Calcium and Magnesium in Preventing Peripheral Neuropathy Caused by Ixabepilone in Patients With Breast Cancer

This study has been terminated.
(Study was terminated due to lack of accrual)
Sponsor:
Collaborator:
Information provided by:
Mayo Clinic
ClinicalTrials.gov Identifier:
NCT00998738
First received: October 19, 2009
Last updated: July 26, 2013
Last verified: July 2013
  Purpose

RATIONALE: Giving calcium together with magnesium may stop or delay the development of peripheral neuropathy in patients with cancer who are receiving treatment with ixabepilone. It is not yet known whether calcium and magnesium are more effective than a placebo in preventing peripheral neuropathy caused by ixabepilone.

PURPOSE: This randomized phase III trial is studying calcium given together with magnesium to see how well it works compared with a placebo in preventing peripheral neuropathy caused by ixabepilone in patients with breast cancer.


Condition Intervention Phase
Stage IV Breast Cancer
Recurrent Breast Cancer
Drug: calcium gluconate
Drug: magnesium sulfate
Other: placebo
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Supportive Care
Official Title: The Use of Calcium and Magnesium for Prevention of Ixabepilone Induced Peripheral Neuropathy: A Phase III Double-Blind Placebo Controlled Study

Resource links provided by NLM:


Further study details as provided by Mayo Clinic:

Primary Outcome Measures:
  • Comparison of Chemotherapy-induced Peripheral Neuropathy Between Calcium With Magnesium (CaMg) and Placebo Arms, as Measured by the Sensory Subscale of EORTC QLQ-CIPN20 [ Time Frame: During the first 18 weeks of ixabepilone-based therapy ] [ Designated as safety issue: No ]
    European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy Module (EORTC QLQ-CIPN20) sensor subscale score was calculated following the standard scoring algorithm and was transformed to a 0 to 100 scale with 0=Low QOL and 100=Best QOL for data analysis.


Secondary Outcome Measures:
  • Percentage of Patients With Grade 2+ and/or Grade 3+ Neurotoxicity as Measured by NCI CTCAE Active Version Neuropathy Scale [ Time Frame: Up to 12 months from initiation of ixabepilone ] [ Designated as safety issue: Yes ]
  • Time to Onset of Grade 2+ and/or Grade 3+ Neurotoxicity as Assessed by NCI CTCAE Active Version [ Time Frame: Up to 12 months from initiation of ixabepilone ] [ Designated as safety issue: Yes ]
    Time to onset of grade 2+ neurotoxicity was defined as time from randomization to the first occurrence of grade 2+ neurotoxicity. Time to onset of grade 3+ neurotoxicity was defined as time from randomization to the first occurrence of grade 3+ neurotoxicity.

  • Proportion of Patients Undergoing Dose Reduction or Discontinuing Ixabepilone Secondary to Peripheral Neuropathy [ Time Frame: Up to 12 months from initiation of ixabepilone ] [ Designated as safety issue: No ]
  • Average Cumulative Ixabepilone Dose [ Time Frame: Up to 12 months from initiation of ixabepilone ] [ Designated as safety issue: No ]
  • Toxicity Profile of CaMg Per CTCAE Active Version [ Time Frame: Up to 12 months from initiation of ixabepilone ] [ Designated as safety issue: Yes ]
  • Incidence of the Acute Pain Syndrome (APS) [ Time Frame: Treatment initiation to day 21 (Cycle 1) ] [ Designated as safety issue: No ]

    APS was measured using the pain item which evaluated the aches/pains at its WORST in the last 24 hours in the scale of 0 to 10, with 0=no aches/pain and 10=aches/pains as bad as can be.

    The outcome measures for each subsequent cycle will be analyzed in a similar fashion.


  • Severity of the Acute Pain Syndrome (APS) [ Time Frame: Treatment initiation to day 21 (Cycle 1) ] [ Designated as safety issue: No ]

    APS was measured using the pain item which evaluated the aches/pains at its WORST in the last 24 hours in the scale of 0 to 10, with 0=no aches/pain and 10=aches/pains as bad as can be.

    The outcome measures for each subsequent cycle will be analyzed in a similar fashion.


  • Association Between the Ixabepilone-APS and Eventual Chemotherapy-induced Neuropathy [ Time Frame: First cycle of therapy (up to 21 days) ] [ Designated as safety issue: No ]
    Correlation coefficients will be produced relating the worst pain scores in the first cycle of therapy and the subsequent neuropathy scores as judged from the daily and weekly questions.


Enrollment: 1
Study Start Date: November 2009
Study Completion Date: November 2012
Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Patients receive calcium gluconate and magnesium sulfate IV over 30 minutes immediately before and after each 3 week dose of ixabepilone treatment.
Drug: calcium gluconate
Given IV
Drug: magnesium sulfate
Given IV
Placebo Comparator: Arm II
Patients receive placebo IV over 30 minutes immediately before and after each 3 week dose of ixabepilone treatment.
Other: placebo
Given IV

Detailed Description:

PRIMARY OBJECTIVES:

To compare ixabepilone-induced peripheral neuropathy (sensory) as measured by European Organisation for Research and Treatment of Cancer 20-item module for chemotherapy-induced peripheral neuropathy (EORTC QLQ-CIPN20) sensory subscale between Calcium with Magnesium (CaMg) and placebo arms.

SECONDARY OBJECTIVES:

I. To compare the incidence of CTCAE measured grade 2+ and/or grade 3+ peripheral neuropathy between CaMg and placebo arms.

II. To compare the times to onset of CTCAE measured grade 2+ and/or grade 3+ peripheral neuropathy between CaMg and placebo arms.

III. To compare the proportion of patients requiring ixabepilone dose reductions and/or stopping ixabepilone secondary to peripheral neuropathy (sensory) between CaMg and placebo arms.

IV. To assess the toxicity of CaMg in this situation. V. To document the incidence and severity of the acute pain syndrome (APS, commonly known as arthralgias/myalgias) induced by ixabepilone.

VI. To evaluate whether CaMg will decrease the acute pain syndrome (APS). VII. To evaluate the incidence and characteristics of, and change in, ixabepilone-APS over several cycles.

VIII. To evaluate the association between the ixabepilone-APS and eventual chemotherapy-induced neuropathy.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive calcium gluconate and magnesium sulfate IV over 30 minutes immediately before and after each 3 week dose of ixabepilone treatment.

ARM II: Patients receive placebo IV over 30 minutes immediately before and after each 3 week dose of ixabepilone treatment.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion:

  • Scheduled to undergo cancer treatment for metastatic breast cancer (weekly or once every three weeks) with ixabepilone with no prior exposure to ixabepilone and no more than 2 prior chemotherapy regimens for metastatic disease
  • Serum calcium =< 1.2 x UNL
  • Serum magnesium =< UNL
  • Serum creatinine =< 1.5 x UNL
  • Ability to sign informed consent and understand the nature of a placebo-controlled trial
  • ECOG Performance Status (PS) of 0, 1, or 2 (this form is on the Mayo Clinic Cancer Research Consortium (MCCRC) website https:/mccrc.mayo.edu/mccrc/forms/NonProtocolSpecificForms/)
  • Ability to complete questionnaire(s) by themselves or with assistance - Life expectancy >= 4 months
  • Presence of a central line placed for administration of calcium and magnesium
  • Please contact study investigator and/or consult protocol document for specific details on laboratory criteria

Exclusion:

  • Pre-existing history of peripheral neuropathy >= grade 2 (NCI CTCAE Active Version) due to any cause (chemotherapy, diabetes, alcohol, toxin, hereditary, etc.)
  • Concurrent treatment with anticonvulsants, tricyclic antidepressants, or other neuropathic pain medications agents such as carbamazepine, phenytoin, valproic acid, gabapentin, lamotrigine, topical lidocaine patch, capsaicin cream, etc., or any other treatments specifically for prevention or treatment of neuropathy
  • Other medical conditions, which in the opinion of the treating physician/allied health professional would make this protocol unreasonably hazardous for the patient
  • Any of the following: Pregnant women; Nursing women; Women of childbearing potential (per physician judgment)
  • Diagnosed diabetes requiring insulin or oral hypoglycemic medications - Receiving digoxin or digitoxin
  • History of heart block (any degree)
  • Current treatment for arrhythmias
  • Concurrent treatment with other neuropathic chemotherapy agents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00998738

Locations
United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
Investigators
Principal Investigator: Charles Loprinzi, M.D. Mayo Clinic
  More Information

No publications provided

Responsible Party: Charles Loprinzi, M.D., Mayo Clinic Cancer Center
ClinicalTrials.gov Identifier: NCT00998738     History of Changes
Other Study ID Numbers: RC08CC, NCI-2009-01229, 08-008811, CA163-195
Study First Received: October 19, 2009
Results First Received: May 16, 2013
Last Updated: July 26, 2013
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Peripheral Nervous System Diseases
Peripheral Nervous System Agents
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Neuromuscular Diseases
Nervous System Diseases
Calcium, Dietary
Magnesium Sulfate
Bone Density Conservation Agents
Physiological Effects of Drugs
Pharmacologic Actions
Analgesics
Sensory System Agents
Central Nervous System Agents
Therapeutic Uses
Anesthetics
Central Nervous System Depressants
Anti-Arrhythmia Agents
Cardiovascular Agents
Anticonvulsants
Calcium Channel Blockers
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Tocolytic Agents
Reproductive Control Agents

ClinicalTrials.gov processed this record on April 22, 2014