TY - BOOK AU - Kurian, Shweta AU - Mohebtash, Mahsa AU - Ottaviano, Yvonne AU - Rao, Suman AU - Swain, Sandra M TI - HALT-D: a randomized open-label phase II study of crofelemer for the prevention of chemotherapy-induced diarrhea in patients with HER2-positive breast cancer receiving trastuzumab, pertuzumab, and a taxane SN - 0167-6806 PY - 2022/// KW - *Antineoplastic Agents KW - *Breast Neoplasms KW - Antineoplastic Agents/tu [Therapeutic Use] KW - Antineoplastic Combined Chemotherapy Protocols/ae [Adverse Effects] KW - Breast Neoplasms/et [Etiology] KW - Diarrhea/ci [Chemically Induced] KW - Diarrhea/pc [Prevention & Control] KW - Docetaxel/ae [Adverse Effects] KW - Female KW - Humans KW - Paclitaxel KW - Quality of Life KW - Receptor, ErbB-2 KW - Taxoids KW - Trastuzumab KW - MedStar Franklin Square Medical Center KW - Associate Dean for Research Development KW - Hematology/Oncology KW - MedStar Health KW - Clinical Trial, Phase II KW - Journal Article KW - Randomized Controlled Trial N1 - Available online from MWHC library: 1997 - present N2 - CONCLUSION: Despite the choice of primary endpoint being insensitive, crofelemer reduced the incidence and severity of CID in patients with HER2-positive breast cancer receiving P-based therapy. These data are supportive of further testing of crofelemer in CID; METHODS: Patients scheduled to receive >= 3 consecutive TCHP/THP cycles were randomized to crofelemer 125 mg orally twice daily during chemotherapy cycles 1 and 2 or no scheduled prophylactic medication (control). All received standard breakthrough antidiarrheal medication (BTAD) as needed. The primary endpoint was incidence of any-grade CID for >= 2 consecutive days. Secondary endpoints were incidence of all-grade and grade 3/4 CID by cycle/stratum; time to onset and duration of CID; stool consistency; use of BTAD; and quality of life (Functional Assessment of Chronic Illness Therapy for Patients With Diarrhea [FACIT-D] score); PURPOSE: To assess whether crofelemer would prevent chemotherapy-induced diarrhea (CID) diarrhea in patients with HER2-positive, any-stage breast cancer receiving trastuzumab (H), pertuzumab (P), and a taxane (T; docetaxel or paclitaxel), with/without carboplatin (C; always combined with docetaxel rather than paclitaxel); RESULTS: Fifty-one patients were randomized to crofelemer (n = 26) or control (n = 25). There was no statistically significant difference between arms for the primary endpoint; however, incidence of grade >= 2 CID was reduced with crofelemer vs control (19.2% vs 24.0% in cycle 1; 8.0% vs 39.1%, in cycle 2). Patients receiving crofelemer were 1.8 times more likely to see their diarrhea resolved and had less frequent watery diarrhea; TRIAL REGISTRATION: Clinicaltrials.gov, NCT02910219, prospectively registered September 21, 2016. Copyright © 2022. The Author(s) UR - https://dx.doi.org/10.1007/s10549-022-06743-9 ER -