Predicting Response to Capecitabine in Women With Metastatic Breast Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00953537
Recruitment Status : Completed
First Posted : August 6, 2009
Last Update Posted : February 10, 2015
Information provided by (Responsible Party):
Centre Antoine Lacassagne

Brief Summary:

RATIONALE: Identifying genes that increase a person's susceptibility to side effects caused by capecitabine may help doctors plan better treatment.

PURPOSE: This clinical trial is studying blood samples in predicting response to capecitabine in women with metastatic breast cancer.

Condition or disease Intervention/treatment Phase
Breast Cancer Drug: capecitabine Other: laboratory biomarker analysis Other: pharmacological study Not Applicable

Detailed Description:



  • To determine the sensitivity, specificity, and positive and negative predictive values of dihydrouracil/uracil (UH_2/U) ratio measured before starting treatment on grade 3-4 capecitabine-related toxicity in women with metastatic breast cancer.


  • To prospectively test the value of the germinal genotype of thymidylate synthase (TS) and methylenetetrahydrofolate reductase (MTHFR) as predictors of resistance to capecitabine.
  • To evaluate the practical feasibility of such pre-therapeutic screening.
  • To determine the sensitivity, specificity, and positive and negative predictive values of dihydropyrimidine dehydrogenase genotyping on grade 3-4 capecitabine-related toxicity in the first and second courses.
  • To evaluate the predictive gain provided by genotyping relative to phenotyping alone.
  • To evaluate the influence of TS and MTHFR gene polymorphisms on clinical response and duration of response.
  • To evaluate the pharmacokinetics of capecitabine and its metabolites and their relationship with UH_2/U and genotype.
  • To evaluate the total cost of pre-therapeutic phenotyping alone and the combination of phenotyping and genotyping.
  • To exhaustively analyze the 23 exons of the dihydropyrimidine dehydrogenase (DPYD) gene in patients who developed toxicity.

OUTLINE: This is a multicenter study.

Patients receive oral capecitabine twice daily on days 1-14. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.

Blood samples are collected 8-15 days before the start of treatment and periodically on the first day of treatment for dihydropyrimidine dehydrogenase phenotyping (dihydrouracil/uracil ratio and high performance liquid chromatography analysis), genotyping (4 most relevant single nucleotide polymorphisms), and pharmacokinetic analysis.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 303 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Multicentric Pilot Study of Dihydropyrimidine Dehydrogenase (DPD) Deficiency for Predicting Capecitabine Toxicity in Breast Cancer Patients
Study Start Date : January 2009
Actual Primary Completion Date : January 2011
Actual Study Completion Date : February 2011

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer
U.S. FDA Resources

Arm Intervention/treatment
capecitabine Drug: capecitabine Other: laboratory biomarker analysis Other: pharmacological study

Primary Outcome Measures :
  1. Capecitabine-related toxicity (i.e., hematological, diarrhea, and hand-foot syndrome) recorded during the first and second courses [ Time Frame: 3 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No


  • Radiologically (by scintography) or histologically confirmed metastatic breast cancer
  • At least 1 measurable or evaluable target lesion
  • Receiving capecitabine as monotherapy or with targeted antiangiogenic therapies (e.g., bevacizumab or trastuzumab)
  • No uncontrolled brain metastases
  • Hormone receptor status not specified


  • Menopausal status not specified
  • Life expectancy ≥ 3 months
  • Fertile patients must use effective contraception
  • No chronic uncontrolled illness
  • No congestive heart failure
  • No peripheral venous disease
  • No severe uncontrolled infection
  • No hypoxemic respiratory failure
  • No prior primary cancer except for basal cell carcinoma of the skin
  • No psychologic disorder


  • See Disease Characteristics
  • No capecitabine co-administered with chemotherapy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00953537

Centre Antoine Lacassagne
Nice, France, 06189
Sponsors and Collaborators
Centre Antoine Lacassagne
Principal Investigator: Jean Marc Ferrero, MD Centre Antoine Lacassagne

Responsible Party: Centre Antoine Lacassagne Identifier: NCT00953537     History of Changes
Other Study ID Numbers: CDR0000638377
First Posted: August 6, 2009    Key Record Dates
Last Update Posted: February 10, 2015
Last Verified: February 2015

Keywords provided by Centre Antoine Lacassagne:
stage IV breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents