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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA043703 | U.S. NIH Grant/Contract | View source | |
| CASE5Y03 | Other Identifier | Case Comprehensive Cancer Center |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Pyridoxine (vitamin B6) may prevent or lessen hand-foot syndrome caused by chemotherapy. It is not yet known whether pyridoxine is more effective than a placebo in preventing hand-foot syndrome.
PURPOSE: This randomized clinical trial is studying pyridoxine to see how well it works compared to a placebo in preventing hand-foot syndrome in patients who are receiving liposomal doxorubicin for recurrent ovarian, fallopian tube, or peritoneal cancer, metastatic breast cancer, or advanced endometrial cancer.
OBJECTIVES:
Primary
OUTLINE: This is a randomized, double-blind study. Patients are stratified according to cancer type (ovarian, fallopian tube, or peritoneal cavity cancer vs breast cancer vs endometrial cancer). Patients are randomized to 1 of 2 treatment arms.
In both arms, treatment repeats every 4 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Patients who develop grade 2-3 palmar-plantar erythrodysesthesia despite dose reduction of doxorubicin HCl liposome are unblinded and removed from the study (for patients in arm I) OR receive oral pyridoxine twice daily beginning day 1 of the next planned therapy (for patients in arm II).
Quality of life is assessed at baseline and after every third course of therapy.
After completion of study treatment, patients are followed periodically for 6 months.
PROJECTED ACCRUAL: A total of 60 patients will be accrued for this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pyridoxine | Experimental | Arm I: Patients receive doxorubicin HCl liposome IV 40 mg/m2 over 1 hour on day 1 and oral pyridoxine 100 mg twice daily on days 1-28. |
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| Placebo | Placebo Comparator | Arm II: Patients receive doxorubicin HCl liposome IV 40 mg/m2 over 1 hour on day 1 and oral placebo twice 100 mg daily on days 1-28. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| pyridoxine hydrochloride | Dietary Supplement | Arm I: Patients receive doxorubicin HCl liposome IV 40 mg/m2 over 1 hour on day 1 and oral pyridoxine twice 100 mg daily on days 1-28. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Palmar-plantar Erythrodysesthesia (PPE) | Patients were monitored weekly with phone calls from the research nurse and monthly at clinic visits for overall (including pyridoxine) and specific doxorubicin HCl liposome related toxicities using the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. | Treatment repeats every 4 weeks for up to 6 courses in the absence of unacceptable toxicity. |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy (FACT-G) | QOL was measured with the FACT-G questionnaire following the third course of doxorubicin HCl liposome before the patient was seen by the treating physician and before chemotherapy was administered. The FACT-G, version 4, is a 27-item core questionnaire evaluating the domains of physical, functional, family-social, and emotional well-being (PWB, FWB, SWB, EWB). Total score ranges from 0-108 and higher scores indicate better QOL. |
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DISEASE CHARACTERISTICS:
Diagnosis of 1 of the following:
Planning to receive chemotherapy with doxorubicin HCl liposome at a dose of 40 mg/m^2
Hormone receptor status:
PATIENT CHARACTERISTICS:
Sex
Menopausal status:
Performance status
Life expectancy
Hematopoietic
Hepatic
Renal
Cardiovascular
Other
PRIOR CONCURRENT THERAPY:
Biologic therapy
Chemotherapy
Recovered from prior chemotherapy
No prior doxorubicin HCl liposome
Other concurrent chemotherapy allowed provided palmar-plantar erythrodysesthesia is not one of the side effects of the therapy
Endocrine therapy
See Chemotherapy
At least 3 weeks since prior and no concurrent oral or topical corticosteroids
At least 1 week since prior hormonal therapy for this cancer
Radiotherapy
Surgery
Other
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| Name | Affiliation | Role |
|---|---|---|
| Vivian von Gruenigen, MD | Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geauga Regional Hospital | Cleveland | Ohio | 44024 | United States | ||
| Lake/University Ireland Cancer Center |
Patients were required to have discontinued corticosteroid therapy at least three weeks prior to enrollment and no corticosteroids were allowed for the duration of the trial. Patients must have discontinued pyridoxine therapy at least three weeks prior to enrollment.
Patients were recruited from the outpatient gynecologic oncology clinics at University Hospitals from May 2004 to December 2007.
