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Effectiveness and Tolerance of Fentanyl Citrate in Painful Pain Induced During Diagnostic or Therapeutic Examinations in Cancer Patients (FARADI)

Primary Purpose

Breakthrough Pain

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Fentanyl citrate
Placebo
Sponsored by
UNICANCER
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breakthrough Pain focused on measuring Breakthrough Pain

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years.
  2. Patients in follow up or being treated for cancer.
  3. Patients with cancer-related pain (area of pain located near primary tumor or metastatic lesions).
  4. Patients:

    1. not having received any opioid treatment (opioid naïve).
    2. or, treated for less than 7 days by a slow-releasing/extend-release opioid treatment; and/or by less than 60 mg per day of oral morphine, or less than 30 mg/day of oral oxycodone, or less than 8 mg/day of oral hydromorphone, or less than 25 µg/h of transdermal fentanyl.
  5. Patients need to have at least one of the following interventions, lasting between 25 and 45 minutes during which they will be request to not move:

    1. Radiotherapy session*, including tomography (patients hospitalized or treated as outpatients).
    2. Dosimetric scanner (hospitalized patients).
    3. Positron-emission tomography** (PET): PET-computed tomography [CT] scan and single photon emission computed tomography [SPECT]-CT scan (hospitalized patients).
  6. Public health insurance coverage.

(*) A patient who has numerous radiotherapy sessions can only be included once; (**) with acquisition phase in a prostrate or decubitus dorsal position and strictly immobile in one of the cameras (PET or SPECT).

Inclusion criteria (cohort):

As for the inclusion criteria for the phase II study, with the following modifications:

4. Patients treated with a slow-releasing/extended-release opioid for:

  1. more than 7 days.
  2. and with at least 60 mg per day of oral morphine, or at least 30 mg/day of oral oxycodone, or at least 8 mg/day of oral hydromorphone, or at least 25 µg/h of transdermal fentanyl.

    5. Patients who believes that they are cannot assume a prostrate or decubitus dorsal position for a diagnostic or therapeutic examination/intervention due to the pain they will experienced in this position,

    Or

    Patients experience breakthrough pain (numerical pain scale 5), in a region corresponding to the localization of the metastatic lesions or the primary tumor, when they assume a prostrate/decubitus dorsal position,

    Or

    Patients who have breakthrough pain (numerical pain scale 5) in a region corresponding to the localization of the metastatic lesions or the primary tumor that prevents the completion of a diagnostic or therapeutic examination/intervention.

    6. Public health insurance coverage.

    Exclusion Criteria:

    1. Patients with contraindication for the administration of fentanyl citrate: severe respiratory depression or a severe obstructive pulmonary disease.
    2. Patients who have already participated in this study.
    3. Patients with a history of alcoholism or substance/drug dependence.
    4. Patients with an intravenous or subcutaneous opioid patient-controlled analgesic (PCA) pump.
    5. Patients unable to communicate or understand instructions in French.
    6. Patients deprived of their liberty or under protective custody or guardianship, or unable to provide their consent for study participation.
    7. Patients who are pregnant or breast-feeding.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    FAR Arm

    Placebo Arm

    Arm Description

    Outcomes

    Primary Outcome Measures

    Successful diagnostic or therapeutic examination
    A patient will be considered a success if the planned immobilization period is completed.

    Secondary Outcome Measures

    Full Information

    First Posted
    October 11, 2018
    Last Updated
    April 20, 2020
    Sponsor
    UNICANCER
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03809455
    Brief Title
    Effectiveness and Tolerance of Fentanyl Citrate in Painful Pain Induced During Diagnostic or Therapeutic Examinations in Cancer Patients
    Acronym
    FARADI
    Official Title
    Effectiveness and Tolerance of Fentanyl Citrate in Painful Pain Induced During Diagnostic or Therapeutic Examinations in Cancer Patients
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2020
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Study was cancelled by Sponsor.
    Study Start Date
    February 1, 2020 (Anticipated)
    Primary Completion Date
    February 1, 2022 (Anticipated)
    Study Completion Date
    February 1, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    UNICANCER

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    A phase II, prospective, multicentre, single-blinded, randomised study (when fentanyl citrate is used outside of its marketing authorisation) Patients will be enrolled in an observational cohort when the fentanyl citrate is used according to its marketing authorisation.
    Detailed Description
    Primary objective (phase II trial): Evaluate the efficacy of an administration of fentanyl citrate to alleviate breakthrough pain caused by positional requirements of a diagnostic or therapeutic intervention/examination in cancer patients who do not meet the prescription criteria for fentanyl citrate's marketing authorisation, as follows: Patients having received less than 60 mg of slow-release/extended-release morphine. Patients having received slow-release/extended-release morphine for less than 7 days. Patients who have not received any opioid treatment. Primary objective (cohort): Evaluate the efficacy of an administration of fentanyl citrate to alleviate breakthrough pain caused by positional requirements of a diagnostic or therapeutic intervention/examination in cancer patients when used within the marketing authorisation, as follows: Patients having at least 60 mg of slow-release/extended-release morphine. Patients having received slow-release/extended-release morphine for at least 7 days. Patients who have already received an opioid treatment (at least equivalent to 60 mg /day of oral morphine) for chronic cancer-related pain for at least 7 days. Secondary objectives (phase II and cohort): Evaluate the tolerance of the administration of fentanyl citrate when used to alleviate breakthrough pain caused by positional requirements of a diagnostic or therapeutic intervention/examination in cancer patients. Evaluate the efficacy of fentanyl citrate for reducing pain. Evaluate the efficacy of fentanyl citrate for reducing anxiety. Evaluate the percentage of relief and patients' satisfaction related to the administration of fentanyl citrate. Secondary objectives (phase II only): • Describe the reasons why the diagnostic or therapeutic intervention/examination failed.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Breakthrough Pain
    Keywords
    Breakthrough Pain

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    A phase II, prospective, multicentre, single-blinded, randomised study (when fentanyl citrate is used outside of its marketing authorisation) Patients will be enrolled in an observational cohort when the fentanyl citrate is used according to its marketing authorisation. The study will randomise patients (2:1; FAR Arm: Placebo Arm) Stratified by: Centre Type of examination: diagnostic (PET-CT scan or SPECT-CT scan) versus therapeutic (radiotherapy, tomotherapy, or dosimetric scanner)
    Masking
    ParticipantCare ProviderInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    FAR Arm
    Arm Type
    Experimental
    Arm Title
    Placebo Arm
    Arm Type
    Placebo Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    Fentanyl citrate
    Intervention Description
    Fentanyl citrate arm (FAR Arm): one intake of fentanyl citrate 100 µg (intranasal or buccal). Placebo Arm: one intake of placebo (intranasal or buccal) The administration route will be left to the discretion of the investigator taking into account the patient's profile (capable of maintaining the sublingual tablet without swallowing, absence of nasal discharge…), and/or the patient's choice. Medication Commercial name Formulation Administration route Dose Fentanyl citrate Pecfent® Nasal spray Intranasal 100 µg Fentanyl citrate Abstral® Sublingual tablet Buccal 100 µg For the cohort the choice of treatment by FAR is at the centres discretion, according to standard of practice. Treatment duration: 1 day
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    one intake of placebo (intranasal or buccal)
    Primary Outcome Measure Information:
    Title
    Successful diagnostic or therapeutic examination
    Description
    A patient will be considered a success if the planned immobilization period is completed.
    Time Frame
    1 hours after randomization

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age ≥18 years. Patients in follow up or being treated for cancer. Patients with cancer-related pain (area of pain located near primary tumor or metastatic lesions). Patients: not having received any opioid treatment (opioid naïve). or, treated for less than 7 days by a slow-releasing/extend-release opioid treatment; and/or by less than 60 mg per day of oral morphine, or less than 30 mg/day of oral oxycodone, or less than 8 mg/day of oral hydromorphone, or less than 25 µg/h of transdermal fentanyl. Patients need to have at least one of the following interventions, lasting between 25 and 45 minutes during which they will be request to not move: Radiotherapy session*, including tomography (patients hospitalized or treated as outpatients). Dosimetric scanner (hospitalized patients). Positron-emission tomography** (PET): PET-computed tomography [CT] scan and single photon emission computed tomography [SPECT]-CT scan (hospitalized patients). Public health insurance coverage. (*) A patient who has numerous radiotherapy sessions can only be included once; (**) with acquisition phase in a prostrate or decubitus dorsal position and strictly immobile in one of the cameras (PET or SPECT). Inclusion criteria (cohort): As for the inclusion criteria for the phase II study, with the following modifications: 4. Patients treated with a slow-releasing/extended-release opioid for: more than 7 days. and with at least 60 mg per day of oral morphine, or at least 30 mg/day of oral oxycodone, or at least 8 mg/day of oral hydromorphone, or at least 25 µg/h of transdermal fentanyl. 5. Patients who believes that they are cannot assume a prostrate or decubitus dorsal position for a diagnostic or therapeutic examination/intervention due to the pain they will experienced in this position, Or Patients experience breakthrough pain (numerical pain scale 5), in a region corresponding to the localization of the metastatic lesions or the primary tumor, when they assume a prostrate/decubitus dorsal position, Or Patients who have breakthrough pain (numerical pain scale 5) in a region corresponding to the localization of the metastatic lesions or the primary tumor that prevents the completion of a diagnostic or therapeutic examination/intervention. 6. Public health insurance coverage. Exclusion Criteria: Patients with contraindication for the administration of fentanyl citrate: severe respiratory depression or a severe obstructive pulmonary disease. Patients who have already participated in this study. Patients with a history of alcoholism or substance/drug dependence. Patients with an intravenous or subcutaneous opioid patient-controlled analgesic (PCA) pump. Patients unable to communicate or understand instructions in French. Patients deprived of their liberty or under protective custody or guardianship, or unable to provide their consent for study participation. Patients who are pregnant or breast-feeding.

    12. IPD Sharing Statement

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