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Capecitabine

Phase 3

Metastases, Brain | Small molecule | Oncology |Novartis AG|Last Updated: Oct 9, 2024

Target and mechanism

Molecular targetTYMS
Target classInhibitor
ModalitySmall molecule

Also known as capecitabine, imatinib mesylate, capecitabine, imatinib

Success Probability

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Market & Valuation

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Trial Design

RandomizedACTIVE_CONTROLLEDDMC
Total Trials1
Total Enrollment540

FDA Designations

No designations recorded

Clinical trial landscape

Capecitabine · 5 trials · 5 indications

Phase 3 2Phase 2 2Phase 1 1
NCT02344472Detect V / CHEVENDO (Chemo vs. Endo)Metastatic Breast Cancer
ACTIVE NOT_RECRUITING271 Analytics
NCT00820222Lapatinib Plus Capecitabine Versus Trastuzumab Plus Capecitabine in ErbB2 (HER2) Positive Metastatic Breast CancerMetastases, Brain
COMPLETED540 Analytics
PHASE3ACTIVE NOT_RECRUITING
Detect V / CHEVENDO (Chemo vs. Endo)
Metastatic Breast CancerUnlock trial analytics
PHASE3COMPLETED
Lapatinib Plus Capecitabine Versus Trastuzumab Plus Capecitabine in ErbB2 (HER2) Positive Metastatic Breast Cancer
Metastases, BrainUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants with Adverse Events
3 - 9 weeks

safety of a dual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (riobciclib) plus endocrine therapy as compared to a dual HER2-targeted therapy with Herceptin® (trastuzumab) and Perjeta® (pertuzumab) plus chemotherapy (followed by endocrine therapy plus ribociclib in combination with trastuzumab and pertuzumab as maintenance therapy) by the proportion of patients experiencing any adverse event (as defined by the modified adverse event score)

Number of Participants With Central Nervous System (CNS) Metastases (as Assessed by Independent Review) as the Site of First Relapse
From randomization until disease progression, death, or discontinuation from the study (average of 10 months). Cut-off 11-Jun-2012

CNS relapse is defined as the appearance of \>=1 enhancing lesion measuring \>=6 millimeters (mm) on T1Weighted (T1W) Magnetic Resonance Imaging (MRI) without CNS symptoms that were considered to be unequivocal based on all relevant radiological features (e.g., associated T2W signal abnormality); the appearance of any enhancing lesion on T1W MRI with CNS symptoms; unequivocal finding of leptomeningeal disease (defined as the dissemination of cancer throughout the spinal fluid), with or without symptoms; and unequivocal finding of multifocal intraparenchymal lesions with or without symptoms. In the event of the appearance of a \<6 mm lesions(s) without CNS lesions, or equivocal findings potentially suggesting leptomeningeal disease, these findings were followed with a subsequent scan within 6 weeks. If unequivocal progression was determined with the subsequent scan and/or CNS symptoms occurred, then CNS relapse crieria were met.

Progression-free Survival
Up to approximately 34 months

Progression-free survival was defined as the time from the date of randomization to the date of the first documented progression as per local review and according to RECIST 1.1 or death due to any cause. PFS was censored at the date of the last adequate tumor assessment if no PFS event was observed at the time of last patient, last visit (LPLV).

Progression Free Survival (PFS) - Everolimus Plus Exemestane Versus Everolimus Alone
Date of randomization to the date of first documented tumor progression or death from any cause, whichever occurs first, reported between day of first patient randomized up to 39 months

Progression Free Survival (PFS) is defined as the time from date of randomization to the date of first radiologically documented progression or death due to any cause. If a patient did not have an event, PFS was censored at the date of the last adequate tumor assessment. PFS was compared between the everolimus + exemestane combination therapy with the everolimus monotherapy.

To determine the dose limiting toxicity (DLT) and maximum tolerated dose (MTD) of Gleevec in combination with a fixed dose of Xeloda po bid daily in patients with colon cancer.
4 weeks

Secondary Endpoints

quality-adjusted survival
3 - 9 weeks
overall response rate (ORR)
3 - 9 weeks
incidence of central nervous system (CNS) metastases and their control rate
3 - 9 weeks
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Chemotherapy with docetaxelEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab) and Perjeta® (pertuzumab) plus docetaxel. Up to three weeks after completion of chemotherapy, patients will be treated with maintenance endocrine therapy plus dual HER2-targeted therapy and Kisqali® (Ribociclib).
Chemotherapy with paclitaxelEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab) and Perjeta® (pertuzumab) plus paclitaxel.Up to three weeks after completion of chemotherapy, patients will be treated with maintenance endocrine therapy plus dual HER2-targeted therapy and Kisqali® (Ribociclib).
Chemotherapy with vinorelbineEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab) and Perjeta® (pertuzumab) plus vinorelbine. Up to three weeks after completion of chemotherapy, patients will be treated with maintenance endocrine therapy plus dual HER2-targeted therapy and Kisqali® (Ribociclib).
Chemotherapy with capecitabineEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab) and Perjeta® (pertuzumab) plus capecitabine. Up to three weeks after completion of chemotherapy, patients will be treated with maintenance endocrine therapy plus dual HER2-targeted therapy and Kisqali® (Ribociclib).
endocrine therapy with exemestaneEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (Ribociclib) plus exemestane.
endocrine therapy with fulvestrantEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (Ribociclib) plus fulvestrant.
endocrine therapy with anastrozoleEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (Ribociclib) plus anastrozole.
endocrine therapy with letrozoleEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (Ribociclib) plus letrozole.
Chemotherapy with nab-PaclitaxelEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab) and Perjeta® (pertuzumab) plus nab-Paclitaxel. Up to three weeks after completion of chemotherapy, patients will be treated with maintenance endocrine therapy plus dual HER2-targeted therapy and Kisqali® (Ribociclib).
Chemotherapy with eribulinEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (Ribociclib) plus eribulin. Up to three weeks after completion of chemotherapy, patients will be treated with maintenance endocrine therapy plus dual HER2-targeted therapy and Kisqali® (Ribociclib).
endocrine therapy with leuprorelinEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (Ribociclib) plus leuprorelin.
endocrine therapy with goserelinEXPERIMENTALdual HER2-targeted therapy with Herceptin® (trastuzumab), Perjeta® (pertuzumab) and Kisqali® (Ribociclib) plus goserelin.
Lapatinib plus capecitabineEXPERIMENTALLapatinib 1250 mg once daily and capecitabine 2000mg/m2/day, days 1-14, every 21 days
Trastuzumab plus capecitabineACTIVE_COMPARATORtrastuzumab loading dose of 8mg/kg followed by 6mg/kg q3weekly infusions, and capecitabine 2500mg/m2/day, days 1-14, every 21 days
Ribociclib 600 mgEXPERIMENTALCombination of non-steroidal aromatase inhibitor: NSAI (letrozole or anastrozole) + goserelin + ribociclib. 1. Ribociclib (600 mg) was dosed orally for the first 21 days out of a 28-day cycle. 2. Letrozole (2.5 mg) or anastrozole (1 mg) were dosed orally daily (28 days out of the 28-day cycle). 3. Goserelin (3.6 mg) was continuously released via a subcutaneous implant injected on Day 1 of each 28-day cycle (regardless of ribociclib treatment cycle) with an administration window of + 3 days.
Combination ChemotherapyACTIVE_COMPARATORCombination chemotherapies of docetaxel/capecitabine, paclitaxel/gemcitabine or capecitabine/vinorelbine were administered to patients enrolled in the control group. The chemotherapy regimen was decided by the treating physician.
Capecitabine 1250 mg/m2EXPERIMENTALCapecitabine (1250 mg/m2 twice daily) for two weeks, followed by one week rest period in 3-weeks cycles (investigational arm).
Everolimus 10 mgEXPERIMENTALEverolimus (10 mg daily) (investigational arm).
Everolimus 10 mg + Exemestane 25 mgACTIVE_COMPARATOREverolimus (10 mg daily) with Exemestane (25 mg daily) (control arm).
AEXPERIMENTALXeloda plus gleevec

