Pilot Study to Evaluate Safety & Biological Effects of Orally Administered Reparixin in Early Breast Cancer

Sponsor
Dompé Farmaceutici S.p.A (Industry)
Overall Status
Terminated
CT.gov ID
NCT01861054
Collaborator
(none)
20
9
1
36.9
2.2
0.1

Study Details

Study Description

Brief Summary

This is a pilot "window of opportunity" clinical study in patients with operable breast cancer investigating use of reparixin as single agent in the time period between clinical diagnosis and surgery.

The primary objectives of this study were:

1- to evaluate the effects of orally administered reparixin on CSCs in the primary tumor and the tumoral microenvironment in an early breast cancer population:

  1. CSC were measured in tissue samples by techniques that could include: ALDEFLUOR assay and assessment of CD44/CD24 by flow cytometry, or examination of RNA transcripts by RT-PCR, aldehyde dehydrogenase-1, CD44/CD24 and epithelial mesenchymal transition markers (Snail, Twist, Notch) by immunohistochemistry (IHC). CSC were defined as ALDEFLUOR positive (ALDH-1+) and/or CD44 high/CD24 low by flow cytometry or RT-PCR and IHC and by the detection of ALDH-1+ cells with or without epithelial mesenchymal transition (EMT) transcription factor in IHC assays.

  2. Serine-threonine protein kinase (AKT), focal adhesion kinase (FAK), phosphatase and tensin homolog (PTEN) and chemokine receptor-1 (CXCR1) levels were measured in tissue samples by IHC.

  3. Measurement of markers of inflammation (interleukin-1beta [IL-1β], interleukin-6 [IL-6], interleukin-8 [IL-8], tumor necrosis factor-alpha [TNF-α], granulocyte macrophage colony stimulating factor [GM-CSF], vascular endothelial growth factor [VEGF], basic fibroblast growth factor [b-FGF] and high-sensitivity C-reactive protein [hsCRP]) in plasma, leukocyte subsets (enumerate T subsets, B, and natural killer/natural killer T [NK/NKT] cells) and study polymorphonuclear leukocyte [PMN] biology in peripheral blood samples. D. Measurement of markers of angiogenesis (CD31 staining), tumor-infiltrating leukocytes (CD4, CD8, NK and macrophages), autophagy (P62 and LC3 by IHC), EpCAM and EMT markers (CD326, CD45, Twist1, SNAIL1, SLUG, ZEB1, FOXC2, TG2, Akt2, P13k and CK19 by RT-PCR) and tissue cellularity (residual disease characterization in tumor bed) in tumor tissue samples.

  1. To evaluate the safety of oral reparixin administered three times daily (t.i.d.) for 21 consecutive days.

The secondary objective was to define the pharmacokinetic (PK) profile of orally administered reparixin.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

According to the cancer stem cell (CSC) model, tumors are organized in a cellular hierarchy maintained by a subpopulation of cells displaying stem cell properties. These properties include self-renewal (which drives tumorigenesis) and differentiation (which generates the tumor bulk and contributes to cellular heterogeneity).

CSCs were first observed in hematological malignancies but have also been identified in solid tumors of breast, prostate, brain, colon and pancreas. CSCs are thought to be resistant to conventional chemotherapies and this may be why relapse occurs in many patients and this might explain the failure to develop therapies that are consistently able to eradicate solid tumors. Although currently available drugs can shrink metastatic tumors, these effects are usually transient and often do not appreciably extend the life of patients. One reason for the failure of these treatments is the acquisition of drug resistance by the cancer cells as they evolve; another possibility is that existing therapies fail to kill CSCs effectively. Existing therapies have been developed largely against the bulk population of tumor cells because they are often identified by their ability to shrink tumors. Because most cancer cells have limited proliferative potential, an ability to shrink a tumor mainly reflects an ability to kill these cells. It seems that normal stem cells from various tissues tend to be more resistant to chemotherapeutics than mature cell types from the same tissues. The reasons for this are not clear, but may relate to high levels of expression of anti-apoptotic proteins or adenosine triphosphate-binding cassette transporters such as the multidrug resistance gene. If the same were true of CSCs, then one would predict that these cells would be more resistant to chemotherapeutics than tumor cells with limited proliferative potential. Even therapies that cause complete regression of tumors might spare enough CSCs to allow re-growth of the tumors. Therapies that are more specifically directed against CSCs might result in much more durable responses and even cures of metastatic tumors.

There are limited data on the impact of treatment tailoring based on CSC detection. Gene profiling of CSCs could lead to identification of therapeutic targets on CSCs (e.g. hormone receptors (HR), human epidermal growth factor receptor-2 [HER-2] expression, epidermal growth factor receptor [EGFR] expression), and could represent tumor biopsy in "real time". Several groups showed frequent discordance of HER-2 status between primary tumor and CSCs, and case reports showed clinical utility for the use of trastuzumab-based therapy based on HER-2 CSCs status. Similarly, the hormonal status of CSCs could be different from that of the primary tumor, which could lead to increase the number of patients suitable for endocrine therapy, but also could explain why endocrine therapy fails in a subset of HR positive (HR+) patients. More specifically, a recent observation from Ginestier et al. demonstrated that over expression of chemokine receptor 1 (CXCR-1) is associated with the aldehyde dehydrogenase positive (ALDH+) cells. In breast carcinomas, the ALDEFLUOR+ phenotype shows partial overlap with the CD44+CD24-Lin-CSC phenotype. Cellular hierarchies have been identified in a series of molecularly characterized breast cancer cell lines and it has been demonstrated that these lines contained ALDEFLUOR+ components that were both tumorigenic and metastatic in NOD/SCID mice. Furthermore, previous observations demonstrated that the addition of recombinant interleukin-8 (IL-8) increased the CSC population as well as increasing its propensity for invasion. Moreover, tissue damage induced by chemotherapeutic agents may induce IL-8 as part of the injury response. This suggests that strategies aimed at interfering with the IL 8/CXCR-1 axis may be able to target CSCs, increasing the efficacy of current therapies. This experimental data provides another therapeutic target in breast cancer.

Reparixin seems to be a good candidate for use in breast cancer patients because of its very acceptable toxicity profile shown in the Phase I and II clinical trials conducted so far, along with its observed activity in vitro against breast cancer cell lines and in vivo in tumor xenografts in mice. A phase 1 study is currently underway to study the effects of reparixin in combination with paclitaxel in metastatic breast cancer.

This small pilot study aims at exploring the effects on breast CSC markers as well as the safety and PK profile of orally administered single agent reparixin in HER-2 negative (HER-2-) early breast cancer patients in the 3 weeks prior to surgery.

The study will be performed in the interval between disease diagnosis and planned surgery and may lead to a minimal delay in surgery. This is balanced by the potential benefits of the study by evaluating CSCs and their prognostic importance as well as obtaining information about the impact of reparixin therapy.

Study Design

Study Type:
Interventional
Actual Enrollment :
20 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Single Arm, Preoperative, Pilot Study to Evaluate the Safety and Biological Effects of Orally Administered Reparixin in Early Breast Cancer Patients Who Are Candidates for Surgery
Study Start Date :
Feb 1, 2013
Actual Primary Completion Date :
Mar 1, 2015
Actual Study Completion Date :
Mar 1, 2016

Arms and Interventions

Arm Intervention/Treatment
Experimental: Treated patients - Total

Patients eligible will be treated with Reparixin as add-in monotherapy

Drug: Reparixin
1000 mg Oral Reparixin t.i.d. for 21 consecutive days prior to surgery
Other Names:
  • REP
  • Outcome Measures

    Primary Outcome Measures

    1. Change From Baseline to Day 21 in Markers of Cancer Stem Cells (CSCs) in the Primary Tumor and the Tumoral Microenvironment (ALDH1,CD44/CD24) [At day 21]

      CSCs were measured in tissue samples by the following techniques: ALDH-1 by ALDEFLUOR and by immunohistochemistry (IHC); CD44/CD24 by flow cytometry or examination of RNA transcripts by RT-PCR and by immunohistochemistry (IHC); epithelial mesenchymal markers (Snail, Twist, Notch) by immunohistochemistry (IHC).

    2. Change From Baseline-1 to Day 21-1 in Pathway Markers by IHC [Day 21 (or last day of treatment)]

      Pathway markers (AKT, FAK, PTEN and CXCR1) were measured in tissue samples at the pre-study (Day -14 to 0) and Day 21 (or within 24 hours of last dose). For the evaluation of the stain extent, the following semi-quantitative score method (0 to 4) was used: 0, no positive cells; 1, 1-25%; 2, 26-50%; 3, 51-75%; and 4, 76-100%. Hence for this scale, the higher the values, the worse is the outcome. For the evaluation of the stain intensity, the following score method (0 to 3) was used: 0, negative; 1, weak; 2, moderate, 3; strong. Also for this scale, the higher the score, the worse the outcome. Serine-threonine protein kinase (AKT, also known as protein kinase B, PKB) Focal adhesion kinase (FAK) Chemokine receptor-1 (CXCR1)

    3. Change From Baseline to Day 21 in Markers of Inflammation [At Day 21]

      Markers of inflammation (IL-1β, IL-6, IL-8, TNF-α, GM-CSF, VEGF, and b-FGF) were measured in plasma from peripheral blood. IL = interleukins TNF-α = tumor necrosis factor-alpha GM-CSF = macrophage colony stimulating factor VEGF = vascular endothelial growth factor b-FGF = basic fibroblast growth factor

    4. Change From Baseline-1 to Day 21-1 in Markers of Angiogenesis (CD31 Staining) [At day 21]

      CD31 staining by IHC. For the evaluation of the stain extent, the following semi-quantitative score method (0 to 4) was used: 0, no positive cells; 1, 1-25%; 2, 26-50%; 3, 51-75%; and 4, 76-100%. Hence for this scale, the higher the values, the worse is the outcome. For the evaluation of the stain intensity, the following score method (0 to 3) was used: 0, negative; 1, weak; 2, moderate, 3; strong. Also for this scale, the higher the score, the worse the outcome. CD31 is a transmembrane glycoprotein, 130-140 kDa, also know as platelet-endothelium cell adhesion molecule (PECAM-1). CD31 is ligand for CD38 and plays a role in thrombosis and angiogenesis. CD31 is strongly expressed in endothelial cells and weakly expressed in megakaryocytes, platelets, occasional plasma cells, lymphocytes (espc. marginal zone B-cells, peripheral T-cells) and neutrophils.

    5. Change From Baseline-1 to Day 21-1 in Markers of Autophagy (P62 and LC3B by IHC) [At day 21]

      Autophagy is a lysosomal degradation and recycling process implicated in cancer progression and therapy resistance. Labeling of p62 serves as a useful marker for the induction of autophagy, clearance of protein aggregates, and the inhibition of autophagy. Labeling of LC3B serves to track the binding of p62 and subsequent recruitment of autophagosomes. For the evaluation of the extent, the following semi-quantitative score method (0 to 4) was used: 0, no positive cells; 1, 1-25%; 2, 26-50%; 3, 51-75%; and 4, 76-100%. Hence for this scale, the higher the values, the worse is the outcome. For the evaluation of the intensity, the following score method (0 to 3) was used: 0, negative; 1, weak; 2, moderate, 3; strong. Also for this scale, the higher the score, the worse the outcome.

    Secondary Outcome Measures

    1. Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - Cmax [At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)]

      Once absorbed, reparixin is highly protein bound. By comparing Cmax and AUC for unbound drug to that for total drug, only < 0.1% to 0.2% of reparixin is available as unbound (free) drug. The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. Cmax = Maximum plasma concentration obtained directly from the data without interpolation, expressed in concentration units

    2. Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - Tmax and T1/2 [At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)]

      Once absorbed, reparixin is highly protein-bound. By comparing Cmax and AUC for unbound drug to that for total drug, only < 0.1% to 0.2% of reparixin is available as unbound (free) drug. The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. tmax = Time to reach the maximum plasma concentration obtained directly from the data without interpolation t1/2 = Terminal elimination half-life calculated as ln(2)/ lambda z; calculated only if the coefficient of determination R2 in lambda z estimation is at least 0.8.

    3. Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - AUC0-8, AUCinf, AUClast, AUCtau at Day 21, [At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)]

      The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. AUC0-8 = The area under the plasma concentration-time curve from time 0 to 8 hours post-dose; AUClast = The area under the concentration-time curve from time 0 to last quantifiable concentration AUCtau = The area under the plasma concentration-time curve for dosing interval (dosing interval [tau] = 8 hours); AUCinf = The total area under the plasma concentration-time curve from time zero to time infinity; AUC0-inf = AUClast + Clast/lambda zeta, where Clast is the last observed concentration ≥ lower limit of quantitation at time tlast. All these parameters were calculated by the linear trapezoidal rule.

