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Human Epidermal Growth Factor 2 Negative Carcinoma of BreastPhase 2MYMENCT01885013

Myocet + Cyclophosphamide + Metformin Vs Myocet + Cyclophosphamide in 1st Line Treatment of HER2 Neg. Metastatic Breast Cancer Patients

A Phase 2 study testing Metformin + Myocet + Cyclophosphamide and Myocet + Cyclophosphamide in people with Human Epidermal Growth Factor 2 Negative Carcinoma of Breast, run by Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS at 25 sites in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is a phase II comparative randomized clinical trial. Eligible patients will be randomized (1:1) to: Arm A: Myocet plus Cyclofosfamide plus Metformin Arm B: Myocet plus Cyclofosfamide Statistical Considerations: In this randomized phase II study, the sample size was calculated basing on the primary end-point (PFS)… Read more about this study

Who is it for?
Ages 18 to 75 years, women only
What is being tested?
Metformin + Myocet + Cyclophosphamide and Myocet + Cyclophosphamide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
126 participants
Where
25 sitesItaly
Study dates
Sep 2010to May 2015
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients must have histologically or cytologically confirmed breast cancer
  • Metastatic disease
  • HER2 negative disease, as measured by IHC or FISH
  • Non endocrine responsive disease (negative hormonal status or failure of endocrine therapy for MBC)
  • Patients with measurable and/or non-measurable disease according to RECIST Criteria (Version 1.1)
  • Homa Index calculated according to Matthews' formula
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  • Prior endocrine therapy is allowed, in the adjuvant and/or metastatic setting
  • Prior chemotherapy is allowed, only in adjuvant setting, provided it is terminated at least 12 months before study entry. Adjuvant anthracyclines are allowed if prior cumulative dose does not exceed 360 mg/m2 in case of epirubicin and 280 mg/m2 in case of doxorubicin. Adjuvant taxanes are allowed.
  • Age 18-75 years
  • Life expectancy of greater than 3 months
  • ECOG performance status <2
  • Patients must have normal organ and marrow function:
  • leukocytes >=3,000/μL
  • absolute neutrophil count >=1,500/μL
  • platelets >=100,000/μL
  • total bilirubin within normal institutional limits
  • AST(SGOT)/ALT(SGPT) <=1.5 X institutional upper limit of normal
  • creatinine within normal institutional limits
  • Adequate cardiac function, i.e. left ventricular ejection fraction (LVEF)>= 50%
  • The effects of liposomal doxorubicin on the developing human fetus at the recommended therapeutic dose are unknown. For this reason and because anthracyclines as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. All women of childbearing potential must have a negative serum or urine pregnancy test within 72 hours prior to the start of study medication. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  • Ability to understand and the willingness to sign a written informed consent document

Who cannot join

  • Known diabetes (type 1 or 2)
  • Currently on metformin, sulfonylureas, thiazolidenediones or insulin for any reason (these drugs alter insulin levels)
  • Current or previous congestive heart failure, renal failure or liver failure; history of acidosis of any type; habitual intake of 3 or more alcoholic beverages per day
  • Creatinine above upper limit of normal for institution, AST above 1.5 times upper limit or normal for institution (to reduce risk of lactic acidosis)
  • Hypersensitivity or allergy to metformin
  • Participation in another clinical trial with any investigational agents within 30 days prior to study screening
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  • Patients with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to Myocet or other agents used in the study
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.

Trial locations and contacts

25 sites in 1 country.

25 sites in 1 country

Italy25 sites
  • ULSS n.8 Asolo Ospedale di Castelfranco

    Asolo

  • Centro di Riferimento Oncologico CRO

    Aviano

  • Ospedale S.Martino

    Belluno

  • Azienda Ospedaliera "Antonio Cardarelli"

    Campobasso

  • P.O. M. Bufalini

    Cesena, FC

  • P.O. "SS. Annunziata"

    Chieti

  • Presidio Ospedaliero E. Profili

    Fabriano

  • Ospedale Civile degli Infermi

    Faenza, RA

  • E.O. Galliera

    Genova

  • Ospedale di Guastalla

    Guastalla

  • Azienda per i Servizi Sanitari n.5 "Bassa Friulana"

    Latisana

  • Presidio Ospedaliero "Vito Fazzi"

    Lecce

  • Ospedale Umberto I

    Lugo, RA

  • UO Oncologia Medica IRCCS IRST

    Meldola (FC), FC, 47014

  • ULSS n.13 di Mirano

    Mirano

  • Arcispedale S. Maria Nuova

    Modena

  • Azienda Ospedaliera S. Salvatore di Pesaro

    Pesaro

  • Ospedale S. Spirito

    Pescara

  • Ospedale Civile di Piacenza

    Piacenza

  • Azienda Ospedaliera Santa Maria degli Angeli

    Pordenone

  • Ospedale Civile Santa Maria delle Croci

    Ravenna, RA

  • Arcispedale S. Maria Nuova

    Reggio Emilia

  • Ospedale Civile degli Infermi

    Rimini

  • IRCCS Centro di riferimento Oncologico di Basilicata di Rionero in Vulture

    Rionero in Vulture

  • Ospedale Nuovo Regina Margherita

    Roma

Other trials in Italy

About this study

Official title: Phase II Comparative Study of Myocet Plus Cyclophosphamide in First Line Treatment of HER2 Negative Metastatic Breast Patients

This is a phase II comparative randomized clinical trial.

Eligible patients will be randomized (1:1) to:

Read more

Arm A: Myocet plus Cyclofosfamide plus Metformin Arm B: Myocet plus Cyclofosfamide

Statistical Considerations:

In this randomized phase II study, the sample size was calculated basing on the primary end-point (PFS) and assuming an error α = 10% (2-tailed) with a power of 80%.

To find an advantage of 4 months of median time to progression (6 months in the control arm B and 10 months in the experimental arm A) will be recruited 112 patients (98 events) for a period of 24 months and will be considered further 12-month of follow-up. The primary analysis of the study will be conducted in accordance with the "intention to treat" principle, the secondary analysis will be conducted in the "per protocol" population.

Read the detailed description

MULTICENTER, RANDOMIZED, COMPARATIVE STUDY OF MYOCET PLUS CYCLOPHOSPHAMIDE PLUS METFORMIN VERSUS MYOCET PLUS CYCLOPHOSPHAMIDE IN FIRST LINE TREATMENT OF HER2 NEGATIVE METASTATIC BREAST CANCER PATIENTS.

The aim of this study is to determine if the addition of metformin to the regime Myocet / Cyclophosphamide improves disease-free survival in patients with HER2-negative metastatic breast cancer.

The primary objective is the evaluation of the clinical efficacy of the combination of Myocet / Cyclophosphamide plus Metformin compared to treatment with only Myocet / Cyclophosphamide, in terms of progression-free survival (PFS).

Clinical secondary objectives are:

  • Objective response rate
  • Overall survival
  • Tolerability
  • Progression-free survival, objective response rate and overall survival according to Homa Index levels.

Secondary biological endpoint is the characterization of the metabolic profile of patients (sensitivity in insulin levels).

Treatment Arm A (experimental treatment):

Metformin 1000 mg, 2 times daily per os*. Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Cyclophosphamide 600 mg/m2, intravenous infusion, at day 1 every 21 days.

  • During cycle 1, patients will assume only metformin from day 1 to day 13 and will begin chemotherapy from day 14. From day 1 to day 3, patients will assume Metformin 1000 mg once a day. Starting from day 4 patients will assume Metformin 1000 mg 2 times a day.

Arm B (standard treatment):

Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Cyclophosphamide 600 mg/m2, intravenous infusion, on day 1, every 21 days

Chemotherapy will be performed for 8 cycles.

The treatment will be continued until progression of disease.

Statistical Considerations:

In this randomized phase II study, the sample size was calculated basing on the primary end-point (PFS) and assuming an error α = 10% (2-tailed) with a power of 80%.

To find an advantage of 4 months of median time to progression (6 months in the control arm B and 10 months in the experimental arm A) will be recruited 112 patients (98 events) for a period of 24 months and will be considered further 12-month of follow-up. The primary analysis of the study will be conducted in accordance with the "intention to treat" principle, the secondary analysis will be conducted in the "per protocol" population.

Being tested
Metformin + Myocet + Cyclophosphamide, Myocet + Cyclophosphamide
Keywords
HER2 negative, metastatic breast cancer, non endocrine responsive disease
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Metformin + Myocet + CyclophosphamideDrug

    Also called metformin, myocet, cyclofosfamide

    Metformin + Myocet + Cyclophosphamide:

    Metformin 1000 mg, 2 times daily per os*. Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Chemotherapy will be performed for 8 cycles Cyclophosphamide 600 mg/m2, intravenous infusion, at day 1 every 21 days.

