A Prospective, Multicenter, Study of APF530 (Granisetron) SC for Prevention of CINV in Patients Receiving HEC
Primary Purpose
Chemotherapy-induced Nausea and Vomiting
Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
APF530
Ondansetron
Ondansetron placebo
APF530 placebo
Fosaprepitant
Dexamethasone
Sponsored by
About this trial
This is an interventional treatment trial for Chemotherapy-induced Nausea and Vomiting focused on measuring Highly emetogenic chemotherapy (HEC), Chemotherapy-Induced Nausea and Vomiting (CINV)
Eligibility Criteria
Inclusion Criteria:
- Subjects will be males or nonpregnant females who are 18-87 years of age at the time of enrollment.
- Subjects must have histologically or cytologically confirmed malignant disease.
- Subjects must be undergoing treatment with a HEC regimen according to the 2011 ASCO CINV guidelines for further details on the emetogenic classifications of chemotherapy agents for this study).
- A life expectancy > 6 months
- Subjects must be able to receive standardized doses of dexamethasone as required in the protocol for the prevention of emesis.
- Subjects must be characterized as having Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Subjects must have adequate bone marrow, kidney, and liver function.
- Subjects must be able to swallow oral medications (pills) without difficulty.
- Subjects must be entering the first cycle of their current chemotherapy regimen.
- Subjects must be willing and able to comply with all testing and requirements defined in the protocol.
- Subjects must be able to provide voluntary, written, informed consent to participate in this study and must be able to fully understand the study requirements.
- Female subjects cannot be pregnant and must be adequately protected from conception for the duration of study, using at least one form of contraception. It is recommended that females and female partners of male subjects remain adequately protected from conception during the study and for up to 1 year following study participation.
Exclusion Criteria:
- Subject has a known hypersensitivity to granisetron or any 5-HT3 receptor antagonist.
- Subject has a history or presence of clinically significant abnormal 12-lead ECG or an ECG with QTc by Bazett's correction of > 450 msec in men and > 470 msec in women on the screening ECG.
- Subject has PR > 240 msec, QRS > 110 msec, or a history of prolongation of QT interval.
- Subject has a family history of long QT syndrome.
- Subject has a history of cardiac disease, including congenital long QT syndrome, angina, myocardial ischemia or infarction, congestive heart failure, myocarditis, or chest pain or dyspnea on exertion.
- Subject has an electrolyte disturbance, such as uncorrected hypokalemia/hyperkalemia, hypomagnesemia, or hypocalcemia.
- Subject has idiopathic cardiomyopathy, syncope, epilepsy, hypertrophic cardiomyopathy, or other clinically significant cardiac disease.
- Subject is pregnant or breast-feeding.
- Subject is planning to receive multiple-day chemotherapy.
- Subject has taken any of the following agents within 7 days prior to initiation of chemotherapy (the study): 5-HT3 receptor antagonists, phenothiazines, benzamides, domperidone, cannabinoids, or NK-1 receptor antagonist.
- Subject has taken any benzodiazepine within 1 day (24 hours) prior to initiation of chemotherapy (the study).
- Subject is scheduled to receive any other chemotherapeutic agent from Day 2 through Day 6.
- Subject is scheduled to receive any radiation therapy to the abdomen or pelvis from Day -5 through Day 6.
- Subject has received systemic corticosteroids or sedative antihistamines within 72 hours of Day 1 of the study, except as premedication for chemotherapy (e.g., taxanes, pemetrexed).
- Subject has symptomatic primary or metastatic central nervous system (CNS) disease.
- Subject has ongoing vomiting, retching, or nausea caused by any etiology, or has a history of anticipatory nausea and vomiting.
- Subject has vomited and/or has had dry heaves or retching within 24 hours prior to the start of HEC on Day 1.
- Subject is NOT able to swallow oral medications (pills) without difficulty.
Sites / Locations
- Arizona Oncology Associates, PC-HAL
- The Oncology Institute of Hope and Innovation
- Compassionate Cancer Medical Center
- Northern Indiana Research
- Northern Indiana Research
- North Shore Oncology
- Gabrail Cancer Center Research
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
APF530 500 mg SC
ondansetron 0.15 mg/kg IV
Arm Description
APF530 500 mg (granisetron 10 mg) SC and ondansetron placebo IV (0.15 mg/kg) and fosaprepitant 150 mg IV and dexamethasone 12 mg IV on Day 1 of Cycle 1 in association with HEC
Ondansetron 2 mg/mL solution to be administered at 0.15 mg/kg IV (up to a maximum of 16 mg) and APF530 placebo SC and fosaprepitant 150 mg IV and dexamethasone 12 mg IV on Day 1 of Cycle 1
Outcomes
Primary Outcome Measures
Delayed Phase Complete Response (CR) Rate
Percentage of Participants with no emesis and no rescue medication in patients receiving HEC in the delayed phase (24 to 120 hours) of CINV.
