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Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 2)

Primary Purpose

Cachexia, Non-Small Cell Lung Cancer

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Anamorelin HCl
Placebo
Sponsored by
Helsinn Therapeutics (U.S.), Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cachexia

Eligibility Criteria

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

Inclusion Criteria:

  • Documented diagnosis of unresectable Stage III or Stage IV NSCLC
  • Patients may be receiving maintenance chemotherapy
  • Patients planning to initiate a new chemotherapy and/or radiation therapy regimen may do so only within ± 14 days of randomization
  • Patients may have completed a chemotherapy and/or radiation therapy and/or have no plan to initiate a new regimen within 12 weeks from randomization; at least 14 days must elapse from the completion of the chemotherapy and/or radiation therapy prior to randomization
  • Involuntary weight loss of ≥5% body weight within 6 months prior to screening or a screening body mass index (BMI) <20 kg/m2
  • Body mass index ≤30 kg/m2
  • Life expectancy of >4 months at time of screening
  • ECOG performance status ≤2
  • Adequate hepatic function, defined as AST and ALT levels ≤5 x upper limit of normal
  • Adequate renal function, defined as creatinine ≤2 x upper limit of normal, or calculated creatinine clearance >30 ml/minute
  • Ability to understand and comply with the procedures for the HGS evaluation
  • If a woman of childbearing potential or a fertile man, he/she must agree to use an effective form of contraception during the study and for 30 days following the last dose of study drug (an effective form of contraception is abstinence, a hormonal contraceptive, or a double-barrier method)
  • Must be willing and able to give signed informed consent and, in the opinion of the Investigator, to comply with the protocol tests and procedures

Exclusion Criteria:

  • Other forms of lung cancer (e.g., small cell, mesothelioma)
  • Women who are pregnant or breast-feeding
  • Known HIV, hepatitis (B&C), or active tuberculosis
  • Had major surgery (central venous access placement and tumor biopsies are not considered major surgery) within 4 weeks prior to randomization; patients must be well recovered from acute effects of surgery prior to screening; patients should not have plans to undergo major surgical procedures during the treatment period
  • Currently taking prescription medications intended to increase appetite or treat weight loss; these include, but are not limited to, testosterone, androgenic compounds, megestrol acetate, methylphenidate, and dronabinol
  • Inability to readily swallow oral tablets; patients with severe gastrointestinal disease (including esophagitis, gastritis, malabsorption, or obstructive symptoms) or intractable or frequent vomiting are excluded
  • Has an active, uncontrolled infection
  • Has uncontrolled diabetes mellitus
  • Has untreated clinically relevant hypothyroidism
  • Has known or symptomatic brain metastases
  • Receiving strong CYP3A4 inhibitors within 14 days of randomization
  • Receiving tube feedings or parenteral nutrition (either total or partial); patients must have discontinued these treatments for at least 6 weeks prior to Day 1, and throughout the study duration
  • Other clinical diagnosis, ongoing or intercurrent illness that in the Investigator's opinion would prevent the patient's participation
  • Has had previous exposure to Anamorelin HCl
  • Patients actively receiving a concurrent investigational agent

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

100 mg QD

Placebo

Arm Description

Investigational: Anamorelin HCl; 100 mg tablets; oral administration QD for 12 weeks, at least 1 hour before the first meal of the day.

Placebo tablets identical in appearance to active tablets; oral administration once daily

Outcomes

Primary Outcome Measures

Change in Lean Body Mass
Change in Lean Body Mass (LBM) from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.
Change in Handgrip Strength
Change in Handgrip Strength (HGS) of the non-dominant hand from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.

Secondary Outcome Measures

Change in A/CS Domain Score
The Functional Assessment of Anorexia/Cachexia Treatment (FAACT) Additional Concerns Subscale (A/CS domain) is a 12-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 12-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the A/CS domain ranges from 0 (worst) to 48 (best).
Change in FACIT-F Fatigue Domain Score
The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) fatigue domain is a 13-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 13-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the FACIT-F fatigue domain ranges from 0 (worst) to 52 (best).
Change in Body Weight
Change in body weight (BW) from baseline overall (i.e., over 12 weeks) for the MITT Population.

Full Information

First Posted
June 30, 2011
Last Updated
September 26, 2017
Sponsor
Helsinn Therapeutics (U.S.), Inc
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1. Study Identification

Unique Protocol Identification Number
NCT01387282
Brief Title
Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 2)
Official Title
Anamorelin HCl in the Treatment of Non-Small Cell Lung Cancer-Cachexia (NSCLC-C): A Randomized Double-Blind Placebo-Controlled Multicenter Phase III Study to Evaluate the Safety and Efficacy of Anamorelin HCl in Patients With NSCLC-C
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
July 2011 (undefined)
Primary Completion Date
November 2013 (Actual)
Study Completion Date
February 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Helsinn Therapeutics (U.S.), Inc

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The administration of Anamorelin in patients with Stage III-IV non-small cell lung cancer-cachexia (NSCLC-C) is expected to increase appetite, lean body mass, weight gain, and muscle strength.
Detailed Description
This is a randomized, double-blind, placebo-controlled, multicenter study to assess the safety and efficacy of Anamorelin in patients with non-small cell lung cancer-cachexia (NSCLC-C). The primary efficacy analysis will include the treatment difference in the change in lean body mass and physical function.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cachexia, Non-Small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
495 (Actual)

8. Arms, Groups, and Interventions

Arm Title
100 mg QD
Arm Type
Active Comparator
Arm Description
Investigational: Anamorelin HCl; 100 mg tablets; oral administration QD for 12 weeks, at least 1 hour before the first meal of the day.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo tablets identical in appearance to active tablets; oral administration once daily
Intervention Type
Drug
Intervention Name(s)
Anamorelin HCl
Intervention Description
Anamorelin HCL 100 mg will be orally administered daily at least 1 hour prior to meal
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo tablets identical in appearance to active tablets; oral administration QD for 12 weeks, at least 1 hour prior to meal before the first meal of the day.
Primary Outcome Measure Information:
Title
Change in Lean Body Mass
Description
Change in Lean Body Mass (LBM) from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.
Time Frame
Change in Lean Body Mass from Baseline Over 12 Weeks
Title
Change in Handgrip Strength
Description
Change in Handgrip Strength (HGS) of the non-dominant hand from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.
Time Frame
Change in Handgrip Strength of the Non-Dominant Hand from Baseline Over 12 Weeks
Secondary Outcome Measure Information:
Title
Change in A/CS Domain Score
Description
The Functional Assessment of Anorexia/Cachexia Treatment (FAACT) Additional Concerns Subscale (A/CS domain) is a 12-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 12-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the A/CS domain ranges from 0 (worst) to 48 (best).
Time Frame
Change in FAACT A/CS Domain Score from Baseline Over 12 Weeks
Title
Change in FACIT-F Fatigue Domain Score
Description
The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) fatigue domain is a 13-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 13-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the FACIT-F fatigue domain ranges from 0 (worst) to 52 (best).
Time Frame
Change in FACIT-F Fatigue Domain Score from Baseline Over 12 Weeks
Title
Change in Body Weight
Description
Change in body weight (BW) from baseline overall (i.e., over 12 weeks) for the MITT Population.
Time Frame
Change in Body Weight from Baseline Over 12 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Documented diagnosis of unresectable Stage III or Stage IV NSCLC Patients may be receiving maintenance chemotherapy Patients planning to initiate a new chemotherapy and/or radiation therapy regimen may do so only within ± 14 days of randomization Patients may have completed a chemotherapy and/or radiation therapy and/or have no plan to initiate a new regimen within 12 weeks from randomization; at least 14 days must elapse from the completion of the chemotherapy and/or radiation therapy prior to randomization Involuntary weight loss of ≥5% body weight within 6 months prior to screening or a screening body mass index (BMI) <20 kg/m2 Body mass index ≤30 kg/m2 Life expectancy of >4 months at time of screening ECOG performance status ≤2 Adequate hepatic function, defined as AST and ALT levels ≤5 x upper limit of normal Adequate renal function, defined as creatinine ≤2 x upper limit of normal, or calculated creatinine clearance >30 ml/minute Ability to understand and comply with the procedures for the HGS evaluation If a woman of childbearing potential or a fertile man, he/she must agree to use an effective form of contraception during the study and for 30 days following the last dose of study drug (an effective form of contraception is abstinence, a hormonal contraceptive, or a double-barrier method) Must be willing and able to give signed informed consent and, in the opinion of the Investigator, to comply with the protocol tests and procedures Exclusion Criteria: Other forms of lung cancer (e.g., small cell, mesothelioma) Women who are pregnant or breast-feeding Known HIV, hepatitis (B&C), or active tuberculosis Had major surgery (central venous access placement and tumor biopsies are not considered major surgery) within 4 weeks prior to randomization; patients must be well recovered from acute effects of surgery prior to screening; patients should not have plans to undergo major surgical procedures during the treatment period Currently taking prescription medications intended to increase appetite or treat weight loss; these include, but are not limited to, testosterone, androgenic compounds, megestrol acetate, methylphenidate, and dronabinol Inability to readily swallow oral tablets; patients with severe gastrointestinal disease (including esophagitis, gastritis, malabsorption, or obstructive symptoms) or intractable or frequent vomiting are excluded Has an active, uncontrolled infection Has uncontrolled diabetes mellitus Has untreated clinically relevant hypothyroidism Has known or symptomatic brain metastases Receiving strong CYP3A4 inhibitors within 14 days of randomization Receiving tube feedings or parenteral nutrition (either total or partial); patients must have discontinued these treatments for at least 6 weeks prior to Day 1, and throughout the study duration Other clinical diagnosis, ongoing or intercurrent illness that in the Investigator's opinion would prevent the patient's participation Has had previous exposure to Anamorelin HCl Patients actively receiving a concurrent investigational agent
Facility Information:
City
Corona
State/Province
California
Country
United States
City
Fountain Valley
State/Province
California
Country
United States
City
Glendale
State/Province
California
Country
United States
City
Washington, D.C.
State/Province
District of Columbia
Country
United States
City
Baltimore
State/Province
Maryland
Country
United States
City
Detroit
State/Province
Michigan
Country
United States
City
Lake Success
State/Province
New York
Country
United States
City
Durham
State/Province
North Carolina
Country
United States
City
Cincinnati
State/Province
Ohio
Country
United States
City
Cleveland
State/Province
Ohio
Country
United States
City
Sylvania
State/Province
Ohio
Country
United States
City
West Reading
State/Province
Pennsylvania
Country
United States
City
Charleston
State/Province
South Carolina
Country
United States
City
Falls Church
State/Province
Virginia
Country
United States
City
Prairiewood
State/Province
New South Wales
Country
Australia
City
East Bentleigh
State/Province
Victoria
Country
Australia
City
Parkville
State/Province
Victoria
Country
Australia
City
Adelaide
Country
Australia
City
Budapest
Country
Hungary
City
Nyiregyhaza
Country
Hungary
City
Szekesfehervar
Country
Hungary
City
Szikszo
Country
Hungary
City
Torokbalint
Country
Hungary
City
Beer-Sheva
Country
Israel
City
Haifa
Country
Israel
City
Jerusalem
Country
Israel
City
Kfar Saba
Country
Israel
City
Petach Tikvah
Country
Israel
City
Tel Aviv
Country
Israel
City
Tel-Hashomer
Country
Israel
City
Zerifin
Country
Israel
City
Bydgoszcz
Country
Poland
City
Grudziadz
Country
Poland
City
Katowice
Country
Poland
City
Krakow
Country
Poland
City
Lodz
Country
Poland
City
Lublin
Country
Poland
City
Szczecin
Country
Poland
City
Warszawa
Country
Poland
City
Ekaterinburg
Country
Russian Federation
City
Krasnodar
Country
Russian Federation
City
Moscow
Country
Russian Federation
City
Novosibirsk
Country
Russian Federation
City
Saint Petersburg
Country
Russian Federation
City
St. Petersburg
Country
Russian Federation
City
Leicester
Country
United Kingdom
City
Middlesex
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
28472437
Citation
Currow D, Temel JS, Abernethy A, Milanowski J, Friend J, Fearon KC. ROMANA 3: a phase 3 safety extension study of anamorelin in advanced non-small-cell lung cancer (NSCLC) patients with cachexia. Ann Oncol. 2017 Aug 1;28(8):1949-1956. doi: 10.1093/annonc/mdx192.
Results Reference
derived
PubMed Identifier
26906526
Citation
Temel JS, Abernethy AP, Currow DC, Friend J, Duus EM, Yan Y, Fearon KC. Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials. Lancet Oncol. 2016 Apr;17(4):519-531. doi: 10.1016/S1470-2045(15)00558-6. Epub 2016 Feb 20.
Results Reference
derived
PubMed Identifier
25351456
Citation
Salsman JM, Beaumont JL, Wortman K, Yan Y, Friend J, Cella D. Brief versions of the FACIT-fatigue and FAACT subscales for patients with non-small cell lung cancer cachexia. Support Care Cancer. 2015 May;23(5):1355-64. doi: 10.1007/s00520-014-2484-9. Epub 2014 Oct 29.
Results Reference
derived

Learn more about this trial

Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 2)

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