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CTRI Number  CTRI/2019/10/021793 [Registered on: 25/10/2019] Trial Registered Prospectively
Last Modified On: 01/11/2019
Post Graduate Thesis  No 
Type of Trial  BA/BE 
Type of Study    
Study Design  Randomized, Crossover Trial 
Public Title of Study   A study comparing capecitabine oral granules 500 mg per packet to capecitabine tablets 500 mg in patients with breast cancer or colorectal cancer 
Scientific Title of Study   A multicenter, open label, balanced, randomized, two-treatment, three-period, three sequence, single oral dose, partial replicate, cross-over, bioequivalence study comparing test formulation of capecitabine oral granules 500 mg per packet (Manufactured by: Intas Pharmaceuticals Ltd, India) to the reference formulation of Xeloda® (capecitabine) tablets 500 mg (Distributed by: Genentech USA, Inc., A member of the Roche group, 1 DNA Way, South San Francisco, CA 94080-4990) in patients with metastatic breast cancer or metastatic colorectal cancer, already receiving a stable twice-daily dose of 1250 mg/m2, equivalent to 2500 mg/m2 total daily dose under fed condition.  
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
1038-18, Version no. 2.0, Date: 22 May 2019  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Mr Prashant Modi 
Designation  General Manager 
Affiliation  Lambda Therapeutic Research Ltd 
Address  Lambda House, Department of Project Management & Regulatory Affairs, Plot No. 38, Survey No. 388
Near Silver Oak Club, S. G. Highway, Gota
Ahmadabad
GUJARAT
382481
India 
Phone  07940202375  
Fax  07940202021  
Email  prashantmodi@lambda-cro.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Naman Shah 
Designation  General Manager 
Affiliation  Lambda Therapeutic Research Ltd. 
Address  Lambda House, Department of CTM Medical Services, Plot No. 38, Survey No. 388
Near Silver Oak Club, S. G. Highway, Gota
Ahmadabad
GUJARAT
382481
India 
Phone  07940202389  
Fax  07940202021  
Email  namanshah@lambda-cro.com  
 
Details of Contact Person
Public Query
 
Name  Mr Prashant Modi 
Designation  General Manager 
Affiliation  Lambda Therapeutic Research Ltd 
Address  Lambda House, Department of Project Management & Regulatory Affairs, Plot No. 38, Survey No. 388
Near Silver Oak Club, S. G. Highway, Gota
Ahmadabad
GUJARAT
382481
India 
Phone  07940202375  
Fax  07940202021  
Email  prashantmodi@lambda-cro.com  
 
Source of Monetary or Material Support  
Intas Pharmaceuticals Ltd, Corporate House, Nr. Sola Bridge, S.G. Highway, Thaltej, Ahmedabad – 380054, Gujarat, India Tel. No. 07939837000 
 
Primary Sponsor  
Name  Intas Pharmaceuticals Ltd 
Address  Corporate House, Nr. Sola Bridge, S.G. Highway, Thaltej, Ahmedabad – 380054, Gujarat, India Tel. No. 07939837000 
Type of Sponsor  Pharmaceutical industry-Indian 
 
Details of Secondary Sponsor  
Name  Address 
NA  NA 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 5  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr KVelavan  Erode Cancer Centre Private Ltd.  1/393, Department of Clinical Research, Room No. NA, Velavan Nagarm, Perundurai Road, Thindal-638012
Erode
TAMIL NADU 
9842334222

kvels@rediffmail.com 
Dr Sushil Meshram  Government Medical College and Hospital.  Department of Radiation Therapy and Oncology, Room No. NA, Near Hanuman Nagar-440003
Nagpur
MAHARASHTRA 
7028966535

drsushilonco@gmail.com 
Dr Rajnish Nagarkar  HCG Manvata Cancer Centre  Behind Shivang Auto, Department of Clinical Research, Room No. NA, Mumbai Naka-422001,
Nashik
MAHARASHTRA 
9823061929

drraj@manavatacancercentre.com 
Dr Rohan Bhise  KLES Dr. Prabhakar Kore Hospital & MRC  Department of Clinical Research, Room No. NA, Nehrunagar, Belagavi-590010
Belgaum
KARNATAKA 
9448866712

rohanbhise30@gmail.com 
Dr Prakash SS  KR Medical College  K.R. Hospital, Department of Clinical Research, Room No. NA, Mysore Medical College & Research Institute-570001
Mysore
KARNATAKA 
9901000559

prakashyesyes@yahoo.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 5  
Name of Committee  Approval Status 
Institute Ethics Committee Erode Cancer Centre, Dr. K.Velavan  Approved 
Institutional Ethics Committee Department of Pharmacology, Government Medical College, Dr. Sushil Meshram  Submittted/Under Review 
Institutional Ethics committee, KAHER, Dr. Rohan Bhise  Submittted/Under Review 
Institutional Ethics Committee, Mysore Medical College & Research Institute and associated hospital, Dr. Prakash S.S.  Submittted/Under Review 
Manavata Clincal Research Institute Ethics Committee, Dr Rajnish Nagarkar  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: C509||Malignant neoplasm of breast of unspecified site,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Capecitabine oral granules 500 mg per packet of Intas Pharmaceuticals Limited, India  Dose: single dose as multiples of 500 mg ; Frequency: single dose on day 1, day 2 and day 3 ; Mode of Administration: oral ; Duration of treatment: 3 days  
Comparator Agent  Xeloda® (capecitabine) tablets 500 mg, Distributed by: Genentech USA, Inc., A member of the Roche group  Dose: single dose as multiples of 500 mg ; Frequency: single dose on day 1, day 2 and day 3 ; Mode of Administration: oral ; Duration of treatment: 3 days 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  1. Patient and /or LAR willing to give written informed consent for participation in the trial.
2. Male or Female ≥18 years and ≤ 65 years of age and having a Body Mass Index (BMI) at least 17 calculated as weight in kg / height in m2.
3. Patients must have/have had histopathologically /cytologically confirmed breast cancer or colorectal cancer.
4. Patients with
a. Dukes C colon cancer patients who have undergone complete resection of the primary tumour when treatment with fluoropyrimidine therapy alone is preferred. OR
b. Metastatic colorectal carcinoma when treatment with fluoropyrimidine therapy alone is preferred. OR
c. Metastatic breast cancer resistant to chemotherapy regimens with paclitaxel and anthracycline-resistant or paclitaxel for patients in whom additional therapy with an anthracycline is not indicated.
5. Patients who require a daily dose of capecitabine monotherapy, who are stabilized
on twice daily dosing for at least one cycle of chemotherapy before randomization and who are eligible to receive a dose of 2500 mg/m2/day.
6. Patients should have their BSA between 1.26-1.91 (Both inclusive).
7. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
8. Patient with adequate bone marrow, renal and hepatic function.
9. Adequate cardiac function (left ventricular ejection fraction [LVEF] ≥50%).
10. Patient should have recovered from any toxic effects of previous chemotherapy as
judged by the Investigator.
11. Patients with life expectancy of at least 3 months (as per the Investigators
discretion).
12. Able to comply with study requirement in opinion of Investigator.
13. Able to give written informed consent for participation in the trial.
14. In case of female patient the serum pregnancy test at screening visit and urine
pregnancy test at day 0 must be negative.
15. Sexually active women, unless surgically sterile (at least 6 months prior to Study
drug administration) or postmenopausal for at least 12 consecutive months, must use an effective method of avoiding pregnancy (including oral, transdermal, or implanted contraceptives [any hormonal method in conjunction with a secondary method], intrauterine device, female condom with spermicide, diaphragm with spermicide, absolute sexual abstinence, use of condom with spermicide by sexual partner or sterile [at least 6 months prior to Study drug administration] sexual partner) for at least 4 weeks prior to study drug administration, during study and up to 180 days after the last dose of study drug. Cessation of birth control after this point should be discussed with a responsible physician.
16. In case of male patients: Either partner or patient must use an effective method of
avoiding pregnancy for at least 4 weeks prior to study drug administration, during
study and up to 90 days after the last dose of study drug. Cessation of birth control
after this point should be discussed with a responsible physician. 
 
ExclusionCriteria 
Details  1. Prior unanticipated severe reaction to fluoropyrimidine therapy, or known sensitivity to 5-fluorouracil, or known DPD (Dihydropyrimidine Dehydrogenase) deficiency.
2. Pregnant or breast-feeding female.
3. Any of the following cardiac conditions:
Unstable angina.
Myocardial infarction within the past 6 months.
NYHA (New York State Heart Association) class II-IV heart failure.
Severe uncontrolled ventricular arrhythmias.
Clinically significant pericardial disease.
Electrocardiographic evidence of acute ischemic or active conduction system abnormalities.
Any other cardiac illness that could lead to a safety risk to the patient in case of enrolment in the study.
4. History of drug/alcohol addiction.
5. Known brain metastasis.
6. Pre-existing motor or sensory neurotoxicity of a severity ≥ grade 2 by NCI CTCAE criteria.
7. A positive hepatitis screen including hepatitis B surface antigen and HCV antibodies.
8. Patients with HIV infection.
9. Patients found positive on urine scan for drugs of abuse and/or breath test for alcohol consumption at screening or baseline.
10. The receipt of an investigational medicinal product or participation in other drug research study within a period of 30 days (or 5 half-lives, whichever is longer) prior to the first dose of investigational medicinal product for the current study.
11. Any other condition that, in the investigators judgment, might increase the risk to the patient or decrease the chance of obtaining satisfactory data needed to achieve
the objectives of the study.
12. Abnormal baseline findings considered by the investigator to indicate conditions that might affect study endpoints.
13. Donation of blood (1 unit or 350 ml) within 90 days prior to receiving the first dose of investigational medicinal product for the current study.
14. Known, existing uncontrolled coagulopathy. 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Not Applicable 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
To characterise the pharmacokinetic profile of the sponsors test formulation
[capecitabine oral granules 500 mg per packet (Manufactured by Intas Pharmaceuticals Ltd, India)] relative to that of reference formulation [Xeloda® (capecitabine) tablets 500 mg (Distributed by: Genentech USA, Inc., A member of the Roche group, 1 DNA Way, South san Francisco, CA 94080-4990)] in patients of metastatic breast cancer or metastatic colorectal cancer under fed condition and to assess the bioequivalence. 
Pre-dose and 0.167, 0.333,
0.500, 0.750, 1.000, 1.250, 1.500, 1.750, 2.000, 2.250, 2.500, 2.750, 3.000, 3.333,
3.667, 4.000, 4.500, 5.000, 6.000, 7.000 and 8.000 hour post-dose 
 
Secondary Outcome  
Outcome  TimePoints 
Safety of the patients  Through out the study 
 
Target Sample Size   Total Sample Size="15"
Sample Size from India="15" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   04/11/2019 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="10"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   None Yet 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Brief Summary  
The present study is a bioequivalence study wherein the relative bioavailability of test formulation [capecitabine oral granules 500 mg (Manufactured by: Intas Pharmaceuticals Limited, India)] will be compared with reference formulation [Xeloda® (capecitabine) tablets 500 mg (Distributed by: Genentech USA, Inc., A member of the Roche group, 1 DNA Way, South san Francisco, CA 94080-4990] in patients with metastatic breast cancer or colorectal cancer under fed condition. Capecitabine is a cytotoxic drug. It would be unethical to do this study on healthy volunteers. Therefore the bioequivalence study is proposed to be carried out on patients of metastatic breast cancer or colorectal cancer, who in the opinion of their treating physicians are candidates for capecitabine therapy. Moreover, this is also in agreement with the current draft guidance on capecitabine by OGD, USFDA. The recommended dose of XELODA® is 1250 mg/m2 administered orally twice daily (morning and evening; equivalent to 2500 mg/m2 total daily dose) for 2 weeks followed by a 1-week rest period given as 3 week cycles. The dose of capecitabine can be reduced in case of toxicity as per the Prescribing information of XELODA®. In current study, test formulation of capecitabine oral granules 500 mg and reference formulation of capecitabine tablets 500 mg will be administered as a single dose as multiples of 500 mg on day 1, day 2 and day 3 morning dose as per randomization schedule. The evening dose on day 1, day 2 and day 3 will be locally approved and marketed capecitabine Tablets 500 mg. Locally approved and marketed capecitabine will also be provided for the remaining treatment cycle/s.
 
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