Secondary Outcome Measures
Overall Complete Response Rate
To determine the effect of APF530 on complete response rates in the overall phase (0 to 120 hours) of CINV.
Delayed Complete Control (CC) Rate
To determine the effect of APF530 on complete control rates defined as no more than mild nausea, no emetic episodes [vomiting or retching], and no use of rescue medications in the delayed phase (24 to 120 hours) of CINV.
Overall Complete Control Rate
To determine the effect of APF530 on complete control rates defined as no more than mild nausea, no emetic episodes [vomiting or retching], and no use of rescue medications in the overall phase (0 to 120 hours) of CINV.
Rate of No Emetic Episodes
To determine the effect of APF530 on the rate of no emetic episodes (vomiting or retching) in the overall phase (0 to 120 hours) of CINV.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02106494
Brief Title
A Prospective, Multicenter, Study of APF530 (Granisetron) SC for Prevention of CINV in Patients Receiving HEC
Official Title
A Phase 3 Clinical Study Protocol: A Prospective, Randomized, Placebo-Controlled, Double-Blind, Multicenter, Phase 3 Study of APF530 500 mg SC, Fosaprepitant 150 mg IV, and Dexamethasone vs. Ondansetron 0.15 mg/kg IV, Fosaprepitant 150 mg IV, and Dexamethasone for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy
Study Type
Interventional
2. Study Status
Record Verification Date
October 2016
Overall Recruitment Status
Completed
Study Start Date
March 2014 (undefined)
Primary Completion Date
May 2015 (Actual)
Study Completion Date
May 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Heron Therapeutics
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The primary study objective is to demonstrate the superiority of APF530 500 mg given subcutaneously (SC) compared with ondansetron 0.15 mg/kg given intravenously (IV) (up to a maximum of 16 mg) in the delayed-phase (> 24-120 hours) complete response (CR) rate (defined as no emesis and no use of rescue medications) in subjects receiving highly emetogenic chemotherapy (HEC) as defined by the 2011 ASCO CINV guidelines
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chemotherapy-induced Nausea and Vomiting
Keywords
Highly emetogenic chemotherapy (HEC), Chemotherapy-Induced Nausea and Vomiting (CINV)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
942 (Actual)
8. Arms, Groups, and Interventions
Arm Title
APF530 500 mg SC
Arm Type
Experimental
Arm Description
APF530 500 mg (granisetron 10 mg) SC and ondansetron placebo IV (0.15 mg/kg) and fosaprepitant 150 mg IV and dexamethasone 12 mg IV on Day 1 of Cycle 1 in association with HEC
Arm Title
ondansetron 0.15 mg/kg IV
Arm Type
Active Comparator
Arm Description
Ondansetron 2 mg/mL solution to be administered at 0.15 mg/kg IV (up to a maximum of 16 mg) and APF530 placebo SC and fosaprepitant 150 mg IV and dexamethasone 12 mg IV on Day 1 of Cycle 1
Intervention Type
Drug
Intervention Name(s)
APF530
Intervention Type
Drug
Intervention Name(s)
Ondansetron
Intervention Type
Drug
Intervention Name(s)
Ondansetron placebo
Intervention Type
Drug
Intervention Name(s)
APF530 placebo
Intervention Type
Drug
Intervention Name(s)
Fosaprepitant
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Primary Outcome Measure Information:
Title
Delayed Phase Complete Response (CR) Rate
Description
Percentage of Participants with no emesis and no rescue medication in patients receiving HEC in the delayed phase (24 to 120 hours) of CINV.
Time Frame
24 - 120 Hours
Secondary Outcome Measure Information:
Title
Overall Complete Response Rate
Description
To determine the effect of APF530 on complete response rates in the overall phase (0 to 120 hours) of CINV.
Time Frame
0 - 120 Hours
Title
Delayed Complete Control (CC) Rate
Description
To determine the effect of APF530 on complete control rates defined as no more than mild nausea, no emetic episodes [vomiting or retching], and no use of rescue medications in the delayed phase (24 to 120 hours) of CINV.
Time Frame
24 - 120 Hours
Title
Overall Complete Control Rate
Description
To determine the effect of APF530 on complete control rates defined as no more than mild nausea, no emetic episodes [vomiting or retching], and no use of rescue medications in the overall phase (0 to 120 hours) of CINV.
Time Frame
0 - 120 Hours
Title
Rate of No Emetic Episodes
Description
To determine the effect of APF530 on the rate of no emetic episodes (vomiting or retching) in the overall phase (0 to 120 hours) of CINV.
