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Management of Severe Chemotherapy-induced Neutropenia in Advanced Breast Cancer

Phase 1
Completed
Conditions
Febrile Neutropenia
Interventions
Registration Number
NCT03104595
Lead Sponsor
Enzychem Lifesciences Corporation
Brief Summary

To assess the safety and establish the dose to assess the pharmacokinetic activity following administration of EC-18 in patients with advanced breast cancer receiving low febrile neutropenia risk chemotherapy who are the candidates for second-line or higher combination therapy with doxorubicin and cyclophosphamide.

Detailed Description

This study will utilize a non-randomized, open-label 3 + 3 dose escalation design in which subjects will receive 500 mg, 1000 mg, 1500 mg, 2000 mg, 3000 mg and 4000mg of EC-18. The stepwise daily dosing by cohort was performed for 21 days (3 weeks)

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
28
Inclusion Criteria
  1. Women ≥19 years of age

  2. Subjects who have voluntarily signed the informed consent prior to the screening tests to participate in the study

  3. Subjects who have been diagnosed as adenocarcinoma of the breast and relapsed after adjuvant or primary (neoadjuvant) chemotherapy, and was confirmed based on documented medical history to be candidates for second-line or higher combination chemotherapy with doxorubicin and cyclophosphamide to treat relapsed or metastatic disease.

  4. Subjects with adequate function of major organs based on the following clinical laboratory values in the latest test performed within 28 days prior to IP dosing:

    • Neutrophil count (ANC): ≥1,500/mm3
    • Platelet count: ≥10.0×10^4/mm3
    • Hemoglobin: ≥9.0 g/dL
    • AST, ALT: ≤3.0 x ULN
    • Serum total bilirubin: ≤1.5 mg/dL
    • Serum creatinine: ≤1.5 mg/dL
  5. Subjects whose Eastern Cooperative Oncology Group (ECOG) performance score is 0-1.

  6. For women of child bearing potential, subjects should have willingness to use acceptable contraceptive methods during the entire clinical study period.

  7. Subjects who are capable of understanding the overall procedure of the clinical study and are willing to participate in compliance with all test procedures.

Exclusion Criteria
  1. Subjects with active and inactive hepatitis, patients with history of HIV, or other uncontrolled infectious disease.
  2. Subjects with a history of HIV positive or currently undergoing/received antiretroviral therapy, and subjects with a history of hepatitis B surface antigen positive, or current positive hepatitis C disease.
  3. Subjects who received radiation therapy within 4 weeks prior to assignment to treatment group.
  4. Subjects who have been diagnosed within 5 years with other types of cancer except for those who have been appropriately treated for superficial non-melanoma skin cancer or cervical intraepithelial neoplasia.
  5. Subjects with a history of intolerance for granulocyte colony stimulating factor treatment
  6. Subjects who are expected to show hypersensitivity to the IP or its ingredients
  7. Subjects with a positive urine pregnancy test result at screening visit or before the first administration of the study drug
  8. Subjects who took any other investigational product in other clinical study within 30 days prior to screening visit.
  9. Clinically significant unstable medical abnormality; psychiatric disorder, chronic disease, alcohol or drug use disorder, or other significant biological, psychological, or social factor, which in the investigator's opinion, unfavorably affects the risk-benefit ratio of study participation or likely to affect study results.
  10. Subjects with heart disease (i.e. congestive heart failure, arrhythmia, symptomatic coronary artery disease); Myocardial infarction within 6 months before initiation of the study.
  11. Subjects with left ventricular ejection fraction (LVEF) < 50% at screening.
  12. Significant neurological or psychiatric disorders including dementia or seizures.
  13. Patients with dyslipidemia not controlled by drugs [based on LDL-C and TG levels for which treatment is recommended by the Korean dyslipidemia treatment guidelines and the U.S. National Cholesterol Education Program-Adult Treatment Panel III]
  14. Uncontrolled diabetes mellitus (HbA1c >7%; if the level is confirmed after 6 months or longer treatment with oral hypoglycemic agents or insulin)
  15. Subjects who have received systemic chemotherapy with doxorubicin to treat metastatic or recurrent breast cancer
  16. Subjects with grade 2 or higher peripheral sensory neuropathy at screening visit or before the first dosing of the study drug
  17. Subjects who have undergone significant gastrectomy along with intractable nausea and vomiting, chronic gastrointestinal disease, or clinically significant sequelae, which would interfere with proper absorption of the study drug
  18. Subjects who administered systemic antibiotics within 14 days prior to administration of the study drug
  19. Subjects whose cumulative dose of doxorubicin exceeded 240 mg/m2
  20. Subjects who were currently receiving trastuzumab

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Cohort 6EC-18EC-18 4000 mg
Cohort 5EC-18EC-18 3000 mg
Cohort 3EC-18EC-18 1500 mg
Cohort 4EC-18EC-18 2000 mg
Cohort 1EC-18EC-18 500 mg
Cohort 2EC-18EC-18 1000 mg
Primary Outcome Measures
NameTimeMethod
Duration of Grade 4 neutropenia15 days after starting chemotherapy

Complete blood count and absolute neutrophil count assessed daily to determine febrile neutropenia

Secondary Outcome Measures
NameTimeMethod
Incidence of Grade 3-4 neutropeniaFor 15 days after starting chemotherapy (except Day 3 and 4)

The grade for Neutropenia is assessed according to NCI CTCAE 4.03 version

Incidence of febrile neutropeniaFor 15 days after starting chemotherapy (except Day 3 and 4)

Febrile neutropenia is assessed by ANC and body temperature according to NCI CTCAE version 4.03

Trial Locations

Locations (3)

Yonsei University Health System Severance Hospital

🇰🇷

Seoul, Korea, Republic of

National Cancer Center

🇰🇷

Gyeonggi-do, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

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