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Granulocyte-colony Stimulating Factors or Antibiotics for Primary Prophylaxis for Febrile Neutropenia (REaCT-TC2)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02816112
Recruitment Status : Completed
First Posted : June 28, 2016
Last Update Posted : May 27, 2020
Information provided by (Responsible Party):
Ottawa Hospital Research Institute

Brief Summary:

Taxotere-cyclophosphamide (TC) chemotherapy is commonly used as an adjuvant chemotherapy regimen in patients with resected early stage breast cancer. TC chemotherapy can cause febrile neutropenia (FN) which can be serious and associated with treatment delays and dose reductions, thereby compromising treatment efficacy. To reduce the risk of chemotherapy-induced FN,TC is administered with either one of two highly effective standard treatments; namely primary prophylaxis with either ciprofloxacin or granulocyte colony-stimulating factor (G-CSF). However, there are considerable cost differences between these strategies; subcutaneous daily G-CSF costs at least $12,000 over 4 cycles of treatment while oral ciprofloxacin costs about $100.

The investigators have therefore been performing a feasibility study to explore whether the "integrated consent model" involving oral consent is feasible in practice; and whether it can be used to increase the number of physicians and patients who take part in clinical trials. This feasibility study (REaCT-TC NCT02173262) has been an amazing success and the investigators are therefore now performing a definitive study comparing G-CSF with ciprofloxacin. This study will not be evaluating feasibility endpoints, but rather clinically important endpoints of hospitalizations and febrile neutropenia rates.

Condition or disease Intervention/treatment Phase
Early Stage Breast Cancer Drug: Ciprofloxacin Drug: Neupogen Phase 4

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 458 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multi-Centre Study to Compare Granulocyte-colony Stimulating Factors to Antibiotics for Primary Prophylaxis of Taxotere/Cyclophosphamide-Induced Febrile Neutropenia REaCT-TC2
Study Start Date : September 2016
Actual Primary Completion Date : March 2020
Actual Study Completion Date : April 2020

Arm Intervention/treatment
Active Comparator: Ciprofloxacin
Oral tablet taken twice a day at home starting 5 days after chemotherapy for 14 days for every cycle of TC
Drug: Ciprofloxacin

Active Comparator: G-CSF
Daily injection at home for the number of days as chosen by the treating physician
Drug: Neupogen
Granulocyte-colony stimulating factor
Other Name: filgrastim

Primary Outcome Measures :
  1. Febrile neutropenia [ Time Frame: 2 years ]
    Number of participants with febrile neutropenia

  2. Treatment-related hospitalization [ Time Frame: 2 years ]
    Number of participants admitted to hospital for treatment-related reasons

Secondary Outcome Measures :
  1. Chemotherapy dose reduction [ Time Frame: 2 years ]
    Number of participants who receive a dose reduction of their TC chemotherapy

  2. Chemotherapy dose delay [ Time Frame: 2 years ]
    Number of participants who receive a dose delay in their TC chemotherapy

  3. Chemotherapy discontinuation [ Time Frame: 2 years ]
    Number of participants who stop TC chemotherapy for any reason

  4. Microbiologic infections [ Time Frame: 2 years ]
    Number of participants who have a microbiologic infection (i.e: Clostridium difficile)

Information from the National Library of Medicine

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Ages Eligible for Study:   19 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically confirmed primary breast cancer
  • Planned TC chemotherapy
  • ≥19 years of age
  • Able to provide verbal consent

Exclusion Criteria:

  • Contraindication to either Ciprofloxacin or G-CSF

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02816112

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Canada, Ontario
The Ottawa Hospital Research Institute
Ottawa, Ontario, Canada
Sponsors and Collaborators
Ottawa Hospital Research Institute
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Principal Investigator: Mark Clemons, MD The Ottawa Hospital
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Responsible Party: Ottawa Hospital Research Institute Identifier: NCT02816112    
Other Study ID Numbers: OTT 16-03
First Posted: June 28, 2016    Key Record Dates
Last Update Posted: May 27, 2020
Last Verified: May 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: There is no plan to make IDP available.
Additional relevant MeSH terms:
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Febrile Neutropenia
Leukocyte Disorders
Hematologic Diseases
Anti-Bacterial Agents
Anti-Infective Agents
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Cytochrome P-450 CYP1A2 Inhibitors
Cytochrome P-450 Enzyme Inhibitors