Fosaprepitant Dimeglumine in Treating Patients With Nausea and Vomiting Caused By Chemotherapy

This study has been terminated.
(Drug contract timelines and inadequate enrollment)
Sponsor:
Collaborator:
Information provided by (Responsible Party):
OHSU Knight Cancer Institute
ClinicalTrials.gov Identifier:
NCT01031953
First received: December 13, 2009
Last updated: February 3, 2014
Last verified: February 2014

December 13, 2009
February 3, 2014
August 2008
February 2013   (final data collection date for primary outcome measure)
Improvement in Nausea Score From Baseline to 2 Hours as Assessed by the Numerical Visual Analogue Scale [ Time Frame: Baseline to 2 hours after study drug administered. ] [ Designated as safety issue: No ]
The outcome measure is the number of participants that self report improvement in a nausea score from baseline, prior to fosaprepitant, to 2 hours post dose. This includes only participants who report breakthrough nausea or vomiting after chemotherapy and after receiving prophylactic anti-emetics. The primary outcome is measured using the visual analogue scale, a self report scale from "No Nausea" to "Nausea as bad as it can be"; a value can be indicated anywhere on this scale using a free hand mark by the participant and gauged with ruler by study staff. Any participant that reported a lower value on the scale 2 hours from baseline would be considered in this outcome measure.
Improvement in nausea score from baseline to 2 hours as assessed by the numerical VAS scale [ Designated as safety issue: No ]
Complete list of historical versions of study NCT01031953 on ClinicalTrials.gov Archive Site
  • Improvement in Nausea Score From Baseline to 12 Hours [ Time Frame: Baseline to 12 hours after study drug administered. ] [ Designated as safety issue: No ]
    The outcome measure is the number of participants that self report improvement in a nausea score from baseline, prior to fosaprepitant, to 12 hours post dose. This includes only participants who report breakthrough nausea or vomiting after chemotherapy and after receiving prophylactic anti-emetics. The primary outcome is measured using the visual analogue scale, a self report scale from "No Nausea" to "Nausea as bad as it can be"; a value can be indicated anywhere on this scale using a free hand mark by the participant and gauged with ruler by study staff. Any participant that reported a lower value on the scale 12 hours from baseline would be considered in this outcome measure.
  • Improvement in Nausea Score From 2 Hours to 24 Hours [ Time Frame: 2 hours to 24 hours after study drug administered. ] [ Designated as safety issue: No ]
    The outcome measure is the number of participants that self report improvement in a nausea score from 2 hours after receiving fosaprepitant to 24 hours post dose. This includes only participants who report breakthrough nausea or vomiting after chemotherapy and after receiving prophylactic anti-emetics. The outcome is measured using the visual analogue scale, a self report scale from "No Nausea" to "Nausea as bad as it can be"; a value can be indicated anywhere on this scale using a free hand mark by the participant and gauged with ruler by study staff. Any participant reporting a lower value on the scale at the 12 or 24 hour time point would be considered in this outcome measure.
  • Number of Participants Who Experienced Vomiting Episodes From Baseline to 24 Hours [ Time Frame: Baseline to 24 hours after study drug administered. ] [ Designated as safety issue: No ]
    Participants were asked to report any episodes of vomiting before (baseline) and up to 24 hours after receiving Fosaprepitant. The outcome considers the number of participants reporting any episodes of emesis after receiving Fosaprepitant.
  • Participants Who Required the Use of Second Rescue Drug (Time to Treatment Failure) [ Time Frame: 2 hours after administration of Fosaprepitant 150 mg IV ] [ Designated as safety issue: No ]
    Participants with persistent nausea/vomiting after 2 hours and who desired further treatment, received standard rescue therapy at the discretion of provider with prochlorperazine, metoclopramide or haloperidol with or without additional lorazepam until relief
  • Participants Achieving a Complete Response (no Emesis, no Additional Rescue Medication Required) [ Time Frame: up to 24 hours after receiving fosaprepitant ] [ Designated as safety issue: No ]
    The recommended dose Fosaprepitant (MK-0517) is 115 mg administered intravenously 30 minutes before chemotherapy treatment. In this study, a 150 mg dose will be given to study patients as rescue therapy after chemotherapy only in the event of breakthrough nausea or vomiting. Those participants who did not report episodes of emesis or did not require additional rescue medications are measured in this outcome
  • Participants With Increased Fatigue or Sedation Within 24 Hours After Receiving Fosaprepitant [ Time Frame: up to 24 hours after study drug administered. ] [ Designated as safety issue: No ]
    Participants meeting this outcome self report experiencing drowsiness at any of the study time points (2, 12 or 24 hours after receiving fosaprepitant).
  • Participants With Specific Side Effects, Including Pain Sensation/Soreness at the Infusion Site, Headache, and Dizziness [ Time Frame: up to 24 hours after study drug administered. ] [ Designated as safety issue: Yes ]
    Participants who self report pain/soreness at drug infusion site, headache, or dizziness at any of the study time points (2, 12, or 24 hours after receiving fosaprepitant) are measured in this outcome.
  • Change in nausea score from baseline to 12 hours [ Designated as safety issue: No ]
  • Change in nausea score from 2 hours to 12 and 24 hours [ Designated as safety issue: No ]
  • Change in quality-of-life score from baseline to 24 hours [ Designated as safety issue: No ]
  • Number of vomiting episodes from baseline to 2, 12, and 24 hours [ Designated as safety issue: No ]
  • Time until use of second rescue drug (time to treatment failure) [ Designated as safety issue: No ]
  • Percentage of patients achieving a complete response (no emesis, no additional rescue medication required) [ Designated as safety issue: No ]
  • Percentage of patients with increased fatigue or sedation at 2, 12, and 24 hours [ Designated as safety issue: No ]
  • Percentage of patients with specific side effects, including pain sensation/soreness at the infusion site, headache, and dizziness [ Designated as safety issue: Yes ]
Not Provided
Not Provided
 
Fosaprepitant Dimeglumine in Treating Patients With Nausea and Vomiting Caused By Chemotherapy
Pilot Study of Fosaprepitant (MK-0517) for Breakthrough Chemotherapy Induced Nausea and Vomiting

RATIONALE: Antiemetic drugs, such as fosaprepitant dimeglumine, may help lessen or prevent nausea and vomiting in patients treated with chemotherapy.

PURPOSE: This clinical trial is studying the side effects of fosaprepitant dimeglumine and to see how well it works in treating patients with nausea and vomiting caused by chemotherapy.

OBJECTIVES:

Primary

  • To evaluate the efficacy and safety of fosaprepitant dimeglumine in patients with breakthrough chemotherapy-induced nausea and vomiting (CINV) after failing prophylactic antiemetic therapy.

Secondary

  • To evaluate toxicity and serious adverse events associated with this regimen in these patients.
  • To evaluate the ability of patients to tolerate oral intake.
  • To evaluate the health-related quality of life of patients treated with this regimen.
  • To evaluate specific side effects associated with this regimen, including pain sensation and/or soreness at the infusion site, headache, dizziness, and somnolence, in these patients .
  • To refine the study design for future phase II and III studies of rescue therapy for breakthrough CINV using various secondary endpoints.

OUTLINE: Patients receive chemotherapy in combination with a pre-defined standard 5-Hydroxytryptamine-3 (5-HT3) antagonist or corticosteroid regimen with or without a benzodiazepine on day 1. If breakthrough nausea or vomiting occurs, patients then receive fosaprepitant dimeglumine IV once per standard administration guidelines. Patients with treatment response may receive additional doses of oral aprepitant once on days 2 and 3. Patients with persistent nausea/vomiting after 2 hours and who desire further treatment may receive standard rescue therapy with prochlorperazine, metoclopramide, or haloperidol with or without additional lorazepam until relief, at the discretion of the provider.

Patients complete a diary at baseline, and then at 2, 12, and 24 hours that includes a Visual Analogue Scale (VAS) for nausea; VAS for sedation; and questions about emesis and retching frequency, headache, dizziness, somnolence, and ability to take food and liquids orally. Patients also complete the Functional Living Index-Emesis Quality of Life survey at baseline and at 24 hours.

Interventional
Phase 1
Phase 2
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Supportive Care
  • Breakthrough Nausea and Vomiting
  • Unspecified Adult Solid Tumor, Protocol Specific
  • Drug: fosaprepitant dimeglumine
    A 150 mg dose will be given to study patients as rescue therapy after chemotherapy only in the event of breakthrough nausea or vomiting.
  • Drug: systemic chemotherapy
    Patients will receive chemotherapy on Day 1 of their scheduled therapeutic regimen in combination with the pre-defined standard 5-Hydroxytryptamine-3 (5HT3) antagonist, corticosteroid regimen, with or without benzodiazepine based on published guidelines3 or as clinically indicated
  • Other: survey administration
    Prior to the first dose of chemotherapy patients will be instructed on how to complete their patient diary
  • Procedure: quality-of-life assessment
    Patients will also be provided the Functional Living Index - Emesis (FLIE) quality of life survey to be completed at time zero and then after 24 hours
Experimental: Fosaprepitant
Interventions:
  • Drug: fosaprepitant dimeglumine
  • Drug: systemic chemotherapy
  • Other: survey administration
  • Procedure: quality-of-life assessment
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Terminated
34
February 2013
February 2013   (final data collection date for primary outcome measure)

DISEASE CHARACTERISTICS:

  • Diagnosis of cancer
  • Scheduled to receive inpatient chemotherapy containing at least moderately emetogenic agents

    • May be given for adjuvant, neoadjuvant, curative, or palliative intent
    • May be given orally, IV, or by continuous infusion on ≥ 1 day
  • Scheduled to receive 5-HT3 receptor antagonist antiemetic (e.g., ondansetron, granisetron, palonosetron, dolasetron mesylate, or dexamethasone with or without a benzodiazepine) on the day of chemotherapy
  • Self-report of at least mild nausea (for which the patient feels needs rescuing) or moderate nausea (a score of ≥ 2 on a 4-point Likert scale) OR has had ≥ 1 episode of emesis since receiving chemotherapy
  • No history of chronic nausea and/or vomiting (without chemotherapy), anticipatory nausea and/or vomiting, or emesis within 24 hours before chemotherapy
  • No symptomatic brain metastases

PATIENT CHARACTERISTICS:

  • Able to understand English
  • Not pregnant or nursing
  • Negative pregnancy test
  • No clinical evidence of current or impending bowel obstruction (i.e., tumor pressing on the bowel)
  • No allergy or intolerance to study drugs

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Prior chemotherapy allowed
  • No aprepitant as prophylaxis or rescue treatment during the current course of chemotherapy (other than as a part of study therapy)
  • Not scheduled to receive a dopamine antagonist after chemotherapy
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01031953
CDR0000612580, P30CA069533, OHSU-HEM-08053-L
Yes
OHSU Knight Cancer Institute
OHSU Knight Cancer Institute
National Cancer Institute (NCI)
Principal Investigator: Joseph Bubalo, PharmD, BCPS, BCOP OHSU Knight Cancer Institute
OHSU Knight Cancer Institute
February 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP