Miracle Mouthwash Plus Hydrocortisone vs Prednisolone Mouth Rinse for Mouth Sores Caused by Everolimus
Verified September 2014 by US Oncology Research
Information provided by (Responsible Party):
US Oncology Research
First received: August 26, 2014
Last updated: September 16, 2014
Last verified: September 2014
This is a randomized Phase 2 study to evaluate two different steroid-based mouth rinses (Miracle Mouth Wash plus hydrocortisone versus prednisolone oral rinse) for the prevention or treatment of everolimus-associated stomatitis (mouth sores) in postmenopausal patients undergoing treatment with an aromatase inhibitor plus everolimus. An exploratory analysis will also evaluate patient response to next anti-cancer therapy of physician's choice following discontinuation of therapy with an aromatase inhibitor plus everolimus.
Neoplasm of the Breast
Malignant Tumor of Breast
Drug: Miracle Mouthwash Plus Hydrocortisone
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Supportive Care
||Evaluation of Miracle Mouthwash (MMW) Plus Hydrocortisone and Prednisolone Mouth Rinse as Prophylaxis for Everolimus-Associated Stomatitis
Primary Outcome Measures:
Secondary Outcome Measures:
- Incidence of all side effects [ Time Frame: 64 weeks ] [ Designated as safety issue: Yes ]
Determination of the incidence of adverse events (all grades)
- Percentage of patients requiring dose interruptions and/or dose reductions of everolimus [ Time Frame: 64 weeks ] [ Designated as safety issue: Yes ]
Determination of the percentage of patients requiring dose interruptions and/or dose reductions of everolimus, as well as the percentage of patients discontinuing therapy with everolimus due to toxicity.
- Reduction in pain score on questionnaires [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
Evaluation of the impact of MMW plus hydrocortisone or a prednisolone mouth rinse on the duration and severity of stomatitis, as assessed by the Oral Stomatitis Daily Questionnaire (OSDQ).
| Estimated Enrollment:
| Study Start Date:
| Estimated Primary Completion Date:
||February 2016 (Final data collection date for primary outcome measure)
Experimental: Miracle Mouthwash plus Hydrocortisone
Miracle Mouthwash plus Hydrocortisone, swish and expectorate 10cc (10 mLs) 4 times per day, every day for 12 weeks.
Drug: Miracle Mouthwash Plus Hydrocortisone
Miracle Mouthwash Plus Hydrocortisone (16 oz recipe/480 ml)
Active Comparator: Prednisolone
Prednisolone oral solution 15 mg/5 ml; swish and expectorate 10cc (10 mL) 4 times per day, every day for 12 weeks.
Prednisolone oral solution 15 mg/5 ml
|Ages Eligible for Study:
||18 Years and older
|Genders Eligible for Study:
|Accepts Healthy Volunteers:
- Age ≥ 18 years;
- ECOG (Eastern Cooperative Group) Performance status ≤ 2;
- Histologic or cytologic confirmation of stage IV hormone receptor-positive breast cancer;
Postmenopausal status, defined either by:
- Age ≥ 55 years and ≥ 1 year of amenorrhea
- Age < 55 years and ≥ 1 year of amenorrhea, with an estradiol assay <20pg/ml
- Surgical menopause with bilateral oophorectomy Note: Ovarian radiation or treatment with a luteinizing hormone-releasing hormone (LHRH) agonist (goserelin acetate or leuprolide acetate) is not permitted for induction of ovarian suppression;
- Planned treatment with an aromatase inhibitor (letrozole, exemestane, or anastrozole) plus everolimus; Note: Prior treatment with an aromatase inhibitor, either for early-stage or metastatic breast cancer, is allowed.
- Adequate bone marrow function as shown by: ANC (absolute neutrophil count) ≥1.5 x 109/L, Platelets ≥100 x 109/L, Hb >9 g/dL;
Adequate liver function as shown by:
- Total serum bilirubin ≤2.0 mg/dL,
- ALT (Alanine aminotransferase) and AST (Aspartate aminotransferase) ≤2.5x ULN (upper limit of normal) (≤5x ULN in patients with liver metastases),
- INR (International Normalized Ratio) ≤2;
- Adequate renal function: serum creatinine ≤1.5x ULN;
Fasting serum cholesterol ≤300 mg/dL OR ≤7.75 mmol/L AND fasting triglycerides ≤2.5x ULN.
Note: In case one or both of these thresholds are exceeded, the patient can only be included after initiation of appropriate lipid lowering medication;
- Willingness to complete a daily stomatitis symptom questionnaire;
- Signed informed consent obtained prior to any screening procedures.
- Known intolerance or hypersensitivity to everolimus or other rapamycin analogs (e.g. sirolimus, temsirolimus);
- Known impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral everolimus;
- Uncontrolled diabetes mellitus as defined by HbA1c (hemoglobin A1c) >8% despite adequate therapy. Patients with a known history of impaired fasting glucose or diabetes mellitus (DM) may be included, however blood glucose and antidiabetic treatment must be monitored closely throughout the trial and adjusted as necessary;
Patient has any severe and/or uncontrolled medical conditions such as:
- unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction ≤6 months prior to start of Everolimus, serious uncontrolled cardiac arrhythmia, or any other clinically significant cardiac disease
- Symptomatic congestive heart failure of New York Heart Association Class III or IV
- active (acute or chronic) or uncontrolled severe infection, liver disease such as cirrhosis, decompensated liver disease, and chronic hepatitis (i.e. quantifiable HBV-DNA (Hepatitis B Virus DNA) and/or positive HbsAg, quantifiable HCV-RNA [Hepatitis C Virus RNA]),
- known severely impaired lung function (spirometry and DLCO [Diffusing capacity of the Lung for Carbon Monoxide] 50% or less of normal and O2 saturation 88% or less at rest on room air),
- active, bleeding diathesis;
- Patient requires chronic treatment with corticosteroids (including inhaled corticosteroids) or other immunosuppressive agents. Topical corticosteroids are allowed;
- Known history of HIV seropositivity;
- Patient received live attenuated vaccines within 1 week of start of everolimus and during the study. Patient should also avoid close contact with others who have received live attenuated vaccines. Examples of live attenuated vaccines include intranasal influenza, measles, mumps, rubella, oral polio, BCG (Bacillus Calmette-Guérin), yellow fever, varicella and TY21a typhoid vaccines;
- Patient has a history of another primary malignancy, with the exceptions of: non-melanoma skin cancer, and carcinoma in situ of the cervix, uteri, or breast from which the patient has been disease free for ≥3 years;
- Patient has a history of non-compliance to medical regimens or who are considered potentially unreliable or will not be able to complete the entire study;
- Patient is currently part of or has participated in any clinical investigation with an investigational drug within 1 month prior to dosing.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02229136
|12 sites incl Yakima, WA, Boulder, CO, and Austin, TX
|US, Texas, United States |
US Oncology Research
||Vicky E. Jones, MD
||US Oncology Research, McKesson Specialty Health
No publications provided
||US Oncology Research
History of Changes
|Other Study ID Numbers:
|Study First Received:
||August 26, 2014
||September 16, 2014
||United States: Institutional Review Board
Keywords provided by US Oncology Research:
Mouth sores from chemotherapy
hormone receptor-positive metastatic breast cancer
metastatic breast cancer
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on May 31, 2015
Neoplasms by Site
Hydrocortisone 17-butyrate 21-propionate
Antineoplastic Agents, Hormonal
Central Nervous System Agents