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Goldstein LJ , Mansutti M , Levy C , Chang JC , Henry S , Fernandez-Perez I , Prausovà J , Staroslawska E , Viale G , Butler B , McCanna S , Ruffini PA , Wicha MS , Schott AF
A randomized, placebo-controlled phase 2 study of paclitaxel in combination with reparixin compared to paclitaxel alone as front-line therapy for metastatic triple-negative breast cancer (fRida)
Breast Cancer Res Treat. 2021 Sep 3
PMID: 34476645   
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Abstract
PURPOSE: CXCR1, one of the receptors for CXCL8, has been identified as a druggable target on breast cancer cancer stem cells (CSC). Reparixin (R), an investigational oral inhibitor of CXCR1, was safely administered to metastatic breast cancer patients in combination with paclitaxel (P) and appeared to reduce CSC in a window-of-opportunity trial in operable breast cancer. The fRida trial (NCT02370238) evaluated the addition of R to weekly as first-line therapy for metastatic (m) TNBC. SUBJECTS AND METHODS: Subjects with untreated mTNBC were randomized 1:1 to R or placebo days 1-21 in combination with weekly P 80 mg/m(2) on days 1, 8, 15 of 28-day cycles. The primary endpoint was PFS by central review. RESULTS: 123 subjects were randomized (62 to R + P and 61 to placebo + P). PFS was not different between the 2 groups (median 5.5 and 5.6 months for R + P and placebo + P, respectively; HR 1.13, p = 0.5996). ALDH(+) and CD24(-)/CD44(+) CSC centrally evaluated by IHC were found in 16 and 34 of the 54 subjects who provided a metastatic tissue biopsy at study entry. Serious adverse events (21.3 and 20% of subjects) and grade ≥ 3 adverse reactions (ADR) (9.1 and 6.3% of all ADRs) occurred at similar frequency in both groups. CONCLUSION: fRida is the first randomized, double-blind clinical trial of a CSC-targeting agent in combination with chemotherapy in breast cancer. The primary endpoint of prolonged PFS was not met. CLINICAL TRIAL REGISTRATION/DATE OF REGISTRATION: NCT01861054/February 24, 2015.
Notes
1573-7217 Goldstein, Lori J Orcid: 0000-0002-6542-3421 Mansutti, Mauro Levy, Christelle Chang, Jenny C Henry, Stephanie Fernandez-Perez, Isaura Prausovà, Jana Staroslawska, Elzbieta Viale, Giuseppe Butler, Beth McCanna, Susan Ruffini, Pier Adelchi Wicha, Max S Schott, Anne F fRida Trial Investigators P30 CA006927/CA/NCI NIH HHS/United States Journal Article Netherlands Breast Cancer Res Treat. 2021 Sep 3. doi: 10.1007/s10549-021-06367-5.