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Mapisal Versus Urea Cream as Prophylaxis for Capecitabine-Associated Hand-Foot Syndrome: A Randomized Phase III Trial of the AIO Quality of Life Working Group.
J Clin Oncol 2015; 33(22):2444-9JC

Abstract

PURPOSE

Hand-foot syndrome (HFS) is a frequently occurring adverse event associated with anticancer drugs. This study compares a newly introduced ointment containing several antioxidants and exhibiting high radical protection factor, which has been available on the German market since 2011, with urea cream for prevention of HFS in patients treated with capecitabine.

PATIENTS AND METHODS

Patients with GI tumors or breast cancer treated with capecitabine were included in this randomized phase III study. The primary end point was prevention of HFS of any grade within 6 weeks of treatment as indicated by a standardized patient diary. The study had 80% power to show a 20% reduction of the incidence of HFS with the new ointment. Secondary end points included time to development of HFS greater than grade 1, evaluation of capecitabine dose intensity, and quality of life analyses.

RESULTS

A total of 152 patients were evaluable. In total, 47 of 152 patients experienced HFS (30.9%), 39.5% with the new ointment and 22.4% in the urea arm (stratified odds ratio, 2.37; P = .02). Time to HFS greater than grade 1 was comparable, but time to any-grade HFS was significantly longer in the urea group (P = .03). Capecitabine dose intensity, time under study, and percentage of days with correct administration of study medication were identical, as were adverse events except for HFS. Skin-related quality of life was significantly worse in the group treated with the new ointment at the end of study treatment.

CONCLUSION

This trial demonstrated that 10% urea cream was superior to the new ointment at preventing HFS over the first 6 weeks of treatment with capecitabine.

Authors+Show Affiliations

Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany Ralf-Dieter.Hofheinz@medma.uni-heidelberg.de.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.Ralf-Dieter Hofheinz and Deniz Gencer, University Hospital Mannheim, Mannheim; Holger Schulz, Praxis Internistische Onkologie und Hämatologie, Frechen; Michael Stahl, Kliniken Essen-Mitte, Essen; Susanna Hegewisch-Becker, Hämatologisch-Onkologische Praxis Eppendorf, Hamburg; Luisa Mantovani Loeffler, Onkologie, Haematologie und Palliativmedizin, Leipzig; Ursula Kronawitter, Onkologische Schwerpunktpraxis, Traunstein; Georg Bolz, Medizinische Klinik I, Ludwigshafen; Jochem Potenberg, Waldkrankenhaus Spandau, Berlin; Felix Tauchert and Salah-Eddin Al-Batran, Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt am Main; and Andreas Schneeweiss, University of Heidelberg, Heidelberg, Germany.

Pub Type(s)

Clinical Trial, Phase III
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26124485

Citation

Hofheinz, Ralf-Dieter, et al. "Mapisal Versus Urea Cream as Prophylaxis for Capecitabine-Associated Hand-Foot Syndrome: a Randomized Phase III Trial of the AIO Quality of Life Working Group." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 33, no. 22, 2015, pp. 2444-9.
Hofheinz RD, Gencer D, Schulz H, et al. Mapisal Versus Urea Cream as Prophylaxis for Capecitabine-Associated Hand-Foot Syndrome: A Randomized Phase III Trial of the AIO Quality of Life Working Group. J Clin Oncol. 2015;33(22):2444-9.
Hofheinz, R. D., Gencer, D., Schulz, H., Stahl, M., Hegewisch-Becker, S., Loeffler, L. M., ... Schneeweiss, A. (2015). Mapisal Versus Urea Cream as Prophylaxis for Capecitabine-Associated Hand-Foot Syndrome: A Randomized Phase III Trial of the AIO Quality of Life Working Group. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 33(22), pp. 2444-9. doi:10.1200/JCO.2014.60.4587.
Hofheinz RD, et al. Mapisal Versus Urea Cream as Prophylaxis for Capecitabine-Associated Hand-Foot Syndrome: a Randomized Phase III Trial of the AIO Quality of Life Working Group. J Clin Oncol. 2015 Aug 1;33(22):2444-9. PubMed PMID: 26124485.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mapisal Versus Urea Cream as Prophylaxis for Capecitabine-Associated Hand-Foot Syndrome: A Randomized Phase III Trial of the AIO Quality of Life Working Group. AU - Hofheinz,Ralf-Dieter, AU - Gencer,Deniz, AU - Schulz,Holger, AU - Stahl,Michael, AU - Hegewisch-Becker,Susanna, AU - Loeffler,Luisa Mantovani, AU - Kronawitter,Ursula, AU - Bolz,Georg, AU - Potenberg,Jochem, AU - Tauchert,Felix, AU - Al-Batran,Salah-Eddin, AU - Schneeweiss,Andreas, Y1 - 2015/06/29/ PY - 2015/7/1/entrez PY - 2015/7/1/pubmed PY - 2015/11/3/medline SP - 2444 EP - 9 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 33 IS - 22 N2 - PURPOSE: Hand-foot syndrome (HFS) is a frequently occurring adverse event associated with anticancer drugs. This study compares a newly introduced ointment containing several antioxidants and exhibiting high radical protection factor, which has been available on the German market since 2011, with urea cream for prevention of HFS in patients treated with capecitabine. PATIENTS AND METHODS: Patients with GI tumors or breast cancer treated with capecitabine were included in this randomized phase III study. The primary end point was prevention of HFS of any grade within 6 weeks of treatment as indicated by a standardized patient diary. The study had 80% power to show a 20% reduction of the incidence of HFS with the new ointment. Secondary end points included time to development of HFS greater than grade 1, evaluation of capecitabine dose intensity, and quality of life analyses. RESULTS: A total of 152 patients were evaluable. In total, 47 of 152 patients experienced HFS (30.9%), 39.5% with the new ointment and 22.4% in the urea arm (stratified odds ratio, 2.37; P = .02). Time to HFS greater than grade 1 was comparable, but time to any-grade HFS was significantly longer in the urea group (P = .03). Capecitabine dose intensity, time under study, and percentage of days with correct administration of study medication were identical, as were adverse events except for HFS. Skin-related quality of life was significantly worse in the group treated with the new ointment at the end of study treatment. CONCLUSION: This trial demonstrated that 10% urea cream was superior to the new ointment at preventing HFS over the first 6 weeks of treatment with capecitabine. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/26124485/Mapisal_Versus_Urea_Cream_as_Prophylaxis_for_Capecitabine_Associated_Hand_Foot_Syndrome:_A_Randomized_Phase_III_Trial_of_the_AIO_Quality_of_Life_Working_Group_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2014.60.4587?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -