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Metastatic Breast CancerPhase 4NCT02864030

PAINTER: Polymorphism And INcidence of Toxicity in ERibulin Treatment

A Phase 4 study testing ERIBULIN MESYLATE in people with Metastatic Breast Cancer and Toxicity, run by Oncologia Medica dell'Ospedale Fatebenefratelli at 20 sites in Italy.

Completed

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

Official record
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Trial summary

On March 17th, 2011, the European Commission issued a marketing authorization valid throughout the European Union for Eribulin mesylate (Halaven; Eisai Limited), for the treatment of patients with locally advanced or metastatic breast cancer who have progressed after at least two chemotherapic regimens for advanced… Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Metastatic Breast Cancer, Toxicity, Neurotoxicity
What is being tested?
ERIBULIN MESYLATE
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
20 sitesItaly
Study dates
May 2014to 31 Dec 2020
Phase
Phase 4
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 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of metastatic breast cancer
  • Previous treatment with anthracyclines and taxanes
  • Patients who will start Eribulin or who have already received only the first dose (cycle 1, day 1) of Eribulin according to the approved indication
  • Ability to comply with sample collection
  • Patient has signed the study Informed Consent Form (ICF) and the specific Pharmacogenetic ICF.
  • Absence of any contraindication to treatment

Who cannot join

  • Previous treatment with Eribulin in a previous line of treatment
  • Previous treatment with Eribulin off label

Trial locations and contacts

20 sites in 1 country.

20 sites in 1 country

Italy20 sites
  • Comprensorio sanitario di Bolzano

    Bolzano, 39100

  • Istituti Ospitalieri di Cremona

    Cremona, 26100

  • Azienda Ospedaliera S. Croce e Carle

    Cuneo, 12100

  • A.O.U. Careggi

    Florence, 50134

  • A.O. Vito Fazzi

    Lecce, 73100

  • Ospedale Civile di Legnano

    Legnano, 20025

  • Oncologia Medica Ospedale Fatebenefratelli

    Milan, 20121

  • ASL Salerno Presidio Ospedaliero Andrea Tortora

    Pagani, 84016

  • Fondazione IRCCS Policlinico San Matteo di Pavia

    Pavia, 27100

  • Azienda Ospedaliera di Piacenza

    Piacenza, 29100

  • POliclinico Universitario Campus Bio-Medico

    Roma, 00128

  • Fondazione Policlinico Tor Vergata

    Roma, 00133

  • Istituto Nazionale Tumori "Regina Elena" Oncologia Medica A

    Roma, 00144

  • Istituto Nazionale Tumori "Regina Elena" Oncologia medica B

    Roma, 00144

  • Policlinico Universitario Agostino Gemelli

    Roma, 00168

  • Azienda Ospedaliera Valtellina e Valchiavenna - Presidio di Sondrio

    Sondrio, 23100

  • ASL di FRosinone Ospedale SS Trinità di Sora

    Sora, 03039

  • A.O. Santa Maria di Terni

    Terni, 5100

  • Ospedale di Treviglio

    Treviglio, 24047

  • Azienda Ospedaliero-Universitaria Santa Maria della Misericordia

    Udine, 33100

Other trials in Italy

About this study

Official title: Multicenter, Interventional, Single-arm, Phase IV Study Evaluating Tolerability of Eribulin and Its Relationship With a Set of Polymorphisms in an Unselected Population of Female Patients With Metastatic Breast Cancer

On March 17th, 2011, the European Commission issued a marketing authorization valid throughout the European Union for Eribulin mesylate (Halaven; Eisai Limited), for the treatment of patients with locally advanced or metastatic breast cancer who have progressed after at least two chemotherapic regimens for advanced disease.

As the use of Eribulin will be widespread in this tumor setting, a better knowledge of its safety profile outside clinical trials is warranted.

Indeed the possibility to select patients at risk for developing Eribulin-induced neuropathy, will allow the exclusion from these treatment of those patients harbouring the specific single nucleotide polymorphism (SNP). Given that Eribulin toxicity often results in treatment discontinuation, the ability to anticipate which patients will experience severe toxicity could allow for either early intervention or even possibly for prophylactic therapy, or for selection of the patients to be treated.

Read the detailed description

This study is primarily aimed at surveying the tolerability profile of Eribulin in an unselected population of patients with metastatic breast cancer in relation to toxicities already described in clinical trials, and neurotoxicity in particular.

The secondary objectives of this trial include:

  • To study the relationship between specific genetic polymorphism and incidence and severity of peripheral neuropathy
  • To describe treatment efficacy in terms of duration of treatment and impact on survival.

All toxicities will be collected and classified according to National Cancer Institute Common Terminology criteria for Adverse Events (NCI CTCAE) version 4.0 and monitored during all the treatment period and up to 30 days after therapy discontinuation.

In particular, evaluation of incidence and outcome of any grade AEs already recorded in previous clinical trials will be collected, as follows:

  • asthenia/fatigue,
  • neutropenia,
  • alopecia,
  • nausea,
  • peripheral neuropathy
  • constipation

Any other unexpected AEs shall be evaluated likewise.

Patients must be followed for AEs until every ongoing Eribulin-related/unrelated toxicity and AE have been resolved, or the Investigator assesses them as "chronic" or "stable" or until the end of the trial, whichever comes first. For patients who will begin a new anticancer therapy after the last study drug administration, the AEs reporting period will end at the time the new treatment starts.

For the determination of polymorphisms, a routine blood collection of two tubes with 3-5 ml of blood be performed. The sample can be collected at any time during the participant's first two treatment cycles. Blood will be collected in a Vacutainer containing ethylendiaminetetraacetic acid (EDTA). Immediately after blood collection, tubes have to be inverted (at least five times) and then stored at - 20° C.

Being tested
ERIBULIN MESYLATE
Keywords
Eribulin mesylate, Halaven, Polymorphisms, Tolerability
Medical subject headings
Breast Neoplasms, Neurotoxicity Syndromes, Drug-Related Side Effects and Adverse Reactions

What participants receive

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

  • ERIBULIN MESYLATEDrug

    Also called HALAVEN

    Eribulin mesylate will be administered according to the European Medicines Agency (EMA) and Italian Medicines Agency (AIFA) approved indications and schedule consists in 1.23 mg/m2 on day 1 and on day 8 of each cycle. Cycles will be repeated every 21 days until progression of disease, unacceptable toxicity, patient refusal or medical decision.

    The decision to treat patients with Eribulin is independent from the trial. Patients will be treated and managed according to clinical practice. The physician can choose any further line of treatment after disease progression with Eribulin.

Study groups in NCT02864030
Study groupRoleWhat they receive
Single arm with Eribulin mesylateOtherNot described
Receives: Drug: ERIBULIN MESYLATE

What is being measured

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

  1. Incidence, time of onset, severity and duration of all Adverse Events (AEs) experienced during treatment with Eribulin (any grade)

    All toxicities and their grade will be reported according to Common Terminology criteria for Adverse Events (CTCAE) v4.0, especially the most common AEs reported in previous clinical studies (asthenia/fatigue, neutropenia, alopecia, nausea, peripheral neuropathy and constipation) but also other possible unexpected toxicities.

    Measured: Trough study completion, an average of 1 year

  2. Association between a set of selected polymorphisms and the onset of any grade peripheral neuropathy

    The association between a set of selected polymorphisms and the onset of all grades peripheral neuropathy will be investigated using blood samples collected at the time of treatment initiation.

    Measured: Trough study completion, an average of 1 year

  3. Treatment tolerability

    Treatment tolerability will also be described in terms of dose intensity and dose schedule maintenance.

    Measured: Trough study completion, an average of 1 year

  4. DOT (Duration Of Treatment)

    DOT will be calculated for each patient from the date of start of Eribulin treatment to the date of last Eribulin administration for any cause (i.e. progression of disease, unacceptable toxicity, patient refusal or physician decision).

    Measured: Trough study completion, an average of 1 year

  5. OS (Overall Survival)

    OS will be calculated from the date of start of therapy to the date of death.

    Measured: Trough study completion, an average of 1 year

Timeline

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

  1. First posted11 Aug 2016 (estimated)
  2. Study startMay 2014
  3. Primary completion31 Dec 2018
  4. Study completion31 Dec 2020

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 4
Primary purpose
Health services research
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02864030
Sponsor's protocol ID
PAINTER01
Status last verified
Mar 2021
First submitted
3 Aug 2016
Last updated
4 Mar 2021
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Guarneri V, Conte PF. The curability of breast cancer and the treatment of advanced disease. Eur J Nucl Med Mol Imaging. 2004 Jun;31 Suppl 1:S149-61. doi: 10.1007/s00259-004-1538-5. Epub 2004 Apr 24.

    PubMed 15107948
  • Mauri D, Polyzos NP, Salanti G, Pavlidis N, Ioannidis JP. Multiple-treatments meta-analysis of chemotherapy and targeted therapies in advanced breast cancer. J Natl Cancer Inst. 2008 Dec 17;100(24):1780-91. doi: 10.1093/jnci/djn414. Epub 2008 Dec 9.

    PubMed 19066278
  • Kobayashi T, Ichiba T, Sakuyama T, Arakawa Y, Nagasaki E, Aiba K, Nogi H, Kawase K, Takeyama H, Toriumi Y, Uchida K, Kobayashi M, Kanehira C, Suzuki M, Ando N, Natori K, Kuraishi Y. Possible clinical cure of metastatic breast cancer: lessons from our 30-year experience with oligometastatic breast cancer patients and literature review. Breast Cancer. 2012 Jul;19(3):218-37. doi: 10.1007/s12282-012-0347-0. Epub 2012 Apr 25.

    PubMed 22532161
  • Jordan MA, Kamath K, Manna T, Okouneva T, Miller HP, Davis C, Littlefield BA, Wilson L. The primary antimitotic mechanism of action of the synthetic halichondrin E7389 is suppression of microtubule growth. Mol Cancer Ther. 2005 Jul;4(7):1086-95. doi: 10.1158/1535-7163.MCT-04-0345.

    PubMed 16020666
  • Okouneva T, Azarenko O, Wilson L, Littlefield BA, Jordan MA. Inhibition of centromere dynamics by eribulin (E7389) during mitotic metaphase. Mol Cancer Ther. 2008 Jul;7(7):2003-11. doi: 10.1158/1535-7163.MCT-08-0095.

    PubMed 18645010
  • Towle MJ, Salvato KA, Budrow J, Wels BF, Kuznetsov G, Aalfs KK, Welsh S, Zheng W, Seletsky BM, Palme MH, Habgood GJ, Singer LA, Dipietro LV, Wang Y, Chen JJ, Quincy DA, Davis A, Yoshimatsu K, Kishi Y, Yu MJ, Littlefield BA. In vitro and in vivo anticancer activities of synthetic macrocyclic ketone analogues of halichondrin B. Cancer Res. 2001 Feb 1;61(3):1013-21.

    PubMed 11221827
  • Goel S, Mita AC, Mita M, Rowinsky EK, Chu QS, Wong N, Desjardins C, Fang F, Jansen M, Shuster DE, Mani S, Takimoto CH. A phase I study of eribulin mesylate (E7389), a mechanistically novel inhibitor of microtubule dynamics, in patients with advanced solid malignancies. Clin Cancer Res. 2009 Jun 15;15(12):4207-12. doi: 10.1158/1078-0432.CCR-08-2429. Epub 2009 Jun 9.

    PubMed 19509177
  • Tan AR, Rubin EH, Walton DC, Shuster DE, Wong YN, Fang F, Ashworth S, Rosen LS. Phase I study of eribulin mesylate administered once every 21 days in patients with advanced solid tumors. Clin Cancer Res. 2009 Jun 15;15(12):4213-9. doi: 10.1158/1078-0432.CCR-09-0360. Epub 2009 Jun 9.

