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RecruitingNCT06639178HAND-TO-HANDUpdated Oct 16, 2024

Effectiveness of an N-acetylcysteine and Urea-based Cream in Prevention of Capecitabine-induced HAND-foot Syndrome in Breast Cancer Patients

An interventional study of DECLARAN cream in Breast Cancer, sponsored by Centro di Riferimento Oncologico - Aviano. Recruiting at 2 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-10-16.

Sponsored by Centro di Riferimento Oncologico - Aviano · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
25
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Breast cancer (BC) is the most frequent tumour in women. To date, among the available treatments, the use of Capecitabine, an oral prodrug of fluorouracil, has been shown activity in different setting. In advanced disease, Capecitabine is often used as monotherapy in patients pretreated with anthracycline, taxane or both.

One of the most frequent toxicities reported by patients receiving capecitabine is hand-foot syndrome (HFS), with an incidence of grade 3 HFS of 28%. HFS, also known as palmar-plantar erythrodysesthesia syndrome, is initially characterized by palmoplantar numbness, tingling, or burning pain. These symptoms usually coincide with sharply demarcated erythema with or without edema, cracking, or desquamation. In advanced stages, blistering and ulceration may occur. Although HFS is not considered life threatening, it can be painful and interfere with daily activities, thusseriously compromising quality of life (QoL), therefore this toxicity is considered dose limiting.Moreover, consistent with the theory that Capecitabine and its metabolites induce an inflammatory effect, the use of COX-2 inhibitors is an emerging strategies, but more evidence are needed from largest study to confirm their efficacy.

Similarly, N-acetylcysteine (NAC), an antioxidant, mucolytic and nephroprotective agent, that affects pathways involved in inflammatory conditions and that has demonstrated to be effective in several dermatologic conditions, could be useful in the management of Capecitabine-induced HFS.

From this arises the present study that has the objective of evaluating the role of NAC plus urea-based cream in the prevention of Capecitabineinduced HFS in patient affected by breast cancer.

Read the detailed description

Breast cancer (BC) is the most frequent tumour in women. To date, among the available treatments, the use of Capecitabine, an oral prodrug of fluorouracil, has been shown activity in different setting. In advanced disease, Capecitabine is often used as monotherapy in patients pretreated with anthracycline, taxane or both.

One of the most frequent toxicities reported by patients receiving capecitabine is hand-foot syndrome (HFS), with an incidence of grade 3 HFS of 28%. HFS, also known as palmar-plantar erythrodysesthesia syndrome, is initially characterized by palmoplantar numbness, tingling, or burning pain. These symptoms usually coincide with sharply demarcated erythema with or without edema, cracking, or desquamation. In advanced stages, blistering and ulceration may occur. Although HFS is not considered life threatening, it can be painful and interfere with daily activities, thusseriously compromising quality of life (QoL), therefore this toxicity is considered dose limiting.Moreover, consistent with the theory that Capecitabine and its metabolites induce an inflammatory effect, the use of COX-2 inhibitors is an emerging strategies, but more evidence are needed from largest study to confirm their efficacy.

Similarly, N-acetylcysteine (NAC), an antioxidant, mucolytic and nephroprotective agent, that affects pathways involved in inflammatory conditions and that has demonstrated to be effective in several dermatologic conditions, could be useful in the management of Capecitabine-induced HFS.

From this arises the present study that has the objective of evaluating the role of NAC plus urea-based cream in the prevention of Capecitabineinduced HFS in patient affected by breast cancer.

02

Conditions studied

  • Breast Cancer
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Women and men ≥18 years old
  • Patients with diagnosis of breast cancer with stage I-III radically operated with residual disease post neoadjuvant treatment or stage IV
  • Patients candidated for capecitabine in a post-neoadjuvant or metastatic setting treated with 2000-2500 mg/m2 d1-14 q21, or 1500 mg daily continuously (metronomic schedule)
  • Patients who provided written informed consent

Exclusion criteria

Exclusion Criteria:

  • Patients previously treated with drugs that may have induced HFS
  • Assessed by the investigator to be unable or unwilling to comply with the requirements of the protocol
  • Pregnant, lactating, or breastfeeding, or intending to become pregnant during the study or within 60 days after the final dose of study treatmen
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    DECLARAN cream

    Patients will apply of DECLARAN cream is the investigational product based on NAC and urea

    Other: DECLARAN cream

Interventions

  • OtherDECLARAN cream

    Patients will apply 1 mL of DECLARAN cream, as a single pressure dispensing (1 for hands, 1 for feet), 2 times/day on hands and feet, starting 3 days before the beginning of treatment with capecitabine and for the first 24 consecutive weeks of treatment.

05

What researchers measure

Primary outcomes

  1. To evaluate the role of NAC plus urea-based cream (DECLARAN) in the prevention of Capecitabine-induced HFS in patient affected by breast cancer.

    Cumulative incidence of any grade HFS (according CTCAE vs 5.0,)

    Time frame: up to 2 years

Secondary outcomes

  1. To evaluate severe HFS

    Cumulative incidence of grade 3 HFS according CTCAE vs 5.0

    Time frame: up to 2 years

  2. To evaluate the impact of HFS on patients' quality of life at 6 weeks

    Cumulative incidence of summary values of patient reported outcome (PRO) assessed with HFS-14 at 6 weeks

    Time frame: up to 2 years

  3. To evaluate the impact of HFS on patients' quality of life at 12 weeks

    Cumulative incidence of summary values of patient reported outcome (PRO) assessed with HFS-14 at 12 weeks

    Time frame: up to 2 years

  4. To evaluate the impact of HFS on patients' quality of life at 24 weeks

    Cumulative incidence of summary values of patient reported outcome (PRO) assessed with HFS-14 at 24 weeks

    Time frame: up to 2 years

  5. To evaluate the safety of NAC plus urea-based cream

    Frequecies of adverse events

    Time frame: up to 2 years

06

Study locations

1 of 2 sites recruiting
  • Centro di Riferimento Oncologico (CRO) di Aviano - IRCCS
    Aviano, Pordenone 33081, Italy
    • Simon Spazzapan, MD · Contact · spazzapan@cro.it · +39 0434 659725
    • Simon Spazzapan, MD · Principal investigator
    • Camilla Lisanti · Principal investigator
    Recruiting
  • Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC)
    Udine, 33100, Italy
    Not yet recruiting
07

Registry details

Key details

Study ID
NCT06639178
Lead sponsor
Centro di Riferimento Oncologico - Aviano
Responsible party
Sponsor
First posted
Oct 15, 2024
Start date
Aug 1, 2024
Primary completion
May 15, 2026 (estimated)
Completion
May 15, 2026 (estimated)
Last update
Oct 16, 2024

Study contacts

Simon Spazzapan, MD
Contact
spazzapan@cro.it
+39 0434 659725
Simon Spazzapan, MD
principal investigator · Centro di Riferimento Oncologico di Aviano (CRO) - IRCCS
Camilla Lisanti, MD
principal investigator · Centro di Riferimento Oncologico di Aviano (CRO) - IRCCS

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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