Fosaprepitant (MK-0517, EMEND® IV) In Salvage Treatment of Chemotherapy-Induced Vomiting (MK-0517-030) (EVADE)
Primary Purpose
Nausea, Vomiting
Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Fosaprepitant dimeglumine
5-HT3 RA
Dexamethasone
Rescue medication
Sponsored by
About this trial
This is an interventional prevention trial for Nausea
Eligibility Criteria
Inclusion Criteria:
- Diagnosed with either breast or gynecological cancer
- Receiving either AC-like or CT MEC
- Experienced at least 1 episode of vomiting or retching during the first 5 days following Cycle 1 of chemotherapy that was thought to be due to chemotherapy. Received standard chemotherapy-induced nausea and vomiting (CINV) prophylaxis not containing aprepitant or fosaprepitant
- No change in chemotherapy at Cycle 2
- No change in Cycle 1 antiemetic regimen at Cycle 2
- Eastern Cooperative Oncology Group (ECOG) status 0-1
Exclusion Criteria:
- Requires increase in systemic corticosteroid therapy
- Used benzodiazepines or opiates in the 48 hours prior to Cycle 2 chemotherapy
- Received or will receive radiation therapy to the abdomen or pelvis in the week prior to Visit 1 or in Days 1-6 following chemotherapy
- Vomited in the 24 hours prior to Treatment Day 1
- Pregnant or breast-feeding
- Participating in a study with aprepitant or fosaprepitant or has taken an investigational drug in the last 4 weeks
- Symptomatic central nervous system metastasis
- History of other malignancies in the last 2 years
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Fosaprepitant 150 mg
Arm Description
Women with breast cancer receiving anthracycline-cyclophosphamide (AC)-like chemotherapy and women with gynecological cancer receiving carboplatin-paclitaxel (CT) chemotherapy receive fosaprepitant 150 mg administered intravenously (IV) on Day 1 of Cycle 2 of chemotherapy
Outcomes
Primary Outcome Measures
Percentage of Participants With No Vomiting and No Retching During Cycle 2 of Chemotherapy
A vomiting episode is defined as one or more episodes of emesis (expulsion of stomach contents through the mouth) or retching (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes are separated by the absence of emesis and retching for at least one minute. The date and time of each vomiting episode was recorded by participants in diaries at the time of occurrence. The percentage of partcipants with no vomiting and no retching episodes 0-120 hours following chemotherapy in Cycle 2 was calculated.
Secondary Outcome Measures
Percentage of Participants With No Vomiting and No Retching During Cycle 2 of Chemotherapy Per Type of Chemotherapy
A vomiting episode is defined as one or more episodes of emesis (expulsion of stomach contents through the mouth) or retching (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes are separated by the absence of emesis and retching for at least one minute. The date and time of each vomiting episode was recorded by participants in diaries at the time of occurrence. The percentage of partcipants with no vomiting and no retching episodes 0-120 hours following initiation of chemotherapy in Cycle 2 was calculated based on type of chemotherapy received.
Percentage of Participants With a Complete Response During Cycle 2 of Chemotherapy
A complete response is defined as no vomiting/no retching episodes and no use of rescue medication during the 120 hours following initiation of chemotherapy. The percentage of participants with a complete response during Cycle 2 of chemotherapy was calculated.
Functional Living Index - Emesis (FLIE) Total Score During Cycle 2 of Chemotherapy
The FLIE Total Score is an 18-question quality-of-life questionnaire on the impact of nausea and vomiting (9 questions on nausea and 9 questions on vomiting) on daily life. Each question uses a visual analog scale (VAS) to rate the impact of nausea/vomiting from 1 to 7. FLIE Total Scores are calculated by summing the responses to the 18 questions and can range from 18-126 (18=a great deal of impairment, 126=no impairment), with a higher score indicating less impairment due to nausea and vomiting. "No Impact" on daily life was defined as a FLIE Total Score >108. Participants completed the FLIE questionnaire on the morning of Day 6 following initiation of chemotherapy in Cycle 2; their responses covered their experiences with nausea and vomiting over the previous 5 days.
Percentage of Participants With No Significant Nausea During Cycle 2 of Chemotherapy
Participants rated their degree of nausea in response to "How much nausea have you had over the last 24 hours?" using a 100-mm visual analog scale (VAS, 0=no nausea, 100=nausea as bad as it could be) on Days 2-6 following initiation of chemotherapy. No significant nausea was defined as VAS score <25 mm over the 24-120 hours following initiation of chemotherapy. The percentage of participants who experienced no significant nausea during Cycle 2 of chemotherapy was calculated.
Percentage of Participants Who Used No Rescue Medication During Cycle 2 of Chemotherapy
Participants recorded any use of rescue medication for established nausea/vomiting in their daily diaries from initiation of chemotherapy infusion through the morning of Day 6. The percentage of participants who used no rescue medication during Cycle 2 of chemotherapy was calculated.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01405924
Brief Title
Fosaprepitant (MK-0517, EMEND® IV) In Salvage Treatment of Chemotherapy-Induced Vomiting (MK-0517-030)
Acronym
EVADE
Official Title
EMEND® IV In Salvage Treatment of Chemotherapy-Induced Vomiting
Study Type
Interventional
2. Study Status
Record Verification Date
July 2018
Overall Recruitment Status
Terminated
Why Stopped
Low enrollment
Study Start Date
October 25, 2011 (Actual)
Primary Completion Date
December 6, 2013 (Actual)
Study Completion Date
December 6, 2013 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck Sharp & Dohme LLC
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study will assess the efficacy of a single dose of intravenous (IV) fosaprepitant (MK-0517, EMEND® IV) as salvage therapy when added to a 5-hydroxytryptamine receptor 3 antagonist (5-HT3 RA) and dexamethasone for the prevention of chemotherapy-induced vomiting (CIV) in participants who experienced CIV in the first cycle of moderately emetic chemotherapy (MEC). The primary hypothesis is that there will be no vomiting and no retching in at least 20% of participants during the second cycle of MEC in participants who previously experienced vomiting during the first cycle of MEC.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nausea, Vomiting
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
111 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Fosaprepitant 150 mg
Arm Type
Experimental
Arm Description
Women with breast cancer receiving anthracycline-cyclophosphamide (AC)-like chemotherapy and women with gynecological cancer receiving carboplatin-paclitaxel (CT) chemotherapy receive fosaprepitant 150 mg administered intravenously (IV) on Day 1 of Cycle 2 of chemotherapy
Intervention Type
Drug
Intervention Name(s)
Fosaprepitant dimeglumine
Other Intervention Name(s)
MK-0517, EMEND® IV
Intervention Description
Fosaprepitant 150 mg, IV on Day 1 of chemotherapy in Cycle 2
Intervention Type
Drug
Intervention Name(s)
5-HT3 RA
Intervention Description
5-HT3 RA will be administered at the same dosage in Cycle 2 of chemotherapy as was used for each particpant in Cycle 1 of chemotherapy.
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
Dexamethasone will be administered at the same dosage in Cycle 2 of chemotherapy as was used for each particpant in Cycle 1 of chemotherapy.
Intervention Type
Drug
Intervention Name(s)
Rescue medication
Intervention Description
Rescue medication is defined as any medication used to relieve the symptoms of established nausea or vomiting. Multiple medications are permitted by the protocol and may be taken by the participant, including 5-HT3 antagonists, phenothiazines and benzodiazepines.
Primary Outcome Measure Information:
Title
Percentage of Participants With No Vomiting and No Retching During Cycle 2 of Chemotherapy
Description
A vomiting episode is defined as one or more episodes of emesis (expulsion of stomach contents through the mouth) or retching (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes are separated by the absence of emesis and retching for at least one minute. The date and time of each vomiting episode was recorded by participants in diaries at the time of occurrence. The percentage of partcipants with no vomiting and no retching episodes 0-120 hours following chemotherapy in Cycle 2 was calculated.
Time Frame
Up to 120 hours following initiation of chemotherapy in Cycle 2
Secondary Outcome Measure Information:
Title
Percentage of Participants With No Vomiting and No Retching During Cycle 2 of Chemotherapy Per Type of Chemotherapy
Description
A vomiting episode is defined as one or more episodes of emesis (expulsion of stomach contents through the mouth) or retching (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes are separated by the absence of emesis and retching for at least one minute. The date and time of each vomiting episode was recorded by participants in diaries at the time of occurrence. The percentage of partcipants with no vomiting and no retching episodes 0-120 hours following initiation of chemotherapy in Cycle 2 was calculated based on type of chemotherapy received.
