Cancer Clinical Trial
Official title:
Evaluation of Mangafodipir Protective Activity Against Oxaliplatin Neurotoxicity
Oxaliplatin is a major antitumor agent but its use is limited by potentially disabling neurotoxicity, characterized by a sensitive defect in the extremities.Mangafodipir is a MRI contrast agent with antioxidant properties. Our previous laboratory works showed that mangafodipir is able to prevent hematologic toxicity of several chemotherapy agents, including oxaliplatin and to increase their antitumor activity. Preliminary clinical data suggested that mangafodipir could prevent oxaliplatin neurotoxicity.The primary purpose of the present study is to assess the protective effect of mangafodipir in patients who have a already moderate oxaliplatin neuropathy and in whom the continuation of this treatment is desirable because of significant antitumor effect.
Phase 2 study aiming to assess the protective effect of mangafodipir against the
oxaliplatine neuropathy.Population: Cancer patient who have a mild (grade 2) oxaliplatin
neuropathy and in whom the continuation of oxaliplatin for at least 4 infusions is desirable
will be include, whatever the location of the primitive tumor and the use of others
anticancer agents.Treatment: Mangafodipir (0.5 ml/kg) is administered as a 30 minutes
infusion just after each administration of oxaliplatin. The oxaliplatin dose (85 to 100
mg/m²) and the length of the infusion (2 hours) are the same that before the inclusion and
modifications are not authorized during all the study participation. Primary objective:
Neuropathy are clinically evaluated according to NCI-CTC criteria before each mangafodipir
and oxaliplatin and thereafter one month after the last infusion. The primary criteria is
the worst grade of oxaliplatin neuropathy experienced by each patient. The improvement of
neuropathy is defined as a decrease by at least one grade of the severity of the neuropathy
for at least 2 months.
Hypothesis: at least 50% of patients will experience an improvement or a stabilization of
the oxaliplatin neuropathy while receiving the mangafodipir - oxaliplatin
association.Treatment discontinuation: the treatment will be stopped if the neuropathy
worsened by at least one grade, in case of tumor progression, intolerable toxicity, and
patient wish.
Number of patients: it will be determined according to a simplified Gehan procedure: The
inclusions will be stopped if no objective response (neuropathy improvement) is observed
among the first 9 evaluable patients. If at least one response is observed, 16 more
evaluable patients will be include. The total number of patients will be between 9 and 30
patients, including non evaluable patients.
Pharmacokinetic: Serum and intra- erythrocytes manganese concentration will be evaluated
before each mangafodipir infusion in order to detect accumulation Pharmacodynamic: plasmatic
total antioxidant activity, superoxide dismutase activity and lipid peroxidation will be
assessed at the first cycle: before and after the administration of oxaliplatin and just
after the perfusion of mangafodipir.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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