A Phase Ib/II Study of Eribulin in Combination With Cyclophosphamide in Patients With Solid Tumor Malignancies
This is a phase Ib/II trial designed to determine the MTD and DLTs of the combination of
eribulin and cyclophosphamide in solid tumors and make preliminary estimates regarding
efficacy of this treatment in patients with advanced breast cancer.
The study includes a standard dose-confirmation schema (phase Ib portion) enrolling 3 to 6
patients/subjects, with any solid tumors, per cohort (3+3 design) with a total of 18
patients. The dose-expansion (phase II portion) will enroll 40 patients with advanced breast
cancer to detect an effect size of 15% with a power of 80% with endpoints of safety,
efficacy, and clinical benefit rate. A maximum of 58 patients will be enrolled on the phase
Ib and II portions of this trial combined and will be treated until disease progression or
toxicity mandate treatment change.
Eribulin is a non-taxane microtubule inhibitor that is FDA approved as monotherapy for the
treatment of taxane and anthracycline resistant metastatic breast cancer. The combination of
docetaxel and cyclophosphamide is a well-accepted adjuvant chemotherapy regimen that has
become an increasingly common therapeutic choice for intermediate risk early stage breast
cancer. Eribulin has a favorable toxicity profile compared to docetaxel with the most common
adverse reactions (incidence ≤25%) including neutropenia, anemia, asthenia/fatigue,
alopecia, peripheral neuropathy, nausea, and constipation. Eribulin appears to have activity
in taxane resistant disease, making it an attractive partner with cyclophosphamide.
Neuropathy can be a devastating complication from adjuvant chemotherapy and in the
metastatic setting, may limit effective therapy and reduce quality of life. Understanding
the host factors that predict risk for neuropathy is critical, as these patients may in
particular benefit from the lower risk of neuropathy associated with eribulin therapy. In
conjunction with this trial, we have included correlative studies to study the proposed
pharmacogenomic factors associated with risk of neuropathy. In this way we will potentially
be able to identify patients who could preferentially be treated with less neurotoxic
microtubule inhibitors.
Interventional
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Phase Ib: 1. Maximum tolerated dose (MTD) of eribulin in combination with cyclophosphamide in patients with any solid tumor
Standard dose-confirmation design: 3 to 6 patients per cohort (3+3 design), 9-18 total patients with any solid tumor malignancy DLTs reviewed to determine dose escalation to the next highest level Highest dose level: no more than one of six subjects experience DLT defines the MTD DLT defined as any treatment-related toxicity in first 28 days of therapy: grade 3 or 4 non-hematologic toxicity; grade 4 neutropenia or thrombocytopenia lasting >7 days or febrile neutropenia; or any clinically significant toxicity grade 2 or higher that requires more than 14 days to resolve
Estimated up to 24 months
Yes
Hope Rugo, MD
Principal Investigator
University of California, San Francisco
United States: Food and Drug Administration
UCSF Protocol Number11996
NCT01554371
March 2012
September 2014
Name | Location |
---|---|
UCSF Helen Diller Family Comprehensive Cancer Center | San Francisco, California 94115 |