check_circleStudy Completed

Breast Cancer

Phase III Trial Comparing Capecitabine in Combination with Sorafenib or Placebo in the Treatment of Locally Advanced or Metastatic HER2-Negative Breast Cancer

Trial purpose

The objective of this phase-III trial is to compare the efficacy and safety of sorafenib in combination with capecitabine versus capecitabine in combination with placebo in the treatment of subjects with locally advanced or metastatic HER2-negative breast cancer who are resistant to or have failed prior taxane and an anthracycline or for whom further anthracycline therapy is not indicated. After signing consent there can be up to 28 days before starting the treatment during which time a number of tests will be carried out which will include tumor evaluations and medical history. The following tests and evaluations will have to be done within 7 days of the start of treatment,on Day 1 of every cycle and at the end of study: Electrocardiogram, blood tests, patient quality of life questionnaires and a complete physical exam and vital signs. Treatment will be given in 21 day cycles with sorafenib/placebo to be taken every day for 21 days and capecitabine to be taken for the first 14 days. Patients will come in weekly for the first 6 weeks and then on Day1 for every cycle after the first 2 cycles. During the weekly visits the subjects will be check for any side effects and blood draws will happen for the study on Day 1 of each cycle. Subjects will be followed for overall survival.

Key Participants Requirements

Sex

Both

Age

18 - N/A
  • - Age is >=18 years
    - Subject has histologically or cytologically confirmed HER2-negative adenocarcinoma of the breast. HER2 status should be determined by an accredited laboratory
    - Subject has locally advanced or metastatic disease; locally advanced disease must not be amenable to resection with curative intent. Must have measurable or non-measurable disease (according to RECIST [Response Evaluation Criteria for Solid Tumors] 1.1)
    - All computer tomography (CT; with contrast) and magnetic resonance imaging (MRI) used to document disease must have been done <= 4 weeks before randomization. Bone scans (if clinically indicated) must have been done <= 12 weeks prior to randomization
    - Subject must have received up to two prior chemotherapy regimens (adjuvant/neo-adjuvant treatments are considered one regimen), and no more than one prior regimen for advanced and/or metastatic disease. Chemotherapy regimens include both targeted and biologic therapy
    - Prior regimens must have included an anthracycline (eg, doxorubicin, epirubicin) and a taxane (eg, paclitaxel, docetaxel), either in combination or in separate regimens, in either the neo-adjuvant/adjuvant or the metastatic setting or both, as either monotherapy or as part of a combination with another agent. Sequential regimens will count as a single regimen; multiple neo-adjuvant / adjuvant regimens will count as a single regimen
    - Subjects are either resistant to or have failed prior taxane and anthracycline
    OR
    Resistant to or have failed prior taxane AND for whom further anthracycline therapy is not indicated (for example, intolerance or cumulative doses of doxorubicin or doxorubicin equivalents [for example, epirubicin)
    - Subjects who relapse beyond 12 months after the last taxane or anthracycline dose given in the adjuvant, neo-adjuvant, or metastatic setting are eligible. Further therapy with the agent(s) for a subsequent regimen must have been considered and ruled out, for example due to prior toxicity or intolerance, or based on the local standard of practice
    - Prior experimental chemotherapy treatment is allowed, provided it is given in combination with at least one drug approved for the treatment of breast cancer (excluding drugs that target VEGF [Vascular Endothelial Growth Factor] or VEGFR [Vascular Endothelial Growth Factor Receptor], eg, bevacizumab, brivanib, sunitinib, vatalinib).