    4. Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - CL/F (L/h) at Day 1, CLSS/F (L/h) Day 21) [At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)]

      The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. CL/F = Apparent oral clearance - for DF1681Y only, calculated as dose/AUCinf.; calculated only when the coefficient of determination R2 in lambda zeta estimation is at least 0.8 and percent AUC extrapolation is less than or equal to 20%. CLss/F = Steady state apparent oral clearance - for DF1681Y only calculated as dose/AUCtau.

    5. Change From Baseline to Day 21 in Leukocytes Subsets [At Day 21]

      The Leukocytes subsets analyzed are the following: Lymphocyte in WBC, Total T cell in lymphocytes, B cells in lymphocytes, T-helper cell in lymphocytes, CTL in lymphocytes, NKT cell in lymphocytes, ADCC NK subsets in lymphocytes, Regulatory NK subsets in lymphocytes, Exhausted NK subsets in lymphocytes, CD56-CD16+ NK subsets in lymphocytes, CD11b in PMNs - IL-8, CD18 in PMNs - IL-8, MFI of CD11b - IL-8, MFI of CD66b - IL-8, MFI of CD18 - IL-8, CD11b in PMNs - US, CD18 in PMNs - US, MFI of CD11b - US, MFI of CD66b - US, MFI of CD18 - US, Percent Monocytes expressing IL6 - IL-8,Percent Monocytes expressing IL1b - IL-8, Percent Monocytes expressing IL8 - IL-8, Percent Monocytes expressing TNFa - IL-8, Percent Neutrophils expressing IL6 - IL-8, Percent Neutrophils expressing IL1b - IL-8, Percent Neutrophils expressing IL8 - IL-8, Percent Neutrophils expressing TNFa - IL-8,Percent Monocytes expressing IL6 - US,Percent Monocytes expressing IL1b - US, etc.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Female aged > 18 years.

    • Patients with operable breast cancer, with measurable tumors of more than 1 cm in diameter, that are not candidates for neoadjuvant therapy.

    • Zubrod (Eastern Co-operative Oncology Group [ECOG]) Performance Status (PS) of 0-1.

    • No prior treatment by surgery, radiotherapy, hormone therapy e.g. TAMOXIFEN® or RALOXIFEN® for prevention or chemotherapy.

    • Scheduled to undergo definitive local surgery for breast cancer.

    • Patients must be willing to undergo two mandatory tumor biopsies (pre and post therapy) that are not required for standard care. A sample of tumor tissue removed during surgery will also be collected for analysis.

    • Patients must be able to swallow and retain oral medication (intact tablet).

    • Able to undergo all screening assessments outlined in the protocol after giving informed consent.

    • Adequate organ function (defined by the following parameters):

    1. Serum creatinine < 140 μmol/L or creatinine clearance > 60 mL/min.

    2. Serum hemoglobin > 9 g/dL; absolute neutrophil count > 1.5 x 109/L; platelets > 100 x 109/L.

    3. Serum bilirubin < upper normal limit (UNL).

    4. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤ UNL; alkaline phosphatase (ALP) ≤ UNL; albumin within normal limits.

    • Documented hormone receptor (ER and progesterone receptor) and HER-2- status.

    • No known hepatitis B virus (unless due to immunization), hepatitis C virus, human immune deficiency virus-I and II positive status.

    Exclusion Criteria:
    • Male.

    • Pregnancy or lactation or unwillingness to use two adequate methods of birth control throughout the study and for 30 days after study discontinuation.

    • Any other breast cancer types including inflammatory form.

    • Prior surgery to the breast area or primary axillary dissection.

    • Prior treatment for breast cancer.

    • Use of an investigational drug within 30 days preceding the first dose of study medication.

    • Any prior or current cancer, except in situ uterine carcinoma or basocellular cutaneous cancer considered as definitively cured.

    • Any associated medical condition considered incompatible with the study, e.g. cardiac, renal, medullar, respiratory or hepatic insufficiency.

    • Neurological or psychiatric disorders which may influence understanding of study and informed consent procedures.

    • Active or uncontrolled infection.

    • Malabsorption syndrome, disease significantly affecting gastrointestinal function.

    • Hypersensitivity to:

    1. ibuprofen or to more than one non-steroidal anti-inflammatory drug;

    2. medications belonging to the class of sulfonamides, such as sulfamethazine, sulfamethoxazole, sulfasalazine, nimesulide or celecoxib.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Indiana University Simon Cancer Center Indianapolis Indiana United States 46202-5289
    2 University of Kansas Cancer Center, 4350 Shawnee Mission Pkwy, Suite 1500, Mailstop 6004 Fairway Kansas United States 66205
    3 The Cancer Institute of New Jersey New Brunswick New Jersey United States 08903
    4 Montefiore Medical Center, MMC Medical Park at Eastchester Bronx New York United States 10461
    5 Weill Cornell Medical College New York New York United States 10065
    6 Fox Chase Cancer Center Philadelphia Pennsylvania United States 19111
    7 Magee-Womens Hospital Pittsburgh Pennsylvania United States 15213
    8 Sara Cannon Research Institute Nashville Tennessee United States 37203
    9 The Methodist Hospital Research Institute Houston Texas United States 77030

    Sponsors and Collaborators

    • Dompé Farmaceutici S.p.A

    Investigators

    • Principal Investigator: Lori J Goldstein, MD, PhD, Fox Chase Cancer Center

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    Dompé Farmaceutici S.p.A
    ClinicalTrials.gov Identifier:
    NCT01861054
    Other Study ID Numbers:
    • REP0210
    First Posted:
    May 23, 2013
    Last Update Posted:
    May 14, 2021
    Last Verified:
    Apr 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Keywords provided by Dompé Farmaceutici S.p.A
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details Patients recruitment: before initiating a study, the Investigator was required to have written and dated approval from the Institutional Review Board (IRB)/Independent Ethics Committee (IEC) for the study protocol, written informed consent form (ICF), consent form updates, subject recruitment procedures (e.g., advertisements), and any other written information to be provided to subjects.
    Pre-assignment Detail It was planned to enroll 2 sub-groups of patients into the study, Group A: ER+ and/or PR+/HER-2- and Group B: ER-/PR-/HER-2-, and the sample size of 20 patients per group was chosen. Twenty patients in total were enrolled, 18 in Group A and 2 in Group B. The study was closed prematurely due to slow enrollment in group B. All 20 patients were included in the Safety Population and 6 (30%) were included in the PK population. All 20 patients completed the study.
    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2-
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack. Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack.
    Period Title: Overall Study
    STARTED 18 2
    Safety Population 18 2
    PK Population 4 2
    COMPLETED 18 2
    NOT COMPLETED 0 0

    Baseline Characteristics

    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2- Total
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack Total of all reporting groups
    Overall Participants 18 2 20
    Age (Count of Participants)
    <=18 years
    0
    0%
    0
    0%
    0
    0%
    Between 18 and 65 years
    16
    88.9%
    1
    50%
    17
    85%
    >=65 years
    2
    11.1%
    1
    50%
    3
    15%
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    54.0
    (8.92)
    56.5
    (12.02)
    54.3
    (8.91)
    Sex: Female, Male (Count of Participants)
    Female
    18
    100%
    2
    100%
    20
    100%
    Male
    0
    0%
    0
    0%
    0
    0%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    6
    33.3%
    0
    0%
    6
    30%
    Not Hispanic or Latino
    12
    66.7%
    2
    100%
    14
    70%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    Asian
    1
    5.6%
    0
    0%
    1
    5%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    1
    5.6%
    0
    0%
    1
    5%
    White
    15
    83.3%
    2
    100%
    17
    85%
    More than one race
    1
    5.6%
    0
    0%
    1
    5%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    Region of Enrollment (participants) [Number]
    United States
    18
    100%
    2
    100%
    20
    100%

    Outcome Measures

    1. Primary Outcome
    Title Change From Baseline to Day 21 in Markers of Cancer Stem Cells (CSCs) in the Primary Tumor and the Tumoral Microenvironment (ALDH1,CD44/CD24)
    Description CSCs were measured in tissue samples by the following techniques: ALDH-1 by ALDEFLUOR and by immunohistochemistry (IHC); CD44/CD24 by flow cytometry or examination of RNA transcripts by RT-PCR and by immunohistochemistry (IHC); epithelial mesenchymal markers (Snail, Twist, Notch) by immunohistochemistry (IHC).
    Time Frame At day 21

    Outcome Measure Data

    Analysis Population Description
    The Safety Population included all enrolled patients who took at least one dose of study drug reparixin. This population was used for primary endpoints and safety analysis
    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2-
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack
    Measure Participants 18 2
    ALDH+
    1.34
    (2.737)
    -0.40
    (1.131)
    CD44+/CD24-
    -0.57
    (5.617)
    0.20
    (1.273)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Comparison on ALDH+ cells by ALDEFLUOR assay
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3149
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Comparison on CD44+/CD24- by flow citometry
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.8148
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method Wilcoxon (Mann-Whitney)
    Comments
    2. Primary Outcome
    Title Change From Baseline-1 to Day 21-1 in Pathway Markers by IHC
    Description Pathway markers (AKT, FAK, PTEN and CXCR1) were measured in tissue samples at the pre-study (Day -14 to 0) and Day 21 (or within 24 hours of last dose). For the evaluation of the stain extent, the following semi-quantitative score method (0 to 4) was used: 0, no positive cells; 1, 1-25%; 2, 26-50%; 3, 51-75%; and 4, 76-100%. Hence for this scale, the higher the values, the worse is the outcome. For the evaluation of the stain intensity, the following score method (0 to 3) was used: 0, negative; 1, weak; 2, moderate, 3; strong. Also for this scale, the higher the score, the worse the outcome. Serine-threonine protein kinase (AKT, also known as protein kinase B, PKB) Focal adhesion kinase (FAK) Chemokine receptor-1 (CXCR1)
    Time Frame Day 21 (or last day of treatment)

    Outcome Measure Data

    Analysis Population Description
    The Safety Population included all enrolled patients who took at least one dose of study drug reparixin. This population was used for primary endpoints and safety analysis.
    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2-
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack
    Measure Participants 18 2
    Stain Phospho-AKT Extent
    0
    0
    Stain Phospho-AKT Intensity
    0
    0
    Stain AKT Extent
    0
    1.0
    Stain AKT Intensity
    -0.5
    0
    Phospho-FAK Extent
    0
    0
    Phospho-FAK Intensity
    0
    -1.0
    Stain FAK Extent
    0
    1.0
    Stain FAK Intens
    0
    0
    Stain C-PTEN Extent
    0
    0
    Stain C-PTEN Intensity
    0
    0
    Stain D-PTEN Extent
    0
    0
    Stain D-PTEN Intensity
    0
    0
    Stain CXCR1 Extent
    0
    1.0
    Stain CXCR1 Intensity
    -0.5
    1.0
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Phospho AKT Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Phospho-AKT Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments AKT Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2245
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments AKT Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.5785
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Phospho-FAK Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Phospho-FAK Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3139
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 7
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments FAK Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2120
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 8
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments FAK Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 9
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments C-PTEN Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 10
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments C-PTEN Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.8728
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 11
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments D-PTEN Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 12
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments D-PTEN Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.8728
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 13
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CXCR1 Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2265
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 14
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CXCR1 Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2403
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    3. Primary Outcome
    Title Change From Baseline to Day 21 in Markers of Inflammation
    Description Markers of inflammation (IL-1β, IL-6, IL-8, TNF-α, GM-CSF, VEGF, and b-FGF) were measured in plasma from peripheral blood. IL = interleukins TNF-α = tumor necrosis factor-alpha GM-CSF = macrophage colony stimulating factor VEGF = vascular endothelial growth factor b-FGF = basic fibroblast growth factor
    Time Frame At Day 21

    Outcome Measure Data

    Analysis Population Description
    The Safety Population included all enrolled patients who took at least one dose of study drug reparixin. This population was used for primary endpoints and safety analysis.
    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2-
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack
    Measure Participants 18 2
    Interleukin 1 Beta
    7.019
    (30.3118)
    0
    (0.000)
    Interleukin 6
    9.593
    (39.2733)
    0
    (0)
    Interleukin 8
    -25.874
    (134.3213)
    29.320
    (41.6910)
    TNFα
    2.669
    (8.0313)
    -0.890
    (3.5780)
    GM-CSF
    -2.678
    (8.2154)
    8.705
    (12.3107)
    VEGF
    253.584
    (1120.6125)
    27.635
    (39.0818)
    b-FGF
    20.164
    (93.4614)
    -9.750
    (13.7886)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Interleukin 1 Beta
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Interleukin 6
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.6945
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Interleukin 8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.9448
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Tumor Necrosis Factor - alpha
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.6292
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Granulocyte Macrophage Colony Stm Factor
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2354
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Vascular Endothelial Growth Factor
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 7
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Basic Fibroblast Growth Factor
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.4719
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method Wilcoxon (Mann-Whitney)
    Comments
    4. Primary Outcome
    Title Change From Baseline-1 to Day 21-1 in Markers of Angiogenesis (CD31 Staining)
    Description CD31 staining by IHC. For the evaluation of the stain extent, the following semi-quantitative score method (0 to 4) was used: 0, no positive cells; 1, 1-25%; 2, 26-50%; 3, 51-75%; and 4, 76-100%. Hence for this scale, the higher the values, the worse is the outcome. For the evaluation of the stain intensity, the following score method (0 to 3) was used: 0, negative; 1, weak; 2, moderate, 3; strong. Also for this scale, the higher the score, the worse the outcome. CD31 is a transmembrane glycoprotein, 130-140 kDa, also know as platelet-endothelium cell adhesion molecule (PECAM-1). CD31 is ligand for CD38 and plays a role in thrombosis and angiogenesis. CD31 is strongly expressed in endothelial cells and weakly expressed in megakaryocytes, platelets, occasional plasma cells, lymphocytes (espc. marginal zone B-cells, peripheral T-cells) and neutrophils.
    Time Frame At day 21

    Outcome Measure Data

    Analysis Population Description
    The Safety Population included all enrolled patients who took at least one dose of study drug reparixin. This population was used for primary endpoints and safety analysis.
    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2-
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack
    Measure Participants 18 2
    Stain CD31 Extent
    0
    1.0
    Stain CD31 Intensity
    0
    1.0
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CD31 Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.0951
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CD31 Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1643
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    5. Primary Outcome
    Title Change From Baseline-1 to Day 21-1 in Markers of Autophagy (P62 and LC3B by IHC)
    Description Autophagy is a lysosomal degradation and recycling process implicated in cancer progression and therapy resistance. Labeling of p62 serves as a useful marker for the induction of autophagy, clearance of protein aggregates, and the inhibition of autophagy. Labeling of LC3B serves to track the binding of p62 and subsequent recruitment of autophagosomes. For the evaluation of the extent, the following semi-quantitative score method (0 to 4) was used: 0, no positive cells; 1, 1-25%; 2, 26-50%; 3, 51-75%; and 4, 76-100%. Hence for this scale, the higher the values, the worse is the outcome. For the evaluation of the intensity, the following score method (0 to 3) was used: 0, negative; 1, weak; 2, moderate, 3; strong. Also for this scale, the higher the score, the worse the outcome.
    Time Frame At day 21

    Outcome Measure Data

    Analysis Population Description
    The Safety Population included all enrolled patients who took at least one dose of study drug reparixin. This population was used for primary endpoints and safety analysis.
    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2-
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack
    Measure Participants 18 2
    Stain P62 Extent
    -1.0
    0
    Stain P62 Intensity
    0
    -1.0
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments P62 Extent
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.4183
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments P62 Intensity
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3702
    Comments
    Method Wilcoxon (Mann-Whitney)
    Comments
    6. Secondary Outcome
    Title Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - Cmax
    Description Once absorbed, reparixin is highly protein bound. By comparing Cmax and AUC for unbound drug to that for total drug, only < 0.1% to 0.2% of reparixin is available as unbound (free) drug. The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. Cmax = Maximum plasma concentration obtained directly from the data without interpolation, expressed in concentration units
    Time Frame At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)

    Outcome Measure Data

    Analysis Population Description
    The PK Population consisted of patients who received at least one dose of reparixin and had at least one valid, quantifiable PK parameter. This population was used for PK analyses.
    Arm/Group Title Treated Patients - Total
    Arm/Group Description Patients eligible were treated with Reparixin as add-in monotherapy Reparixin: 1000 mg Oral Reparixin t.i.d. for 21 consecutive days prior to surgery
    Measure Participants 6
    Day1 - DF1681Y
    62.925
    (31.5024)
    Day21 - DF1681Y
    63.927
    (15.7616)
    Day1 - DF1681Y unbound
    145.167
    (116.6114)
    Day21 - DF1681Y unbound
    136.552
    (104.8681)
    Day 1 - DF2243Y
    15.788
    (2.5240)
    Day 21 - DF2243Y
    20.812
    (9.9776)
    Day 1 - DF2188Y
    7.302
    (1.5129)
    Day 21 - DF2188Y
    10.367
    (4.3439)
    7. Secondary Outcome
    Title Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - Tmax and T1/2
    Description Once absorbed, reparixin is highly protein-bound. By comparing Cmax and AUC for unbound drug to that for total drug, only < 0.1% to 0.2% of reparixin is available as unbound (free) drug. The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. tmax = Time to reach the maximum plasma concentration obtained directly from the data without interpolation t1/2 = Terminal elimination half-life calculated as ln(2)/ lambda z; calculated only if the coefficient of determination R2 in lambda z estimation is at least 0.8.
    Time Frame At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)

    Outcome Measure Data

    Analysis Population Description
    The PK Population consisted of patients who received at least one dose of reparixin and had at least one valid, quantifiable PK parameter. This population was used for PK analyses.
    Arm/Group Title Treated Patients - Total
    Arm/Group Description Patients eligible will be treated with Reparixin as add-in monotherapy Reparixin: 1000 mg Oral Reparixin t.i.d. for 21 consecutive days prior to surgery
    Measure Participants 6
    Day1 - DF1681Y tmax
    2.667
    (2.8752)
    Day21 - DF1681Y tmax
    0.997
    (0.5508)
    Day1 - DF1681Y unbound tmax
    1.583
    (1.2813)
    Day21 - DF1681Y unbound tmax
    1.092
    (0.4903)
    Day 1 - DF2243Y tmax
    4.333
    (2.3381)
    Day 21 - DF2243Y tmax
    2.331
    (0.8179)
    Day 1 - DF2188Y tmax
    2.500
    (1.2247)
    Day 21 - DF2188Y tmax
    1.508
    (0.5389)
    Day1 - DF1681Y t1/2
    2.090
    (0.9847)
    Day21 - DF1681Y t1/2
    1.626
    (0.4068)
    Day1 - DF1681Y unbound t1/2
    1.403
    (0.4592)
    Day21 - DF1681Y unbound t1/2
    0.989
    (0.1683)
    Day 1 - DF2243Y t1/2
    1.913
    (0.3268)
    Day 21 - DF2243Y t1/2
    2.575
    (0.6442)
    Day 1 - DF2188Y t1/2
    2.035
    (1.0618)
    Day 21 - DF2188Y t1/2
    1.575
    (0.1953)
    8. Secondary Outcome
    Title Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - AUC0-8, AUCinf, AUClast, AUCtau at Day 21,
    Description The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. AUC0-8 = The area under the plasma concentration-time curve from time 0 to 8 hours post-dose; AUClast = The area under the concentration-time curve from time 0 to last quantifiable concentration AUCtau = The area under the plasma concentration-time curve for dosing interval (dosing interval [tau] = 8 hours); AUCinf = The total area under the plasma concentration-time curve from time zero to time infinity; AUC0-inf = AUClast + Clast/lambda zeta, where Clast is the last observed concentration ≥ lower limit of quantitation at time tlast. All these parameters were calculated by the linear trapezoidal rule.
    Time Frame At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)

    Outcome Measure Data

    Analysis Population Description
    The PK Population consisted of patients who received at least one dose of reparixin and had at least one valid, quantifiable PK parameter. This population was used for PK analyses.
    Arm/Group Title Treated Patients - Total
    Arm/Group Description Patients eligible will be treated with Reparixin as add-in monotherapy Reparixin: 1000 mg Oral Reparixin t.i.d. for 21 consecutive days prior to surgery
    Measure Participants 6
    DF1681Y - AUC0-8 - Day 1
    189.357
    (60.2362)
    DF1681Y - AUC0-8 - Day 21
    174.303
    (29.8012)
    DF1681Y unbound- AUC0-8 - Day 1
    222.602
    (128.0328)
    DF1681Y unbound- AUC0-8 - Day 21
    233.382
    (166.0402)
    DF2243Y - AUC0-8 - Day 1
    78.469
    (18.8116)
    DF2243Y - AUC0-8 - Day 21
    105.001
    (58.2634)
    DF2188Y - AUC0-8 - Day 1
    31.040
    (7.9369)
    DF2188Y - AUC0-8 - Day 21
    33.395
    (13.2129)
    DF1681Y - AUCinf - Day 1
    211.243
    (71.4823)
    DF1681Y - AUCinf - Day 21
    182.479
    (36.1551)
    DF1681Y unbound - AUCinf - Day 1
    235.152
    (180.1547)
    DF1681Y unbound - AUCinf - Day 21
    234.547
    (166.3017)
    DF2243Y - AUCinf - Day 1
    71.297
    (25.6857)
    DF2243Y - AUCinf - Day 21
    129.275
    (74.5406)
    DF2188Y - AUCinf - Day 1
    31.669
    (11.2792)
    DF2188Y - AUCinf - Day 21
    35.092
    (13.9473)
    DF1681Y - AUClast - Day 1
    189.319
    (60.2817)
    DF1681Y - AUClast - Day 21
    172.296
    (28.1847)
    DF1681Y unbound - AUClast - Day 1
    222.078
    (128.1305)
    DF1681Y unbound - AUClast - Day 21
    231.235
    (167.0377)
    DF2243Y - AUClast - Day 1
    76.821
    (17.3033)
    DF2243Y - AUClast - Day 21
    97.360
    (46.6809)
    DF2188Y - AUClast - Day 1
    31.028
    (7.9336)
    DF2188Y - AUClast - Day 21
    35.433
    (12.8434)
    DF1681Y - AUCtau - Day 21
    174.303
    (29.8012)
    DF1681Y unbound - AUCtau - Day 21
    233.382
    (166.0402)
    DF2243Y - AUCtau - Day 21
    105.001
    (58.2634)
    DF2188Y - AUCtau - Day 21
    33.395
    (13.2129)
    9. Secondary Outcome
    Title Pharmacokinetics of Reparixin (DF1681Y, DF1681Y Unbound, DF2243Y, DF2188Y) - CL/F (L/h) at Day 1, CLSS/F (L/h) Day 21)
    Description The intent of the PK outcomes was not to compare the results between the two cohorts; for this reason results for the PK outcomes are reported for the whole group of the treated patients. CL/F = Apparent oral clearance - for DF1681Y only, calculated as dose/AUCinf.; calculated only when the coefficient of determination R2 in lambda zeta estimation is at least 0.8 and percent AUC extrapolation is less than or equal to 20%. CLss/F = Steady state apparent oral clearance - for DF1681Y only calculated as dose/AUCtau.
    Time Frame At Days 1 (pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose) and 21(pre-first dose and 0.25, 0.5, 1, 2, 4, 6, 8h post dose)

    Outcome Measure Data

    Analysis Population Description
    The PK Population consisted of patients who received at least one dose of reparixin and had at least one valid, quantifiable PK parameter. This population was used for PK analyses.
    Arm/Group Title Treated Patients - Total
    Arm/Group Description Patients eligible will be treated with Reparixin as add-in monotherapy Reparixin: 1000 mg Oral Reparixin t.i.d. for 21 consecutive days prior to surgery
    Measure Participants 6
    DF1681Y - CL/F - Day 1
    5.173
    (1.7466)
    DF1681Y - CLSS/F - Day 21
    5.866
    (0.9086)
    DF1681Y unbound - CL/F - Day 1
    7156.189
    (6334.8463)
    DF1681Y unbound - CLSS/F - Day 21
    5604.781
    (2335.8016)
    10. Secondary Outcome
    Title Change From Baseline to Day 21 in Leukocytes Subsets
    Description The Leukocytes subsets analyzed are the following: Lymphocyte in WBC, Total T cell in lymphocytes, B cells in lymphocytes, T-helper cell in lymphocytes, CTL in lymphocytes, NKT cell in lymphocytes, ADCC NK subsets in lymphocytes, Regulatory NK subsets in lymphocytes, Exhausted NK subsets in lymphocytes, CD56-CD16+ NK subsets in lymphocytes, CD11b in PMNs - IL-8, CD18 in PMNs - IL-8, MFI of CD11b - IL-8, MFI of CD66b - IL-8, MFI of CD18 - IL-8, CD11b in PMNs - US, CD18 in PMNs - US, MFI of CD11b - US, MFI of CD66b - US, MFI of CD18 - US, Percent Monocytes expressing IL6 - IL-8,Percent Monocytes expressing IL1b - IL-8, Percent Monocytes expressing IL8 - IL-8, Percent Monocytes expressing TNFa - IL-8, Percent Neutrophils expressing IL6 - IL-8, Percent Neutrophils expressing IL1b - IL-8, Percent Neutrophils expressing IL8 - IL-8, Percent Neutrophils expressing TNFa - IL-8,Percent Monocytes expressing IL6 - US,Percent Monocytes expressing IL1b - US, etc.
    Time Frame At Day 21

    Outcome Measure Data

    Analysis Population Description
    The Safety Population included all enrolled patients who took at least one dose of study drug reparixin. This population was used for primary endpoints and safety analysis
    Arm/Group Title ER+ and/or PR+/ HER-2 - ER-/PR-/HER-2-
    Arm/Group Description Patients of Group A (estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)/human epidermal growth factor receptor-2 negative (HER-2-)) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack. Patients of Group B (estrogen receptor negative (ER-)/progesterone receptor negative (PR-)/HER-2-) were given Reparixin 1000 mg (two 500 mg tablets) for 21 consecutive days. Reparixin was administered orally, every six to eight hours t.i.d. preferably with food. However, if the patient was unable to eat, reparixin could still be administered. Reparixin was administered with about 250 mL water and a light meal or snack.
    Measure Participants 16 1
    Lymphocyte in WBC
    -2.51
    (9.099)
    -3.70
    (NA)
    Total T cell in lymphocytes
    1.28
    (4.602)
    -2.80
    (NA)
    B cell in lymphocytes
    2.678
    (7.5565)
    43.190
    (NA)
    T-helper cell in lymphocytes
    -1.44
    (5.158)
    -24.90
    (NA)
    CTL in lymphocytes
    -0.639
    (5.5106)
    -24.100
    (NA)
    NKT cell in lymphocytes
    0.510
    (1.5759)
    0.140
    (NA)
    ADCC NK subsets in lymphocytes
    0.727
    (4.1787)
    1.430
    (NA)
    Regulatory NK subsets in lymphocytes
    -1.358
    (3.2465)
    0.370
    (NA)
    Exhausted NK subsets in lymphocytes
    -0.177
    (1.7006)
    -0.170
    (NA)
    CD56-CD16+ NK subsets in lymphocytes
    0.708
    (1.6772)
    0.310
    (NA)
    CD11b in PMNs - IL-8
    -1.48
    (4.877)
    -11.60
    (NA)
    CD18 in PMNs - IL-8
    -0.23
    (4.104)
    2.10
    (NA)
    MFI of CD11b - IL-8
    -1.63
    (2.205)
    3.50
    (NA)
    MFI of CD66b - IL-8
    -3.9
    (507.79)
    -929.0
    (NA)
    MFI of CD18 - IL-8
    -13.0
    (495.89)
    71.0
    (NA)
    CD11b in PMNs - US
    1.56
    (9.515)
    -4.20
    (NA)
    CD18 in PMNs - US
    -5.758
    (23.7696)
    -0.400
    (NA)
    MFI of CD11b - US
    -0.84
    (1.571)
    -0.30
    (NA)
    MFI of CD66b - US
    35.1
    (536.54)
    -757.0
    (NA)
    MFI of CD18 - US
    -105.64
    (679.547)
    -47.00
    (NA)
    Percent Monocytes expressing IL6 - IL-8
    8.40590
    (27.654326)
    0.52600
    (NA)
    Percent Monocytes expressing IL1b - IL-8
    8.27479
    (24.364503)
    0.32600
    (NA)
    Percent Monocytes expressing IL8 - IL-8
    -0.35947
    (3.983235)
    -0.04400
    (NA)
    Percent Monocytes expressing TNFa - IL-8
    0.40504
    (1.906309)
    -0.39900
    (NA)
    Percent Neutrophils expressing IL6 - IL-8
    2.83019
    (26.145843)
    0.36340
    (NA)
    Percent Neutrophils expressing IL1b - IL-8
    10.24530
    (32.068081)
    0.33400
    (NA)
    Percent Neutrophils expressing IL8 - IL-8
    0.04596
    (1.667000)
    0.05742
    (NA)
    Percent Neutrophils expressing TNFa - IL-8
    0.35635
    (2.269023)
    0.03500
    (NA)
    Percent Monocytes expressing IL6 - US
    9.77675
    (29.705447)
    0.26500
    (NA)
    Percent Monocytes expressing IL1b - US
    5.58031
    (28.862940)
    1.03400
    (NA)
    Percent Monocytes expressing IL8 - US
    0.14087
    (2.716051)
    -0.27600
    (NA)
    Percent Monocytes expressing TNFa - US
    -0.11532
    (1.333406)
    0.28200
    (NA)
    Percent Neutrophils expressing IL6 - US
    5.50297
    (21.932274)
    0.59260
    (NA)
    Percent Neutrophils expressing IL1b - US
    9.28329
    (33.754437)
    1.36450
    (NA)
    Percent Neutrophils expressing IL8 - US
    0.45567
    (2.053990)
    0.15020
    (NA)
    Percent Neutrophils expressing TNFa - US
    0.46929
    (2.876200)
    0.54910
    (NA)
    Percent Monocytes expressing IL6 - LPS
    -0.23
    (8.015)
    -9.60
    (NA)
    Percent Monocytes expressing IL1b - LPS
    -5.18
    (18.237)
    27.80
    (NA)
    Percent Monocytes expressing IL8 - LPS
    -4.2057
    (21.72201)
    -74.3700
    (NA)
    Percent Monocytes expressing TNFa - LPS
    -3.145
    (8.8075)
    -56.400
    (NA)
    Percent Neutrophils expressing IL6 - LPS
    -2.0310
    (4.60857)
    72.3690
    (NA)
    Percent Neutrophils expressing IL1b - LPS
    -1.68086
    (5.470114)
    78.19200
    (NA)
    Percent Neutrophils expressing IL8 - LPS
    0.14986
    (1.844687)
    1.18700
    (NA)
    Percent Neutrophils expressing TNFa - LPS
    0.1497
    (1.97537)
    1.7720
    (NA)
    Percent Monocytes expressing IL6 - LPS+IL-8
    -3.42
    (6.783)
    1.20
    (NA)
    Percent Monocytes expressing IL1b - LPS+IL-8
    -4.79
    (14.168)
    25.90
    (NA)
    Percent Monocytes expressing IL8 - LPS+IL-8
    -7.738
    (12.9421)
    -76.990
    (NA)
    Percent Monocytes expressing TNFa - LPS+IL-8
    -0.3018
    (9.97119)
    -57.9100
    (NA)
    Percent Neutrophils expressing IL6 - LPS+IL-8
    1.2629
    (20.77484)
    62.7900
    (NA)
    Percent Neutrophils expressing IL1b - LPS+IL-8
    0.1980
    (27.96300)
    81.6290
    (NA)
    Percent Neutrophils expressing IL8 - LPS+IL-8
    0.0348
    (1.81583)
    1.0010
    (NA)
    Percent Neutrophils expressing TNFa - LPS+IL-8
    -0.0349
    (1.75308)
    2.6490
    (NA)
    Percent FITC eColi Control
    4.327
    (7.7795)
    -8.500
    (NA)
    Percent FITC eColi Test
    -1.056
    (3.6456)
    -4.200
    (NA)
    Percent PMNs unstimulated
    -5.025
    (16.3554)
    28.690
    (NA)
    Percent PMNs fMLP
    9.152
    (18.2092)
    23.300
    (NA)
    Percent L-selectin unstimulated
    4.341
    (25.8071)
    -25.000
    (NA)
    Percent L-selectin fMLP
    -0.2845
    (0.95877)
    -0.2460
    (NA)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Lymphocyte in WBC
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.6168
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Total T cell in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.6168
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments B cell in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1453
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments T-helper cell in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1453
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CTL in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1453
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments NKT cell in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 7
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments ADCC NK subsets in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.7634
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 8
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Regulatory NK subsets in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.5487
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 9
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Exhausted NK subsets in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 10
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CD56-CD16+ NK subsets in lymphocytes
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 11
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CD11b in PMNs - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1451
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 12
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CD18 in PMNs - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2779
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 13
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments MFI of CD11b - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1444
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 14
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments MFI of CD66b - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1453
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 15
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments MFI of CD18 - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.9200
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 16
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CD11b in PMNs - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2779
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 17
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments CD18 in PMNs - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.6164
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 18
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments MFI of CD11b - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 19
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments MFI of CD66b - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2032
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 20
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments MFI of CD18 - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 21
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL6 - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.5250
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 22
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL1b - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.6706
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 23
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL8 - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.8312
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 24
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing TNFa - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3992
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 25
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL6 - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2952
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 26
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL1b - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3992
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 27
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL8 - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2952
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 28
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing TNFa - IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.5250
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 29
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL6 - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3992
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 30
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL1b - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2952
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 31
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL8 - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value >0.9999
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 32
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing TNFa - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3992
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 33
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL6 - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3992
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 34
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL1b - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2952
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 35
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL8 - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3992
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 36
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing TNFa - US
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2952
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 37
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL6 - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2238
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 38
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL1b - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2238
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 39
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL8 - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1543
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 40
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing TNFa - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1547
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 41
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL6 - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1547
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 42
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL1b - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1547
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 43
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL8 - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.4314
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 44
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing TNFa - LPS
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3153
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 45
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL6 - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.4700
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 46
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL1b - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1605
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 47
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing IL8 - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1605
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 48
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Monocytes expressing TNFa - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1605
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 49
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL6 - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1547
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 50
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL1b - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1547
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 51
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing IL8 - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3153
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 52
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent Neutrophils expressing TNFa - LPS+IL-8
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1543
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 53
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent FITC eColi Control
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1601
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 54
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent FITC eColi Test
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.2368
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 55
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent PMNs unstimulated
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1605
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 56
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent PMNs fMLP
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.4700
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 57
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent L-selectin unstimulated
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.3392
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments
    Statistical Analysis 58
    Statistical Analysis Overview Comparison Group Selection ER+ and/or PR+/ HER-2 -, ER-/PR-/HER-2-
    Comments Percent L-selectin fMLP
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value 0.8080
    Comments P-Value is based on two-sample t-test or Wilcoxon Rank-Sum test, where appropriate, comparing the 2 study groups.
    Method t-test, 2 sided
    Comments

