A Dose Titration Study of Fentanyl Buccal Soluble Film for Breakthrough Cancer Pain in Taiwan

NCT ID: NCT03669263

Last Updated: 2018-09-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-11-25

Study Completion Date

2016-07-01

Brief Summary

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Primary Objective:

To determine the feasible dose range of Painkyl® required for Taiwanese population.

Secondary Objectives:

To evaluate the efficacy of Painkyl® by calculating squared mean of pain intensity difference at 30 minutes after taking Painkyl® (SPID30, an 11-point scale).

To evaluate subjects' satisfaction by conducting global evaluation of medication performance (a 5-point categorical scale).

To identify percentage of episodes requiring rescue medication during maintenance treatment period.

To evaluate the safety data of Painkyl® for breakthrough pain.

Detailed Description

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The primary endpoint was the feasible range of FBSF required for Taiwanese population. The secondary endpoints were the difference in pain intensity at 30 minutes (PID30) after FBSF administration, subjects' satisfaction, and the percentage of episodes requiring rescue medications.

Pain intensity was determined using an 11-point numeric scale from 0="no pain" to 10="worst pain." Patients were assessed with baseline pain as well as pain intensity at 30 minutes after dosing. The PID30 was obtained by baseline pain score minus score rated 30 minutes after dosing.

Patient's satisfaction was assessed using a 5-point (poor, fair, good, very good, and excellent) categorical scale at 30 minutes after taking FBSF with the following question: "What was your overall satisfaction with the medication?" At each episode of BTP, subjects recorded whether a rescue medication was taken after administration of FBSF.

Conditions

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Breakthrough Cancer Pain

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Fentanyl buccal soluble film (FBSF)

Single arm

Group Type EXPERIMENTAL

Fentanyl buccal soluble film (FBSF)

Intervention Type DRUG

After screening, eligible subjects were individually titrated to an adequate dose of FBSF (titration period) and continued on this dose as required to control their BTP throughout the maintenance period of the study.

During the dose titration period, subjects were administered with FBSF in a dose escalation manner until a treatment dose was identified (defined as an adequate relief of BTP observed for at least two consecutive episodes). All patient started with a dose of 200 μg and increased by 200 μg in each subsequent episode until an adequate pain relief with tolerable side effects was achieved. Doses above 1200 μg were not allowed.

Interventions

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Fentanyl buccal soluble film (FBSF)

After screening, eligible subjects were individually titrated to an adequate dose of FBSF (titration period) and continued on this dose as required to control their BTP throughout the maintenance period of the study.

During the dose titration period, subjects were administered with FBSF in a dose escalation manner until a treatment dose was identified (defined as an adequate relief of BTP observed for at least two consecutive episodes). All patient started with a dose of 200 μg and increased by 200 μg in each subsequent episode until an adequate pain relief with tolerable side effects was achieved. Doses above 1200 μg were not allowed.

Intervention Type DRUG

Other Intervention Names

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Painkyl, fentanyl buccal soluble film (FBSF)

Eligibility Criteria

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Inclusion Criteria

* a. a stable current regimen of oral opioids equivalent to 60-1000 mg/day of oral morphine or 20-120 mg/day of iv morphine or 25-300 mcg/hr of transdermal fentanyl for one week or longer;
* b. regularly experienced 1 to 3 breakthrough pain episodes per day that required additional opioids from pain control;
* c. at least partial relief of breakthrough pain by use of opioid therapy;
* d. 20 years of age or older;
* e. ability to understand and willingness to sign a written informed consent document;
* f. able to self-administer the study medication correctly or has the availability of a responsible adult caregiver available to administer the study medication correctly;
* g. willing and able to complete patient diary with each pain episode

Exclusion Criteria

* a. rapidly escalating pain (e.g., regularly more than 3 breakthrough pain episodes per day) that are hard to be controlled by analgesics;
* b. history of hypersensitivity or intolerance to fentanyl;
* c. cardiopulmonary disease that, in the opinion of the investigator, would significantly increase the risk of respiratory depression;
* d. psychiatric/cognitive or neurological impairment that would limit the subject's ability to understand or complete the diary;
* e. moderate (Grade 3) to severe (Grade 4) mucositis (subjects with less than moderate mucositis are permitted and must be instructed to not apply the Painkyl® film at a site of inflammation);
* f. abnormal oral mucosa which will impede drug absorption;
* g. currently under other treatments that may alter effect of pain control based on investigator's judgment;
* h. recent history or current evidence of alcohol or other drug substance (licit or illicit) abuse;
* i. use of an investigational drug within 4 weeks preceding this study;
* j. pregnant women or nursing mothers, or positive pregnancy test for women of childbearing potential;
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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TTY Biopharm

INDUSTRY

Sponsor Role collaborator

Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cheng-Hsu Wang

Role: STUDY_CHAIR

Chang Gung Memorial Hospital, Linkou, Taiwan

Locations

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Chang Gung Memorial Hospital

Keelung, , Taiwan

Site Status

Countries

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Taiwan

References

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Greco MT, Corli O, Montanari M, Deandrea S, Zagonel V, Apolone G; Writing Protocol Committee; Cancer Pain Outcome Research Study Group (CPOR SG) Investigators. Epidemiology and pattern of care of breakthrough cancer pain in a longitudinal sample of cancer patients: results from the Cancer Pain Outcome Research Study Group. Clin J Pain. 2011 Jan;27(1):9-18. doi: 10.1097/AJP.0b013e3181edc250.

Reference Type BACKGROUND
PMID: 20842024 (View on PubMed)

Rhiner MI, von Gunten CF. Cancer breakthrough pain in the presence of cancer-related chronic pain: fact versus perceptions of health-care providers and patients. J Support Oncol. 2010 Nov-Dec;8(6):232-8. doi: 10.1016/j.suponc.2010.10.006.

Reference Type BACKGROUND
PMID: 21265388 (View on PubMed)

Mercadante S. The use of rapid onset opioids for breakthrough cancer pain: the challenge of its dosing. Crit Rev Oncol Hematol. 2011 Dec;80(3):460-5. doi: 10.1016/j.critrevonc.2010.12.002. Epub 2011 Jan 6.

Reference Type BACKGROUND
PMID: 21215653 (View on PubMed)

Rauck R, North J, Gever LN, Tagarro I, Finn AL. Fentanyl buccal soluble film (FBSF) for breakthrough pain in patients with cancer: a randomized, double-blind, placebo-controlled study. Ann Oncol. 2010 Jun;21(6):1308-1314. doi: 10.1093/annonc/mdp541. Epub 2009 Nov 25.

Reference Type BACKGROUND
PMID: 19940014 (View on PubMed)

Chiou TJ, Chao TC, Chao TY, Huang JS, Chang YF, Wang CH. A dose titration study of fentanyl buccal soluble film for breakthrough cancer pain in Taiwan. Cancer Rep (Hoboken). 2019 Oct;2(5):e1179. doi: 10.1002/cnr2.1179. Epub 2019 Apr 23.

Reference Type DERIVED
PMID: 32721110 (View on PubMed)

Other Identifiers

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PK1302

Identifier Type: -

Identifier Source: org_study_id

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