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Daptomycin in Treating Neutropenia and Fever in Patients With Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00335478
Recruitment Status : Completed
First Posted : June 12, 2006
Results First Posted : August 9, 2011
Last Update Posted : May 9, 2017
Information provided by (Responsible Party):
Joseph Bubalo, OHSU Knight Cancer Institute

Brief Summary:

RATIONALE: Antibiotics, such as daptomycin, may control neutropenia, fever, and infection in patients with cancer.

PURPOSE: This phase II trial is studying how well daptomycin works in treating neutropenia and fever in patients with cancer.

Condition or disease Intervention/treatment Phase
Fever Sweating Hot Flashes Infection Neutropenia Unspecified Adult Solid Tumor, Protocol Specific Drug: Daptomycin Phase 2

Detailed Description:



  • Assess the response rate to therapy within 72 hours of starting daptomycin in cancer patients with neutropenic fever.


  • Assess the percentage of bacterial cures in patients with documented gram-positive bacterial infections.
  • Assess time to afebrile state.
  • Assess the pharmacokinetic data of daptomycin in neutropenic patients.
  • Document the incidence of breakthrough infections that require a change of therapy or additional agents to clear.
  • Assess the tolerability of daptomycin in neutropenic patients.
  • Assess and document adverse events and toxicity due to daptomycin.

OUTLINE: This is an open-label, pilot study.

Patients first receive standard treatment for gram-negative bacteria for 72 hours. If the patient is still febrile at 72 hours, daptomycin is administered.

Patients receive daptomycin IV over 30 minutes once daily. Patients who are afebrile, not neutropenic (absolute neutrophil count [ANC] > 500/mm³), and have no signs of infection after 72 hours of therapy may discontinue daptomycin. Patients who are afebrile and neutropenic (ANC < 500/mm³) after 72 hours of therapy continue to receive daptomycin until absolute neutrophil count (ANC) > 500/mm³ for 2 consecutive days. Patients who are febrile with or without continued neutropenia (ANC < 500/mm³) after 72 hours of therapy continue to receive daptomycin for up to 10-14 days in the absence of unacceptable toxicity.

PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 54 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Phase II Open Label Pilot Trial of Empiric Daptomycin Treatment for Oncology Patients With Neutropenic Fever
Study Start Date : December 2006
Actual Primary Completion Date : October 2008
Actual Study Completion Date : October 2008

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Fever
Drug Information available for: Daptomycin

Arm Intervention/treatment
Experimental: Daptomycin Drug: Daptomycin
daptomycin 6 mg/kg over 30 minutes every 24 hours until patient is afebrile and ANC is >500 cells/mm^3.
Other Name: Cubicin

Primary Outcome Measures :
  1. Number of Participants Who Became Afebrile Within 72 Hours of Starting Daptomycin. [ Time Frame: Within 72 hours of starting daptomycin ]

    If after 72 hours of daptomycin treatment, the patient is afebrile and has absolute neutrophil count (ANC) >500 cells/mm^3 for 48 hours with no site of infection, negative cultures, and no clinical indications for therapy, the antibiotic regimen will be discontinued.

    Complete Response: Resolution of fever and clinical signs/symptoms of infection.

    Partial Response: Resolution of fever without resolution of clinical signs of infection.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 99 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Diagnosis of cancer
  • Diagnosis of neutropenic fever

    • Temperature > 38.3°C once OR ≥ 38°C twice within 12 hours
    • Absolute neutrophil count < 500/mm^³ and ≥ 1 of the following:

      • Mucositis
      • Concurrent skin or soft tissue infection
      • Indwelling catheter and/or suspected catheter infection
      • Recent quinolone prophylaxis
      • Positive blood cultures for gram-positive cocci before final identification or other documented gram-positive pathogen
      • Colonization with β-lactam resistant gram-positive organisms (commonly the nares or the skin)
      • Hypotension, tachycardia, narrowed pulse pressures, tachypnea, or other signs of cardiovascular compromise
    • Expected duration of neutropenia ≥ 3 days
  • No known infection with daptomycin-resistant organism or gram-negative organism and not yet meeting criteria for the addition of gram-positive antimicrobial therapy
  • No suspected meningitis or osteomyelitis
  • No documented or suspected gram-positive pneumonia
  • No suspected or proven endocarditis


  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Life expectancy ≥ 2 weeks
  • Creatinine clearance ≥ 50 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective double-method contraception
  • No known sensitivity to daptomycin or product excipients
  • No history of or concurrent rhabdomyolysis
  • No HIV positivity
  • No psychiatric disorders that would preclude study compliance
  • No signs or symptoms of myopathy with creatine phosphokinase (CPK) elevation > 1,000 U/L (5 times upper limit of normal [ULN])

    • No CPK elevations > 10 times ULN in patients with no signs or symptoms of myopathy


  • See Disease Characteristics
  • At least 7 days since prior daptomycin or other antibiotic agents covering gram-positive organisms
  • No concurrent hemodialysis or continuous ambulatory peritoneal dialysis
  • No concurrent succinylcholine, ethanol, fludrocortisone, olanzapine, or pioglitazone
  • No concurrent hydroxymethyl glutaryl (HMG) coenzyme A (HMG CoA) reductase inhibitors (e.g., lovastatin, simvastatin, atorvastatin)
  • Concurrent therapy for gram-negative bacterial infection allowed

Information from the National Library of Medicine

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

Please refer to this study by its identifier (NCT number): NCT00335478

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United States, Oregon
OHSU Knight Cancer Institute
Portland, Oregon, United States, 97239
Sponsors and Collaborators
OHSU Knight Cancer Institute
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Principal Investigator: Joseph Bubalo, PharmD OHSU Knight Cancer Institute

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Responsible Party: Joseph Bubalo, PharmD, OHSU Knight Cancer Institute Identifier: NCT00335478     History of Changes
Other Study ID Numbers: CDR0000476568
OHSU-CPC-05052-L ( Other Identifier: OHSU Knight Cancer Institute )
OHSU-1321 ( Other Identifier: OHSU IRB )
CUBIST-OHSU-CPC-05052-L ( Other Identifier: Cubist Pharmaceuticals )
First Posted: June 12, 2006    Key Record Dates
Results First Posted: August 9, 2011
Last Update Posted: May 9, 2017
Last Verified: May 2017

Keywords provided by Joseph Bubalo, OHSU Knight Cancer Institute:
unspecified adult solid tumor, protocol specific
fever, sweats, and hot flashes

Additional relevant MeSH terms:
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Hot Flashes
Body Temperature Changes
Signs and Symptoms
Leukocyte Disorders
Hematologic Diseases
Anti-Bacterial Agents
Anti-Infective Agents