Trial Outcomes & Findings for Multi-day Doses in Prevention of Nausea and Emesis (NCT NCT00600353)

NCT ID: NCT00600353

Last Updated: 2017-03-09

Results Overview

Complete Control (CC) - no emetic episode in 24 hours, no rescue medications and nausea visual scale (NVS) of ≤ 2.5, Complete Emetic Response (CR) - 0 emetic episodes, no rescue medications. Major Emetic Response (MR) - 0 to 2 emetic episodes within 24 hour period with or without rescue medications. Minor Emetic Response (mR) - 3 to 5 emetic episodes within 24 hour period with or without rescue medications. Failure - \>5 emetic episodes within 24 hour period. No Significant Nausea (NSN) - maximum NVS ≤ 5.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

20 participants

Primary outcome timeframe

24 hours after chemotherapy

Results posted on

2017-03-09

Participant Flow

20 patients undergoing Autologous Stem Cell Transplant (ASCT) for multiple myeloma (MM) (n=10) and relapsed lymphoma (n=10) at the University of Kansas Medical Center were enrolled. 2 patients were excluded from analysis - both patients met exclusion criteria

Emetic responses were assessed by daily patient diaries and the Multinational Association for Supportive Care in Cancer Antiemetic Tool (MAT). Nausea was measured using a Nausea Visual Score (NVS) of 0 to 10 with score of 0 having no nausea. A "modified" Osoba module was used to assess quality of life (QOL).

Participant milestones

Participant milestones
Measure
Group A - Subjects With Multiple Myeloma
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion
Group B - Subjects With Relpased Lymphoma
Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * carmustin (BCNU) 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Overall Study
STARTED
10
10
Overall Study
COMPLETED
9
9
Overall Study
NOT COMPLETED
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Group A - Subjects With Multiple Myeloma
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion
Group B - Subjects With Relpased Lymphoma
Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * carmustin (BCNU) 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Overall Study
history of malignancy within 5 years
1
0
Overall Study
History of prepartive regimen
0
1

Baseline Characteristics

Multi-day Doses in Prevention of Nausea and Emesis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Subjects With Multiple Myeloma
n=9 Participants
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * BCNU 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Group B Lymphoma
n=9 Participants
Includes patients with Hodgkin's Disease and Non-Hodgkin's lymphoma
Total
n=18 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
8 Participants
n=5 Participants
9 Participants
n=7 Participants
17 Participants
n=5 Participants
Age, Categorical
>=65 years
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants
Sex: Female, Male
Male
4 Participants
n=5 Participants
7 Participants
n=7 Participants
11 Participants
n=5 Participants
Region of Enrollment
United States
9 participants
n=5 Participants
9 participants
n=7 Participants
18 participants
n=5 Participants
emetic response, adverse events, quality of care
9 participants
n=5 Participants
9 participants
n=7 Participants
9 participants
n=5 Participants

PRIMARY outcome

Timeframe: 24 hours after chemotherapy

Complete Control (CC) - no emetic episode in 24 hours, no rescue medications and nausea visual scale (NVS) of ≤ 2.5, Complete Emetic Response (CR) - 0 emetic episodes, no rescue medications. Major Emetic Response (MR) - 0 to 2 emetic episodes within 24 hour period with or without rescue medications. Minor Emetic Response (mR) - 3 to 5 emetic episodes within 24 hour period with or without rescue medications. Failure - \>5 emetic episodes within 24 hour period. No Significant Nausea (NSN) - maximum NVS ≤ 5.

Outcome measures

Outcome measures
Measure
Group A - Subjects With Multiple Myeloma
n=9 Participants
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion
Group B - Subjects With Relpased Lymphoma
n=9 Participants
Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * carmustin (BCNU) 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Overall Emetic Response: Acute
mr
0 Participants
0 Participants
Overall Emetic Response: Acute
Failure
0 Participants
0 Participants
Overall Emetic Response: Acute
NSN
9 Participants
9 Participants
Overall Emetic Response: Acute
CC
5 Participants
9 Participants
Overall Emetic Response: Acute
CR
1 Participants
0 Participants
Overall Emetic Response: Acute
MR
3 Participants
0 Participants

PRIMARY outcome

Timeframe: 24 to 72 hours after chemotherapy

Complete Control (CC) - no emetic episode in 24 hours, no rescue medications and nausea visual scale (NVS) of ≤ 2.5, Complete Emetic Response (CR) - 0 emetic episodes, no rescue medications. Major Emetic Response (MR) - 0 to 2 emetic episodes within 24 hour period with or without rescue medications. Minor Emetic Response (mR) - 3 to 5 emetic episodes within 24 hour period with or without rescue medications. Failure - \>5 emetic episodes within 24 hour period. No Significant Nausea (NSN) - maximum NVS ≤ 5.

Outcome measures

Outcome measures
Measure
Group A - Subjects With Multiple Myeloma
n=9 Participants
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion
Group B - Subjects With Relpased Lymphoma
n=9 Participants
Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * carmustin (BCNU) 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Overall Emetic Response: Delayed
MR
6 Participants
5 Participants
Overall Emetic Response: Delayed
mR
0 Participants
0 Participants
Overall Emetic Response: Delayed
Failure
0 Participants
0 Participants
Overall Emetic Response: Delayed
NSN
0 Participants
8 Participants
Overall Emetic Response: Delayed
CC
2 Participants
4 Participants
Overall Emetic Response: Delayed
CR
1 Participants
0 Participants

PRIMARY outcome

Timeframe: 72 hours after chemotherapy

Complete Control (CC) - no emetic episode in 24 hours, no rescue medications and nausea visual scale (NVS) of ≤ 2.5, Complete Emetic Response (CR) - 0 emetic episodes, no rescue medications. Major Emetic Response (MR) - 0 to 2 emetic episodes within 24 hour period with or without rescue medications. Minor Emetic Response (mR) - 3 to 5 emetic episodes within 24 hour period with or without rescue medications. Failure - \>5 emetic episodes within 24 hour period. No Significant Nausea (NSN) - maximum NVS ≤ 5.

Outcome measures

Outcome measures
Measure
Group A - Subjects With Multiple Myeloma
n=9 Participants
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion
Group B - Subjects With Relpased Lymphoma
n=9 Participants
Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * carmustin (BCNU) 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Overall Emetic Response: Extended
CC
1 Participants
2 Participants
Overall Emetic Response: Extended
CR
0 Participants
0 Participants
Overall Emetic Response: Extended
MR
7 Participants
7 Participants
Overall Emetic Response: Extended
mR
0 Participants
0 Participants
Overall Emetic Response: Extended
Failure
0 Participants
0 Participants
Overall Emetic Response: Extended
NSN
0 Participants
5 Participants

PRIMARY outcome

Timeframe: At leaset 24 hours to more than 72 hours after chemotherapy

Clinical responses were summarized using frequencies and percentages by phase, disease group, and overall. To compute emetic response by phase, the previously defined criteria were applied to each day of the three phases independently. The worst response was used to represent the response in each of these phases and overall emetic response. Overall emetic response was computed by applying the same definitions of emetic response to the entire study period.

Outcome measures

Outcome measures
Measure
Group A - Subjects With Multiple Myeloma
n=9 Participants
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion
Group B - Subjects With Relpased Lymphoma
n=9 Participants
Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * carmustin (BCNU) 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Overall Emetic Response
CC
0 Participants
1 Participants
Overall Emetic Response
CR
0 Participants
0 Participants
Overall Emetic Response
MR
8 Participants
6 Participants
Overall Emetic Response
Failure
0 Participants
0 Participants
Overall Emetic Response
NSN
6 Participants
5 Participants
Overall Emetic Response
mR
1 Participants
2 Participants

SECONDARY outcome

Timeframe: 24 hours, Day 3, Day 7

To determine quality of life, subjects' responses to the modified Osoba modules were converted to a 0 - 100 scale, with higher scores indicative of better QOL

Outcome measures

Outcome data not reported

Adverse Events

Subjects With Multiple Myeloma

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Patients With Lymphoma

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Subjects With Multiple Myeloma
n=9 participants at risk
Group A: Subjects with Multiple Myeloma * Conditioning regimen, over a 7 day period, includes: * Melphalan 70-100 mg, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Dexamethasone 4 mg IV and Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell infusion
Patients With Lymphoma
n=9 participants at risk
Group B: Subjects with Lymphoma * Conditioning regimen, over a 7 day period, includes: (BEAC) * BCNU 300 mg/m2 IV x 1,Cytarabine 100 mg/m2 IV BID, Etoposide 100 mg/m2 IV BID, administer after, Cyclophosphamide 35 mg/kg QD, Dexamethasone 4 mg IV push, Aprepitant 125 mg PO, Palonosetron 0.25 mg IV over 30 seconds, Aprepitant 80 mg PO, Lorazepam 1 mg IV x 1 dose 30 minutes prior to stem cell transplant
Infections and infestations
Infection, Abdomen NOS
0.00%
0/9 • Day +30
11.1%
1/9 • Number of events 1 • Day +30
Gastrointestinal disorders
Gastric Mucositis
0.00%
0/9 • Day +30
11.1%
1/9 • Number of events 1 • Day +30
Gastrointestinal disorders
Gallbladder pain
0.00%
0/9 • Day +30
11.1%
1/9 • Number of events 1 • Day +30
Infections and infestations
Febrile neutropenia
11.1%
1/9 • Number of events 1 • Day +30
11.1%
1/9 • Number of events 1 • Day +30
Metabolism and nutrition disorders
Hyponatremia
0.00%
0/9 • Day +30
11.1%
1/9 • Number of events 1 • Day +30
Cardiac disorders
Conduction disorder
11.1%
1/9 • Number of events 1 • Day +30
0.00%
0/9 • Day +30
Infections and infestations
Infection, Catheter-related
11.1%
1/9 • Number of events 1 • Day +30
0.00%
0/9 • Day +30

Additional Information

Dr. Omar Aljitawi

University of Kansas Medical Center

Phone: 913-588-6029

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place