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CTRI Number  CTRI/2011/11/002171 [Registered on: 25/11/2011] Trial Registered Prospectively
Last Modified On: 23/05/2012
Post Graduate Thesis  No 
Type of Trial  BA/BE 
Type of Study    
Study Design  Randomized, Crossover Trial 
Public Title of Study   A Clinical trial intended to compare two formulations of Capecitabine tablets, in patients with Breast Cancer or Colorectal Cancer. 
Scientific Title of Study   Single-Dose Fed Bioequivalence Study of Capecitabine Tablets (500 mg; Mylan) to Xeloda® Tablets (500 mg; Genentech) in Adult Cancer Patients with Metastatic Breast Cancer, Duke’s C Colon Cancer or Metastatic Colorectal Cancer. 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
CAPE 11121  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Charu Gautam 
Designation  Director- Global Clinical Operations 
Affiliation  BA Research India Limited  
Address  BA Research India Limited Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat.
BA House, Opp. Pushparaj Tower, Near Judges Bungalow Road, Bodakdev, Ahmedabad, Gujarat
Ahmadabad
GUJARAT
380054.
India 
Phone  07966135655  
Fax  07966135641  
Email  charu@baresearchindia.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Charu Gautam 
Designation  Director- Global Clinical Operations 
Affiliation  BA Research India Limited  
Address  BA Research India Limited Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat.
BA House, Opp. Pushparaj Tower, Near Judges Bungalow Road, Bodakdev, Ahmedabad, Gujarat
Ahmadabad
GUJARAT
380054.
India 
Phone  07966135655  
Fax  07966135641  
Email  charu@baresearchindia.com  
 
Details of Contact Person
Public Query
 
Name  Dr Charu Gautam 
Designation  Director- Global Clinical Operations 
Affiliation  BA Research India Limited  
Address  BA Research India Limited Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat.
BA House, Opp. Pushparaj Tower, Near Judges Bungalow Road, Bodakdev, Ahmedabad, Gujarat
Ahmadabad
GUJARAT
380054.
India 
Phone  07966135655  
Fax  07966135641  
Email  charu@baresearchindia.com  
 
Source of Monetary or Material Support  
Mylan Pharmaceuticals Inc 
 
Primary Sponsor  
Name  Mylan Pharmaceuticals Inc 
Address  Mylan Pharmaceuticals Inc. 3711 Collins Ferry Road Morgantown, WV 26505, USA Tel: (304) 554-6718 Fax: (304) 554-6483  
Type of Sponsor  Pharmaceutical industry-Global 
 
Details of Secondary Sponsor  
Name  Address 
BA Research India Ltd  BA House, Opposite Pushparaj Towers Nr. Judges Bungalows Bodakdev, Ahmedabad - 380 054 Gujarat, India  
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 10  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Tanveer Maksud  Bharat Cancer Hospital & Research Institute  Dept. of Medical Oncology, Surat-bardoli Road,Saroli-394 211 Surat
Surat
GUJARAT 
9909918887

abu.ansar@yahoo.co.in 
Dr Ajay Mehta  Central India Cancer Research Institute,   Dept. of Surgical Oncology, 11, Shankar Nagar , West High Court Road , Nagpur- , Maharashtra
Nagpur
MAHARASHTRA 
09823190192

ajayonco@hotmail.com 
Dr Rajanish Nagarkar  Curie Manavata Cancer Centre  Department of Radiation Oncology , Opp Hotel Sandeep, Mumbai Naka , Nasik
Nashik
MAHARASHTRA 
9823061929

drrajnagarkar@yahoo.co.in 
Dr G N Patel  Jeevandip Hospital,  Dept. of Surgical Oncology, AYUSH doctor house , 302, 3rd floor, Near Param Doctor House, Station to lal darwaja road, Near Resham Bhuvan , Surat
Surat
GUJARAT 
09376913131

v_desai02@yahoo.com 
Dr J K singh  Mahavir Cancer Sansthan,   Dept. of Radiation Oncology, Phulwarisharif Patna-801 505
Patna
BIHAR 
09431021001

drjksingh147@hotmail.com 
Dr Kirushnakumar  Meenakshi Mission Hospital & Research Centre  Dept. of Radiation Oncology, Opp. Lake area, Melur Road, Madurai, Tamil Nadu
Madurai
TAMIL NADU 
9787713004

drksku@yahoo.com 
Dr Anup Majumdar  Nightingale Hospital  Dept. of Medical Oncology, 11 Shakespere Sarani, Kolkata
Kolkata
WEST BENGAL 
9830152485

anup.majumdar@gmail.com 
Dr Minish Jain  Noble Hospital  Dept. of Medical Oncology, Noble Hospital, 153, Magarpatta City Prad , Pune
Pune
MAHARASHTRA 
9823133390

minishjain009@gmail.com 
Dr C Haritha  Shree Krishna Hospital  DEPT. OF MEDICAL ONCOLOGY, M S PATEL CANCER CENTRE SHREE KRISHNA HOSPITAL, GOKAL NAGAR, KARAMSAD, Anand
Anand
GUJARAT 
9427042969

chiragp@charutarhealth.org 
Dr Pradeep Shah  Shreyas Medical clinic and hospital  Dept. of Medical Oncology, 2 Premal appartment, GPO, Raopura, Vadodara - 390001, Gujarat
Surat
GUJARAT 
9714974409

pradeeprshah@msn.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 10  
Name of Committee  Approval Status 
Central India Cancer Institute Ethics Committee, Nagpur  Approved 
Ethical Review Board, Mahavir cancer institute & research centre  Approved 
Ethical Review Board, Minakshi Mission Hospital & Research Centre, Madurai  Approved 
Ethical Trail of Health In Community (ETHIC) Committee, Surat  Approved 
Ethics Committee of Balaji Hospital, Baroda  Approved 
Human Research Ethics Committee of H.M. Patel Center for Medical Care & Education, Karamsad  Approved 
Institutional ethics committee Nightingale Hospital, Kolkata.  Approved 
Institutional ethics committee Nobel Hospital, Pune  Approved 
Professional Ethics Committee, Manavata Clinical Research Insitute, Nashik  Approved 
Research Independent Ethics Committee, Surat  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  Metastatic Breast Cancer, Duke’s C Colon Cancer or Metastatic Colorectal Cancer,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Capecitabine Manufactured by Mylan Pharmaceutical Inc., USA  Each patient will receive a Capecitabine 1250 mg/m2 administered twice daily orally :BD (morning and evening; equivalent to 2500 mg/m2 total daily dose)for 14 days. The dose will be comprised of multiples of the 500 mg tablet 
Comparator Agent  XELODA® (Capecitabine 500 mg) tablets.  XELODA® 500 mg tablets, Manufactured by Genentech US Inc. USA).Each patient will receive a Capecitabine 1250 mg/m2 administered twice daily orally :BD (morning and evening; equivalent to 2500 mg/m2 total daily dose)for 14 days. The dose will be comprised of multiples of the 500 mg tablet. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  80.00 Year(s)
Gender  Both 
Details  1. Volunteers must be receiving stable doses of capecitabine (e.g. 2500 mg/m2/day in two divided dose) for the treatment of metastatic breast cancer (in combination with docetaxel), Dukes’ C colon cancer following complete resection, and metastatic colorectal carcinoma in combination with capecitabine (e.g. 2500 mg/m2/day in two divided doses).
a. Patients must have completed at least one 21-day cycle of capecitabine (i.e. 14 days of capecitabine and 7 days washout) at the dose to be utilized in this study.
b. The dose of capecitabine must be administered as a multiple of the intact, unbroken, 500 mg tablet.
2. Cancer patients with monotherapy are preferred. However, cancer patients receiving concomitant drug(s) are allowed to participate, provided:
a. The concomitant medication is the same during all study days. Each concurrent medication will be documented and clearly identified. Information recorded will include at least the following information: generic name, strength, dosing regimen, and time of dosing.
b. The subjects will follow the same dosing regimen for the concurrent medications for all dosing of the bioequivalent study.
c. Patients will not change their concurrent medications during the BE study.
d. Prior to inclusion of the subject into the study, a list of all concurrent medications will be provided to the sponsor for approval.
1. 3. Age: 18 – 80 years of age (inclusive)
2. 4. Sex: Females of non-childbearing potential and Males (with equal numbers of each sex, if possible).
a. Women will not be considered of childbearing potential if one of the following is reported and documented on the medical history:
i. postmenopausal with spontaneous amenorrhea for at least one (1) year, or
ii. bilateral oophorectomy with or without a hysterectomy and an absence of bleeding for at least 6 months, or
iii. total hysterectomy and an absence of bleeding for at least 3 months.
b. Non-lactating (or not nursing)
5. Capable of informed consent.
6. Weight Restrictions:
a. At least 50 kg (110 lbs) for men and
b. At least 48 kg (106 lbs) for women
c. All subjects will have a Body Mass Index (BMI) less than or equal to 35 but greater than or equal to 19. BMI values should be rounded to the nearest integer (ex. 35.4 rounds down to 35, while 18.5 rounds up to 19).
7. Tobacco Use: Non-smokers to moderate-smokers (< 20 cigarettes per day) will be eligible to participate in this study.
8. All subjects should be judged by the principal or Medical Sub-Investigator physician listed on the Form FDA 1572 as normal and healthy during a pre-study medical evaluation performed within 28 days of the initial dose of study medication which will include:
a. Normal or non-clinically significant physical examination including vital signs (respiration rate, blood pressure, temperature and heart rate).
b. Within normal limits or non-clinically significant laboratory evaluation results, (unless otherwise noted in the exclusion criteria), for the following tests:
i. Serum Chemistries
ii. Hematology
iii. Urinalysis
c. negative Hepatitis B and Hepatitis C tests,
d. negative HIV test,
e. INR within normal range
f. normal or non-clinically significant 12-lead ECG
g. negative urine drug screen for all of the following compounds: amphetamines, barbiturates, benzodiazepines, cannabinoid, cocaine, methadone, opiates, and phencyclidine.
9. Additional tests and or examinations may be performed, if judged necessary by the Principal Investigator or Medical Sub-Investigator physician.

