Granisetron Extended Release Injection (GERSC) for the Prevention of Chemotherapy-induced Nausea and Vomiting
Primary Purpose
Chemotherapy-induced Nausea and Vomiting
Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
GRANISETRON EXTENDED RELEASE INJECTION (GERSC)
Sponsored by
About this trial
This is an interventional treatment trial for Chemotherapy-induced Nausea and Vomiting
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of malignant disease and scheduled for MEC or HEC
- Chemotherapy naive
- Age ≥18 years.
- ECOG Performance Status 0 or 1
- Required Initial Laboratory Values ≤28 days prior to registration. Patient must have adequate bone marrow, kidney, and liver function as evidenced by:
- Platelet count ≥ 100,000/ mm3
- Bilirubin ≤ 1.5 x ULN, except for subjects with Gilbert's syndrome
- Serum Creatinine ≤2.0 mg/dL
- SGOT or SGPT ≤3 x upper limit of normal (ULN)
- Absolute neutrophil count (ANC) ≥1500/mm3
- Patients receiving HEC will have received the 5HT3 receptor antagonist palonosetron, a NK-1, and dexamethasone as antiemetic prophylaxis during cycle 1 of chemotherapy
- Patients receiving MEC will have received the 5HT3 receptor antagonist palonosetron, and dexamethasone as antiemetic prophylaxis during cycle 1 of chemotherapy
Exclusion Criteria:
- No nausea or vomiting ≤ 24 hours prior to registration.
- Negative pregnancy test (serum β hCG) done ≤7 days prior to registration, for women of childbearing potential only (per clinician discretion).
- No severe cognitive compromise.
- No known history of active, untreated CNS disease (e.g. brain metastases, seizure disorder).
- No concurrent use of amifostine, thioridazine, pimozide or St. John's wort.
- No concurrent abdominal radiotherapy.
- No concurrent use of olanzapine therapy.
- No chronic alcoholism (as determined by the investigator).
- No known hypersensitivity to granisetron.
- No known uncontrolled cardiac arrhythmia or uncontrolled congestive heart failure.
- No acute myocardial infarction within the previous six months.
- No history of uncontrolled diabetes mellitus (may be on a stable dose of insulin or on a stable dose of an oral hypoglycemic agent).
- Patients with psychiatric illness that would prevent the patient from giving informed consent are not eligible for the trial
- Medical condition such as uncontrolled infection (including HIV),uncontrolled Diabetes Mellitus, unstable cardiac disease which, in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient are not eligible for the trial
- Patients with a "currently active" second malignancy other than non-melanoma skin cancers are not eligible for the trial; Patients are not considered to have a "currently active" malignancy if they have completed therapy and are free of disease for ≥ 3 years.
- Patients who cannot swallow oral formulations of the agent(s) are not eligible for the trial.
Sites / Locations
- The University of Alabama at Birmingham
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
GERSC for patients receiving highly emetogenic chemotherapy
GERSC on patients receiving moderately emetogenic chemotherapy
Arm Description
Participants will receive GERSC, and two other standard antiemetics prior to chemotherapy
Participants will receive GERSC and one other standard antiemetic prior to chemotherapy
Outcomes
Primary Outcome Measures
Percentage of participants with a previous history of emetic episodes
After participants have completed their informed consent, they will complete a baseline assessment to record emetic episodes prior to chemotherapy.
Percentage of participants with a complete response of no emetic episode
Patient will be monitored for vomiting on Day 1 after receiving chemotherapy. The participants will complete a vomiting assessment and record the number of episodes (none, once, more than once and number)
Percentage of participants with a complete response of no emetic episode
Patient will be monitored for vomiting on Day 2 through Day 6 after receiving chemotherapy. The participants will complete a vomiting assessment and record the number of episodes (none, once, more than once and number)
Percentage of participants with a complete response of no emetic episode
Patient will be monitored for total vomiting episodes starting from Day 1 through Day 6 after receiving chemotherapy. The participants will complete a vomiting assessment and record the number of episodes (none, once, more than once and number)
Secondary Outcome Measures
Percentage of participants frequency rate of No Nausea
Participants will complete a Visual Analogue Scale at baseline to record their history of the presence or absence of nausea and frequency prior to chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Percentage of participants frequency rate of No Nausea
Participants will complete a Visual Analogue Scale on Day 1 to record the presence or absence of nausea and frequency after receiving chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Percentage of participants frequency rate of No Nausea
Participants will complete a Visual Analogue Scale on Day 2 through Day 6 to record the presence or absence of nausea and frequency after receiving chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Percentage of participants frequency rate of No Nausea
Participants will complete a Visual Analogue Scale on Day 1 through Day 6 to record the presence or absence of nausea and frequency after receiving chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Percentage of participants experiencing GERSC toxicity
The toxicity will be assessed by the severity of the side effects listed below. The descriptions and grading scales found in the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4 will be utilized for reporting.
Constipation
Fatigue
Headache
Diarrhea
Abdominal Pain
Sleeplessness (Insomnia)
Indigestion (Dyspepsia)
Dizziness
Asthenia
Gastroesophageal Reflux
Full Information
NCT ID
NCT04085393
First Posted
August 29, 2019
Last Updated
September 28, 2020
Sponsor
University of Alabama at Birmingham
Collaborators
Heron Therapeutics
1. Study Identification
Unique Protocol Identification Number
NCT04085393
Brief Title
Granisetron Extended Release Injection (GERSC) for the Prevention of Chemotherapy-induced Nausea and Vomiting
Official Title
Granisetron Extended Release Injection (GERSC) for the Prevention of Chemotherapy-induced Breakthrough Nausea and Vomiting (CINV) in Patients Receiving Moderately or Highly Emetogenic Chemotherapy: A Phase II Clinical Trial
Study Type
Interventional
2. Study Status
Record Verification Date
September 2020
Overall Recruitment Status
Withdrawn
Why Stopped
sponsor withdrew study
Study Start Date
August 15, 2020 (Actual)
Primary Completion Date
August 15, 2020 (Actual)
Study Completion Date
December 1, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Alabama at Birmingham
Collaborators
Heron Therapeutics
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Chemotherapy-induced nausea and vomiting (CINV) adversely affects patients' quality of life and may affect patients' treatment decisions. The emetogenicity of the chemotherapy administered and specific patient characteristics such as female gender, age, and history of low alcohol intake can increase a patients' risk for CINV.
GERSC is a new, subcutaneously (SC) administered polymeric formulation of Granisetron that was developed to provide slow, controlled, and sustained release of Granisetron to prevent both acute and delayed CINV associated with moderately emetic chemotherapy (MEC) and highly emetic chemotherapy (HEC)
Detailed Description
All patients eligible for the study receiving moderately emetogenic (MEC) chemotherapy will receive GERSC receptor antagonist on day one. All patients eligible for the study receiving highly emetogenic Chemotherapy (HEC) chemotherapy will receive GERSC receptor antagonist on day one including dexamethasone and NK-1 Receptor antagonist during cycle 1.
The primary objective is to measure the Complete Response (no emetic episodes, no use of rescue medications) in patients receiving GERSC as a replacement for the second generation 5 HT3 receptor antagonist palonosetron used in the first chemotherapy cycle for those patients receiving MEC or HEC and developed Breakthrough CINV. Complete response would be recorded specifically for the acute (0-24 hours post-chemotherapy), delayed (24-120 hours post-chemotherapy), and overall periods (0-120 hours post-chemotherapy).
This study has two study groups.
Group 1 (HEC) will receive GERSC, dexamethasone and NK-1 antagonist prior to chemotherapy
Group 2 (MEC) will receive GERSC and dexamethasone prior to chemotherapy
During the study:
Participants will be completing questionnaires on day 1 prior to treatment and at approximately the same time treatment was given each day for the next seven days. Participant will be assessed each day on the amount of nausea, vomiting, and/or sedation experienced in the previous 24-hour period. The assessment should take less than 5 minutes to complete each day.
Participants will be registered for Quality of Life measurement. Validated QOL measurements of fatigue and overall perception of QOL will be assessed upon registration in this study. Fatigue and overall well-being clearly can impact how well patients will do in terms of being able to tolerate and experience nausea and vomiting
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chemotherapy-induced Nausea and Vomiting
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
GERSC for patients receiving highly emetogenic chemotherapy
Arm Type
Active Comparator
Arm Description
Participants will receive GERSC, and two other standard antiemetics prior to chemotherapy
Arm Title
GERSC on patients receiving moderately emetogenic chemotherapy
Arm Type
Active Comparator
Arm Description
Participants will receive GERSC and one other standard antiemetic prior to chemotherapy
Intervention Type
Drug
Intervention Name(s)
GRANISETRON EXTENDED RELEASE INJECTION (GERSC)
Intervention Description
GERSC is a new, subcutaneously (SC) administered polymeric formulation of granisetron that was developed to provide slow, controlled, and sustained release of granisetron to prevent both acute and delayed CINV associated with MEC and HEC. Due to the prolonged efficacy, GERSC may potentially improve CINV in the acute and delayed periods and the single dose regimen may improve patient adherence to antiemetic therapy
Primary Outcome Measure Information:
Title
Percentage of participants with a previous history of emetic episodes
Description
After participants have completed their informed consent, they will complete a baseline assessment to record emetic episodes prior to chemotherapy.
Time Frame
Baseline assessment
Title
Percentage of participants with a complete response of no emetic episode
Description
Patient will be monitored for vomiting on Day 1 after receiving chemotherapy. The participants will complete a vomiting assessment and record the number of episodes (none, once, more than once and number)
Time Frame
Baseline through 24 hours
Title
Percentage of participants with a complete response of no emetic episode
Description
Patient will be monitored for vomiting on Day 2 through Day 6 after receiving chemotherapy. The participants will complete a vomiting assessment and record the number of episodes (none, once, more than once and number)
Time Frame
Day 2 through Day 6
Title
Percentage of participants with a complete response of no emetic episode
Description
Patient will be monitored for total vomiting episodes starting from Day 1 through Day 6 after receiving chemotherapy. The participants will complete a vomiting assessment and record the number of episodes (none, once, more than once and number)
Time Frame
Day 1 through Day 6
Secondary Outcome Measure Information:
Title
Percentage of participants frequency rate of No Nausea
Description
Participants will complete a Visual Analogue Scale at baseline to record their history of the presence or absence of nausea and frequency prior to chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Time Frame
Baseline
Title
Percentage of participants frequency rate of No Nausea
Description
Participants will complete a Visual Analogue Scale on Day 1 to record the presence or absence of nausea and frequency after receiving chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Time Frame
Baseline through 24 hours
Title
Percentage of participants frequency rate of No Nausea
Description
Participants will complete a Visual Analogue Scale on Day 2 through Day 6 to record the presence or absence of nausea and frequency after receiving chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Time Frame
Day 2 through Day 6
Title
Percentage of participants frequency rate of No Nausea
Description
Participants will complete a Visual Analogue Scale on Day 1 through Day 6 to record the presence or absence of nausea and frequency after receiving chemotherapy. The scale range is between 0 - 10 (0 = No Nausea; 10 = Excessive Nausea).
Time Frame
Day 1 through Day 6
Title
Percentage of participants experiencing GERSC toxicity
Description
The toxicity will be assessed by the severity of the side effects listed below. The descriptions and grading scales found in the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4 will be utilized for reporting.
Constipation
Fatigue
Headache
Diarrhea
Abdominal Pain
Sleeplessness (Insomnia)
Indigestion (Dyspepsia)
Dizziness
Asthenia
Gastroesophageal Reflux
Time Frame
Baseline through 30 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of malignant disease and scheduled for MEC or HEC
Chemotherapy naive
Age ≥18 years.
ECOG Performance Status 0 or 1
Required Initial Laboratory Values ≤28 days prior to registration. Patient must have adequate bone marrow, kidney, and liver function as evidenced by:
Platelet count ≥ 100,000/ mm3
Bilirubin ≤ 1.5 x ULN, except for subjects with Gilbert's syndrome
Serum Creatinine ≤2.0 mg/dL
SGOT or SGPT ≤3 x upper limit of normal (ULN)
Absolute neutrophil count (ANC) ≥1500/mm3
Patients receiving HEC will have received the 5HT3 receptor antagonist palonosetron, a NK-1, and dexamethasone as antiemetic prophylaxis during cycle 1 of chemotherapy
Patients receiving MEC will have received the 5HT3 receptor antagonist palonosetron, and dexamethasone as antiemetic prophylaxis during cycle 1 of chemotherapy
Exclusion Criteria:
No nausea or vomiting ≤ 24 hours prior to registration.
Negative pregnancy test (serum β hCG) done ≤7 days prior to registration, for women of childbearing potential only (per clinician discretion).
No severe cognitive compromise.
No known history of active, untreated CNS disease (e.g. brain metastases, seizure disorder).
No concurrent use of amifostine, thioridazine, pimozide or St. John's wort.
No concurrent abdominal radiotherapy.
No concurrent use of olanzapine therapy.
No chronic alcoholism (as determined by the investigator).
No known hypersensitivity to granisetron.
No known uncontrolled cardiac arrhythmia or uncontrolled congestive heart failure.
No acute myocardial infarction within the previous six months.
No history of uncontrolled diabetes mellitus (may be on a stable dose of insulin or on a stable dose of an oral hypoglycemic agent).
Patients with psychiatric illness that would prevent the patient from giving informed consent are not eligible for the trial
Medical condition such as uncontrolled infection (including HIV),uncontrolled Diabetes Mellitus, unstable cardiac disease which, in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient are not eligible for the trial
Patients with a "currently active" second malignancy other than non-melanoma skin cancers are not eligible for the trial; Patients are not considered to have a "currently active" malignancy if they have completed therapy and are free of disease for ≥ 3 years.
Patients who cannot swallow oral formulations of the agent(s) are not eligible for the trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rudolph M Navari, MD
Organizational Affiliation
University of Alabama at Birmingham
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Granisetron Extended Release Injection (GERSC) for the Prevention of Chemotherapy-induced Nausea and Vomiting
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