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CTRI Number  CTRI/2014/05/004605 [Registered on: 19/05/2014] Trial Registered Prospectively
Last Modified On: 05/02/2015
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group Trial 
Public Title of Study   A clinical trial intended to compare two formulations of Trastuzumab, tablets in patients with metastatic breast cancer. 
Scientific Title of Study   “A prospective, randomized, multi-centric clinical study to compare Trastuzumab (Test Product, Zydus) with Trastuzumab (Reference Product, Roche/Genentech ) in patients with metastatic breast cancer.” 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
TRA.12.001.02.1, version 2.1 dated 18 Feb 2014  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Charu Gautam 
Designation  Associate VP – Global Clinical Operation 
Affiliation  Cliantha Research Limited 
Address  Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat. Cliantha House, Opp. Pushparaj Tower,Near Judges Bungalow Road, Bodakdev

Ahmadabad
GUJARAT
380054
India 
Phone  07966135655  
Fax  07966135641  
Email  cgautam@clianthatrials.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Charu Gautam 
Designation  Associate VP – Global Clinical Operation 
Affiliation  Cliantha Research Limited 
Address  Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat. Cliantha House, Opp. Pushparaj Tower,Near Judges Bungalow Road, Bodakdev

Ahmadabad
GUJARAT
380054
India 
Phone  07966135655  
Fax  07966135641  
Email  cgautam@clianthatrials.com  
 
Details of Contact Person
Public Query
 
Name  Dr Chirag Shah 
Designation  Head- Clinical Trials 
Affiliation  Cliantha Research Limited 
Address  Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat. Cliantha House, Opp. Pushparaj Tower,Near Judges Bungalow Road, Bodakdev

Ahmadabad
GUJARAT
380054
India 
Phone  07966135631  
Fax  07966135641  
Email  cshah@clianthatrials.com  
 
Source of Monetary or Material Support  
Sponsor: Cadila Healthcare limited 
 
Primary Sponsor  
Name  Cadila Healthcare limited 
Address  Sarkhej – Bavla N.H. No.8A, Moraiya, Tal: Sanand, Dist: Ahmedabad – 382 210, Gujarat, India 
Type of Sponsor  Pharmaceutical industry-Indian 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 19  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Ajay Sharma   Acharya Tulsi Regional Cancer Treatment & Research Institute  Acharya Tulsi Regional Cancer Treatment & Research Institute, Dept. Of Radiotherapy, P.B.M. Hospital Campus, S.P. Medical College, Bikaner, Rajasthan 334003
Bikaner
RAJASTHAN 
0151-2226304
0151-2226329
drajaysharma55@gmail.com 
Dr Kalyan Kusum Mukherjee  Chittaranjan National Cancer Institute  Chittaranjan National Cancer Institute, Department of Oncology, 37,S.P.Mukherjee Road,Kolkata-700 026 P.O.: Kalighat, West Nengal, India
Kolkata
WEST BENGAL 
033-24765101
033-24757606
kkmukharjee4u@hotmail.com 
Dr Arun Seshachalam  Dr. GVN Cancer Institute  Dr. GVN Cancer Institute, Dept. Of Oncology, No. 46, Singarathope, Trichy-62008, Tamil Nadu
Tiruchirappalli
TAMIL NADU 
0431-2700712
0431-4010000
arunonco@gmail.com 
Dr Kambale krishna Marotiro  Goverment Medical College and Hospital Nagpur  Goverment Medical College and Hospital Nagpur, Depoartment of Radiation Therapy, Goverment Medical College and Hospital Nagpur
Nagpur
MAHARASHTRA 
9850246275

drkambleonco@gmail.com 
Dr Murali Subramanian  Gurushree Hi-Tech Multi speicality Hopsital  Gurushree Hi-Tech Multi speicality Hopsital, Dept. of Oncology, No.1558 Opp. Chandra layout Bus Stand, Vijaynagar Bangalore Karnataka, India
Bangalore
KARNATAKA 
080-23392641
080-23394781
muralis_14@yahoo.com 
Dr Shibashish Bhattacharya  Health Point Hospital  Health Point Hospital, Department of Oncology, 21, Prannath Pandit Street, Opp. Lansdown Padmapukur, Kolkata-700 025, India
Kolkata
WEST BENGAL 
033-30575700
033-24559037
shibashishbhattacharya@ymail.com 
Dr Siddhartha Basu  IPGME&R AND SSKM   IPGME&R AND SSKM , Dept. Of Radio Oncology, 244 AJC Bose Road, Kolkata- 700 020 West Bengal, India
Kolkata
WEST BENGAL 
09874166240

siddharthabasu24@gmail.com 
Dr Niraj Bhatt  Kailash Cancer Hospital and Research centre  Kailash Cancer Hospital and Research centre, Dept. of Oncology, Muni Seva Ashram, PO- Goraj- 391760, Tal. waghodia, Dist Vadodara
Vadodara
GUJARAT 
9925581480

medonc12@gamil.com 
Dr Mohan Chandra Pant  King Georges Medical University  King Georges Medical University, Medical University),Chowk, Lucknow, Uttar Pradesh, INDIA 226003
Lucknow
UTTAR PRADESH 
0522-2258672