    - Prior hormonal therapy for locally advanced or metastatic breast cancer is allowed. Subjects who are refractory to hormonal therapy are allowed.
    - Prior neo-adjuvant or adjuvant chemotherapy is allowed.
    - Subject must have discontinued prior chemotherapy (including both targeted and biologic therapies), prior therapeutic radiation therapy, or prior hormonal therapy for locally advanced or metastatic disease >= 4 weeks (28 days) before randomization. Start of study treatment is allowed within less than 28 days of the prior therapy provided that 5 half-lives of the prior treatment drug(s) have elapsed
    - ECOG (Eastern Cooperative Oncology Group) performance status 0 or 1
    - Adequate bone marrow, liver and renal function within 7 days prior to randomization
    - All acute toxic effects of any prior treatment have resolved to NCI-CTCAE (National Cancer Institute-Common Terminology Criteria for Adverse Events) v4.0 Grade 1 or less
    - Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to randomization
    - Subjects (men and women) of childbearing potential must agree to use adequate contraception beginning at the signing of the ICF (Informed Consent Form) until at least 30 days after the last dose of study drug.
    - Subject must be able to swallow and retain oral medication
  • - HER2 positive breast cancer
    - Unknown hormone receptor status (estrogen and progesterone receptor).
    - Subjects with bilateral breast cancer or a history of two distinct breast cancers.
    - Subjects with inflammatory breast carcinoma.
    - Subjects who have received no prior taxane and anthracycline for the treatment of breast cancer (either in adjuvant, neo-adjuvant or metastatic setting).
    - Prior use of sorafenib or capecitabine
    - Subjects considered by the treating investigator to be appropriate candidates for hormonal therapy as current treatment for locally advanced/metastatic breast cancer
    - Subjects with locally advanced disease who are considered by the treating investigator to be appropriate candidates for radiation therapy as current treatment for locally advanced breast cancer
    - Subjects with active brain metastases or leptomeningeal disease.
    - Subjects with seizure disorder requiring medication.
    - Radiation to any lesions <= 4 weeks prior to randomization. Palliative radiation to bone metastasis for pain control is permitted with provisions
    - Major surgery, open biopsy, or significant traumatic injury <= 4 weeks
    - Evidence or history of bleeding diathesis or coagulopathy. Uncontrolled hypertension, active or clinically significant cardiac disease. Subject with thrombotic, embolic, venus or arterial events
    - Subjects with any hemorrhage/bleeding event of NCI-CTCAE v4.0 Grade 3 or higher within 4 weeks before randomization
    - Subjects with an infection of NCI-CTCAE v4.0 > Grade 2
    - Subjects with a history of human immunodeficiency virus infection or current chronic or active hepatitis B or C infection.
    - Subjects who have used strong CYP3A4 inducers (eg, phenytoin, carbamazepine, phenobarbital, St. John’s Wort [Hypericum perforatum], dexamethasone at a dose of greater than 16 mg daily, or rifampin [rifampicin], and/or rifabutin) within 28 days before randomization.
    - Subjects with any previously untreated or concurrent cancer that is distinct in primary site or histology from breast cancer
    - Subjects with a history DHPD (Dihydropyrimidine dehydrogenase) reaction to fluropyrimidine or history of known or suspected allergy or hypersensitivity to any of the study drugs
    - Presence of a non-healing wound, non-healing ulcer, or bone fracture
    - Women pregnant or breast feeding
    - Any condition which, in the investigator’s opinion, makes the subject unsuitable for trial participation

Trial summary

Enrollment Goal
537
Trial Dates
February 2011 - October 2017
Phase
Phase 3
Could I Receive a placebo
Yes
Products
Nexavar (Sorafenib, BAY43-9006)
Accepts Healthy Volunteer
No

