Epirubicin and Paclitaxel, Alone or Together With Capecitabine as First Line Treatment in Metastatic Breast Cancer (TEX)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified February 2012 by Karolinska University Hospital.
Recruitment status was  Active, not recruiting
Information provided by (Responsible Party):
Thomas Hatschek, Karolinska University Hospital
ClinicalTrials.gov Identifier:
First received: September 1, 2011
Last updated: February 27, 2012
Last verified: February 2012

September 1, 2011
February 27, 2012
December 2002
June 2006   (final data collection date for primary outcome measure)
Time to progression [ Time Frame: Every 9 weeks during treatment and every three months after termination of treatment ] [ Designated as safety issue: No ]
Time to progression comparing treatment with ET vs. TEX in patients with advanced breast cancer.
Same as current
Complete list of historical versions of study NCT01433614 on ClinicalTrials.gov Archive Site
  • Time to treatment failure [ Time Frame: Time from date of randomization until treatment disruption ] [ Designated as safety issue: No ]
  • Response rate [ Time Frame: Every 9 weeks during treatment ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Number of participants with adverse events [ Time Frame: Continuously during treatment and until 2 months after termination ] [ Designated as safety issue: Yes ]
    All side effects which appear during treatment are reported and graded according CTC v.2.
  • Quality of life [ Time Frame: Baseline, 2, 4, 6 and 9 months ] [ Designated as safety issue: No ]
    Measured at five points during nine months from randomization.
  • Tumor biological data related to treatment [ Time Frame: Within two weeks before start of treatment ] [ Designated as safety issue: No ]
    Fine needle aspirates from metastases
Same as current
Not Provided
Not Provided
Epirubicin and Paclitaxel, Alone or Together With Capecitabine as First Line Treatment in Metastatic Breast Cancer
Treatment With the Combination of Epirubicin and Paclitaxel Alone or Together With Capecitabine as First Line Treatment in Metastatic Breast Cancer. A Multicenter, Randomized Phase III Study

Anthracycline-taxane regimens are effective means of postponing progression in metastatic breast cancer. It is yet unclear whether addition of capecitabine to this combination improves the treatment outcome.

Patients with advanced breast cancer are randomized to first-line chemotherapy with a combination of epirubicin (Farmorubicin®) and paclitaxel (Taxol®) alone (ET) or in combination with capecitabine (Xeloda®, TEX). Starting doses for ET are epirubicin 75 mg/m2 plus paclitaxel 175 mg/m2, and for TEX epirubicin 75mg/m2, paclitaxel 155 mg/m2, and capecitabine 825 mg/m2 BID for 14 days. Subsequently, doses are tailored related to side effects.

Primary endpoint is progression-free survival (PFS); secondary endpoints are overall survival (OS), time to treatment failure (TTF), objective response (OR), safety and quality of life (QoL).

Not Provided
Phase 3
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Metastatic Breast Cancer
  • Drug: Epirubicin
    75mg/m2 i.v. every 3 weeks
  • Drug: Paclitaxel
    175 mg/m2 i.v., every 3 weeks arm A 155 mg/m2 i.v., every 3 weeks arm B
    Other Name: Taxol
  • Drug: Capecitabine
    1650 mg/m2 p.o. on days 1-14 every 3 weeks.
    Other Name: Xeloda
  • Active Comparator: Epirubicin + paclitaxel (Taxol)
    Epirubicin 75mg/m2 i.v., paclitaxel 175 mg/m2 i.v. on day 1 every 21 days.
    • Drug: Epirubicin
    • Drug: Paclitaxel
  • Active Comparator: Paclitaxel + epirubicin + capecitabine
    Paclitaxel 155 mg/m2 i.v., epirubicin 75 mg/m2 i.v day 1, capecitabine 1650 mg/m2 p.o. on days 1-14 every 21 days.
    • Drug: Epirubicin
    • Drug: Paclitaxel
    • Drug: Capecitabine
Tobin NP, Harrell JC, Lövrot J, Egyhazi Brage S, Frostvik Stolt M, Carlsson L, Einbeigi Z, Linderholm B, Loman N, Malmberg M, Walz T, Fernö M, Perou CM, Bergh J, Hatschek T, Lindström LS; TEX Trialists Group. Molecular subtype and tumor characteristics of breast cancer metastases as assessed by gene expression significantly influence patient post-relapse survival. Ann Oncol. 2015 Jan;26(1):81-8. doi: 10.1093/annonc/mdu498. Epub 2014 Oct 31.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
Active, not recruiting
March 2012
June 2006   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Morphologically proven breast carcinoma
  • Written patient consent must be obtained
  • Measurable disease (i.e. at least one lesion that can be accurately measured in at least one dimension as ≥20 mm by conventional techniques, or as ≥10 mm by spiral CT scan) as defined in section 8.
  • Lytic and blastic bone metastases as only site of recurrence are allowed
  • Age 18 years or older
  • ECOG performance status 0-2
  • Life expectancy of at least three months
  • Adequate cardiac functions
  • Adequate hematological, renal and hepatic functions
  • Patient must be accessible for treatment and follow-up.

Exclusion Criteria:

  • Treatment-free interval less than one year, if previous adjuvant, neoadjuvant or after radically treated locoregional recurrence given regimen contained anthracycline, taxane or capecitabine. This limitation does not apply for regimens containing other than the drugs mentioned
  • During adjuvant treatment obtained cumulative doses exceeding 375 mg/m2 for doxorubicin, or 550 mg/m2 for epirubicin, abnormal ECG or reduced cardiac function measured by left ventricular ejection fraction (LVEF).
  • Indication for the use of trastuzumab (Herceptin) as first-line treatment in patients with tumor overexpressing c-erbB2.
  • Any previous chemotherapy for metastatic disease, except for radically treated locoregional relapse
  • Neoplasm other than breast carcinoma, except for non-melanoma skin cancer or curatively treated carcinoma in situ of the cervix, diagnosed during the past five years
  • Pregnancy or lactation
  • Known brain metastases
  • History of atrial or ventricular arrhythmias and/or congestive heart failure, even if medically controlled. History of clinical and electrocardiographically documented myocardial infarction
  • Preexisting motor or sensory neuropathy ≥ grade 2 according to NCI CTC 2.0 criteria (severe paresthesia and/or mild weakness, or worse)
  • Severe hepatic or renal impairment (for capecitabine: calculated creatinine clearance below 30 ml/min; for calculation, see p. 5.1.4) not allowing for adequate use of the proposed regimens
  • History of known dihydropyrimidine dehydrogenase (DPD) deficiency (severe reaction on previous treatment with fluorouracil, e.g experience of mucositis, hand-foot syndrome, or diarrhea)
  • Active infection or other serious underlying medical condition which would impair the ability of the patient to receive protocol treatment, including prior allergic reactions to drugs containing cremophor, such as teniposide, cyclosporin or vitamin K
  • Dementia or significantly altered mental status that would prohibit the understanding and giving of informed consent.
18 Years and older
Contact information is only displayed when the study is recruiting subjects
TEX trial
Thomas Hatschek, Karolinska University Hospital
Thomas Hatschek
Not Provided
Principal Investigator: Thomas Hatschek, PhD Karolinska University Hospital
Karolinska University Hospital
February 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP