APF530 or Aloxi (Palonosetron Hydrochloride) Combined With Dexamethasone in Preventing Nausea and Vomiting in Patients Receiving Chemotherapy for Cancer

NCT ID: NCT00343460

Last Updated: 2017-02-23

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1428 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-06-30

Study Completion Date

2009-02-28

Brief Summary

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This randomized phase III trial is studying APF530 and dexamethasone to see how well they work compared with palonosetron and dexamethasone in preventing nausea and vomiting in patients receiving chemotherapy for cancer.

Detailed Description

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OBJECTIVES:

Primary

* Compare the overall activity and effects of APF530 versus palonosetron hydrochloride in combination with dexamethasone for prophylaxis of acute- or delayed-onset, chemotherapy-induced nausea and vomiting in patients undergoing moderately or highly emetogenic chemotherapy for cancer.

Secondary

* Evaluate the safety, tolerability, and efficacy of APF530, in terms of prevention of acute- and delayed-onset nausea and vomiting, in these patients.
* Gather the pharmacokinetics of APF530 in a subset of patients during chemotherapy course 1.
* Gather ECG data (using 24-hour Holter monitoring) in a subset of patients during chemotherapy course 1.

OUTLINE: This is a randomized, placebo-controlled, double-blind, parallel-group, multicenter study. Patients are stratified according to emetogenicity of scheduled chemotherapy (moderate-risk \[level 3 or 4\] vs high-risk \[level 5\]). Patients are randomized to 1 of 3 treatment arms (I, II, and III). Patients who are randomized to receive palonosetron hydrochloride during chemotherapy course 1 (arm I) are then re-randomized to 1 of 2 treatment arms (II and III) after chemotherapy course 1 to receive treatment during chemotherapy courses 2-4.

Patients receive palonosetron hydrochloride or APF530 and/or placebo 30-60 minutes before the start of chemotherapy. Patients receive dexamethasone 30-90 minutes before the start of chemotherapy.

* Arm I: Patients receive palonosetron hydrochloride IV, placebo subcutaneously (SC), and dexamethasone IV on day 1 of chemotherapy course 1. Patients in the high-risk (level 5) stratum also receive oral dexamethasone on days 2-4 of all treatment courses.
* Arm II: Patients receive APF530 SC, placebo IV, and dexamethasone IV on day 1 of chemotherapy course 1. Patients then receive APF530 SC and dexamethasone IV on day 1 of chemotherapy courses 2-4. Patients in the high-risk (level 5) stratum also receive oral dexamethasone as in arm I.
* Arm III: Patients receive APF530 SC at a higher dose, placebo IV, and dexamethasone IV on day 1 of chemotherapy course 1. Patients then receive APF530 SC (at the same higher dose) and dexamethasone IV on day 1 of chemotherapy courses 2-4. Patients in the high-risk (level 5) stratum also receive oral dexamethasone as in arm I.

A subset of patients undergo blood collection periodically during study for analysis of plasma APF530 concentration.

Quality of life is assessed on day 5 after completion of chemotherapy course 1.

After completion of study treatment, patients are followed at approximately 30 days.

Conditions

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Nausea and Vomiting Unspecified Adult Solid Tumor, Protocol Specific

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Arm I

Patients receive palonosetron hydrochloride IV, placebo subcutaneously (SC), and dexamethasone IV on day 1 of chemotherapy course 1. Patients in the high-risk (level 5) stratum also receive oral dexamethasone on days 2-4 of all treatment courses.

Group Type ACTIVE_COMPARATOR

dexamethasone

Intervention Type DRUG

Given IV and orally

Palonosetron Hydrochloride

Intervention Type DRUG

Given IV

placebo

Intervention Type OTHER

Given subcutanously or IV

Arm II

Patients receive APF530 SC, placebo IV, and dexamethasone IV on day 1 of chemotherapy course 1. Patients then receive APF530 SC and dexamethasone IV on day 1 of chemotherapy courses 2-4. Patients in the high-risk (level 5) stratum also receive oral dexamethasone as in arm I.

Group Type EXPERIMENTAL

APF530

Intervention Type DRUG

Given subcutanously

dexamethasone

Intervention Type DRUG

Given IV and orally

placebo

Intervention Type OTHER

Given subcutanously or IV

Arm III

Patients receive APF530 SC at a higher dose, placebo IV, and dexamethasone IV on day 1 of chemotherapy course 1. Patients then receive APF530 SC (at the same higher dose) and dexamethasone IV on day 1 of chemotherapy courses 2-4. Patients in the high-risk (level 5) stratum also receive oral dexamethasone as in arm I.

Group Type EXPERIMENTAL

APF530

Intervention Type DRUG

Given subcutanously

dexamethasone

Intervention Type DRUG

Given IV and orally

placebo

Intervention Type OTHER

Given subcutanously or IV

Interventions

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APF530

Given subcutanously

Intervention Type DRUG

dexamethasone

Given IV and orally

Intervention Type DRUG

Palonosetron Hydrochloride

Given IV

Intervention Type DRUG

placebo

Given subcutanously or IV

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed malignant disease

* No head and neck cancer or upper gastrointestinal cancer
* Scheduled to receive a single day of moderately or highly emetogenic chemotherapy regimen (for ≤ 4 courses)

* Chemotherapy administration ≤ 4 hours
* Duration of each course ≤ 28 days
* Causing nausea and vomiting in 30-100% of patients if untreated according to Hesketh algorithm
* Must be able to receive standardized doses of dexamethasone for the prevention of emesis during study treatment
* No greater than mild nausea or any vomiting within 24 hours before beginning study treatment

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No known allergy or hypersensitivity to other selective 5-HT3 receptor antagonists or local anesthetics
* QTc interval ≤ 500 ms
* No cardiac abnormality predisposing the patient to arrhythmia
* No psychological problem that, in the opinion of the investigator, is severe enough to preclude study participation
* No recent history (i.e., ≤ 1 year) of alcohol or drug abuse
* No concurrent condition that, in the opinion of the investigator, could affect assessment of study medication or interfere with the nausea/vomiting response (e.g., severe renal or hepatic impairment)

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* No radiotherapy 7 days prior to, during, and 5 days after completion of study treatment
* More than 7 days since prior chemotherapy
* More than 7 days since prior and no concurrent prohibited medications (e.g., CYP3A4 inhibitors or other antiemetic medications)
* More than 7 days since prior antinausea medications
* More than 30 days since prior treatment on an investigational trial
* No other concurrent corticosteroids or dexamethasone at a different dose than study treatment
* No concurrent use of APF530, palonosetron hydrochloride, or aprepitant as rescue medications
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Heron Therapeutics

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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John Barr, PhD

Role: STUDY_CHAIR

Heron Therapeutics

Locations

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Anniston Oncology, PC

Anniston, Alabama, United States

Site Status

Palo Verde Hematology Oncology - Glendale

Glendale, Arizona, United States

Site Status

Arizona Clinical Research Center, Incorporated

Tucson, Arizona, United States

Site Status

Arkansas Cancer Research Center at University of Arkansas for Medical Sciences

Little Rock, Arkansas, United States

Site Status

Pacific Cancer Medical Center, Incorporated

Anaheim, California, United States

Site Status

Southbay Oncology / Hematology Medical Group

Campbell, California, United States

Site Status

Compassionate Cancer Care Medical Group Incorporated - Corona

Corona, California, United States

Site Status

Compassionate Cancer Care Medical Group Incorporated - Fountain Valley

Fountain Valley, California, United States

Site Status

Advanced Research Management Services, Incorporated

Los Angeles, California, United States

Site Status

Kenmar Research Institute

Los Angeles, California, United States

Site Status

Medical Oncology Care Associates - Orange

Orange, California, United States

Site Status

Eastern Connecticut Hematology and Oncology Associates

Norwich, Connecticut, United States

Site Status

Providence Hospital

Washington D.C., District of Columbia, United States

Site Status

Pasco Pinellas Cancer Center - New Port Richey

New Port Richey, Florida, United States

Site Status

Innovative Medical Research of South Florida, Incorporated

North Miami Beach, Florida, United States

Site Status

Columbus Clinic, PC

Columbus, Georgia, United States

Site Status

Clintell, Incorporated

Skokie, Illinois, United States

Site Status

Investigative Clinical Research, LLC

Indianapolis, Indiana, United States

Site Status

Cancer Center of Indiana

New Albany, Indiana, United States

Site Status

Family Medicine of Vincennes Clinical Trial Center

Vincennes, Indiana, United States

Site Status

Medical Center Vincennes

Vincennes, Indiana, United States

Site Status

Kentucky Cancer Clinic - Hazard

Hazard, Kentucky, United States

Site Status

Kentuckiana Cancer Institute, PLLC

Louisville, Kentucky, United States

Site Status

Hematology-Medical Oncology Associates at Central Maine Comprehensive Cancer Center

Lewiston, Maine, United States

Site Status

Mercy Medical Center

Baltimore, Maryland, United States

Site Status

Center for Cancer and Blood Disorders at Suburban Hospital

Bethesda, Maryland, United States

Site Status

Center for Clinical Research at Washington County Hospital

Hagerstown, Maryland, United States

Site Status

Northern Michigan Hospital

Petoskey, Michigan, United States

Site Status

Regional Cancer Center at Singing River Hospital

Pascagoula, Mississippi, United States

Site Status

Kansas City Cancer Centers - South

Kansas City, Missouri, United States

Site Status

Star Hematology & Oncology

Phillipsburg, New Jersey, United States

Site Status

Veterans Affairs Medical Center - Buffalo

Buffalo, New York, United States

Site Status

Falck Cancer Center at Arnot Ogden Medical Center

Elmira, New York, United States

Site Status

Hudson Valley Hematology-Oncology Associates - Poughkeepsie

Poughkeepsie, New York, United States

Site Status

Comprehensive Cancer Center at Pardee Hospital

Hendersonville, North Carolina, United States

Site Status

Boice Willis Clinic, PA

Rocky Mount, North Carolina, United States

Site Status

Eastern North Carolina Medical Group, PLLC

Rocky Mount, North Carolina, United States

Site Status

McDowell Cancer Center at Akron General Medical Center

Akron, Ohio, United States

Site Status

Gabrail Cancer Center - Canton Office

Canton, Ohio, United States

Site Status

Gabrail Cancer Center - Dover Office

Dover, Ohio, United States

Site Status

MedCentral - Mansfield Hospital

Mansfield, Ohio, United States

Site Status

Signal Point Hematology Oncology Incorporated

Middletown, Ohio, United States

Site Status

Cancer Treatment Centers of America at Southwestern Regional Medical Center

Tulsa, Oklahoma, United States

Site Status

Pottsville Cancer Clinic

Pottsville, Pennsylvania, United States

Site Status

Charleston Hematology Oncology Associates, PA

Charleston, South Carolina, United States

Site Status

Julie and Ben Rogers Cancer Institute at Memorial Hermann Baptist Beaumont Hospital

Beaumont, Texas, United States

Site Status

Texas Cancer Clinic

San Antonio, Texas, United States

Site Status

Cancer Outreach Associates - Abingdon

Abingdon, Virginia, United States

Site Status

Virginia Oncology Care, PC

Richlands, Virginia, United States

Site Status

Western Washington Oncology, Incorporated, PS at Western Washington Cancer Center

Lacey, Washington, United States

Site Status

MultiCare Regional Cancer Center at Tacoma General Hospital

Tacoma, Washington, United States

Site Status

Mary Babb Randolph Cancer Center at West Virginia University Hospitals

Morgantown, West Virginia, United States

Site Status

Countries

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United States

References

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Boccia R, O'Boyle E, Cooper W. Randomized phase III trial of APF530 versus palonosetron in the prevention of chemotherapy-induced nausea and vomiting in a subset of patients with breast cancer receiving moderately or highly emetogenic chemotherapy. BMC Cancer. 2016 Feb 26;16:166. doi: 10.1186/s12885-016-2186-4.

Reference Type DERIVED
PMID: 26921245 (View on PubMed)

Raftopoulos H, Boccia R, Cooper W, O'Boyle E, Gralla RJ. Slow-release granisetron (APF530) versus palonosetron for chemotherapy-induced nausea/vomiting: analysis by American Society of Clinical Oncology emetogenicity criteria. Future Oncol. 2015 Sep;11(18):2541-51. doi: 10.2217/fon.15.185. Epub 2015 Aug 20.

Reference Type DERIVED
PMID: 26289588 (View on PubMed)

Other Identifiers

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APPA-C2006-01

Identifier Type: -

Identifier Source: secondary_id

C2006-01

Identifier Type: -

Identifier Source: org_study_id

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