Ondansetron Versus Palonosetron Antiemetic Regimen Prior to Highly Emetogenic Chemotherapy(HEC)

NCT ID: NCT01640340

Last Updated: 2013-11-07

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-01-31

Study Completion Date

2011-08-31

Brief Summary

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Palonosetron is different from ondansetron because it stays in the body longer and may prevent nausea and vomiting for a longer period of time than ondansetron. It is standard practice to use dexamethasone and aprepitant with either ondansetron or palonosetron to prevent nausea and vomiting caused by highly emetogenic chemotherapy. Although these combinations are commonly used, they have never been compared to each other. The purpose of this study is to record the amount of nausea and vomiting, and the amount of "rescue" medication that is used with these two different anti-emetic regimens

Detailed Description

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PRIMARY OBJECTIVES:

I. The goal of this study is to evaluate the overall complete response rate (CR, no emesis and no use of rescue medication from 0 to 120 hours after chemotherapy) of two different antiemetic regimens (palonosetron + aprepitant + dexamethasone and ondansetron + aprepitant + dexamethasone) for patients undergoing the first cycle of highly emetogenic chemotherapy (HEC).

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive palonosetron hydrochloride intravenously (IV) 30 minutes prior to chemotherapy on day 1, aprepitant orally (PO) 60 minutes prior to chemotherapy on days 1-3, and dexamethasone PO 30 minutes prior to chemotherapy on days 1-4.

ARM II: Patients receive ondansetron PO 30 minutes prior to chemotherapy on day 1 and aprepitant and dexamethasone as in Arm I.

After completion of study treatment, patients are followed up for 7 days.

Conditions

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Malignant Neoplasm

Keywords

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ondansetron palonosetron emetogenic chemotherapy HEC

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Arm I (palonosetron hydrochloride)

Patients receive palonosetron hydrochloride IV 30 minutes prior to chemotherapy on day 1, aprepitant PO (by mouth) 60 minutes prior to chemotherapy on days 1-3, and dexamethasone PO 30 minutes prior to chemotherapy on days 1-4.

Group Type EXPERIMENTAL

aprepitant

Intervention Type DRUG

Given by mouth

palonosetron hydrochloride

Intervention Type DRUG

Given IV(intervenous infusion)

dexamethasone

Intervention Type DRUG

Given PO

Arm II (ondansetron)

Patients receive ondansetron PO 30 minutes prior to chemotherapy on day 1 and aprepitant and dexamethasone as in Arm I.

Group Type EXPERIMENTAL

aprepitant

Intervention Type DRUG

Given by mouth

ondansetron

Intervention Type DRUG

Given PO

dexamethasone

Intervention Type DRUG

Given PO

Interventions

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aprepitant

Given by mouth

Intervention Type DRUG

palonosetron hydrochloride

Given IV(intervenous infusion)

Intervention Type DRUG

ondansetron

Given PO

Intervention Type DRUG

dexamethasone

Given PO

Intervention Type DRUG

Other Intervention Names

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Emend L-754030 MK-0869 ONO-7436 Aloxi RS 25259-197 GR 38032F GR-C507/75 Zofran Aeroseb-Dex Decaderm Decadron DM DXM

Eligibility Criteria

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Inclusion Criteria

* Confirmed malignancy
* Chemotherapy naive or treated with only low or minimally emetogenic chemotherapy in the past (as defined by the National Comprehensive Cancer Network version \[v\].2.201 Antiemetic Guidelines)
* Scheduled to receive the first dose of their first cycle of HEC
* Patients receiving multi-day chemotherapy, the HEC portion must be on day 1 and the remaining days of chemotherapy must be minimally emetogenic (i.e. fluorouracil)
* Performance status of Eastern Cooperative Oncology Group (ECOG) grade 0-2
* Able to provide informed consent
* Able to read and write in English or have someone that can that can translate to them and record their diary entries
* Able to take oral medications
* Patients are allowed to participate in a concurrent clinical trial, if the other trial:

* Does not mandate an antiemetic regimen that interferes with this study
* Allows antiemetic administration at the physician's discretion
* Does not prohibit the patient from participating in this study
* Patients must be willing to participate with daily diary entries for 5 days following chemotherapy, and agree to have a 5 minute follow-up call on day 2 or 3 and day 5, 6 or 7

Exclusion Criteria

* Has stage IV (metastatic) disease
* Known hypersensitivity to ondansetron, palonosetron, aprepitant, or dexamethasone
* Have received or will receive agents that are strong cytochrome P450 3A4 (CYP450 3A4) inducers and/or inhibitors and known to cause clinically relevant drug interactions within one week prior to study treatment and continuing through day 5; any vomiting or retching within 24 hours before administration of chemotherapy
* Grade 2 nausea or greater, according to the Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v 4.0) within 24 hours before administration of chemotherapy
* Received an antiemetic within 24 hours before study drug administration, excluding the use of benzodiazepines
* Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) \> 2.5 times upper limit of normal
* Total bilirubin \> 1.5 times upper limit of normal
Minimum Eligible Age

18 Years

Maximum Eligible Age

88 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ohio State University Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Rachel Layman

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rachel Layman

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Locations

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Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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NCI-2012-01009

Identifier Type: REGISTRY

Identifier Source: secondary_id

OSU-10118

Identifier Type: -

Identifier Source: org_study_id