Breast Cancer Clinical Trial
Official title:
Phase I Dose-Escalation Study, to Evaluate the Safety, Tolerability and Pharmacokinetics of a Topical Compound 31543 (Calcitriol, USP) in Adult Cancer Patients Receiving Taxane-based Chemotherapy Regimens for the Treatment of Advanced or Recurrent Disease
This will be a dose escalation study to determine the maximum tolerated dose (MTD) and the overall safety and tolerability of a topical compound 31543 (Calcitriol) in patients with metastatic or recurrent cancer who are undergoing chemotherapy with a taxane-based regimen.
This will be a dose escalation study to determine the maximum tolerated dose (MTD) and the
overall safety and tolerability of a topical compound 31543 (Calcitriol) in patients with
metastatic or recurrent cancer who are undergoing chemotherapy with a taxane-based regimen.
A standard 3+3 dose escalation design will be employed with 3-6 patients at each dose level.
Eligible patients ≥18 years of age and scheduled to receive a taxane-based regimen with
treatment breaks as per physician's discretion, will start applying the topical solution
twice a day at each cohort dose level two weeks or 7 days ± 2 days prior to initiation of
chemotherapy and then continue twice daily for 3 months or until termination of chemotherapy
treatment. If topical calcitriol is found to be effective in preventing and/or diminishing
taxane chemotherapy-induced alopecia as determined by the photographic assessments and
patient self-assessments, patients will be allowed to continue topical application for the
duration of their chemotherapy treatment, assuming no dose limiting toxicities (DLTs)
related to the topical agent or intolerable side effects are observed. Toxicity to the
topical compound 31543 (calcitriol) will be assessed on a weekly basis during the first 28
days of topical treatment and subsequently every four weeks by a study clinician, either a
physician or a nurse. For the purpose of pharmacokinetic studies (PKs), blood samples will
be collected on Day 1 of topical treatment at the following time points: pre-dose, at 2 hrs
(±30 minutes), 4 hrs (±30 minutes), and 8 hrs (±1 hr post dose) after a single application
on the morning of Day 1. The second application of drug product will be applied 10-14 hrs
after the initial application and after the 8 hr PK sample. Thereafter, topical application
frequency will be twice daily, morning and night. Subsequently, a PK sample will be taken 12
hrs (±2 hrs) after the last dose of each 28-day treatment, before the first application of
Day 1 of the next 28-day treatment cycle. This schedule will continue for three consecutive
28-day topical treatment cycles. (PKs will be drawn at Weeks 1, 5, 9, and 13. In addition,
if patients are still on study, a PK will also be drawn at Week 54.) As a secondary
objective, potential efficacy of the topical calcitriol will be evaluated by photographic
assessment. Photographic assessment will be performed using a Canon digital camera system to
ensure standardization and uniformity among all enrolled patients. The following five views
will be obtained at each photographic assessment: bilateral sides of head/scalp view, front
of head/face view, back of head/scalp view, and top of head/scalp view.Additionally,
close-up photographs will be taken at the same time points. They will include the
mid-pattern of the scalp from a superior view and a vertex view with hair parted in the
center and combed away from the center part. Photographs will be standardized for lighting,
camera angle, and position to the participant's head.These assessments will be performed at
the following time points: at baseline, Weeks 7, 15, 27, and 54. Photographs for patients in
each cohort representing baseline, and treatment Weeks 7 and 15 will be presented blind to
the study PI and dermatologist, Mario Lacouture, after at least 3 patients have completed 15
weeks of treatment. Photographs will also be taken at Week 27 and Week 54 of the study but
will be included in the final photographic assessment as secondary information. In addition,
all patients will be asked to maintain an application log throughout treatment to ensure
compliance.
Additionally patients will maintain a medication application diary and a self-assessment
diary. The medication application diary will collect daily application details of the
medication. This will include application dates and times, chemotherapy cycle, and whether
the medication was applied (or reason if the medication was not applied). The
self-assessment diary will require assessment of hair thickness, hair fullness, hair
breakage, and hair cosmetic qualities (ease of styling, etc.) on an analog 10 point scale to
assess patient-reported efficacy. The PI clinical assessment of baseline, Weeks 7 and 15
photographs will be used, together with the patient diary information, for the primary
assessment of alopecia. The study is expected to take place over a period of approximately
12 months, including the screening period.
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