Efficacy and tolerability of BP-C1 in metastatic breast cancer: a Phase II, randomized, double-blind, and placebo-controlled Thai multi-center study
Received 16 May 2018
Accepted for publication 26 November 2018
Published 14 January 2019 Volume 2019:11 Pages 43—51
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Professor Pranela Rameshwar
Kritiya Butthongkomvong,1 Nilubol Raunroadroong,2 Sirikul Sorrarichingchai,2 Isaraporn Sangsaikae,3 Vichien Srimuninnimit,4 Henrik Harling,5 Stig Larsen6
1Udonthani Cancer Hospital, Udonthani, Thailand; 2Lampang Cancer Hospital, Lampang, Thailand; 3Ubonratchathani Cancer Hospital, Ubonratchathani, Thailand; 4Division of Medical Oncology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; 5Bispebjerg University Hospital, Department of Gastroenterology, Center for Digestive Disease, Copenhagen, Denmark; 6Digestive Disease Center, Centre for Epidemiology and Biostatistics, Norwegian University of Life Sciences, Oslo, Norway
Aims: The aim of this study was to compare the efficacy and tolerability of BP-C1 vs equal-looking placebo in metastatic breast cancer.
Materials and methods: A randomized, double-blind, placebo-controlled multi-center study with a semicross-over design was performed. Sixteen patients received daily intramuscular injection of 0.035 mg/kg bodyweight of BP-C1 and 15 patients received equal-looking placebo for 32 days. After 32 days, the placebo patients crossed to BP-C1 with the last observation in the placebo period as baseline. The status of receptors including estrogen receptor (ER), progesterone receptor (PtR), and human EGF receptor 2 (HER2) was analyzed prior to inclusion in the study. Thoracoabdominal CT scan was blindly analyzed by the same independent radiologist in accordance with the RECIST criteria 1.1. Toxicity was assessed according to the NCI Bethesda Version 2.0 (CTC-NCI), and the quality of life (QOL) was assessed according to European Organization for the Research and Treatment of Cancer QOL-C30 and QOL-BR23.
Results: The sum of target lesion diameters (sum lesions) after 32 days of treatment increased by 8.9% (P=0.08) in the BP-C1 arm compared to 37.6% (P<0.001) in placebo patients. Twelve of the 15 placebo patients subsequently had BP-C1 treatment. The increase in sum lesions was 3.5% in these patients. The sum of CTC-NCI was increased 18.7% in the BP-C1 arm (P=0.38) compared to 50.9% (P=0.04) in placebo patients. Four mild/moderate adverse events (AEs) present in BP-C1. Two mild/moderate AEs and one severe AE present in placebo. The QOL benchmarks “breast cancer problems last week”, “sexual interest and activity last 4 weeks”, and “breast cancer-related pain and discomfort last week” were stable in the BP-C1 arm but deteriorated in placebo patients. The sum lesions increased significantly in ER+ (P=0.02) and PtR+ (P=0.03) but not in HER2+. The increase in sum lesions significantly decreased (P=0.02) with an increasing number of negative receptors.
Conclusion: A total of 32 days of BP-C1 treatment inhibited cancer growth and was well tolerated with few and mainly mild AEs. The efficacy of BP-C1 was superior in receptor-negative patients.
ClinicalTrials.gov Identifier: NCT03603197.
Keywords: benzene-polycarboxylic acid complex, BP-C1, low-dose cisplatin, breast cancer, stage IV, hormone receptors, randomized double-blind
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