Dose-finding Study of APD403 to Prevent Nausea and Vomiting After Chemotherapy
Primary Purpose
CINV
Status
Completed
Phase
Phase 2
Locations
Denmark
Study Type
Interventional
Intervention
Ondansetron
Placebo
Dexamethasone
Fosaprepitant
APD403 IV
APD403 oral
Sponsored by
About this trial
This is an interventional prevention trial for CINV
Eligibility Criteria
Inclusion criteria
- Male or female patients ≥ 18 years of age
- Ability and willingness to give written informed consent
- Patients scheduled to receive, on day 1 of their chemotherapy, either: (i) a first cisplatin chemotherapy infusion at a dose of ≥70 mg/m2 (males and females); or (ii) a first infusion of cyclophosphamide at a dose of 500-1500 mg/m2 in combination with either epirubicin at a dose of 60-100 mg/m2 or doxorubicin at a dose of 40-60 mg/m2 (females only)
- Karnofsky performance score ≥ 60%
Adequate cardiac, hepatic and renal function
- QTc interval < 500 ms
- Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) < 5 x upper limit normal (ULN)
- Bilirubin < 5 x ULN
- Creatinine < 3 x ULN
Adequate haematological function
- Haemoglobin ≥ 8 g/dL
- White blood count ≥ 3.0 x 109/L
- Platelet count ≥ 100 x 109/L
- For females of child-bearing potential: ability and willingness to use a highly effective form of contraception (e.g., abstinence from sexual intercourse, surgical sterilisation (of subject or partner) or a double-barrier method of contraception such as either an intra-uterine device (IUD) or an occlusive cap with spermicide, in conjunction with partner's use of a condom) during the study and for a period of at least 48 hours afterwards
Exclusion Criteria
- Patients scheduled to receive, prior to or in the 120 hours after cisplatin or AC, any other chemotherapeutic agent with a high or moderate emetic risk
- Patients who have previously received anti-neoplastic chemotherapy
- Patients scheduled to receive paclitaxel or docetaxel during the first cycle of their chemotherapy
- Patients undergoing abdominal or pelvic irradiation within 48 hours prior to screening or scheduled to receive abdominal or pelvic irradiation between screening and 24 hours after cisplatin or AC administration
- Patients with a known prolactin-dependent tumour (e.g. pituitary gland prolactinoma or confirmed prolactin-dependent breast cancer) or phaeochromocytoma
- Patients with a pre-existing vestibular disorder
- Patients being treated with regular anti-emetic therapy including corticosteroids
- Patients receiving inhaled corticosteroids, unless started more than one month prior to the expected date of study entry
Sites / Locations
- Odense University Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Other
Placebo Comparator
Experimental
Experimental
Experimental
Arm Label
Control
Placebo
Low dose APD403
Mid dose APD403
High dose APD403
Arm Description
OND + DEX + FOS followed by oral DEX
OND + APD403 followed by oral PLACEBO
OND + APD403 followed by oral APD403 low dose
OND + APD403 followed by oral APD403 mid dose
OND + APD403 followed by oral APD403 high dose
Outcomes
Primary Outcome Measures
Number of Participants With Delayed Phase Complete Response(CR)
Delayed phase complete response (CR), defined as an absence of emetic episodes and no rescue medication use in the period from 24 to 120 hours after the initiation of chemotherapy.
The primary endpoint was analysed separately in the strata of chemotherapy regimen and gender, and in the strata of country.
Secondary Outcome Measures
Number of Participants With CR in the Overall Phase.
CR defined as no emesis and no use of rescue medication, in the overall phase (0 to 120 hours after the initiation of chemotherapy)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01857232
Brief Title
Dose-finding Study of APD403 to Prevent Nausea and Vomiting After Chemotherapy
Official Title
Randomised, Double-blind, Dose-finding Phase II Study to Assess the Efficacy of APD403 in the Prevention of Nausea and Vomiting Caused by Cisplatin- or Anthracycline/Cyclophosphamide (AC)-Based Chemotherapy
Study Type
Interventional
2. Study Status
Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
February 2015 (Actual)
Study Completion Date
February 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Acacia Pharma Ltd
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Comparison of efficacy of APD403 at preventing delayed sickness in patients who have received cancer chemotherapy
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
CINV
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
342 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Control
Arm Type
Other
Arm Description
OND + DEX + FOS followed by oral DEX
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
OND + APD403 followed by oral PLACEBO
Arm Title
Low dose APD403
Arm Type
Experimental
Arm Description
OND + APD403 followed by oral APD403 low dose
Arm Title
Mid dose APD403
Arm Type
Experimental
Arm Description
OND + APD403 followed by oral APD403 mid dose
Arm Title
High dose APD403
Arm Type
Experimental
Arm Description
OND + APD403 followed by oral APD403 high dose
Intervention Type
Drug
Intervention Name(s)
Ondansetron
Intervention Description
5HT3-antagonist
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Comparator
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
Corticosteroid
Intervention Type
Drug
Intervention Name(s)
Fosaprepitant
Intervention Description
NK1 antagonist
Intervention Type
Drug
Intervention Name(s)
APD403 IV
Intervention Description
Amisulpride IV 20 mg
Intervention Type
Drug
Intervention Name(s)
APD403 oral
Intervention Description
Amisulpride oral 10, 20 or 40 mg
Primary Outcome Measure Information:
Title
Number of Participants With Delayed Phase Complete Response(CR)
Description
Delayed phase complete response (CR), defined as an absence of emetic episodes and no rescue medication use in the period from 24 to 120 hours after the initiation of chemotherapy.
The primary endpoint was analysed separately in the strata of chemotherapy regimen and gender, and in the strata of country.
Time Frame
24-120 hours
Secondary Outcome Measure Information:
Title
Number of Participants With CR in the Overall Phase.
Description
CR defined as no emesis and no use of rescue medication, in the overall phase (0 to 120 hours after the initiation of chemotherapy)
Time Frame
0 to 120 hours after the initiation of chemotherapy
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria
Male or female patients ≥ 18 years of age
Ability and willingness to give written informed consent
Patients scheduled to receive, on day 1 of their chemotherapy, either: (i) a first cisplatin chemotherapy infusion at a dose of ≥70 mg/m2 (males and females); or (ii) a first infusion of cyclophosphamide at a dose of 500-1500 mg/m2 in combination with either epirubicin at a dose of 60-100 mg/m2 or doxorubicin at a dose of 40-60 mg/m2 (females only)
Karnofsky performance score ≥ 60%
Adequate cardiac, hepatic and renal function
QTc interval < 500 ms
Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) < 5 x upper limit normal (ULN)
Bilirubin < 5 x ULN
Creatinine < 3 x ULN
Adequate haematological function
Haemoglobin ≥ 8 g/dL
White blood count ≥ 3.0 x 109/L
Platelet count ≥ 100 x 109/L
For females of child-bearing potential: ability and willingness to use a highly effective form of contraception (e.g., abstinence from sexual intercourse, surgical sterilisation (of subject or partner) or a double-barrier method of contraception such as either an intra-uterine device (IUD) or an occlusive cap with spermicide, in conjunction with partner's use of a condom) during the study and for a period of at least 48 hours afterwards
Exclusion Criteria
Patients scheduled to receive, prior to or in the 120 hours after cisplatin or AC, any other chemotherapeutic agent with a high or moderate emetic risk
Patients who have previously received anti-neoplastic chemotherapy
Patients scheduled to receive paclitaxel or docetaxel during the first cycle of their chemotherapy
Patients undergoing abdominal or pelvic irradiation within 48 hours prior to screening or scheduled to receive abdominal or pelvic irradiation between screening and 24 hours after cisplatin or AC administration
Patients with a known prolactin-dependent tumour (e.g. pituitary gland prolactinoma or confirmed prolactin-dependent breast cancer) or phaeochromocytoma
Patients with a pre-existing vestibular disorder
Patients being treated with regular anti-emetic therapy including corticosteroids
Patients receiving inhaled corticosteroids, unless started more than one month prior to the expected date of study entry
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jørn Herrstedt, MD
Organizational Affiliation
Odense University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Odense University Hospital
City
Odense
Country
Denmark
12. IPD Sharing Statement
Citations:
PubMed Identifier
30488222
Citation
Herrstedt J, Summers Y, Jordan K, von Pawel J, Jakobsen AH, Ewertz M, Chan S, Naik JD, Karthaus M, Dubey S, Davis R, Fox GM. Amisulpride prevents nausea and vomiting associated with highly emetogenic chemotherapy: a randomised, double-blind, placebo-controlled, dose-ranging trial. Support Care Cancer. 2019 Jul;27(7):2699-2705. doi: 10.1007/s00520-018-4564-8. Epub 2018 Nov 28.
Results Reference
derived
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Dose-finding Study of APD403 to Prevent Nausea and Vomiting After Chemotherapy
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