The aim of this study is to evaluate the safety and efficacy of ATH008 cream in patients with Palmar-Plantar Erythrodysesthesia Syndrome (PPES) secondary to capecitabine therapy. In part I, the safety and plasmatic levels of the active ingredient and its metabolite will allow to determine the most appropriate and beneficial dose for the second part of the study. In Part II, the efficacy of ATH008 cream in reducing the number of patients presenting PPES grade 2/3 secondary to capecitabine therapy following a four times daily application will be tested.
This is a Phase II Placebo Controlled, Multicenter Study that will involve up to 114 patients with Palmar-Plantar Erythrodysesthesia Syndrome (PPES) secondary to capecitabine therapy. Eligible patients will be enrolled into Part I or Part II of the study. The first part of the study (Part I) is designed * to demonstrate the safety of ATH008 cream 1%, 3% and 8% and ATH008 cream placebo, * to determine the plasmatic levels of the active ingredient and its metabolite after repeated doses of ATH008 cream 1%, 3% and 8%, and * to determine the grade of PPES at Day 1 and Day 21 of ATH008 cream treatment Part I will have four different arms; patients will receive one of the three different doses of drug product (ATH008 cream 1%, ATH008 cream 3% or ATH008 cream 8%) or placebo (ATH008 cream placebo) in repeated doses (twice daily) during a period of 21 days. Patients will continue to be assessed for safety and pharmacokinetics of active ingredient and its metabolite (Pre-dose, Day 1 and Day 21). Results of Part I will determine the most appropriate and beneficial dose for the second part of the study. The second part of the study (Part II) is aimed at demonstrating the safety and efficacy of ATH008 cream in reducing the number of patients presenting PPES grade 2/3 secondary to capecitabine therapy following a four times daily application. Part II will have three different arms; patients will receive ATH008 cream 3%, 8% or placebo in repeated doses (four times per day) since appearance of PPES grade 1 until appearance of grade 2-3 or a maximum of 4 cycles. Patients will continue to be assessed for safety. The clinical signs will be reported by iconographic register of lesions and pain will be evaluated using a pain scale. Patient will fill a questionnaire reporting QoL.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
122
The subject will be incorporated in the study and randomised to ATH008 cream 3% or 8% or ATH008 cream placebo
Imelda
Bonheiden, Belgium
Institute Jules Bordet
Brussels, Belgium
AZ Maria Middelares
St-Niklaas, Belgium
Iniversitätsklinikum Hamburg Eppendorf
Hamburg, Germany
OncoResearch Lerchenfeld UG
Hamburg, Germany
Klinikum Offenbach GmbH
Offenbach, Germany
Prosper Hospital
Recklinghausen, Germany
IRCCS - Istituto Europeo di Oncologia (IEO) di Milano
Milan, Dr. Franco Nolè, Italy
A.O. Universitaria Policlinico S.Orsola-Malpighi di Bologna
Bologna, Italy
Azienda Ospedaliero Universitaria "Maggiore Della Carità" di Novara
Novara, Italy
...and 16 more locations
Efficacy of ATH008 cream in reducing the number of subjects presenting PPES grade 2/3 secondary to capecitabine therapy
percentage of subjects that develop PPES grade 2 or 3 according to the NCI CTCAE v4.03 criteria
Time frame: minimum every 21 days, maximum of 4 capecitabine cycles, followed by a safety observation period of 14 days
Safety of ATH008 cream in patients presenting PPES secondary to capecitabine therapy
adverse events and serious adverse events (incidence, causality, and severity) related to treatment with ATH008 cream
Time frame: minimum every 21 days, maximum of 4 capecitabine cycles, followed by a safety observation period of 14 days
Plasmatic levels of ATH008 cream when given topically
plasmatic levels of the active ingredient and its metabolite when given topically
Time frame: blood sampling at specific timepoints (Pre-dose, Day 1 and Day 21)
Efficacy of ATH008 cream in improving the quality of life of patients presenting PPES
quality of life compared to baseline
Time frame: minimum every 21 days, maximum of 4 capecitabine cycles, followed by a safety observation period of 14 days
Efficacy of ATH008 cream in improving signs and symptoms of PPES
proportion of subjects that present no PPES signs or symptoms, time to progression and time to improvement of PPES grades,assessment from photographs of erythema, desquamation, existence of blisters, fissures and ulcers; percentage of palms and soles affected by PPES
Time frame: minimum every 21 days, maximum of 4 capecitabine cycles, followed by a safety observation period of 14 days
Assessment of patient reported pain
assessment of pain, using a 0-10 score, analysed comparing the values measured during the study treatment period with the baseline pain value
Time frame: minimum every 21 days, maximum of 4 capecitabine cycles, followed by a safety observation period of 14 days
Accumulated dose intensity of capecitabine before and during ATH008 cream treatment
accumulated capecitabine dose during study treatment (mg / m2) from the starting of ATH008 cream treatment
Time frame: minimum every 21 days, maximum of 4 capecitabine cycles, followed by a safety observation period of 14 days
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