 
 
ExclusionCriteria 
Details  Subject candidates must not be enrolled in the study if they meet any of the following criteria:
1. Institutionalized subjects will not be used.
2. Individuals with dihydropyrimidine dehydrogenase (DPD) deficiency.
3. Individuals with rapidly progressing disease, especially with visceral organ involvement.
4. Individuals requiring a change in dose or regimen of either capecitabine or had their dosing regimen altered within the previous 21 days.
5. Social Habits:
a. Ingestion of any alcoholic, caffeine- or xanthine-containing food or beverage within the 48 hours prior to the initial dose of study medication.
b. Ingestion of any vitamins, food, or herbal supplement known to induce or inhibit hepatic enzyme activity within 7 days prior to the initial dose of study medication. Especially those known to inhibit or induce CYP3A4.
6. Medications:
a. Use of warfarin currently or within the last 3 months.
b. Use of any prescription or over-the-counter (OTC) medications within the 24 hours prior to the initial dose of study medication, except for any necessary medication for which dosing has been stabilized for a period of at least 21 days and is expected to remain stable for the entire study.
c. Use of any medication known to induce or inhibit hepatic enzyme activity within 28 days prior to the initial dose of study medication except for any necessary medication for which dosing has been stabilized for a period of at least 28 days and is expected to remain stable for the entire study.
7. Diseases:
a. History of unstable or clinically significant gastrointestinal disease, including a history of chronic diarrhea, inflammatory bowel disease, unresolved gastrointestinal symptoms (e.g. diarrhea, vomiting). History of difficulties in swallowing.
b. ALT and AST greater than 2.5 times the upper limit of normal and/or total bilirubin greater than 2.5 times the upper limit of normal.
c. Patients with significant hepatic or renal dysfunction, or for whom the need for dose changes during the study can be anticipated.
d. Patients with a prolonged QT
e. Known history of prior tuberculosis infection, or any contact within the past 2 years with person with active tuberculosis.
f. History of moderate (30-50 mL/min creatinine clearance) or severe (≤ 30 mL/min creatinine clearance) renal disease.
g. History of unstable or clinically significant cardiovascular disease, hepatic, pulmonary, hematologic, endocrine, immunologic, dermatologic, neurologic (including any history of seizure disorder), psychological, musculoskeletal disease or malignancies unless deemed not clinically significant by the Principal Investigator or Medical Sub-Investigator.
h. Acute illness at the time of either the pre-study medical evaluation or dosing.
8. Any reason which, in the opinion of the Principal Investigator or Medical Sub-Investigator, would prevent the subject form safely participating in the study.
9. Donation or loss of blood or plasma: 50 mL to 499 mL within 30 days prior to the initial dose of the study medication; or more than 499 mL within 56 days prior to the initial dose of study medication.
10. Intolerance to venipuncture.
11. Subjects who have received an investigational drug within 30 days prior to the initial dose of study medication.
12. History of allergy or hypersensitivity to capecitabine, or other related products, or any of the inactive ingredients.
13. Consumption of grapefruit, grapefruit-like, or grapefruit containing products within 7 days of drug administration.
14. Any food allergy, intolerance, restriction or special diet that, in the opinion of the Principal Investigator or Medical Sub-Investigator, could contraindicate the subject’s participation in this study.
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   An Open list of random numbers 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
To characterize the pharmacokinetic profile of the sponsor’s test formulation (Capecitabine Tablets 500 mg, Manufactured by Mylan Pharmaceutical Inc., USA) relative to that of reference formulation (XELODA® 500 mg tablets, Manufactured by Genentech US Inc. USA) in patients of Metastatic Breast Cancer, Duke’s C Colon Cancer or Metastatic Colorectal Cancer under fed condition and to assess the bioequivalence.  NIL 
 
Secondary Outcome  
Outcome  TimePoints 
To monitor the safety of the patients  Period one, two and three of the cycle 
 
Target Sample Size   Total Sample Size="42"
Sample Size from India="42" 
Final Enrollment numbers achieved (Total)= ""
Final Enrollment numbers achieved (India)="" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   12/12/2011 
Date of Study Completion (India) Date Missing 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Date Missing 
Estimated Duration of Trial   Years="0"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Completed 
Publication Details   None 
Individual Participant Data (IPD) Sharing Statement

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

Brief Summary  

This study is a multi-center, open-label, single-dose, three-period, randomized, two-treatment, crossover study to investigate the bioequivalence of a single formulation of Mylan’s Capecitabine Tablets, 500 mg compared to the Genentech’s Xeloda® Tablets, 500 mg.

The single-dose pharmacokinetics of capecitabine will be characterized in forty-two (42) adult, male and not of childbearing potential female volunteers with metastatic breast cancer, Duke’s C colon cancer after complete resection, or metastatic colorectal cancer for whom the drug is indicated either alone or in combination with another drug. 

Each patient will receive a capecitabine dose of 1250 mg/m2 dose in the morning under fed conditions.  The dose will be comprised of multiples of the 500 mg tablet.  In order to determine the pharmacokinetic parameter (CPEAK and AUC) intra-patient variability for Xeloda®, each patient will receive Xeloda® twice during the course of the study.

Subjects will be housed at least 10 hours prior to the first dose of investigational product until at least 12 hours after the final dose of investigational product.  Blood samples (1×4 mL) will be collected in K2 EDTA tubes 30 minutes prior to drug dosing and 0.25, 0.50, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8 and 10  hours post-dose. Patients will receive their regularly scheduled dose of capecitabine 12 hours after the morning dose of investigational product. Patients will receive a single dose of the test product and two doses of the reference product between Cycle Day 2 and Cycle Day 13 (inclusive) of a single treatment cycle.

In between investigational (test/reference) product administration, the patient will continue to receive their standard dosing regimen medication.  

The collected blood samples will be cooled in an ice bath or sample cooling rack (e.g. Kryorack) and centrifuged under refrigeration as soon as possible. 

Plasma will be extracted, divided into two (2) equal aliquots, and stored in suitably labeled tubes at −20°C ± 5°C or colder until shipment to the central storage site. For each subject the duration of the study will be 3 to 11 days. 
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