Pilot Study to Evaluate the Safety and Biological Effects of Orally Administered Reparixin in Early Breast Cancer Patients

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: NCT01861054
Recruitment Status : Terminated (Enrollment target not reached)
First Posted : May 23, 2013
Last Update Posted : October 18, 2017
Information provided by (Responsible Party):
Dompé Farmaceutici S.p.A

Brief Summary:
This is a pilot "window of opportunity" clinical study in patients with operable breast cancer investigating use of reparixin as single agent in the time period between clinical diagnosis and surgery. This study evaluates the effects of orally administered reparixin on CSCs in the primary tumor and the tumoral microenvironment in an early breast cancer population. The aim is to investigate if cancer stem cells (CSCs) and pathway markers decrease in two early breast cancer subgroups (ER+ and/or progesterone receptor positive/HER-2- and ER negative/progesterone receptor negative/HER‑2-) and to compare any differences between the two subgroups to try to better identify a target population. 20 patients will be enrolled to each subgroup at ten sites in the US.

Condition or disease Intervention/treatment Phase
Breast Cancer Drug: Reparixin Phase 2

  Show Detailed Description

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 20 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Single Arm, Preoperative, Pilot Study to Evaluate the Safety and Biological Effects of Orally Administered Reparixin in Early Breast Cancer Patients Who Are Candidates for Surgery
Study Start Date : February 2013
Actual Primary Completion Date : March 2015
Actual Study Completion Date : March 1, 2016

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arm Intervention/treatment
Experimental: Treated patients
Patients eligible will be treated with Reparixin as add-in monotherapy
Drug: Reparixin
1000 mg Oral Reparixin t.i.d. for 21 consecutive days prior to surgery

Primary Outcome Measures :
  1. Markers of Cancer Stem Cells (CSCs) in the primary tumor and the tumoral microenvironment [ Time Frame: Change in markers from baseline at day 21 ]
    CSCs will be measured in tissue samples by techniques that may include: ALDEFLUOR assay and assessment of CD44/CD24 by flow cytometry or examination of RNA transcripts by RT-PCR, aldehyde dehydrogenase 1 (ALDH1), CD44/CD24 and epithelial mesenchymal markers (Snail, Twist, Notch) by immunohistochemistry (IHC).

  2. Serine-threonine protein kinase (AKT) [ Time Frame: Change in markers from baseline at day 21 ]
  3. Focal adhesion kinase (FAK) [ Time Frame: Change in markers from baseline at day 21 ]
  4. CXCR1 levels [ Time Frame: Change in markers from baseline at day 21 ]
  5. interleukin-1beta [IL-1beta] [ Time Frame: Change in markers from baseline at day 21 ]
  6. interleukin-6 [IL-6] [ Time Frame: Change in markers from baseline at day 21 ]
  7. tumor necrosis factor-alpha [TNF-alfa] [ Time Frame: Change in markers from baseline at day 21 ]
  8. granulocyte macrophage colony stimulating factor [GM-CSF] [ Time Frame: Change in markers from baseline at day 21 ]
  9. IL-8 [ Time Frame: Evaluation at day 0 and day 21 ]
  10. CD4, CD8, NK and Macrophages [ Time Frame: Change in markers from baseline at day 21 ]

Secondary Outcome Measures :
  1. PK profile of the treatment [ Time Frame: Day 1; Day 21 ]

    Day 1: Cmax, AUCinf (area under the concentration time curve from time 0 extrapolated to infinity calculated by adding Clast/LambdaZ to AUClast [area under the concentration time curve calculated by the linear trapezoidal rule - time 0 to last sample with a quantifiable concentration Clast at time tlast]), AUC0-8 (area under the concentration time curve from time 8 hours post dosing), tmax (time to maximum plasma concentration), LambdaZ (terminal rate constant), t1/2 (calculated as (ln 2)/LambdaZ) and CL/F (apparent oral clearance for DF 1681Y only).

    Day 21 (steady state): Cmax, AUCtau (AUC for a dosing interval), AUClast, tmax, and CL/F.