Where to participate

StatusInstitutionLocation
Completed
Memphis, 38120, United States
Withdrawn
La Jolla, 92093-1503, United States
Completed
Greenbrae, 94904-2007, United States
Withdrawn
Zrifin, 6093000, Israel
Completed
Petah Tikva, 4941492, Israel
Completed
Jerusalem, 9372212, Israel
Completed
Albuquerque, 87131, United States
Withdrawn
Hazard, 41701, United States
Withdrawn
Davie, 33328, United States
Completed
Mar del Plata, B7600CTO, Argentina
Withdrawn
Córdoba, X5004BAL, Argentina
Withdrawn
La Plata, B1902CMK, Argentina
Withdrawn
Buenos Aires, Argentina
Withdrawn
Fortaleza, 60160-230, Brazil
Withdrawn
Sao Paulo, 01317-000, Brazil
Withdrawn
Porto Alegre, 90430-090, Brazil
Withdrawn
Porto Alegre, Brazil
Withdrawn
Belo Horizonte, 30110-090, Brazil
Withdrawn
Ijuí, 98700-000, Brazil
Withdrawn
Sao Paulo, 01509-900, Brazil
Withdrawn
Goiânia, 74605-070, Brazil
Withdrawn
Cachoeiro de Itapemirim, 29308-020, Brazil
Withdrawn
Itajaí, 88301-220, Brazil
Withdrawn
Florianópolis, 88034-000, Brazil
Withdrawn
Goiania, 74140-050, Brazil
Completed
West Palm Beach, 33407, United States
Completed
BRUGGE, 8000, Belgium
Withdrawn
LA LOUVIERE, 7100, Belgium
Completed
HASSELT, 3500, Belgium
Completed
BRUXELLES - BRUSSEL, 1000, Belgium
Completed
LIEGE, 4000, Belgium
Completed
Madrid, 28034, Spain
Completed
Madrid, 28033, Spain
Completed
Madrid, 28040, Spain
Completed
Barcelona, 08003, Spain
Completed
Barcelona, 08025, Spain
Completed
Barcelona, 08035, Spain
Completed
Terrassa, 08221, Spain
Completed
Lleida, 25198, Spain
Completed
Valencia, 46009, Spain
Completed
Valencia, 46014, Spain
Completed
Palma de Mallorca, 07198, Spain
Completed
Reus, 43204, Spain
Completed
EDEGEM, 2650, Belgium
Completed
Bunkyo, 113-8677, Japan
Completed
Kita-Adachigun, 362-0806, Japan
Completed
Hidaka, 350-1298, Japan
Completed
Nagoya, 464-8681, Japan
Completed
Matsuyama, 791-0280, Japan
Completed
Chiba, 260-8717, Japan
Completed
Fukuoka, 811-1395, Japan
Completed
Suita, 565-0871, Japan
Completed
Koto-ku, 135-8550, Japan
Completed
Osaka, 540-0006, Japan
Completed
Beer Sheva, 8410101, Israel
Completed
Haifa, 3109601, Israel
Completed
Haifa, 35152, Israel
Completed
Jerusalem, 9112001, Israel
Completed
Dublin, DUBLIN 4, Ireland
Completed
Cork, Ireland
Withdrawn
Cork, Ireland
Completed
Modena, 41124, Italy
Completed
Milano, 20089, Italy
Completed
Forlì-Cesena, 47014, Italy
Completed
Ancona, 60126, Italy
Completed
Pisa, 56126, Italy
Completed
Bologna, 40138, Italy
Withdrawn
Lecce, 73100, Italy
Completed
Palermo, 90127, Italy
Withdrawn
Pavia, 27100, Italy
Completed
Cremona, 26100, Italy
Completed
Ravenna, 48121, Italy
Completed
Wien, 1100, Austria
Completed
Linz, 4010, Austria
Completed
A Coruña, 15006, Spain
Withdrawn
Magdeburg, 38108, Germany
Withdrawn
Chemnitz, 09116, Germany
Withdrawn
Hamburg, 22081, Germany
Completed
Erlangen, 91054, Germany
Completed
Mainz, 55131, Germany
Completed
Stendal, 39576, Germany
Withdrawn
Lodz, 93-509, Poland
Completed
Gdansk, 80-952, Poland
Withdrawn
Szczecin, 70-115, Poland
Withdrawn
Warszawa, 04-125, Poland
Completed
Poznan, 61-485, Poland
Completed
Gdynia, 81-519, Poland
Withdrawn
Krakow, 31-115, Poland
Completed
Praha 5, 150 30, Czech Republic
Withdrawn
Praha, 18081, Czech Republic
Completed
Praha 5, 150 06, Czech Republic
Completed
Olomouc, 775 20, Czech Republic
Withdrawn
St. Petersburg, 188663, Russia
Withdrawn
Moscow, 115478, Russia
Completed
Chelyabinsk, 454087, Russia
Completed
Castellón de la Plana, 12002, Spain
Completed
Szentes, 6600, Hungary
Completed
Pecs, 7624, Hungary
Completed
Budapest, 1032, Hungary
Completed
Szolnok, H-5004, Hungary
Withdrawn
Szekesfehervar, 8000, Hungary
Completed
Nyiregyhaza, H-4400, Hungary
Withdrawn
Santiago, Chile
Withdrawn
Santiago, 7500921, Chile
Withdrawn
Santiago, 838-0455, Chile
Completed
Ramat Gan, 5266202, Israel
Completed
Nantes, 44805, France
Completed
Lille, 59020, France
Completed
Roma, 00161, Italy
Completed
Sevilla, 41013, Spain
Completed
Sevilla, 41071, Spain
Completed
Valencia, 46010, Spain
Completed
Madrid, 28041, Spain
Completed
Santiago de Compostela, 15706, Spain
Completed
Liverpool, 2170, Australia
Completed
Perth, 6000, Australia
Completed
Garran, 2605, Australia
Completed
Frankston, Australia
Completed
Waratah, 2298, Australia
Withdrawn
Fitzroy, 3065, Australia
Withdrawn
Thessaloniki, 540 07, Greece
Completed
Athens, 11528, Greece
Withdrawn
Pylaia / Thessaloniki, 57010, Greece
Completed
Heraklion, 711 10, Greece
Withdrawn
Athens, 11527, Greece
Completed
Larissa, 41100, Greece
Completed
Ioannina, 45500, Greece
Completed
Patras, 26500, Greece
Completed
London, NW3 2QG, United Kingdom
Completed
Northwood, HA6 2RN, United Kingdom
Completed
Nottingham, NG5 1PB, United Kingdom
Completed
Manchester, M20 4BX, United Kingdom
Completed
Truro, TR1 3LJ, United Kingdom
Completed
TOULOUSE, 31052, France
Withdrawn
Cape Town, South Africa
Completed
Pretoria, 0181, South Africa
Completed
Johannesburg, 2196, South Africa
Withdrawn
Sandton, 2199, South Africa
Completed
Pretoria, 0081, South Africa
Completed
Praha 10, 10034, Czech Republic
Completed
Ceske Budejovice, 370 01, Czech Republic
Completed
Nymburk, 288 02, Czech Republic
Withdrawn
Moscow, 115478, Russia
Withdrawn
Ufa, 450054, Russia
Completed
Kazan, 420029, Russia
Completed
Dublin, DUBLIN 8, Ireland
Withdrawn
Porto Alegre, 90610-000, Brazil
Withdrawn
Fortaleza, 60430-230, Brazil
Withdrawn
Porto Alegre, 90110-270, Brazil
Withdrawn
São Paulo, 03102 002, Brazil
Withdrawn
Jaú, 17210-120, Brazil
Withdrawn
Abingdon, 24211, United States
Withdrawn
Burlington, 01805, United States
Completed
Boston, 02114, United States
Withdrawn
Tacoma, 98431-5000, United States
Withdrawn
Jacksonville, 32209, United States
Withdrawn
Winston-Salem, 24103, United States
Withdrawn
Seattle, 98109-1023, United States
Withdrawn
New Orleans, 70121, United States
Completed
Lake Success, 11042, United States
Completed
Madison, 53792, United States
Completed
Sylmar, 91342, United States
Completed
Durham, 27710, United States
Withdrawn
Danville, 17822-2001, United States
Withdrawn
Lake City, 32024, United States
Completed
Buenos Aires, C1280AEB, Argentina
Completed
Buenos Aires, C1425AWC, Argentina
Withdrawn
Santa Fé, S3000FFV, Argentina
Completed
Bendigo, 3550, Australia
Completed
Adelaide, 5000, Australia
Completed
Berlin, 13589, Germany
Completed
Monza-Brianza, 20900, Italy
Completed
Palma de Mallorca, 07120, Spain
Completed
Sabadell, 08208, Spain
Withdrawn
Kalmar, 391 85, Sweden
Completed
Pretoria, 0084, South Africa
Completed
Praha 2, 128 08, Czech Republic
Completed
Galway, Ireland
Withdrawn
Dooradoyle, Ireland
Withdrawn
Piracicaba, 13416-225, Brazil
Completed
Leipzig, 04103, Germany
Withdrawn
Weston, M9N 1N8, Canada
Completed
Lake Success, 11042, United States
Withdrawn
Atlanta, 30322, United States
Completed
Montreal, H2L 4M1, Canada
Completed
Dublin, 9, Ireland
Completed
Köln, 51067, Germany
Withdrawn
ANGERS cedex 9, 49933, France
Completed
Barcelona, 08036, Spain
Withdrawn
Racine, 53405, United States
Completed
Springfield, 65804, United States
Completed
San Juan, 00918, United States
Completed
Evansville, 47713, United States
Completed
Montreal, H3G 1A4, Canada
Withdrawn
Chicago, 60611, United States
Completed
Louisville, 40207, United States
Completed
Bristol, 37620, United States
Completed
Joliet, 60435, United States
Completed
Philadelphia, 19104, United States
Completed
El Paso, 79905, United States
Completed
Burlington, 05405, United States
Completed
Frankfurt, 60389, Germany
Completed
Offenbach, 63069, Germany
Completed
Jackson, 39202, United States
Completed
CLERMONT FERRAND CEDEX 1, 63011, France
Completed
SAINT CLOUD, 92210, France
Completed
Dublin, 7, Ireland
Completed
Dublin, 7, Ireland
Withdrawn
Weston, 54476, United States
Completed
Stockholm, 171 76, Sweden
Completed
Köln, 50931, Germany
Completed
Port Elizabeth, 6045, South Africa
Completed
Nova Ves Pod Plesi, 262 04, Czech Republic
Withdrawn
Genova, 16132, Italy
Withdrawn
Langen, 63225, Germany
Completed
Stockholm, 118 83, Sweden
Completed
Boston, 02115-6084, United States
Withdrawn
Ramat Gan, 5262000, Israel
Completed
Beijing, 100021, China
Completed
Beijing, 100071, China
Completed
Shenyang, 110001, China
Completed
Tianjin, 300060, China
Completed
Shanghai, 200030, China
Completed
Nanning, 530021, China
Completed
Xi'an, 710032, China
Completed
Madrid, 28050, Spain
Completed
Kagoshima, 892-0833, Japan
Withdrawn
Boston, 02130, United States

Primary Outcome

  • Progression-free Survival (PFS) Assessed by the Independent Review Panel According to Response Evaluation Criteria for Solid Tumors (RECIST) 1.1
    PFS was defined as the time from date of randomization to disease progression, radiological or death due to any cause, whichever occurs first. Per RECIST version 1.1, progressive disease was determined when there was at least 20% increase in the sum of diameters of the target lesions, taking as a reference the smallest sum on study (this included the baseline sum if that was the smallest sum on trial). In addition to a relative increase of 20%, the sum had demonstrated an absolute increase of at least 5 mm. Appearance of new lesions and unequivocal progression of existing non-target lesions was also interpreted as progressive disease. Participants without progression or death at the time of analysis were censored at their last date of evaluable tumor evaluation. Median and other 95% confidence intervals (CIs) computed using Kaplan-Meier estimates.
    date_rangeTime Frame:
    From randomization of the first participant until approximately 3 years or until disease radiological progression
    enhanced_encryption
    Safety Issue:
    No

Secondary Outcome

  • Overall Survival (OS)
    OS was defined as the time from date of randomization to death due to any cause. Participants still alive at the time of analysis were censored at their last known alive date. Median and other 95% CIs computed using Kaplan-Meier estimates.
    date_rangeTime Frame:
    From randomization of the first participant until approximately 3 years later
    enhanced_encryption
    Safety Issue:
    No
  • Time to Progression (TTP) by Central Review
    TTP was defined as the time from date of randomization to disease radiological progression by central review. Per RECIST version 1.1, progressive disease was determined when there was at least 20% increase in the sum of diameters of the target lesions, taking as a reference the smallest sum on study (this included the baseline sum if that was the smallest sum on trial). In addition to a relative increase of 20%, the sum had demonstrated an absolute increase of at least 5 mm. Appearance of new lesions and unequivocal progression of existing non-target lesions was also interpreted as progressive disease. Participants without progression or death at the time of analysis were censored at their last date of evaluable tumor evaluation. Median and other 95% confidence intervals (CIs) computed using Kaplan-Meier estimates.
    date_rangeTime Frame:
    From randomization of the first participant until approximately 3 years later or until disease radiological progression
    enhanced_encryption
    Safety Issue:
    No
  • Objective Response Rate (ORR) by Central Review
    ORR was defined as the best tumor response (Complete Response [CR] or Partial Response [PR]) observed during treatment or within 30 days after termination of study treatment, assessed according to the RECIST version 1.1. CR=all target lesions disappeared, and any pathological lymph node, whether target or non-target, had a reduction in short axis to <10 mm. If any residual lesion was present, cyto-histology was made available to unequivocally document benignity. PR=at least 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. ORR=CR+PR. CR and PR were confirmed by another scan at least 4 weeks later.
    date_rangeTime Frame:
    From randomization of the first participant until approximately 3 years later or until disease radiological progression
    enhanced_encryption
    Safety Issue:
    No
  • Disease Control Rate (DCR) by Central Review
    DCR was defined as the proportion of participants whose best response was CR, PR, stable disease (SD) or Non-CR/Non-PD. Per RECIST version 1.1, CR=all target lesions disappeared, any pathological lymph node, target/non-target, a reduction in short axis to <10 mm. PR=at least 30% decrease in the sum of diameters of target lesions taking as reference baseline sum diameters. PD=at least 20% increase in the sum of diameters of the target lesions, taking as a reference smallest sum on study. Appearance of new lesions and unequivocal progression of existing non-target lesions. SD=neither sufficient shrinkage qualified for PR nor sufficient increase qualified for PD, taking smallest sum of diameters as a reference. Non-CR/Non-PD=persistence of 1/more non-target lesion(s) and/or maintenance of tumor marker level above normal limits. DCR=CR+PR+SD or Non-CR/Non-PD. CR and PR confirmed by another scan at least 4 weeks later. SD and Non-CR/Non-PD documented at least 6 weeks after randomization.
    date_rangeTime Frame:
    From randomization of the first participant until approximately 3 years later or until disease radiological progression
    enhanced_encryption
    Safety Issue:
    No
  • Duration of Response (DOR) by Central Reader
    DOR was defined as the time from date of first response (CR or PR) to the date when PD is first documented, or to the date of death, whichever occurred first according to RECIST version 1.1. CR=all target lesions disappeared, and any pathological lymph node, whether target or non-target, had a reduction in short axis to <10 mm. If any residual lesion was present, cyto-histology was made available to unequivocally document benignity. PR=at least 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Participants still having CR or PR and have not died at the time of analysis were censored at their last date of tumor evaluation. DOR defined for confirmed responders only (that is, CR or PR). 'NA' indicates that value could not be estimated due to censored data. Median and 95% CIs were computed using Kaplan-Meier estimates.
    date_rangeTime Frame:
    From randomization of the first participant until approximately 3 years later or until disease radiological progression
    enhanced_encryption
    Safety Issue:
    No

Trial design

A Phase III Randomized, Double blind, Placebo-controlled Trial Comparing Capecitabine Plus Sorafenib Versus Capecitabine Plus Placebo in the Treatment of Locally Advanced or Metastatic HER2-Negative Breast Cancer
Trial Type
Interventional
Intervention Type
Drug
Trial Purpose
Treatment
Allocation
Randomized
Blinding
Double Blind
Assignment
Parallel Assignment
Trial Arms
2