Evaluation of the effects of simvastatin in metastatic breast cancer patients

ISRCTN ISRCTN12964275
DOI https://doi.org/10.1186/ISRCTN12964275
Secondary identifying numbers Damascus University/15073/
Submission date
24/09/2019
Registration date
11/10/2019
Last edited
02/09/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Preclinical studies support the anticancer activity of statins, however, the existing clinical evidence is inconsistent and not definitive. The aim of this study is to assess the possible cancer chemosensitizing effect of a statin (simvastatin) in metastatic breast cancer (MBC) patients.

Who can participate?
MBC patients undergoing a chemotherapy course of carboplatin and vinorelbine

What does the study involve?
Patients are randomly allocated to receive a 15-day course of either simvastatin or placebo (dummy drug) at day -7 of each chemotherapy cycle. The primary endpoints are objective response rate (ORR) and toxicity, and the secondary endpoint is overall survival (OS).

What are the possible benefits and risks of participating?
Although the beneficial effects of statins in lowering cholesterol are well established, their importance in the area of cancer therapeutics is now gaining greater recognition. At present there is ample evidence to suggest that statins could be used in breast cancer. It provides solid ground for further research on whether statins can improve the efficacy of commonly used cytotoxic agents if given in combination. Possible risks: simvastatin known toxicity.

Where is the study run from?
Al-Baironi Hospital (Syria)

When is the study starting and how long is it expected to run for?
December 2010 to July 2017

Who is funding the study?
Damascus University (Syria)

Who is the main contact?
Prof. Lama Youssef
ylama@hotmail.com

Contact information

Prof Lama Youssef
Scientific

International University of Science and Technology
Kiwan Land Campus
Damascus
ylama@hotmail.com
Syria

Phone +963-935-797914
Email ylama@hotmail.com

Study information

Study designProspective single-center randomized double-blind placebo-controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific titleEvaluation of the effects of lipophilic statins on the responsiveness of metastatic breast cancer patients to chemotherapy regimens
Study objectivesPreclinical studies support the anticancer activity of statins, however, the existing clinical evidence is inconsistent and not definitive. This study aimed at evaluating a postulated cancer chemosensitizing effect of a statin (simvastatin) in a cohort of metastatic breast cancer (MBC) patients.
Ethics approval(s)Approved 26/11/2013, Scientific Research Ethics Committee at the Faculty of Pharmacy, Damascus University (7 Nissan Street, Mazzeh, Damascus, Syria; Tel: +963 (0)112131871), Number: 10
Health condition(s) or problem(s) studiedMetastatic breast cancer
InterventionPatients were randomly allocated to receive a 15-day course of either simvastatin (40 mg) or placebo at the day -7 of each chemotherapy cycle.

Chemotherapy regimen was conducted every 3 weeks according to the hospital protocol as follows; carboplatin (Carboplatin “Ebewe”), Area under the curve (AUC) 4, intravenously on day 1 and vinorelbine (Navelbine®) intravenously (25 mg/m2) or orally (60 mg/m2) on days 1 and 8 of each cycle. Simvastatin 40 mg or placebo administered orally once daily for 15 days starting at the day -7 of each chemotherapy cycle.

Primary endpoints were objective response rate (ORR) and toxicity, and secondary endpoint was overall survival (OS).
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Carboplatin, vinorelbine, simvastatin
Primary outcome measure1. Objective response rate (ORR) calculated based on both complete response + partial response. Patients’ response classified according to the response evaluation criteria in solid tumor (RECIST) (version 1.1) as follows: complete response (CR): complete disappearance of clinical evidence of disease for a minimum of 8 weeks; partial response (PR): decreased in tumor burden ≥30%; stable disease (SD): decreased by <30% or increased by <20%; progressive disease (PD): increase in tumor burden by ≥20%; and non-evaluable response due to specific reasons (e.g., early death or toxicity). To assess tumor progression, physical examination, tumor markers (carcinoembryonic antigen (CEA) and cancer antigen 15–3 (CA15-3)), and radiological studies were conducted at baseline and every three cycles, and bone scan was repeated by the end of the sixth cycle
2. Treatment related-toxicity graded according to the Common Terminology Criteria for Adverse Events, version 4 at each cycle
Secondary outcome measuresOverall survival defined as the time from study entry to death from any cause over the follow-up period (the follow-up lasted until death or the cutoff date of July 2017)
Overall study start date28/12/2010
Completion date01/07/2017

Eligibility

Participant type(s)Patient
Age groupMixed
SexFemale
Target number of participants82
Total final enrolment82
Key inclusion criteria1. Female patients attending the breast cancer unit at Al-Baironi Hospital
2. Confirmed diagnosis of metastases (stage IV) prior to commencing chemotherapy course consisting of carboplatin and vinorelbine
3. Age between 20 and 75 years
4. Adequate function of major organs (including cardiac, hepatic and renal functions)
5. ECOG Performance Status score ≤2
Key exclusion criteria1. Pregnant patients
2. Previous treatment with statins or carboplatin and vinorelbine within 30 days of the study
Date of first enrolment11/08/2011
Date of final enrolment30/07/2012

Locations

Countries of recruitment

  • Syria

Study participating centre

Al-Baironi Hospital
Harasta
Damascus
-
Syria

Sponsor information

Damascus University
University/education

Baramka
Damascus
-
Syria

Phone +963 (0)11 33923192
Email info@damascusuniversity.edu.sy
Website http://damascusuniversity.edu.sy
ROR logo "ROR" https://ror.org/03m098d13

Funders

Funder type

University/education

Damascus University

No information available

Results and Publications

Intention to publish date31/12/2019
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication after registration is completed.
IPD sharing planThe datasets generated during and/or analysed during the current study are available upon request from Lama A Youssef, B.Pharm, PhD (ylama@hotmail.com).

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 10/08/2020 02/09/2020 Yes No

Editorial Notes

02/09/2020: Publication reference added.
11/10/2019: Trial's existence confirmed by ethics committee.