    PubMed 19509146
  • Mukohara T, Nagai S, Mukai H, Namiki M, Minami H. Eribulin mesylate in patients with refractory cancers: a Phase I study. Invest New Drugs. 2012 Oct;30(5):1926-33. doi: 10.1007/s10637-011-9741-2. Epub 2011 Sep 2.

    PubMed 21887501
  • Vahdat LT, Pruitt B, Fabian CJ, Rivera RR, Smith DA, Tan-Chiu E, Wright J, Tan AR, Dacosta NA, Chuang E, Smith J, O'Shaughnessy J, Shuster DE, Meneses NL, Chandrawansa K, Fang F, Cole PE, Ashworth S, Blum JL. Phase II study of eribulin mesylate, a halichondrin B analog, in patients with metastatic breast cancer previously treated with an anthracycline and a taxane. J Clin Oncol. 2009 Jun 20;27(18):2954-61. doi: 10.1200/JCO.2008.17.7618. Epub 2009 Apr 6.

    PubMed 19349550
  • Cortes J, Vahdat L, Blum JL, Twelves C, Campone M, Roche H, Bachelot T, Awada A, Paridaens R, Goncalves A, Shuster DE, Wanders J, Fang F, Gurnani R, Richmond E, Cole PE, Ashworth S, Allison MA. Phase II study of the halichondrin B analog eribulin mesylate in patients with locally advanced or metastatic breast cancer previously treated with an anthracycline, a taxane, and capecitabine. J Clin Oncol. 2010 Sep 1;28(25):3922-8. doi: 10.1200/JCO.2009.25.8467. Epub 2010 Aug 2.

    PubMed 20679609
  • Aogi K, Iwata H, Masuda N, Mukai H, Yoshida M, Rai Y, Taguchi K, Sasaki Y, Takashima S. A phase II study of eribulin in Japanese patients with heavily pretreated metastatic breast cancer. Ann Oncol. 2012 Jun;23(6):1441-8. doi: 10.1093/annonc/mdr444. Epub 2011 Oct 11.

    PubMed 21989327
  • Cortes J, O'Shaughnessy J, Loesch D, Blum JL, Vahdat LT, Petrakova K, Chollet P, Manikas A, Dieras V, Delozier T, Vladimirov V, Cardoso F, Koh H, Bougnoux P, Dutcus CE, Seegobin S, Mir D, Meneses N, Wanders J, Twelves C; EMBRACE (Eisai Metastatic Breast Cancer Study Assessing Physician's Choice Versus E7389) investigators. Eribulin monotherapy versus treatment of physician's choice in patients with metastatic breast cancer (EMBRACE): a phase 3 open-label randomised study. Lancet. 2011 Mar 12;377(9769):914-23. doi: 10.1016/S0140-6736(11)60070-6. Epub 2011 Mar 2.

    PubMed 21376385
  • Cavaletti G, Alberti P, Marmiroli P. Chemotherapy-induced peripheral neurotoxicity in the era of pharmacogenomics. Lancet Oncol. 2011 Nov;12(12):1151-61. doi: 10.1016/S1470-2045(11)70131-0. Epub 2011 Jun 28.

    PubMed 21719347
  • Swain SM, Arezzo JC. Neuropathy associated with microtubule inhibitors: diagnosis, incidence, and management. Clin Adv Hematol Oncol. 2008 Jun;6(6):455-67.

    PubMed 18567992

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing ERIBULIN MESYLATE in people with Metastatic Breast Cancer and Toxicity, run by Oncologia Medica dell'Ospedale Fatebenefratelli at 20 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 6 inclusion and 2 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 4 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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?

Incidence, time of onset, severity and duration of all Adverse Events (AEs) experienced during treatment with Eribulin (any grade) (time frame: Trough study completion, an average of 1 year). The study lists 5 primary outcomes in all. 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 NCT02864030, which also lists 22 linked publications.

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 4 Mar 2021.

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