anand.misra02@gmail.com 
Dr Naresh Soni  Manu Hospital and Research Centre  Manu Hospital and Research Centre, Dept. of oncology, Jawahar Lal Nehru Marg, Malviya Nagar, Jaipur - 302017, Rajasthan
Jaipur
RAJASTHAN 
0141-2292530
0141-2293800
nareshsoni@yahoo.com 
Dr Mukta Srinivasulu  Mehdi Nawaz Jung Institute of Oncology and regional Cancer centre  Mehdi Nawaz Jung Institute of Oncology and regional Cancer centre, Dept. of Oncology, Red Hills Hyderabad-500004
Hyderabad
ANDHRA PRADESH 
040-22314063

muktasrinivasulu@yahoo.co.in 
Dr Mukesh S  Mysore Medical College & Research Institute  Mysore Medical College & Research Institute, Department of Department of Radiation oncology, Irwin Road, Mysore, Karnataka-570 001, India
Mysore
KARNATAKA 
0821-2520512

dalmuk1@hotmail.com 
Dr Yathish Kumar  NRR Hospital  NRR Hospital, Department of Oncology, No.3 and 3A, Hesarghatta Main Road, Chikkasandra, Next to Janapriya Apartments, Near Chikkabanavara Railway Station, Bangalore 560 090
Bangalore
KARNATAKA 
08028374115
08028374117
dryathish@hotmail.com 
Dr Asha Arjunan  Regional Cancer Centre  Regional Cancer Centre, Dept. of Oncology, Medical College Campus, Thiruvananthapuram 695011
Thiruvananthapuram
KERALA 
0471-2442541
0471-2447454
drashaarjun@gmail.com 
Dr Gaurav Agrawal  Sanjay Gandhi Post Graduate Institute of Medical Sciences  Sanjay Gandhi Post Graduate Institute of Medical Sciences, Dept. of Endocrinology & Brest Cancer, Rae Bareli Rd, Lucknow, Uttar Pradesh 226014
Lucknow
UTTAR PRADESH 
0522-2494160
05222668017
gaurav@sgpgi.ac.in 
Dr Uttam Soni  Sita devi Hospital  Sita devi Hospital, Department of Oncology, 74, Shri Ram Colony, B/H Chambal Grid, Hawa Sadak , Jaipur
Jaipur
RAJASTHAN 
01412211372
01412210734
soniuttam@hotmail.com 
Dr Om prakash Sharma  SMS Medical College  Department of Radiotheraphy,SMS Medical College, Department of Oncology, Jaipur-302 004, Rajasthan, India
Jaipur
RAJASTHAN 
01412502158
01412359313
dromsharma22@gmail.com 
Dr Sudeep Gupta  Tata Memorial Hospital  Tata Memorial Hospital, Dept. Of Oncology, Dr. E Borges Road, Parel, Mumbai 400 012 India
Mumbai (Suburban)
MAHARASHTRA 
09821298642

sudeepgupta04@gmail.com 
Dr Unmesh Vidyadhar Takalkar  United CIIGMA Institute Medical Sciences Pvt. Ltd  United CIIGMA Institute Medical Sciences Pvt. Ltd, Dept. Oncology, Plot No. 6, 6, Survey no. 10, Shahaoorwadi, Dargah Road Aurangabad-431005
Aurangabad
MAHARASHTRA 
9822042425

takalkar.unmesh@gmail.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 20  
Name of Committee  Approval Status 
CIMS Ethics Committee- Dr. C. Desai  Approved 
Dr. GVN Cancer Institute Institutional Ethics Committee, Trichy-Tamil Nadu  Submittted/Under Review 
Ethic Committee Kodliker,Memorial Hospital & CHGMA Hospital, Aurangabad, Maharashtra, India  Submittted/Under Review 
Ethics Committee of Mysore Medical College and Associated Hospitals, Mysore, Karnataka, India  Submittted/Under Review 
Ethics Committee of S.M.S. Medical College and Attached Hospitals, Jaipur, Rajasthan, India  Submittted/Under Review 
Ethics Committee, S.P Medical College & A.G Hospitals Ethics Committee, Bikaner INDIA  Submittted/Under Review 
Health Point Ethics Committee, Kolkata- India  Approved 
Human Ethics Committee, Thiruvananthapuram INDIA  Submittted/Under Review 
Institutional Ethics committee for Research Involving Human subjects, IPGME&R and SSKM Hospital, Kolkata- West Bengal, India   Approved 
Institutional Ethics Committee Manu Hospital & Research Centre, Jaipur  Approved 
Institutional Ethics Committee NRR Hospital, Bangalore, INDIA  Submittted/Under Review 
Institutional Ethics Committee of CNCI, Chittaranjan National Cancer Institute INDIA  Submittted/Under Review 
Institutional Ethics Committee Vijaynagar Bangalore India   Submittted/Under Review 
Institutional Ethics Committee, CBMR, Lucknow INDIA  Submittted/Under Review 
Institutional Ethics Committee, Jaipur, Rajasthan. India  Submittted/Under Review 
Institutional Ethics Committee, King George s Medical College, Lucknow, INDIA   Submittted/Under Review 
Institutional Ethics Committee, Mehdi Nawaz Jung Institute of Oncology and Regional Cancer Centre, Hyderabad  Submittted/Under Review 
Institutional Ethics Committee, Sita devi Hospital, Jaipur, INDIA  Approved 
Institutional Ethics Committee, TATA Memorial Hospital, , Mumbai Maharashtra, India   Submittted/Under Review 
Kailash Cancer and Medical Centre Institutional Ethics Committee, Vadodra, India  Submittted/Under Review 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  Patients with metastatic breast cancer,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Herceptin (Roche/Genentech)  Herceptin will be administered in combination with paclitaxel, and Loading dose of 8 mg/kg over 90 min on day 1 followed by 6 mg/kg over 30-90 min every 3 weekly maintenance dose.Total duration of therapy is approx 3 months. 
Intervention  Trastuzumab (Zydus)  Trastuzumab will be administered in combination with paclitaxel, at an initial dose of 8 mg/kg as a 90 minute intravenous infusion followed by subsequent once every three weeks, dose of 6 mg/kg i.v 30-90 minute intravenous infusions.Total durationof therapy is approx 3 months. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  80.00 Year(s)
Gender  Female 
Details  1. Patients with histologically or cytologically confirmed uni-dimensionally measurable metastatic breast cancer.

2. Have a strong Her-2 over-expression as described by a 3+

3. Patients with ECOG performance status 0-2.  
 
ExclusionCriteria 
Details  1. Newly diagnosed metastatic breast cancer patients other than HER2 +ve patients. (Note since there is no treatment other than Trastuzumab for HER2+ve MBC such patients will not be excluded)

2. Have a history of congestive heart failure (CHF)

3. Have an abnormal LVEF

4. History of myocardial infarction within 6 months before randomization.

5. Have severe dyspnea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy.

6. Have had prior mediastinal irradiation (except internal mammary-node irradiation for the present breast cancer).

7. Have a history of hypersensitivity to the Trastuzumab or to drugs with similar chemical structures, or to any of the excipients, or to murine proteins.

8. Have any concurrent disease or condition that, in the opinion of the investigator, would make the patient unsuitable for participation in the 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 compare the single dose truncated pharmacokinetics (Cmax, AUC0-168hrs) of Trastuzumab (Zydus) as
compared to Herceptin (Reference) upto Day 7, both in combination with Paclitaxel in patients with
Metastatic Breast Cancer. 
Day 1, Cycle 1 - Before the study drug administration i.e. 0 minutes, end of study drug administration (i.e. after 1.5 hours (end of infusion) ±15 minutes, after 3 hours ±15 minutes, after 4.5 hours ±15 minutes and after 6 hours ±15 minutes)

Day 7 - (168 hours ± 24 hours)
Day 14 - Optional - (336 hours ± 24 hours)
Day 1, Cycle2 ± 2 days
Day 1, Cycle 3 ± 2 days
Day 1, Cycle 4 ± 2 days
Day 21 after cycle 4 ± 7 days 
 
Secondary Outcome  
Outcome  TimePoints 
To compare Objective Response Rate (ORR) – Sum of Complete response (CR) and partial response at end of study and to compare the pharmacokinetics (Cmax, AUC0-last) and immunogenicity  At the End of study (21 days after last dose). i.e.
After 3 months. 
 
Target Sample Size   Total Sample Size="102"
Sample Size from India="102" 
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   Phase 3 
Date of First Enrollment (India)   26/05/2014 
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="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Closed to Recruitment of Participants 
Publication Details   None Yet 
Individual Participant Data (IPD) Sharing Statement

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

Brief Summary  
The purpose of this study is to determine the Pharmacokinetics, Safety, tolerability and efficacy of Trastuzumab (test, Zydus) as compared to Herceptin (Reference Product, Roche/Genentech), both in combination with Paclitaxel in patients with Metastatic Breast Cancer. The proposed subjects will be randomly assigned in a 2:1 ratio to Trastuzumab (Zydus - Test) and Trastuzumab (Reference). The computer generated randomization scheme will use blocks of 3 to maintain randomization balance. This study will be initiated only after obtaining the approvals of Institutional/ Independent Ethics Committee (IEC), clinical trial permission from the Drug Controller General of India (DCGI). The subjects qualifying inclusion and exclusion criteria will be invited to participate in this study. The recruitment will happen as per randomization schedule. Randomization list will be generated by computer generated randomization number. Randomization concealment will be achieved by the use of temper proof sealed opaque envelopes. The study will be an open label study. All the Response assessment for the enrolled patients will be based on RECIST Criteria Version 1.1. The study will be conducted in 5 patients to determine the infusion toxicities. These patients will be reviewed by the DSMB. If there are no clinically significant or higher incidences of infusion reactions, the participants will continue to receive the therapy and complete the 4 cycles as per the protocol. On completion of review of single cycle of infusion toxicity of 5 subjects, further randomization of the study will be initiated.
 
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