Time Frame
0 - 120 Hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
87 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects will be males or nonpregnant females who are 18-87 years of age at the time of enrollment.
Subjects must have histologically or cytologically confirmed malignant disease.
Subjects must be undergoing treatment with a HEC regimen according to the 2011 ASCO CINV guidelines for further details on the emetogenic classifications of chemotherapy agents for this study).
A life expectancy > 6 months
Subjects must be able to receive standardized doses of dexamethasone as required in the protocol for the prevention of emesis.
Subjects must be characterized as having Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
Subjects must have adequate bone marrow, kidney, and liver function.
Subjects must be able to swallow oral medications (pills) without difficulty.
Subjects must be entering the first cycle of their current chemotherapy regimen.
Subjects must be willing and able to comply with all testing and requirements defined in the protocol.
Subjects must be able to provide voluntary, written, informed consent to participate in this study and must be able to fully understand the study requirements.
Female subjects cannot be pregnant and must be adequately protected from conception for the duration of study, using at least one form of contraception. It is recommended that females and female partners of male subjects remain adequately protected from conception during the study and for up to 1 year following study participation.
Exclusion Criteria:
Subject has a known hypersensitivity to granisetron or any 5-HT3 receptor antagonist.
Subject has a history or presence of clinically significant abnormal 12-lead ECG or an ECG with QTc by Bazett's correction of > 450 msec in men and > 470 msec in women on the screening ECG.
Subject has PR > 240 msec, QRS > 110 msec, or a history of prolongation of QT interval.
Subject has a family history of long QT syndrome.
Subject has a history of cardiac disease, including congenital long QT syndrome, angina, myocardial ischemia or infarction, congestive heart failure, myocarditis, or chest pain or dyspnea on exertion.
Subject has an electrolyte disturbance, such as uncorrected hypokalemia/hyperkalemia, hypomagnesemia, or hypocalcemia.
Subject has idiopathic cardiomyopathy, syncope, epilepsy, hypertrophic cardiomyopathy, or other clinically significant cardiac disease.
Subject is pregnant or breast-feeding.
Subject is planning to receive multiple-day chemotherapy.
Subject has taken any of the following agents within 7 days prior to initiation of chemotherapy (the study): 5-HT3 receptor antagonists, phenothiazines, benzamides, domperidone, cannabinoids, or NK-1 receptor antagonist.
Subject has taken any benzodiazepine within 1 day (24 hours) prior to initiation of chemotherapy (the study).
Subject is scheduled to receive any other chemotherapeutic agent from Day 2 through Day 6.
Subject is scheduled to receive any radiation therapy to the abdomen or pelvis from Day -5 through Day 6.
Subject has received systemic corticosteroids or sedative antihistamines within 72 hours of Day 1 of the study, except as premedication for chemotherapy (e.g., taxanes, pemetrexed).
Subject has symptomatic primary or metastatic central nervous system (CNS) disease.
Subject has ongoing vomiting, retching, or nausea caused by any etiology, or has a history of anticipatory nausea and vomiting.
Subject has vomited and/or has had dry heaves or retching within 24 hours prior to the start of HEC on Day 1.
Subject is NOT able to swallow oral medications (pills) without difficulty.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Gelder, MD
Organizational Affiliation
Heron Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Arizona Oncology Associates, PC-HAL
City
Pheonix
State/Province
Arizona
ZIP/Postal Code
85016
Country
United States
Facility Name
The Oncology Institute of Hope and Innovation
City
Downey
State/Province
California
ZIP/Postal Code
90241
Country
United States
Facility Name
Compassionate Cancer Medical Center
City
Riverside
State/Province
California
ZIP/Postal Code
92501
Country
United States
Facility Name
Northern Indiana Research
City
Mishawaka
State/Province
Indiana
ZIP/Postal Code
46545
Country
United States
Facility Name
Northern Indiana Research
City
South Bend
State/Province
Indiana
ZIP/Postal Code
46804
Country
United States
Facility Name
North Shore Oncology
City
East Setauket
State/Province
New York
ZIP/Postal Code
11733
Country
United States
Facility Name
Gabrail Cancer Center Research
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
26997579
Citation
Schnadig ID, Agajanian R, Dakhil C, Gabrail NY, Smith RE Jr, Taylor C, Wilks ST, Schwartzberg LS, Cooper W, Mosier MC, Payne JY, Klepper MJ, Vacirca JL. APF530 (granisetron injection extended-release) in a three-drug regimen for delayed CINV in highly emetogenic chemotherapy. Future Oncol. 2016 Jun;12(12):1469-81. doi: 10.2217/fon-2016-0070. Epub 2016 Mar 21.
Results Reference
result
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A Prospective, Multicenter, Study of APF530 (Granisetron) SC for Prevention of CINV in Patients Receiving HEC
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