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An Assessment of the Ability of Fentanyl Citrate Nasal Spray to Manage Breakthrough Pain in Cancer Patients. (FCNS)

Primary Purpose

Pain

Status
Withdrawn
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Fentanyl Citrate Nasal Spray (FCNS)
Sponsored by
University of Louisville
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Pain focused on measuring Fentanyl Citrate Nasal Spray (FCNS), Lazanda, Breakthrough pain in cancer patients

Eligibility Criteria

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

Inclusion Criteria:

  • Patients who meet the following criteria will be eligible:

    1. At least 18 years of age or older.
    2. Diagnosed with cancer.
    3. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
    4. Patients with cancer who are experiencing episodes of BTPc in spite of optimized background analgesia with at least 60 mg/day of morphine (or equivalent analgesic) for at least 7 days.
    5. Patients with cancer currently using an SAO (short acting opioid) to manage their episodes of BTPc.
    6. Patients with cancer who have failed to obtain a timely response, as determined by the Principal Investigator, to pain from their SAO therapy.
    7. Laboratory values consistent with the stage of disease that are deemed clinically insignificant by the investigator.
    8. Female patients of child bearing potential or male patients with partners of child bearing potential who are using an adequate form of contraception before study entry, and agree to use an adequate form of contraception for an additional month after the study. Adequate contraception is defined as the use of any hormonal contraception or intra-uterine device by the female patient/partner plus use by at least 1 of the partners of an additional spermicide-containing barrier method of contraception. The use of a barrier method alone or abstinence is not considered adequate.
    9. Willing and able to give written informed consent before participating in the study.

Exclusion Criteria:

  • Patients meeting the following criteria will be excluded from the study:

    1. Patients who are not opioid tolerant.
    2. Patients with a known intolerance or hypersensitivity to fentanyl.
    3. Physical abnormalities of the nose that could affect nasal absorption.
    4. Patients with uncontrolled or rapidly escalating pain.
    5. Patients with a history of alcohol or substance abuse.
    6. A clinically significant medical history (past or present) of any disease that would compromise the study or the well-being of the patient .
    7. Patients who have participated in another clinical trial with an analgesic within the last month.
    8. Patients who have previously used FCNS and did not have adequate responses.
    9. Female patients with a positive pregnancy test or who are currently lactating.
    10. Patients who are taking medications that are known inhibitors of the CYP3A4 isoenzyme, such as ketoconazole.
    11. Patients who have taken a monoamine oxidase inhibitor within 14 days before a dose of study medication.
    12. Patients who are unsuitable for inclusion for any other reason, in the opinion of the investigator.

Sites / Locations

  • James Graham Brown Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Fentanyl Citrate Nasal Spray (FCNS)

Arm Description

Treatment for breakthrough pain with Fentanyl Citrate Nasal Spray (FCNS)

Outcomes

Primary Outcome Measures

Pain Intensity
The primary efficacy outcome measure is pain intensity difference at 15 minutes (PID15) after dosing during the Maintenance Stage. (PID15 is defined as the difference between pain intensity at 15 minutes and baseline.)Maintenance stage is defined as 6 breakthrough pain episodes for up to 6 weeks.

Secondary Outcome Measures

Pain Management Satisfaction
The key secondary outcome measure is the proportion of episodes that the patient defines as satisfactorily managed at 15 minutes. Satisfaction will be considered to have been achieved for an individual episode of BTPc(Breakthrough pain)if the patient rates pain management as "Satisfied" or "Very Satisfied." Patients complete a satisfaction questionnaire at end of study.

