Trial Outcomes & Findings for Multicenter Study of Pharmacokinetic-Guided Docetaxel in Breast Cancer Patients Receiving Docetaxel and Cyclophosphamide (NCT NCT02502864)

NCT ID: NCT02502864

Last Updated: 2020-09-11

Results Overview

Rate of PK guided dosing of docetaxel chemotherapy improving the ability to achieve a targeted AUC ( 2.5-3.7 mg\*hr/L) within 4 cycles of therapy in patients \> 65 years of age with breast cancer receiving TC (docetaxel and cyclophosphamide) as compared with historical non-PK guided therapy from patients receiving a similar regimen.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

9 participants

Primary outcome timeframe

Cycle 4 - Up to 6 months

Results posted on

2020-09-11

Participant Flow

Participants were enrolled at Moffitt Cancer Center, February 2016 through June 2017.

Participant milestones

Participant milestones
Measure
Standard of Care + Surveys
Standard of Care Docetaxel and Cyclophosphamide (TC) Chemotherapy + Surveys. TC Regimen with Function Assessment of Cancer Therapy (FACT) Surveys. All participants will receive TC for cycle 1 with subsequent cycles repeated every 3 weeks for a total of 4 cycles. All initial dosing will be based on actual body weight and height. Participants will receive up to 4 doses of chemotherapy. Following their 4th dose of chemotherapy, or the last dose of chemotherapy in which blood level monitoring was performed, participants will be assessed for side effects from the chemotherapy and complete their final written 53 question survey about their quality of life. Standard of Care: Docetaxel: Pharmacokinetic(PK)-guided docetaxel. Cycle 1: 75 mg/m\^2, intravenously (IV) on Day 1 for 60 minutes. Beginning with cycle 2, the docetaxel dose will be individually adjusted before each cycle.
Overall Study
STARTED
9
Overall Study
COMPLETED
8
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Standard of Care + Surveys
Standard of Care Docetaxel and Cyclophosphamide (TC) Chemotherapy + Surveys. TC Regimen with Function Assessment of Cancer Therapy (FACT) Surveys. All participants will receive TC for cycle 1 with subsequent cycles repeated every 3 weeks for a total of 4 cycles. All initial dosing will be based on actual body weight and height. Participants will receive up to 4 doses of chemotherapy. Following their 4th dose of chemotherapy, or the last dose of chemotherapy in which blood level monitoring was performed, participants will be assessed for side effects from the chemotherapy and complete their final written 53 question survey about their quality of life. Standard of Care: Docetaxel: Pharmacokinetic(PK)-guided docetaxel. Cycle 1: 75 mg/m\^2, intravenously (IV) on Day 1 for 60 minutes. Beginning with cycle 2, the docetaxel dose will be individually adjusted before each cycle.
Overall Study
Withdrawal by Subject
1

Baseline Characteristics

Multicenter Study of Pharmacokinetic-Guided Docetaxel in Breast Cancer Patients Receiving Docetaxel and Cyclophosphamide

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Standard of Care + Surveys
n=9 Participants
Standard of Care Docetaxel and Cyclophosphamide (TC) Chemotherapy + Surveys. TC Regimen with Function Assessment of Cancer Therapy (FACT) Surveys.
Age, Continuous
72 years
n=93 Participants
Sex: Female, Male
Female
9 Participants
n=93 Participants
Sex: Female, Male
Male
0 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
8 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=93 Participants
Race (NIH/OMB)
White
9 Participants
n=93 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
Region of Enrollment
United States
9 participants
n=93 Participants

PRIMARY outcome

Timeframe: Cycle 4 - Up to 6 months

Population: All participants evaluable at time of analysis.

Rate of PK guided dosing of docetaxel chemotherapy improving the ability to achieve a targeted AUC ( 2.5-3.7 mg\*hr/L) within 4 cycles of therapy in patients \> 65 years of age with breast cancer receiving TC (docetaxel and cyclophosphamide) as compared with historical non-PK guided therapy from patients receiving a similar regimen.

Outcome measures

Outcome measures
Measure
Standard of Care + Surveys
n=8 Participants
Standard of Care Docetaxel and Cyclophosphamide (TC) Chemotherapy + Surveys. TC Regimen with Function Assessment of Cancer Therapy (FACT) Surveys.
Rate of Achieving Targeted Area Under the Curve (AUC)
AUC mg*hr/L: 2.5-3.7
5 Participants
Rate of Achieving Targeted Area Under the Curve (AUC)
AUC mg*hr/L: <2.5
3 Participants

SECONDARY outcome

Timeframe: Up to 6 months

Population: All participants.

The incidence of grade 3 and 4 neutropenia and febrile neutropenia in cycles following PK adjustment (cycles 2-4) will be compared with cycle 1 and historical non-PK guided therapy using the Wilcoxon-Rank sum assessment.

Outcome measures

Outcome measures
Measure
Standard of Care + Surveys
n=9 Participants
Standard of Care Docetaxel and Cyclophosphamide (TC) Chemotherapy + Surveys. TC Regimen with Function Assessment of Cancer Therapy (FACT) Surveys.
Incidence of Grade 3 and 4 Neutropenia and Febrile Neutropenia
Participants with Grade 3 or 4 neutropenia
2 Participants
Incidence of Grade 3 and 4 Neutropenia and Febrile Neutropenia
Participants with Febrile neutropenia
0 Participants

SECONDARY outcome

Timeframe: Baseline and Post Cycle 1

Population: Descriptive analysis was planned for 52 participants. Due to the small number of participants enrolled, analyzing additional correlations was not possible.

The Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score will be reported as ordinal data (low, intermediate-low, intermediate-high, or high risk).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline and Post Cycle 1

Population: Descriptive analysis was planned for 52 participants. Due to the small number of participants enrolled, analyzing additional correlations was not possible.

The Instrumental Activities of Daily Living (IADL) total score will be reported as binomial data (greater or less than 26 based on how it is incorporated into the CRASH score).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline and Post Cycle 1

Population: Descriptive analysis was planned for 52 participants. Due to the small number of participants enrolled, analyzing additional correlations was not possible.

The Cumulative Illness Rating Scale for Geriatrics (CIRS-G) will be reported as discrete data out of a possible score of 65. The Wilcoxon-Rank sum and Chi-squared tests will be used as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 6 months

Population: Descriptive analysis was planned for 52 participants. Due to the small number of participants enrolled, analyzing additional correlations was not possible.

The relationship between PK-guided docetaxel patient PK profiles and the Function Assessment of Cancer Therapy (FACT) Taxane and Breast Cancer scores will be described.

Outcome measures

Outcome data not reported

Adverse Events

Standard of Care + Surveys

Serious events: 3 serious events
Other events: 9 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Standard of Care + Surveys
n=9 participants at risk
Standard of Care Docetaxel and Cyclophosphamide (TC) Chemotherapy + Surveys. TC Regimen with Function Assessment of Cancer Therapy (FACT) Surveys.
General disorders
Fatigue
11.1%
1/9 • Number of events 1 • 1 year, 9 months
General disorders
Non-cardiac chest pain
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Infections and infestations
Sepsis
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Infections and infestations
Urinary tract infection
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Nervous system disorders
Syncope
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Psychiatric disorders
Anxiety
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Vascular disorders
Thromboembolic event
11.1%
1/9 • Number of events 1 • 1 year, 9 months