    Adverse Events

    Time Frame throughout the study and at OTV (off treatment visit) up to the 30 days after the last dose of reparixin
    Adverse Event Reporting Description
    Arm/Group Title Total
    Arm/Group Description This represents the total safety population of 20 patients
    All Cause Mortality
    Total
    Affected / at Risk (%) # Events
    Total 0/20 (0%)
    Serious Adverse Events
    Total
    Affected / at Risk (%) # Events
    Total 1/20 (5%)
    Infections and infestations
    POSTOPERATIVE WOUND INFECTION 1/20 (5%) 1
    Other (Not Including Serious) Adverse Events
    Total
    Affected / at Risk (%) # Events
    Total 15/20 (75%)
    Blood and lymphatic system disorders
    Anaemia 1/20 (5%)
    Congenital, familial and genetic disorders
    Epidermolysis 1/20 (5%)
    Eye disorders
    Vision blurred 1/20 (5%)
    Gastrointestinal disorders
    Nausea 5/20 (25%)
    Abdominal pain 2/20 (10%)
    Constipation 2/20 (10%)
    Flatulence 2/20 (10%)
    Vomiting 2/20 (10%)
    Abdominal discomfort 1/20 (5%)
    Abdominal distension 1/20 (5%)
    Diarrhoea 1/20 (5%)
    Dry mouth 1/20 (5%)
    Dyspepsia 1/20 (5%)
    General disorders
    Fatigue 8/20 (40%)
    Pain 2/20 (10%)
    Oedema peripheral 1/20 (5%)
    Infections and infestations
    Eye infection 1/20 (5%)
    Infection 1/20 (5%)
    Injury, poisoning and procedural complications
    Procedural pain 5/20 (25%)
    Incision site haemorrhage 1/20 (5%)
    Incision site pain 1/20 (5%)
    Post procedural haematoma 1/20 (5%)
    Investigations
    Aspartate aminotransferase increased 1/20 (5%)
    Blood alkaline phosphatase increased 1/20 (5%)
    Metabolism and nutrition disorders
    Decreased appetite 1/20 (5%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Melanocytic naevus 1/20 (5%)
    Nervous system disorders
    Headache 3/20 (15%)
    Dizziness 2/20 (10%)
    Paraesthesia 2/20 (10%)
    Pheripheral sensory neuropathy 1/20 (5%)
    Psychiatric disorders
    Insomnia 3/20 (15%)
    Anxiety 1/20 (5%)
    Mood swings 1/20 (5%)
    Reproductive system and breast disorders
    Breast mass 1/20 (5%)
    Breast pain 1/20 (5%)
    Pelvic pain 1/20 (5%)
    Respiratory, thoracic and mediastinal disorders
    Cough 1/20 (5%)
    nasal congestion 1/20 (5%)
    Skin and subcutaneous tissue disorders
    Rash 2/20 (10%)
    Petechiae 1/20 (5%)
    Pruritus 1/20 (5%)
    Rash macular 1/20 (5%)
    Vascular disorders
    Hot flush 1/20 (5%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Pier Adelchi Ruffini, MD
    Organization Dompé Farmaceutici
    Phone +39 (0)2 583831
    Email info@dompe.it
    Responsible Party:
    Dompé Farmaceutici S.p.A
    ClinicalTrials.gov Identifier:
    NCT01861054
    Other Study ID Numbers:
    • REP0210
    First Posted:
    May 23, 2013
    Last Update Posted:
    May 14, 2021
    Last Verified:
    Apr 1, 2021