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| ID | Title | Description |
|---|---|---|
| FG000 | Pyridoxine | Arm I: Patients receive doxorubicin HCl liposome IV 40mg/m2 over 1 hour on day 1 and oral pyridoxine 100 mg twice daily on days 1-28. |
| FG001 | Placebo | Arm II: Patients receive doxorubicin HCl liposome IV 40mg/m2 over 1 hour on day 1 and oral placebo 100 mg twice daily on days 1-28. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Placebo | Drug | Arm II: Patients receive doxorubicin HCl liposome IV 40 mg/m2 over 1 hour on day 1 and oral placebo 100 mg twice daily on days 1-28. |
|
| doxorubicin HCL liposome | Drug | IV, 40mg/m2 |
|
| After Cycle 3 of chemotherapy (on average at 3 months) |
| Cleveland |
| Ohio |
| 44060 |
| United States |
| Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center | Cleveland | Ohio | 44106-5065 | United States |
| Southwest General Health Center | Cleveland | Ohio | 44130 | United States |
| University Suburban Health Center | Cleveland | Ohio | 44143 | United States |
| UHHS Westlake Medical Center | Cleveland | Ohio | 44145 | United States |
| Mercy Cancer Center at Mercy Medical Center | Cleveland | Ohio | 44708 | United States |
| UHHS Chagrin Highlands Medical Center | Cleveland | Ohio | 44708 | United States |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Pyridoxine | Arm I: Patients receive doxorubicin HCl liposome IV 40mg/m2 over 1 hour on day 1 and oral pyridoxine 100 mg twice daily on days 1-28. |
| BG001 | Placebo | Arm II: Patients receive doxorubicin HCl liposome IV 40mg/m2 over 1 hour on day 1 and oral placebo 100 mg twice daily on days 1-28. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||
| Age Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Palmar-plantar Erythrodysesthesia (PPE) | Patients were monitored weekly with phone calls from the research nurse and monthly at clinic visits for overall (including pyridoxine) and specific doxorubicin HCl liposome related toxicities using the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. | Patients were evaluable for PPE/HFS(Hand-Foot Syndrome) incidence and toxicity assessment if they received at least one course of chemotherapy. Intention to treat analysis was used. | Posted | Number | participants | Treatment repeats every 4 weeks for up to 6 courses in the absence of unacceptable toxicity. |
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| Secondary | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy (FACT-G) | QOL was measured with the FACT-G questionnaire following the third course of doxorubicin HCl liposome before the patient was seen by the treating physician and before chemotherapy was administered. The FACT-G, version 4, is a 27-item core questionnaire evaluating the domains of physical, functional, family-social, and emotional well-being (PWB, FWB, SWB, EWB). Total score ranges from 0-108 and higher scores indicate better QOL. | Posted | Mean | Standard Deviation | Total scores on FACT-G scale | After Cycle 3 of chemotherapy (on average at 3 months) |
|
|
Patients were monitored weekly with phone calls from the research nurse and monthly at clinic visits for overall (including pyridoxine) and specific PLD-related toxicities using the NCI CTCAE, version 3.0
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Pyridoxine | Arm I: Patients receive doxorubicin HCl liposome IV 40mg/m2 over 1 hour on day 1 and oral pyridoxine 100 mg twice daily on days 1-28. | 8 | 15 | 13 | 15 | ||
| EG001 | Placebo | Arm II: Patients receive doxorubicin HCl liposome IV 40mg/m2 over 1 hour on day 1 and oral placebo 100 mg twice daily on days 1-28. | 6 | 14 | 10 | 14 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Allergy/immunologic | Immune system disorders | Systematic Assessment |
| ||
| Blood/bone marrow | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Constitutional symptoms | General disorders | Systematic Assessment |
| ||
| Gastrointestinal | Gastrointestinal disorders | Systematic Assessment |
| ||
| Hemorrhage/bleeding | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Infection | Infections and infestations | Systematic Assessment |
| ||
| Lymphatics | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Metabolic/laboratory | Metabolism and nutrition disorders | Systematic Assessment |
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| Neurology | Nervous system disorders | Systematic Assessment |
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| Pain | General disorders | Systematic Assessment |
| ||
| Pulmonary/upper respiratory | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Renal/genitourinary | Renal and urinary disorders | Systematic Assessment |
| ||
| Vascular | Vascular disorders | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Blood/bone marrow | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Constitutional symptoms | General disorders | Systematic Assessment |
| ||
| Gastrointestinal | Gastrointestinal disorders | Systematic Assessment |
| ||
| Hepatic/pancreas | Hepatobiliary disorders | Systematic Assessment |
| ||
| Infection | Infections and infestations | Systematic Assessment |
| ||
| Lymphatics | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Metabolic/laboratory | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Musculoskeletal/soft tissue | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Neurology | Nervous system disorders | Systematic Assessment |
| ||
| Pain | General disorders | Systematic Assessment |
| ||
| Pulmonary/upper respiratory | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Renal/genitourinary | Renal and urinary disorders | Systematic Assessment |
|
Interim analysis was conducted after 30 patients were enrolled and had evaluable PPE assessment data. Due to decreased accrual and similar PPE rates between groups, the trial was closed for enrollment after the interim analyses was completed.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Vivian von Gruenigen, MD | Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center | 216-844-5011 | vev1@case.edu |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D064420 | Drug-Related Side Effects and Adverse Reactions |
| D016889 | Endometrial Neoplasms |
| D005185 | Fallopian Tube Neoplasms |
| D010051 | Ovarian Neoplasms |
| D000077216 | Carcinoma, Ovarian Epithelial |
| D018567 | Breast Neoplasms, Male |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D064419 | Chemically-Induced Disorders |
| D014594 | Uterine Neoplasms |
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D014591 | Uterine Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D005184 | Fallopian Tube Diseases |
| D000291 | Adnexal Diseases |
| D004701 | Endocrine Gland Neoplasms |
| D010049 | Ovarian Diseases |
| D004700 | Endocrine System Diseases |
| D006058 | Gonadal Disorders |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| D011736 | Pyridoxine |
| ID | Term |
|---|---|
| D025101 | Vitamin B 6 |
| D010847 | Picolines |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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| >=65 years |
|
| Male |
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| Grade 3 HFS |
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