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Evaluate the Efficacy of Armodafinil for Patients With B-cell Lymphoma and Severe Fatigue

Primary Purpose

B-cell Lymphoma, Fatigue

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Armodafinil
placebo
Armodafinil
placebo
Sponsored by
Washington University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Lymphoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria for both arms:

  • Age ≥ 18 with diagnosis of B-cell lymphoma
  • Average score of ≥ 7 on daily worst fatigue severity assessment from the BFI questionnaire during screening
  • Able to demonstrate appropriate use of the wrist actigraphy device and to complete questionnaires
  • ECOG performance status 0-2
  • Laboratory values:
  • Hemoglobin ≥ 10 g/dL
  • Total Bilirubin ≤ 1.5 x institutional ULN
  • AST/ALT ≤ 2.5 x institutional ULN
  • Creatinine ≤ 1.5 x institutional ULN
  • Albumin ≥ 3.5 g/dl
  • Life expectancy > 6 months
  • IRB-approved informed consent form must be signed before any protocol-specific screening procedures are performed.

Inclusion criteria for patients undergoing R-CHOP chemotherapy:

  • Scheduled to receive 6 cycles of standard R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy as first-line treatment

Inclusion criteria for patients in remission following chemotherapy and/or radiotherapy:

  • May have received one prior regimen of chemotherapy and/or radiotherapy
  • Adequate response to upfront chemotherapy and/or radiotherapy
  • Indolent lymphomas - must have achieved a partial or complete response with no immediate plans for further treatment
  • Aggressive lymphomas - must have achieved a complete response:

    • ≥ 4 weeks since completion of chemotherapy
    • ≥ 8 weeks since completion of radiotherapy
    • ≤ 18 months since completion of chemotherapy or radiotherapy

Exclusion Criteria for both arms:

  • Uncontrolled medical and/or psychiatric condition that may cause fatigue or that the PI feels is clinically significant and might adversely affect patient safety (such as sleep disorders, moderate/severe depression, metabolic/endocrine abnormalities, infections)
  • History of clinically significant cardiac disorders, such as left ventricular hypertrophy or mitral valve prolapse experienced in conjunction with receiving CNS stimulants
  • History of serious skin reactions, such as serious rash or Stevens-Johnson Syndrome
  • Concurrent stimulant medication
  • Any other active malignancy within the past 3 years except cervical carcinoma in situ and non-melanoma skin cancers
  • Known CNS involvement by lymphoma
  • Cachexia
  • Use of opioids at time of randomization
  • Known sensitivity to modafinil and/or armodafinil

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Placebo Comparator

    Experimental

    Placebo Comparator

    Arm Label

    Post treatment remission armodafinil

    Post treatment remission placebo

    Chemotherapy armodafinil

    Chemotherapy placebo

    Arm Description

    Armodafinil 150 mg/day for 13 weeks

    Placebo 150mg/day for 13 weeks

    Armodafinil 150 mg/day for 13 weeks

    Placebo 150mg/day for 13 weeks

    Outcomes

    Primary Outcome Measures

    To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by the change in scores from the FACT-Fatigue reported at study entry, week 7 of study treatment, and study completion (week 13).

    Secondary Outcome Measures

    To determine whether armodafinil is more effective than placebo in improving work quality as measured by the change in scores from the WLQ© reported at study entry (week 1) and study completion (week 13).
    To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by standard actigraphy summary statistics will be done at week 1 of screening, week 7 of study treatment, and study completion (week 13).
    To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by actigraphy using applied functional data analysis during week 1 of screening, week 7 of study treatment, and study completion (week 13).
    To evaluate whether measured cytokines (IL-2, IL-6, IL-10, TNF-α, and TGF-α) are elevated at baseline.
    To evaluate whether measured cytokines (IL-2, IL-6, IL-10, TNF-α, and TGF-α) change from the time of study entry to study completion.
    To assess whether cytokine levels (IL-2, IL-6, IL-10, TNF-α, and TGF-α) correlate with circadian patterns in wrist actigraphy and self-described reports of fatigue as measured by the FACT-Fatigue at baseline and study completion.

    Full Information

    First Posted
    January 6, 2010
    Last Updated
    July 22, 2013
    Sponsor
    Washington University School of Medicine
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01044004
    Brief Title
    Evaluate the Efficacy of Armodafinil for Patients With B-cell Lymphoma and Severe Fatigue
    Official Title
    A Randomized, Double-Blind, Placebo-Controlled Pilot Study to Evaluate the Efficacy of Armodafinil for Patients With B-cell Lymphoma and Severe Fatigue Undergoing Standard R-CHOP Chemotherapy or in Remission Following Chemo and/or Radiation
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2013
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    March 2010 (undefined)
    Primary Completion Date
    June 2012 (Anticipated)
    Study Completion Date
    June 2012 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Washington University School of Medicine

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    To determine whether armodafinil is more effective than placebo in reducing fatigue.
    Detailed Description
    Aims will be analyzed separately as stratified by treatment arm (chemotherapy treatment arm vs. post-treatment remission arm). Primary Objective: To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by the change in scores from the FACT-Fatigue reported at study entry, week 7 of study treatment, and study completion (week 13). Secondary Objectives: To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by standard actigraphy summary statistics including total sleep time (TST), wake after sleep onset (WASO), sleep latency, number of awakenings, daytime sleep time, mean daytime activity, peak activity, acrophase, and circadian mesor at week 1 of screening, week 7 of study treatment, and study completion (week 13). To determine whether armodafinil is more effective than placebo in improving work quality as measured by the change in scores from the WLQ© reported at study entry (week 1) and study completion (week 13). To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by the change in activity patterns with actigraphy using applied functional data analysis during week 1 of screening, week 7 of study treatment, and study completion (week 13). To evaluate whether measured cytokines (IL-2, IL-6, IL-10, TNF-α, and TGF-α) are elevated at baseline. To evaluate whether measured cytokines (IL-2, IL-6, IL-10, TNF-α, and TGF-α) change from the time of study entry to study completion. To assess whether cytokine levels (IL-2, IL-6, IL-10, TNF-α, and TGF-α) correlate with circadian patterns in wrist actigraphy and self-described reports of fatigue as measured by the FACT-Fatigue at baseline and study completion.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    B-cell Lymphoma, Fatigue

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Post treatment remission armodafinil
    Arm Type
    Experimental
    Arm Description
    Armodafinil 150 mg/day for 13 weeks
    Arm Title
    Post treatment remission placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo 150mg/day for 13 weeks
    Arm Title
    Chemotherapy armodafinil
    Arm Type
    Experimental
    Arm Description
    Armodafinil 150 mg/day for 13 weeks
    Arm Title
    Chemotherapy placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo 150mg/day for 13 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Armodafinil
    Other Intervention Name(s)
    Nuvigil
    Intervention Description
    Armodafinil 150 mg/day for 13 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    placebo
    Intervention Description
    Placebo 150mg/day for 13 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Armodafinil
    Other Intervention Name(s)
    Nuvigil
    Intervention Description
    Armodafinil 150 mg/day for 13 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    placebo
    Intervention Description
    Placebo 150mg/day for 13 weeks
    Primary Outcome Measure Information:
    Title
    To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by the change in scores from the FACT-Fatigue reported at study entry, week 7 of study treatment, and study completion (week 13).
    Time Frame
    13 weeks
    Secondary Outcome Measure Information:
    Title
    To determine whether armodafinil is more effective than placebo in improving work quality as measured by the change in scores from the WLQ© reported at study entry (week 1) and study completion (week 13).
    Time Frame
    13 weeks
    Title
    To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by standard actigraphy summary statistics will be done at week 1 of screening, week 7 of study treatment, and study completion (week 13).
    Time Frame
    13 weeks
    Title
    To determine whether armodafinil is more effective than placebo in reducing fatigue as measured by actigraphy using applied functional data analysis during week 1 of screening, week 7 of study treatment, and study completion (week 13).
    Time Frame
    13 weeks
    Title
    To evaluate whether measured cytokines (IL-2, IL-6, IL-10, TNF-α, and TGF-α) are elevated at baseline.
    Time Frame
    13 weeks
    Title
    To evaluate whether measured cytokines (IL-2, IL-6, IL-10, TNF-α, and TGF-α) change from the time of study entry to study completion.
    Time Frame
    13 weeks
    Title
    To assess whether cytokine levels (IL-2, IL-6, IL-10, TNF-α, and TGF-α) correlate with circadian patterns in wrist actigraphy and self-described reports of fatigue as measured by the FACT-Fatigue at baseline and study completion.
    Time Frame
    13 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria for both arms: Age ≥ 18 with diagnosis of B-cell lymphoma Average score of ≥ 7 on daily worst fatigue severity assessment from the BFI questionnaire during screening Able to demonstrate appropriate use of the wrist actigraphy device and to complete questionnaires ECOG performance status 0-2 Laboratory values: Hemoglobin ≥ 10 g/dL Total Bilirubin ≤ 1.5 x institutional ULN AST/ALT ≤ 2.5 x institutional ULN Creatinine ≤ 1.5 x institutional ULN Albumin ≥ 3.5 g/dl Life expectancy > 6 months IRB-approved informed consent form must be signed before any protocol-specific screening procedures are performed. Inclusion criteria for patients undergoing R-CHOP chemotherapy: Scheduled to receive 6 cycles of standard R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy as first-line treatment Inclusion criteria for patients in remission following chemotherapy and/or radiotherapy: May have received one prior regimen of chemotherapy and/or radiotherapy Adequate response to upfront chemotherapy and/or radiotherapy Indolent lymphomas - must have achieved a partial or complete response with no immediate plans for further treatment Aggressive lymphomas - must have achieved a complete response: ≥ 4 weeks since completion of chemotherapy ≥ 8 weeks since completion of radiotherapy ≤ 18 months since completion of chemotherapy or radiotherapy Exclusion Criteria for both arms: Uncontrolled medical and/or psychiatric condition that may cause fatigue or that the PI feels is clinically significant and might adversely affect patient safety (such as sleep disorders, moderate/severe depression, metabolic/endocrine abnormalities, infections) History of clinically significant cardiac disorders, such as left ventricular hypertrophy or mitral valve prolapse experienced in conjunction with receiving CNS stimulants History of serious skin reactions, such as serious rash or Stevens-Johnson Syndrome Concurrent stimulant medication Any other active malignancy within the past 3 years except cervical carcinoma in situ and non-melanoma skin cancers Known CNS involvement by lymphoma Cachexia Use of opioids at time of randomization Known sensitivity to modafinil and/or armodafinil
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Nina Wagner-Johnston, M
    Organizational Affiliation
    Washington University School of Medicine
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Links:
    URL
    http://www.siteman.wustl.edu
    Description
    Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

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    Evaluate the Efficacy of Armodafinil for Patients With B-cell Lymphoma and Severe Fatigue

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