Time Frame
Up to 120 hours following initiation of chemotherapy in Cycle 2
Title
Percentage of Participants With a Complete Response During Cycle 2 of Chemotherapy
Description
A complete response is defined as no vomiting/no retching episodes and no use of rescue medication during the 120 hours following initiation of chemotherapy. The percentage of participants with a complete response during Cycle 2 of chemotherapy was calculated.
Time Frame
Up to 120 hours following initiation of chemotherapy in Cycle 2
Title
Functional Living Index - Emesis (FLIE) Total Score During Cycle 2 of Chemotherapy
Description
The FLIE Total Score is an 18-question quality-of-life questionnaire on the impact of nausea and vomiting (9 questions on nausea and 9 questions on vomiting) on daily life. Each question uses a visual analog scale (VAS) to rate the impact of nausea/vomiting from 1 to 7. FLIE Total Scores are calculated by summing the responses to the 18 questions and can range from 18-126 (18=a great deal of impairment, 126=no impairment), with a higher score indicating less impairment due to nausea and vomiting. "No Impact" on daily life was defined as a FLIE Total Score >108. Participants completed the FLIE questionnaire on the morning of Day 6 following initiation of chemotherapy in Cycle 2; their responses covered their experiences with nausea and vomiting over the previous 5 days.
Time Frame
From Day 1 (prior to initiation of chemotherapy in Cycle 2) to morning of Day 6 (up to ~120 hours following initiation of chemotherapy in Cycle 2)
Title
Percentage of Participants With No Significant Nausea During Cycle 2 of Chemotherapy
Description
Participants rated their degree of nausea in response to "How much nausea have you had over the last 24 hours?" using a 100-mm visual analog scale (VAS, 0=no nausea, 100=nausea as bad as it could be) on Days 2-6 following initiation of chemotherapy. No significant nausea was defined as VAS score <25 mm over the 24-120 hours following initiation of chemotherapy. The percentage of participants who experienced no significant nausea during Cycle 2 of chemotherapy was calculated.
Time Frame
From 24 to 120 hours following initiation of chemotherapy in Cycle 2
Title
Percentage of Participants Who Used No Rescue Medication During Cycle 2 of Chemotherapy
Description
Participants recorded any use of rescue medication for established nausea/vomiting in their daily diaries from initiation of chemotherapy infusion through the morning of Day 6. The percentage of participants who used no rescue medication during Cycle 2 of chemotherapy was calculated.
Time Frame
Up to 120 hours following initiation of chemotherapy in Cycle 2
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosed with either breast or gynecological cancer
Receiving either AC-like or CT MEC
Experienced at least 1 episode of vomiting or retching during the first 5 days following Cycle 1 of chemotherapy that was thought to be due to chemotherapy. Received standard chemotherapy-induced nausea and vomiting (CINV) prophylaxis not containing aprepitant or fosaprepitant
No change in chemotherapy at Cycle 2
No change in Cycle 1 antiemetic regimen at Cycle 2
Eastern Cooperative Oncology Group (ECOG) status 0-1
Exclusion Criteria:
Requires increase in systemic corticosteroid therapy
Used benzodiazepines or opiates in the 48 hours prior to Cycle 2 chemotherapy
Received or will receive radiation therapy to the abdomen or pelvis in the week prior to Visit 1 or in Days 1-6 following chemotherapy
Vomited in the 24 hours prior to Treatment Day 1
Pregnant or breast-feeding
Participating in a study with aprepitant or fosaprepitant or has taken an investigational drug in the last 4 weeks
Symptomatic central nervous system metastasis
History of other malignancies in the last 2 years
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Merck Sharp & Dohme LLC
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf
IPD Sharing URL
http://engagezone.msd.com/ds_documentation.php
Available IPD and Supporting Information:
Available IPD/Information Type
CSR Synopsis
Available IPD/Information URL
http://www.merck.com/clinical-trials/study.html?id=0517-030&kw=0517-030&tab=access
Learn more about this trial
Fosaprepitant (MK-0517, EMEND® IV) In Salvage Treatment of Chemotherapy-Induced Vomiting (MK-0517-030)
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