Interventions

NameTypeDescription
pertuzumabDRUGHER2 targeted Therapy
TrastuzumabDRUGHER2 targeted Therapy
CapecitabineDRUGChemotherapy
PaclitaxelDRUGChemotherapy
VinorelbineDRUGChemotherapy
DocetaxelDRUGChemotherapy
ExemestaneDRUGendocrine therapy
LetrozoleDRUGendocrine therapy
AnastrozoleDRUGendocrine therapy
FulvestrantDRUGendocrine therapy
RibociclibDRUGCDK 4/6 inhibitor
nab-PaclitaxelDRUGchemotherapy
eribulinDRUGchemotherapy
leuprorelinDRUGendocrine therapy
goserelinDRUGendocrine therapy
lapatinibDRUGoral medication; daily dose taken once a day
Docetaxel / CapecitabineCOMBINATION_PRODUCTDocetaxel (IV Infusion) / Capecitabine (Tablets for oral use): Docetaxel once, on day 1 of the 3-weeks cycle. Capecitabine twice daily, on Days 1 to 14, followed by a 1-week rest period, in 3 weeks cycle. Docetaxel (60 - 75 mg/m²)/capecitabine (1600 - 2500 mg/m²/day)
Capecitabine / VinorelbineCOMBINATION_PRODUCTCapecitabine (Tablets for oral use) / Vinorelbine (Capsule for Oral use/IV infusion ). Capecitabine twice daily on day 1 to 14, followed by a 1-week rest period, in 3 weeks cycle. Vinorelbine, once, on Day 1 and Day 8 in 3 weeks cycles. Capecitabine (1600 - 2500 mg/m2/day)/vinorelbine (60 to 80 mg/m2/day \[oral\] or (25 to 30 mg/m2 \[IV infusion\]
Paclitaxel / GemcitabineCOMBINATION_PRODUCTPaclitaxel (IV Infusion) / Gemcitabine (IV Infusion): Paclitaxel via 3-hour intravenous (IV) infusion on Day 1 in 3-weeks cycles, OR Paclitaxel via 1 hour intravenous (IV) infusion on Day 1 and day 8- in 3-weeks cycles. Gemcitabine at via 30 minute IV infusion on Day 1 and Day 8 in 3 weeks cycles. Paclitaxel (175 mg/m2) (on Day 1 in 3-weeks cycles)/ gemcitabine (1000 - 1250 mg/m2) OR Paclitaxel (80 - 90 mg/m2) (on Day 1 and Day 8 in 3-weeks cycles) / gemcitabine (800 - 1250 mg/m2)
Letrozole OR AnastrozoleDRUGLetrozole: Dose: 2.5 mg All days of every cycle without interruption). Tablets for oral use Anastrozole: dose: 1 mg All days of every cycle without interruption. Tablets for oral use The NSAI (letrozole or anastrozole) will be decided by the treating physician.
EverolimusDRUGEverolimus, 5 mg tablets for oral use, 10 mg (2 x 5 mg) per day (centrally supplied)
capecitabine, imatinib mesylateDRUGCapecitabine and imatinib mesylate will both be taken by mouth twice a day
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Eligibility Criteria

Age Range18 Years to N/A
SexFEMALE
Healthy VolunteersNo
Study Sites1

Inclusion criteria: * Signed, written informed consent in study participation * The primary tumor and/or biopsies from metastatic sites or locoregional recurrences have been confirmed as HER2-positive (FISH-positive or IHC 3+) and hormone receptor positive breast cancer by histopathology according ...

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