Full Information

First Posted
April 10, 2013
Last Updated
March 1, 2018
Sponsor
University of Louisville
Collaborators
James Graham Brown Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT01839552
Brief Title
An Assessment of the Ability of Fentanyl Citrate Nasal Spray to Manage Breakthrough Pain in Cancer Patients.
Acronym
FCNS
Official Title
An Assessment of the Ability of Fentanyl Citrate Nasal Spray to Manage Breakthrough Pain in Cancer Patients Without a Timely Response to Their Short-acting Opioids.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Site chose to close due to lack of enrollment
Study Start Date
October 2014 (undefined)
Primary Completion Date
April 2017 (Anticipated)
Study Completion Date
April 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Louisville
Collaborators
James Graham Brown Cancer Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Lazanda is a prescription nasal spray medicine that contains the medicine fentanyl. It is used to manage breakthrough pain in adults with cancer who are already routinely taking other opioid pain medicines around-the-clock for cancer pain. Lazanda is started only after taking other opioid pain medicines and the patient's body has become used to them (opioid tolerant). The purpose of this study is to assess the ability of Lazanda to control pain during an episode of breakthrough pain in cancer patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain
Keywords
Fentanyl Citrate Nasal Spray (FCNS), Lazanda, Breakthrough pain in cancer patients

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fentanyl Citrate Nasal Spray (FCNS)
Arm Type
Experimental
Arm Description
Treatment for breakthrough pain with Fentanyl Citrate Nasal Spray (FCNS)
Intervention Type
Drug
Intervention Name(s)
Fentanyl Citrate Nasal Spray (FCNS)
Other Intervention Name(s)
Lazanda
Primary Outcome Measure Information:
Title
Pain Intensity
Description
The primary efficacy outcome measure is pain intensity difference at 15 minutes (PID15) after dosing during the Maintenance Stage. (PID15 is defined as the difference between pain intensity at 15 minutes and baseline.)Maintenance stage is defined as 6 breakthrough pain episodes for up to 6 weeks.
Time Frame
Assessed at end of Maintenance Stage
Secondary Outcome Measure Information:
Title
Pain Management Satisfaction
Description
The key secondary outcome measure is the proportion of episodes that the patient defines as satisfactorily managed at 15 minutes. Satisfaction will be considered to have been achieved for an individual episode of BTPc(Breakthrough pain)if the patient rates pain management as "Satisfied" or "Very Satisfied." Patients complete a satisfaction questionnaire at end of study.
Time Frame
participants will be followed during maintenance phase, up to 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients who meet the following criteria will be eligible: At least 18 years of age or older. Diagnosed with cancer. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2. Patients with cancer who are experiencing episodes of BTPc in spite of optimized background analgesia with at least 60 mg/day of morphine (or equivalent analgesic) for at least 7 days. Patients with cancer currently using an SAO (short acting opioid) to manage their episodes of BTPc. Patients with cancer who have failed to obtain a timely response, as determined by the Principal Investigator, to pain from their SAO therapy. Laboratory values consistent with the stage of disease that are deemed clinically insignificant by the investigator. Female patients of child bearing potential or male patients with partners of child bearing potential who are using an adequate form of contraception before study entry, and agree to use an adequate form of contraception for an additional month after the study. Adequate contraception is defined as the use of any hormonal contraception or intra-uterine device by the female patient/partner plus use by at least 1 of the partners of an additional spermicide-containing barrier method of contraception. The use of a barrier method alone or abstinence is not considered adequate. Willing and able to give written informed consent before participating in the study. Exclusion Criteria: Patients meeting the following criteria will be excluded from the study: Patients who are not opioid tolerant. Patients with a known intolerance or hypersensitivity to fentanyl. Physical abnormalities of the nose that could affect nasal absorption. Patients with uncontrolled or rapidly escalating pain. Patients with a history of alcohol or substance abuse. A clinically significant medical history (past or present) of any disease that would compromise the study or the well-being of the patient . Patients who have participated in another clinical trial with an analgesic within the last month. Patients who have previously used FCNS and did not have adequate responses. Female patients with a positive pregnancy test or who are currently lactating. Patients who are taking medications that are known inhibitors of the CYP3A4 isoenzyme, such as ketoconazole. Patients who have taken a monoamine oxidase inhibitor within 14 days before a dose of study medication. Patients who are unsuitable for inclusion for any other reason, in the opinion of the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Goetz Kloecker, MD, FACP, MBA, MSPH
Organizational Affiliation
James Graham Brown Cancer Center-University of Louisville
Official's Role
Principal Investigator
Facility Information:
Facility Name
James Graham Brown Cancer Center
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States

12. IPD Sharing Statement

Learn more about this trial

An Assessment of the Ability of Fentanyl Citrate Nasal Spray to Manage Breakthrough Pain in Cancer Patients.

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