as appropriately treated cervical carcinoma in situ, non melanoma skin cancer or stage I cancer)

   Uterine cancer, thyroid cancer, etc.);

2. Any accompanying disease or condition that may interfere with the study, or any serious medical impairment that may affect the safety of the subject

   (for example, uncontrollable heart disease, hypertension, active or uncontrollable infection, active hepatitis B virus infection);

3. there are diseases affecting skin: diabetes, dermatomyositis, sclerosing disease, lupus erythematosus and so on.
4. Known history of psychotropic substance abuse or drug abuse;
5. Pregnant or lactating patients;
6. Inability to swallow, intestinal obstruction or other factors affecting drug administration and absorption.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Mecobalamin group; Mecobalamin (0.5mg / time, 3 times / day) for 6 months	Drug: Mecobalamin 5 MG Disintegrating Oral Tablet; Mecobalamin 0.5mg / time, 3 times / day,was taken continuously for 6 months
Placebo Comparator: Placebo group; placebo (0.5mg / time, 3 times / day) for 6 months	Drug: placebo; placebo 0.5mg / time, 3 times / day,was taken continuously for 6 months

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The incidence of grade 2 / 3 hand foot syndrome	The incidence equals the numbers of patients happens 2nd or 3rd level hand foot syndrome/the number of total patients in each group	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The reduction or withdrawal rate of capecitabine	the proportion of subjects with capecitabine reduction of more than 75% or capecitabine withdrawal accounted for the proportion of subjects in each group	6 months
Disease Free Survival	The time from the beginning of treatment to the recurrence of the disease or death from any cause or the end of the visit	5 years
Overall Survival	The time from the beginning of treatment to the death of the patient caused by any factor	5 year
The score of life quality questionnaire	The score of HF-Qol	6 months
The score of life quality	The score of QLQ-C30	6 months
The score of life quality QLQ-BR23	The score of QLQ-BR23	6 months
The incidence of adverse events	Incidence of adverse outcome events (such as fatigue, malignancy / vomiting, abdominal pain, diarrhea, stomatitis, impaired liver function, bone marrow suppression, etc.)	6 months

Collaborators and Investigators

• Sponsor: Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
• Investigators: Study Chair: Chang Gong, Sun Yat-sen Memorial Hospital of Sun Yat-sen Univeristy

Publications and helpful links

General Publications

• Xia Y, Zhu Y, Ling L, Xu F, Yang Y, Ye J, Tan W, Chen Z, Liu Q, Wei W, Zhang J, Zhang A, Zhang L, Song E, Gong C. Effect of methylcobalamin on capecitabine induced hand-foot syndrome in patients with HER2 negative early breast cancer: multicentre, double blind, randomised, placebo controlled, phase 3 trial. BMJ. 2025 Sep 11;390:e084290. doi: 10.1136/bmj-2025-084290.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2022
• Primary Completion (Actual): August 22, 2024
• Study Completion (Estimated): December 31, 2030

Study Registration Dates

• First Submitted: December 15, 2021
• First Submitted That Met QC Criteria: December 20, 2021
• First Posted (Actual): December 21, 2021

Study Record Updates

• Last Update Posted (Actual): February 2, 2026
• Last Update Submitted That Met QC Criteria: January 29, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Hand-foot Syndrome, Mecobalamin, Capecitabine, Breast Cancer
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Chemically-Induced Disorders; Skin Diseases; Breast Diseases; Drug-Related Side Effects and Adverse Reactions; Dermatitis; Drug Eruptions; Drug Hypersensitivity; Skin and Connective Tissue Diseases; Breast Neoplasms; Hand-Foot Syndrome; mecobalamin
• Other Study ID Numbers: 2020-KY-007

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No