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Association of Capecitabine Pharmacokinetics and Toxicity With Aging

7 de marzo de 2018 actualizado por: Newcastle-upon-Tyne Hospitals NHS Trust

A Prospective Evaluation of Capecitabine and Metabolite Pharmacokinetics in Elderly Breast and Colorectal Cancer Patients and Their Association With Toxicity and Molecular Markers of Enzyme Activity and Aging

This is a multi-centre prospective non-interventional study designed to evaluate the effects of patient age on the pharmacokinetics of capecitabine and its metabolites 5'DFCR, 5'DFUR, and 5-FU. In addition, the study will assess the correlation between the pharmacokinetic parameters calculated and cytidine deaminase, biomarkers of aging, clinical frailty, treatment outcome, and toxicity. To be enrolled, patients must have breast or colorectal cancer and be eligible to receive capecitabine monotherapy in accordance with its approved clinical usage in the UK. Treatment will be administered according to NICE guidelines as well as the clinical judgement of the prescribing physician. One hundred patients (50 breast cancer patients, 50 colorectal cancer patients) who are about to start treatment with capecitabine monotherapy will be recruited to the study and undergo study procedures within the first week of treatment.

Descripción general del estudio

Estado

Desconocido

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Anticipado)

100

Fase

  • Fase 4

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • 1) Histologic or cytologic diagnosis of breast cancer or colorectal cancer. Patients should have disease that is suitable for capecitabine monotherapy as defined by the NICE Guidelines.

    2) Patients must be within the first week of their first cycle of capecitabine treatment.

    3) Estimated life expectancy of greater than 3 months. 4) Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2. 5) Total serum bilirubin less than or equal to 25 micromol/L. 6) Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels less than 2.5 times the upper limit of the normal range.

    7) Serum albumin level greater than 32 g/L. 8) Creatinine clearance greater than or equal to 30 mL/minute. 9) Blood haemoglobin level of greater than 9 g/dL, with transfusion allowed. 10) Absolute neutrophil count greater than 2.5 x 109/L. 11) Platelet count greater than 100 x 109/L. 12) 18 years of age or older. 13) Written informed consent.

Exclusion Criteria:

  1. Pregnancy or breast feeding.
  2. Known HIV, Hepatitis B, or Hepatitis C infection.
  3. Known Gilbert syndrome.
  4. Uncontrolled diabetes (HbA1c greater than 7.5%).
  5. Any condition or disease that might affect oral absorption of medications, including:

    1. Crohn's disease
    2. Ulcerative colitis
    3. Major gastric or small bowel resection

      -

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Ciencia básica
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Capecitabina
Otros nombres:
  • Xeloda

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Area under the curve (AUC) of capecitabine and metabolites
Periodo de tiempo: 0 (pre-dose), 0.5, 1, 2, 4, and 6 hours post dose
Measurement of AUC of capecitabine and its metabolites 5'deoxy-5-fluorocytidine (5'DFCR), 5'deoxy-5-fluorouridine (5'DFUR), and 5-fluorouracil.
0 (pre-dose), 0.5, 1, 2, 4, and 6 hours post dose

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Toxicities and grades as scaled by Common Toxicity Criteria for Adverse Effects (CTCAE) version 4.03
Periodo de tiempo: Six months
Toxicity grade(s) as measured by CTCAE version 4.03 (published by the U.S. Department of Heath and Human Services 2009). General grading scheme is as follows: Grade 1: Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2: Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental activities of daily living (ADL). Grade 3: Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL. Grade 4: Life-threatening consequences; urgent intervention indicated. Grade 5: Death related to AE.
Six months
Progression free survival as measured by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria version 1.1
Periodo de tiempo: From time of enrollment until first documented progression
Progression free survival as measured by the RECIST criteria version 1.1 (Eisenhauer et al., 2009). The RECIST criteria define progression as 'at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Note: the appearance of one or more new lesions is also considered progression)'
From time of enrollment until first documented progression
Response as measured by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria version 1.1
Periodo de tiempo: From time of enrollment to first documented response

Complete or partial response as measured by the RECIST criteria version 1.1. (Eisenhauer et al., 2009) Complete response = 'Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.

