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Buccal Film Versus IV Injection Palonosetron for Moderately Emetogenic Chemotherapy Induced Nausea and Vomiting

Primary Purpose

Nausea With Vomiting Chemotherapy-Induced

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Palonosetron Hydrochloride Buccal Film 0.25 Mg
Palonosetron Hydrochloride Buccal Film 0.5 Mg
Palonosetron Hydrochloride, 0.25 Mg/5 mL Intravenous Solution
Sponsored by
Xiamen LP Pharmaceutical Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Nausea With Vomiting Chemotherapy-Induced

Eligibility Criteria

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

Inclusion Criteria:

  • With histologically or cytologically confirmed malignant disease;

    • Karnofsky index ≥ 50;
    • Be scheduled to receive the first course of MEC to be administered on Day 1
  • Using reliable contraceptive measures;
  • negative serum pregnancy test (if potentially child bearing)
  • Be able to read, understand, and follow the study procedures and able to complete patient diary autonomously.

Exclusion Criteria:

  • Expect to be non-compliant with the study procedures;
  • Received investigational drugs within 30 days before the start of study treatment or scheduled to receive a highly or moderately emetogenic chemotherapeutic agent during Day 2 to 6 of the study;
  • Has any condition that could have been associated with a risk of emesis near or at the time of study drug administration;
  • Have a clinically unstable seizure disorder with seizure activity requiring anticonvulsant medication;
  • Experienced any vomiting, retching, or National Cancer Institute (NCI) Common Toxicity Criteria grade 2 or 3 or nausea within 24 hours preceding chemotherapy;
  • Have ongoing nausea or vomiting from any organic etiology;
  • Have severe renal or hepatic impairment;
  • Have positive serology test results;
  • Have a known contraindication to 5-HT3 receptor antagonists;
  • Treated with commercially available or investigative palonosetron formulation within 2 weeks prior to start of study treatment;
  • Allergic to palonosetron or any other 5-HT3 antagonist;
  • Currently a user of any recreational or illicit drugs (including marijuana) or has current evidence of drug or alcohol abuse or dependence as determined by the investigator;
  • Will be receiving stem cell rescue therapy in conjunction with study related course of emetogenic chemotherapy;
  • Received or will receive total body irradiation or radiation therapy to the abdomen or pelvis in the week prior to Treatment Day 1 and/or during the diary reporting period.
  • Had non-chronic benzodiazepine, opioid or opioid like (e.g., tramadol hydrochloride) therapy initiated within 48 hours prior to study drug administration or is expected to receive within 120 hours following initiation of chemotherapy, except for single daily doses of midazolam, temazepam or triazolam.
  • Started on systemic corticosteroid therapy within 72 hours prior to study drug administration or is expected to receive a corticosteroid as part of chemotherapy regimen.

Sites / Locations

  • Pacific Cancer Medical Center, Inc.
  • Ocala Oncology Center PL DBA Florida Cancer Affiliates
  • Edward H. Kaplan MD & Associates
  • Hattiesburg Clinic Hematology/Oncology
  • Gettysburg Cancer Center
  • Monongahela Valley Hospital/ Regional Cancer Center
  • Charleston Oncology

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

A (Buccal 0.25 Mg)

B (Buccal 0.5 Mg)

C (IV Injection 0.25 Mg)

Arm Description

Palonosetron HCl Buccal Film 0.25 Mg and oral dexamethasone 12 Mg, both administered on Day 1, and dexamethasone 8 Mg PO on days 2 and 3

Palonosetron HCl Buccal Film 0.5 Mg and oral dexamethasone 12 Mg, both administered on Day 1, and dexamethasone 8 Mg PO on days 2 and 3

IV palonosetron 0.25 Mg (ALOXI®) and oral dexamethasone 12 Mg, both administered on Day 1, and dexamethasone 8 Mg PO on days 2 and 3

Outcomes

Primary Outcome Measures

Complete acute response
no emetic episode and no rescue medication

Secondary Outcome Measures

Complete delayed response
no emetic episode and no rescue medication
Complete response
no emetic episode and no rescue medication
No nausea
visual analog scale (0-100 mm, 0=no, 100=severe) < 5 mm
No significant nausea
visual analog scale (0-100 mm, 0=no, 100=severe) < 25 mm
Complete protection
no emesis, no rescue therapy, no significant nausea (questionnaire)
Number of emetic episodes
Number of emetic episodes
Time to rescue medication
Time to rescue medication
Time to treatment failure
time to first emetic episode or administration of rescue therapy, whichever occurred first
Severity of nausea
Rhodes Index of Nausea, Vomiting and Retching (0-4, 0=no nausea, 4=severe nausea)
Subject global satisfaction with therapy
visual analog scale (0-100mm, 0=not at all satisfied, 100=totally satisfied)
Quality of life questionnaire
Functional Living Index-Emesis

Full Information

First Posted
October 15, 2020
Last Updated
May 13, 2021
Sponsor
Xiamen LP Pharmaceutical Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT04592198
Brief Title
Buccal Film Versus IV Injection Palonosetron for Moderately Emetogenic Chemotherapy Induced Nausea and Vomiting
Official Title
A Randomized, Dose-ranging, Open-label, Parallel Group Study to Assess the Efficacy, Safety and Pharmacokinetics of Palonosetron HCl Buccal Film Versus IV Palonosetron 0.25 mg (ALOXI®) for the Prevention of Chemotherapy-induced Nausea and
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
October 1, 2020 (Actual)
Primary Completion Date
March 26, 2021 (Actual)
Study Completion Date
March 26, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Xiamen LP Pharmaceutical Co., Ltd

4. Oversight

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

5. Study Description

Brief Summary
Phase 2 study to compare efficacy, safety and PK of palonosetron, a long acting 5-HT3 receptor antagonist, by buccal film delivery compared to iv injection for chemotherapy induced nausea or vomiting (CINV). Subjects receive a single dose of palonosetron prior to moderately emetogenic chemotherapy.
Detailed Description
This is a Phase 2 study to compare efficacy, safety and PK of palonosetron, a long acting 5-HT3 receptor antagonist, by buccal film compared to iv injection for moderately emetogenic chemotherapy-induced nausea or vomiting (CINV) in cancer patients. Subjects are randomized into three treatment groups, two with the experimental study drug palonosetron in buccal film at one of two different doses or the control treatment using Palonosetron hydrochloride iv injection. Palonosetron PK will be assessed in a subgroup of each treatment group.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nausea With Vomiting Chemotherapy-Induced

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A (Buccal 0.25 Mg)
Arm Type
Experimental
Arm Description
Palonosetron HCl Buccal Film 0.25 Mg and oral dexamethasone 12 Mg, both administered on Day 1, and dexamethasone 8 Mg PO on days 2 and 3
Arm Title
B (Buccal 0.5 Mg)
Arm Type
Experimental
Arm Description
Palonosetron HCl Buccal Film 0.5 Mg and oral dexamethasone 12 Mg, both administered on Day 1, and dexamethasone 8 Mg PO on days 2 and 3
Arm Title
C (IV Injection 0.25 Mg)
Arm Type
Active Comparator
Arm Description
IV palonosetron 0.25 Mg (ALOXI®) and oral dexamethasone 12 Mg, both administered on Day 1, and dexamethasone 8 Mg PO on days 2 and 3
Intervention Type
Drug
Intervention Name(s)
Palonosetron Hydrochloride Buccal Film 0.25 Mg
Other Intervention Name(s)
Buccal Film Low Dose
Intervention Description
Dose equal to the iv control
Intervention Type
Drug
Intervention Name(s)
Palonosetron Hydrochloride Buccal Film 0.5 Mg
Other Intervention Name(s)
Buccal Film High dose
Intervention Description
Dose twice that of iv control
Intervention Type
Drug
Intervention Name(s)
Palonosetron Hydrochloride, 0.25 Mg/5 mL Intravenous Solution
Other Intervention Name(s)
Control Standard Treatment (Aloxi)
Intervention Description
iv control
Primary Outcome Measure Information:
Title
Complete acute response
Description
no emetic episode and no rescue medication
Time Frame
during the first 24 hours after chemotherapy
Secondary Outcome Measure Information:
Title
Complete delayed response
Description
no emetic episode and no rescue medication
Time Frame
24-120 hours post chemotherapy
Title
Complete response
Description
no emetic episode and no rescue medication
Time Frame
up to 120 hours post chemotherapy
Title
No nausea
Description
visual analog scale (0-100 mm, 0=no, 100=severe) < 5 mm
Time Frame
up to 120 hours post chemotherapy
Title
No significant nausea
Description
visual analog scale (0-100 mm, 0=no, 100=severe) < 25 mm
Time Frame
up to 120 hours post chemotherapy
Title
Complete protection
Description
no emesis, no rescue therapy, no significant nausea (questionnaire)
Time Frame
up to 120 hours post chemotherapy
Title
Number of emetic episodes
Description
Number of emetic episodes
Time Frame
up to 120 hours post chemotherapy
Title
Time to rescue medication
Description
Time to rescue medication
Time Frame
up to 120 hours post chemotherapy
Title
Time to treatment failure
Description
time to first emetic episode or administration of rescue therapy, whichever occurred first
Time Frame
up to 120 hours post chemotherapy
Title
Severity of nausea
Description
Rhodes Index of Nausea, Vomiting and Retching (0-4, 0=no nausea, 4=severe nausea)
Time Frame
up to 120 hours post chemotherapy
Title
Subject global satisfaction with therapy
Description
visual analog scale (0-100mm, 0=not at all satisfied, 100=totally satisfied)
Time Frame
up to 120 hours post chemotherapy
Title
Quality of life questionnaire
Description
Functional Living Index-Emesis
Time Frame
up to 120 hours post chemotherapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: With histologically or cytologically confirmed malignant disease; Karnofsky index ≥ 50; Be scheduled to receive the first course of MEC to be administered on Day 1 Using reliable contraceptive measures; negative serum pregnancy test (if potentially child bearing) Be able to read, understand, and follow the study procedures and able to complete patient diary autonomously. Exclusion Criteria: Expect to be non-compliant with the study procedures; Received investigational drugs within 30 days before the start of study treatment or scheduled to receive a highly or moderately emetogenic chemotherapeutic agent during Day 2 to 6 of the study; Has any condition that could have been associated with a risk of emesis near or at the time of study drug administration; Have a clinically unstable seizure disorder with seizure activity requiring anticonvulsant medication; Experienced any vomiting, retching, or National Cancer Institute (NCI) Common Toxicity Criteria grade 2 or 3 or nausea within 24 hours preceding chemotherapy; Have ongoing nausea or vomiting from any organic etiology; Have severe renal or hepatic impairment; Have positive serology test results; Have a known contraindication to 5-HT3 receptor antagonists; Treated with commercially available or investigative palonosetron formulation within 2 weeks prior to start of study treatment; Allergic to palonosetron or any other 5-HT3 antagonist; Currently a user of any recreational or illicit drugs (including marijuana) or has current evidence of drug or alcohol abuse or dependence as determined by the investigator; Will be receiving stem cell rescue therapy in conjunction with study related course of emetogenic chemotherapy; Received or will receive total body irradiation or radiation therapy to the abdomen or pelvis in the week prior to Treatment Day 1 and/or during the diary reporting period. Had non-chronic benzodiazepine, opioid or opioid like (e.g., tramadol hydrochloride) therapy initiated within 48 hours prior to study drug administration or is expected to receive within 120 hours following initiation of chemotherapy, except for single daily doses of midazolam, temazepam or triazolam. Started on systemic corticosteroid therapy within 72 hours prior to study drug administration or is expected to receive a corticosteroid as part of chemotherapy regimen.
Facility Information:
Facility Name
Pacific Cancer Medical Center, Inc.
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
Facility Name
Ocala Oncology Center PL DBA Florida Cancer Affiliates
City
Ocala
State/Province
Florida
ZIP/Postal Code
34474
Country
United States
Facility Name
Edward H. Kaplan MD & Associates
City
Skokie
State/Province
Illinois
ZIP/Postal Code
60076
Country
United States
Facility Name
Hattiesburg Clinic Hematology/Oncology
City
Hattiesburg
State/Province
Mississippi
ZIP/Postal Code
39401
Country
United States
Facility Name
Gettysburg Cancer Center
City
Gettysburg
State/Province
Pennsylvania
ZIP/Postal Code
17325
Country
United States
Facility Name
Monongahela Valley Hospital/ Regional Cancer Center
City
Monongahela
State/Province
Pennsylvania
ZIP/Postal Code
15063
Country
United States
Facility Name
Charleston Oncology
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29406
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Buccal Film Versus IV Injection Palonosetron for Moderately Emetogenic Chemotherapy Induced Nausea and Vomiting

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