    • During cycle 1, patients will assume only metformin from day 1 to day 13 and will begin chemotherapy from day 14. From day 1 to day 3, patients will assume Metformin 1000 mg once a day. Starting from day 4 patients will assume Metformin 1000 mg 2 times a day.
  • Myocet + CyclophosphamideDrug

    Also called myocet, cyclofosfamide

    Myocet + Cyclophosphamide:

    Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Cyclophosphamide 600 mg/m2, intravenous infusion, on day 1, every 21 days Chemotherapy will be performed for 8 cycles

Study groups in NCT01885013
Study groupRoleWhat they receive
Metformin + Myocet + CyclophosphamideExperimentalarm A : Metformin 1000 mg, 2 times daily per os*. Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Cyclophosphamide 600 mg/m2, intravenous infusion, at day 1 every 21 days. * During cycle 1, patients will assume only metformin from day 1 to day 13 and will begin chemotherapy from day 14. From day 1 to day 3, patients will assume Metformin 1000 mg once a day. Starting from day 4 patients will assume Metformin 1000 mg 2 times a day.
Receives: Drug: Metformin + Myocet + Cyclophosphamide
Myocet + CyclophosphamideActive comparatorarm B : Myocet 60 mg/m2, intravenous infusion, on day 1, every 21 days Cyclophosphamide 600 mg/m2, intravenous infusion, on day 1, every 21 days
Receives: Drug: Myocet + Cyclophosphamide

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. progression-free survival (PFS)

    Clinical efficacy of the combination of Myocet / Cyclophosphamide plus Metformin compared to treatment with only Myocet / Cyclophosphamide, in terms of progression-free survival (PFS)

    Measured: 42 months

Secondary outcomes (6)
  1. Objective response rate

    Objective Response Rate after treatment with Myocet/Cyclophosphamide/Metformin compared with after therapy with Myocet/Cyclophosphamide

    Measured: 42 months

  2. Overall survival

    Overall survival after treatment with Myocet/Cyclophosphamide/Metformin compared with after therapy with Myocet/Cyclophosphamide

    Measured: 42 months

  3. Progression free survival as function of Homa Index levels

    Clinical efficacy of the combination of Myocet / Cyclophosphamide plus Metformin compared to treatment with only Myocet / Cyclophosphamide, in terms of progression-free survival (PFS) as function of Homa Index levels

    Measured: 42 months

  4. objective response rate as function of Homa Index levels

    Objective Response Rate after treatment with Myocet/Cyclophosphamide/Metformin compared with after therapy with Myocet/Cyclophosphamide, as function of Homa Index levels

    Measured: 42 months

  5. overall survival as function of Homa Index levels

    Overall survival after treatment with Myocet/Cyclophosphamide/Metformin compared with after therapy with Myocet/Cyclophosphamide, as function of Homa Index levels

    Measured: 42 months

  6. patient metabolic profile (metabolic syndrome)

    Characterization of the metabolic profile of patients: sensitivity in insulin levels

    Measured: 42 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Jun 2013 (estimated)
  2. Study startSep 2010
  3. Primary completionMay 2015
  4. Study completionMay 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
126 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01885013
Sponsor's protocol ID
IRST174.04
Other IDs
2009-014662-26, 2009
Acronym
MYME
Status last verified
Dec 2015
First submitted
19 Jun 2013
Last updated
1 Jan 2016
Results posted
No
Data monitoring committee
No

Publications

  • Gennari A, Foca F, Zamarchi R, Rocca A, Amadori D, De Censi A, Bologna A, Cavanna L, Gianni L, Scaltriti L, Rossi E, Facchinetti A, Martini V, Bruzzi P, Nanni O. Insulin-like growth factor-1 receptor (IGF-1R) expression on circulating tumor cells (CTCs) and metastatic breast cancer outcome: results from the TransMYME trial. Breast Cancer Res Treat. 2020 May;181(1):61-68. doi: 10.1007/s10549-020-05596-4. Epub 2020 Mar 21.

    PubMed 32200486

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Metformin + Myocet + Cyclophosphamide and Myocet + Cyclophosphamide in people with Human Epidermal Growth Factor 2 Negative Carcinoma of Breast, run by Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS at 25 sites in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 21 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Jan 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 25 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

progression-free survival (PFS) (time frame: 42 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01885013, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Jan 2016.

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