Other adverse events

Other adverse events
Measure
Standard of Care + Surveys
n=9 participants at risk
Standard of Care Docetaxel and Cyclophosphamide (TC) Chemotherapy + Surveys. TC Regimen with Function Assessment of Cancer Therapy (FACT) Surveys.
Gastrointestinal disorders
Constipation
66.7%
6/9 • Number of events 6 • 1 year, 9 months
Gastrointestinal disorders
Diarrhea
55.6%
5/9 • Number of events 8 • 1 year, 9 months
Gastrointestinal disorders
Nausea
44.4%
4/9 • Number of events 4 • 1 year, 9 months
Gastrointestinal disorders
Dry mouth
33.3%
3/9 • Number of events 3 • 1 year, 9 months
Gastrointestinal disorders
Abdominal pain
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Gastrointestinal disorders
Oral pain
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Gastrointestinal disorders
Salivary duct inflammation
11.1%
1/9 • Number of events 1 • 1 year, 9 months
General disorders
Fatigue
100.0%
9/9 • Number of events 15 • 1 year, 9 months
General disorders
Edema limbs
33.3%
3/9 • Number of events 3 • 1 year, 9 months
Blood and lymphatic system disorders
Anemia
66.7%
6/9 • Number of events 7 • 1 year, 9 months
Musculoskeletal and connective tissue disorders
Bone pain
55.6%
5/9 • Number of events 5 • 1 year, 9 months
Musculoskeletal and connective tissue disorders
Arthralgia
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Musculoskeletal and connective tissue disorders
Back pain
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Musculoskeletal and connective tissue disorders
Musculoskeletal and connective tissue disorder - Other
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Skin and subcutaneous tissue disorders
Alopecia
66.7%
6/9 • Number of events 6 • 1 year, 9 months
Skin and subcutaneous tissue disorders
Pruritus
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Investigations
Neutrophil count decreased
44.4%
4/9 • Number of events 6 • 1 year, 9 months
Investigations
White blood cell decreased
44.4%
4/9 • Number of events 4 • 1 year, 9 months
Investigations
Alkaline phosphatase increased
22.2%
2/9 • Number of events 2 • 1 year, 9 months
Investigations
Lymphocyte count decreased
22.2%
2/9 • Number of events 2 • 1 year, 9 months
Investigations
Platelet count decreased
22.2%
2/9 • Number of events 2 • 1 year, 9 months
Investigations
Creatinine increased
11.1%
1/9 • Number of events 2 • 1 year, 9 months
Nervous system disorders
Dizziness
22.2%
2/9 • Number of events 2 • 1 year, 9 months
Nervous system disorders
Headache
22.2%
2/9 • Number of events 2 • 1 year, 9 months
Nervous system disorders
Peripheral sensory neuropathy
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Nervous system disorders
Syncope
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Respiratory, thoracic and mediastinal disorders
Dyspnea
33.3%
3/9 • Number of events 3 • 1 year, 9 months
Respiratory, thoracic and mediastinal disorders
Epistaxis
22.2%
2/9 • Number of events 2 • 1 year, 9 months
Respiratory, thoracic and mediastinal disorders
Pneumonitis
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Respiratory, thoracic and mediastinal disorders
Sore throat
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Metabolism and nutrition disorders
Dehydration
11.1%
1/9 • Number of events 2 • 1 year, 9 months
Metabolism and nutrition disorders
Hyperkalemia
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Metabolism and nutrition disorders
Hypoalbuminemia
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Metabolism and nutrition disorders
Hypocalcemia
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Metabolism and nutrition disorders
Hypokalemia
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Metabolism and nutrition disorders
Hyponatremia
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Vascular disorders
Hypotension
33.3%
3/9 • Number of events 3 • 1 year, 9 months
Vascular disorders
Hypertension
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Eye disorders
Dry eye
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Eye disorders
Watering eyes
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Infections and infestations
Papulopustular rash
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Infections and infestations
Sepsis
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Infections and infestations
Urinary tract infection
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Immune system disorders
Allergic reaction
11.1%
1/9 • Number of events 2 • 1 year, 9 months
Psychiatric disorders
Anxiety
11.1%
1/9 • Number of events 1 • 1 year, 9 months
Renal and urinary disorders
Hematuria
11.1%
1/9 • Number of events 1 • 1 year, 9 months

Additional Information

Christine M. Walko, Pharm.D., BCOP

H. Lee Moffitt Cancer Center and Research Institute

Phone: 813-745-1519

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place