Partial response = 'At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.'

From time of enrollment to first documented response
Grip strength measured in kg
Periodo de tiempo: During 6-hour pharmacokinetic study session
Grip strength measured in kg by the grip strength test (using the Takei handheld dynamometer)
During 6-hour pharmacokinetic study session
Frailty as measured by the Edmonton Frail Scale
Periodo de tiempo: During 6-hour pharmacokinetic study session
Frailty as measured by the Edmonton Frail Scale. A 17 point scale that measures 9 frailty domains. 0-5: not frail; 6-7: vulnerable; 8-9: mild frailty; 10-11: moderate frailty; 12-17: severe frailty.
During 6-hour pharmacokinetic study session
Nutritional status as measured by the Mini Nutritional Assessment questionnaire
Periodo de tiempo: During 6-hour pharmacokinetic study session

Nutritional status as measured by the Mini Nutritional Assessment questionnaire, a 30 point test on nutritional status. Scoring: 24 to 30 points: Normal nutritional status.

17 to 23.5 points: At risk of malnutrition. Less than 17 points: malnourished.

During 6-hour pharmacokinetic study session
Quality of life as assessed by the European Organization for Research and Treatment of Cancer quality of life (EORTC-QLQ-C30 version 3) questionnaire
Periodo de tiempo: During 6-hour pharmacokinetic study session
Quality of life as measured by the EORTC-QLQ-C30 version 3 questionnaire. This questionnaire assesses the quality of life of cancer patients in a series of 30 questions, with 28 of the questions on a scale of 1 to 4 where 1 is 'not at all' and 4 is 'very much'. Final two questions relate to overall quality of life and health on a scale of 1 to 7, where 1 is 'very poor' and 7 is 'excellent'.
During 6-hour pharmacokinetic study session
Plasma cytidine deaminase activity (measured in units/mg protein by spectrophotometric assay)
Periodo de tiempo: 0 hours post dose (pre-dose)
Plasma cytidine deaminase activity (measured in units/mg protein by spectrophotometric assay).
0 hours post dose (pre-dose)
Maximum plasma concentration (Cmax) of capecitabine and metabolites
Periodo de tiempo: 0 (pre-dose), 0.5, 1, 2, 4, and 6 hours post dose
Cmax of capecitabine and its metabolites 5'deoxy-5-fluorocytidine (5'DFCR), 5'deoxy-5-fluorouridine (5'DFUR), and 5-fluorouracil.
0 (pre-dose), 0.5, 1, 2, 4, and 6 hours post dose
Time of maximum plasma concentration (Tmax) of capecitabine and metabolites
Periodo de tiempo: 0 (pre-dose), 0.5, 1, 2, 4, and 6 hours post dose
Cmax of capecitabine and its metabolites 5'deoxy-5-fluorocytidine (5'DFCR), 5'deoxy-5-fluorouridine (5'DFUR), and 5-fluorouracil.
0 (pre-dose), 0.5, 1, 2, 4, and 6 hours post dose

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Colaboradores

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de mayo de 2016

Finalización primaria (Anticipado)

1 de mayo de 2018

Finalización del estudio (Anticipado)

1 de noviembre de 2019

Fechas de registro del estudio

Enviado por primera vez

7 de agosto de 2015

Primero enviado que cumplió con los criterios de control de calidad

7 de marzo de 2018

Publicado por primera vez (Actual)

14 de marzo de 2018

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

14 de marzo de 2018

Última actualización enviada que cumplió con los criterios de control de calidad

7 de marzo de 2018

Última verificación

1 de marzo de 2018

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • SBRU201501

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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