  2. Vital signs (Blood Pressure, Heart rate, Body Temperature) [ Time Frame: Day 0 and within 28 days of last dose ]
  3. Hematology parameters (hemoglobin, white blood cell (WBC) and differential count, platelets) [ Time Frame: Days 1, 7, 14 and 21 and at the off-treatment visit ]
  4. Clinical chemistry parameters (sodium, potassium, calcium, serum creatinine, total protein, albumin, aspartate aminotransferase [AST], alanine aminotransferase [ALT], alkaline phosphatase [ALP], urea, total bilirubin) [ Time Frame: Days 1, 7, 14 and 21 and at the off treatment visit ]
  5. Urinalysis (pH, specific gravity and dipstick) [ Time Frame: up to 14 days prior to treatment; up to 28 days after treatment ]

Other Outcome Measures:
  1. Markers of angiogenesis (CD31 staining) [ Time Frame: Change in markers from baseline at day 21 ]
  2. Tumor infiltrating leukocytes (CD4, CD8, NK and macrophages) [ Time Frame: Change in markers from baseline at day 21 ]
  3. Autophagy (P62 and LC3 by IHC) [ Time Frame: Change in markers from baseline at day 21 ]

Information from the National Library of Medicine

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

Inclusion Criteria:

  • Female aged > 18 years.
  • Patients with operable breast cancer, with measurable tumors of more than 1 cm in diameter, that are not candidates for neoadjuvant therapy.
  • Zubrod (Eastern Co-operative Oncology Group [ECOG]) Performance Status (PS) of 0-1.
  • No prior treatment by surgery, radiotherapy, hormone therapy e.g. TAMOXIFEN® or RALOXIFEN® for prevention or chemotherapy.
  • Scheduled to undergo definitive local surgery for breast cancer.
  • Patients must be willing to undergo two mandatory tumor biopsies (pre and post therapy) that are not required for standard care. A sample of tumor tissue removed during surgery will also be collected for analysis.
  • Patients must be able to swallow and retain oral medication (intact tablet).
  • Able to undergo all screening assessments outlined in the protocol after giving informed consent.
  • Adequate organ function (defined by the following parameters):

    1. Serum creatinine < 140 μmol/L or creatinine clearance > 60 mL/min.
    2. Serum hemoglobin > 9 g/dL; absolute neutrophil count > 1.5 x 109/L; platelets > 100 x 109/L.
    3. Serum bilirubin < upper normal limit (UNL).
    4. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤ UNL; alkaline phosphatase (ALP) ≤ UNL; albumin within normal limits.
  • Documented hormone receptor (ER and progesterone receptor) and HER-2- status.
  • No known hepatitis B virus (unless due to immunization), hepatitis C virus, human immune deficiency virus-I and II positive status.

Exclusion Criteria:

  • Male.
  • Pregnancy or lactation or unwillingness to use two adequate methods of birth control throughout the study and for 30 days after study discontinuation.
  • Any other breast cancer types including inflammatory form.
  • Prior surgery to the breast area or primary axillary dissection.
  • Prior treatment for breast cancer.
  • Use of an investigational drug within 30 days preceding the first dose of study medication.
  • Any prior or current cancer, except in situ uterine carcinoma or basocellular cutaneous cancer considered as definitively cured.
  • Any associated medical condition considered incompatible with the study, e.g. cardiac, renal, medullar, respiratory or hepatic insufficiency.
  • Neurological or psychiatric disorders which may influence understanding of study and informed consent procedures.
  • Active or uncontrolled infection.
  • Malabsorption syndrome, disease significantly affecting gastrointestinal function.
  • Hypersensitivity to:

    1. ibuprofen or to more than one non-steroidal anti-inflammatory drug;
    2. medications belonging to the class of sulfonamides, such as sulfamethazine, sulfamethoxazole, sulfasalazine, nimesulide or celecoxib.

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): NCT01861054

United States, Indiana
Indiana University Simon Cancer Center
Indianapolis, Indiana, United States, 46202-5289
United States, Kansas
University of Kansas Cancer Center, 4350 Shawnee Mission Pkwy, Suite 1500, Mailstop 6004
Fairway, Kansas, United States, 66205
United States, New Jersey
The Cancer Institute of New Jersey
New Brunswick, New Jersey, United States, 08903
United States, New York
Weill Cornell Medical College
New York, New York, United States, 10065
Montefiore Medical Center, MMC Medical Park at Eastchester
The Bronx, New York, United States, 10461
United States, Pennsylvania
Fox Chase Cancer Center
Philadelphia, Pennsylvania, United States, 19111
Magee-Womens Hospital
Pittsburgh, Pennsylvania, United States, 15213
United States, Tennessee
Sara Cannon Research Institute
Nashville, Tennessee, United States, 37203
United States, Texas
The Methodist Hospital Research Institute
Houston, Texas, United States, 77030
Sponsors and Collaborators
Dompé Farmaceutici S.p.A

Responsible Party: Dompé Farmaceutici S.p.A Identifier: NCT01861054     History of Changes
Other Study ID Numbers: REP0210
First Posted: May 23, 2013    Key Record Dates
Last Update Posted: October 18, 2017
Last Verified: February 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by Dompé Farmaceutici S.p.A:
Cancer Stem Cells
Novel targeted therapy
CXCR1/2 Inhibitors

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases