Efficacy and Safety of DLBS1425 as Neoadjuvant in Stage II or III Breast Cancer Patients

Dexa Medica Group40 enrolled

Overview

This is a 2-arm, randomized, double-blind, placebo-controlled study aiming to determine the efficacy and safety of DLBS1425 in combination with anthracyclin-based regimen as a neoadjuvant therapy in subjects with previously untreated stage II or III (operable) breast cancer. The anthracyclin-based regimen in the study will be either CAF/iv and CEF/iv only. The neoadjuvant anthracyclin-based chemotherapy will be given for 3 cycles. The length of each cycle will be 21-28 days.

The duration of treatment for each subject will be 63 - 84 days (or 3 cycles). The cycle will be initiated at Day-1 (D1 of the 1st cycle). The subsequent cycles will start on Day-22 (D1 of the 2nd cycle) and Day-43 (D1 of the 3rd cycle). DLBS1425 capsules will be administered orally every day (starting from D1 of each cycle) during the study period. All subjects will be under direct supervision of a medical doctor during the study period. Clinical and laboratory examinations to evaluate investigational drug's efficacy and safety will be performed at baseline and at the end of every cycle over the study course; whilst breast-CT scan will be performed at baseline and at the end of study course. In addition, at the end of study, at the discretion of Investigator and subjects' own willingness, subjects with good response to treatment (i.e. RECIST and pathological evaluation are regarded as complete or partial response) may continue their breast-cancer therapy with DLBS1425.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Breast Cancer

Interventions

DLBS1425DRUG

DLBS1425 capsule 150 mg thrice daily for 3 cycles @ 21 days. CAF (Cyclophosphamide (500 mg/m2 iv), Doxorubicin 50 mg/m2 iv, Fluorouracil 500 mg/m2 iv) or CEF (Cyclophosphamide 500 mg/m2 iv, Epirubicin 70 mg/m2 iv, Fluorouracil 500 mg/m2 iv) regimens on Day-1 of every cycle for the total of 3 cycles.

Placebo DLBS1425DRUG

Placebo DLBS1425 capsule thrice daily for 3 cycles @ 21 days. CAF (Cyclophosphamide (500 mg/m2 iv), Doxorubicin 50 mg/m2 iv, Fluorouracil 500 mg/m2 iv) or CEF (Cyclophosphamide 500 mg/m2 iv, Epirubicin 70 mg/m2 iv, Fluorouracil 500 mg/m2 iv) regimens on Day-1 of every cycle for the total of 3 cycles.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Confirmed stage II or III (operable) primary breast cancer * Having radiologically evaluable and measurable lesion(s) of the primary tumor * Karnofsky performance status 80 % * Normal cardiac function: LVEF \> 50 % * Adequate hematological function: Hb ≥ 10.0 g/dL, WBC ≥ 3,000/mm3, ANC ≥ 1,500 /mm3, platelet count ≥ 100,000/mm3 * Adequate liver function: ALT ≤ 2.5 times upper limit of normal, total bilirubin level ≤ 1.5 times upper limit of normal * Adequate renal function: serum creatinine ≤ 1.5 times upper limit of normal * Able to take oral medication Exclusion Criteria: * Pregnancy or breast feeding subjects * History of previous breast cancer (recurrent breast cancer) * History of other cancer within the past 5 years * Prior systemic treatment for the current breast cancer * Prior preoperative topical treatments for the current breast cancer * Uncontrolled or serious CVD * Known or suspected hypersensitivity to any of the chemotherapeutic agents used in the study * Any other serious disease state or medical condition which judged by investigator could interfere with trial participation or trial evaluation * Concurrent herbal (alternative) medicines or food supplements suspected to have effect on breast cancer disease within 14 days prior to screening * Severe psychological or neurological disorder or dementia that would preclude understanding of the informed consent * Participation in any other clinical studies within 30 days prior to screening

Locations (1)

Surgery-Oncology Division, Department of Surgery, Faculty of Medicine, University of Airlangga / Dr. Soetomo Hospital

Surabaya, East Java, Indonesia

Outcomes

Primary Outcomes

Clinical response as measured by RECIST

Best overall response rate defined as proportion of subjects with either complete or partial response, according to the RECIST criteria at the end of study.

Time frame: 63 - 84 days

Secondary Outcomes

Rate of clinical response

Rate of clinical response categorized as complete response, partial response, stable, and progressive disease, which will be evaluated clinically at the end of every cycle

Time frame: 21 - 84 days

Rate of pathological complete response (after surgery)

Pathological complete response based on histological examination will be assessed after surgery. The surgery itself will be performed within 7 - 14 days after the last cycle.

Time frame: 7 - 14 days after the last cycle

Rate of potential breast-conserving procedure

Rate of potential breast-conserving procedure as assessed by mammography, will be evaluated at the end of study.

Time frame: 63-84 days

The change level of relevant biomarkers

Relevant biomarkers related to breast cancer (CEA, CA-15.3, and serum LDH)will be measured at baseline and at the end of every cycle.

Time frame: 21 - 84 days

Haematology

Haematology parameters (Haemoglobin level, Haematocrit, red blood cell count, white blood cell count as well as its differentials, and platelet count) will be evaluated at baseline and the end of every cycle.

Time frame: 21-84 days

Liver Function

Data from ClinicalTrials.gov

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