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Olanzapine Plus Fosaprepitant Standard Antiemetic Therapy in the Prevention of Chemotherapy-induced Nausea and Vomiting in Patients Receiving High Emetic Risk Multi-day Chemotherapy: a Multicenter, Randomized, Double-blind, Placebo-controlled, Phase 3 Study (OFFER)

Primary Purpose

Solid Tumor Patients Receiving High Emetic Risk Multi-day Chemotherapy

Status
Unknown status
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
olanzapine plus fosaprepitant-based triple regimen
placebo plus fosaprepitant-based triple regimen
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Solid Tumor Patients Receiving High Emetic Risk Multi-day Chemotherapy

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: (abbreviated)

  1. Male and female patients aged ≥ 18 and ≤ 75 years old;
  2. Patients were diagnosed with histologically or cytology confirmed solid malignant tumors;
  3. Patients have a Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2;
  4. Patients were predicted life expectancy of ≥ 3 months;
  5. Patients who were scheduled for 3 days of cisplatin based chemotherapy.

Exclusion Criteria: (abbreviated)

  1. Patients were mentally disable or suffered from emotional disorders;
  2. Patients were current illicit drug use, including alcohol abuse;
  3. Patients scheduled administration of stem cell rescue therapy during cisplatin chemotherapy;
  4. Patients have participated in other clinical trials in the past 4 weeks;
  5. Patients were treated with chemotherapy including ordinary paclitaxel(using castor oil as a solvent);
  6. Patients with active infections (e.g., pneumonia) or any uncontrolled disease (e.g., diabetic ketoacidosis, gastrointestinal obstruction) other than malignant tumors, and the researchers believe that it may confound the results of the study or expose patients receiving treatment with the study drug at unnecessary risk;
  7. Patients have any disease that the researcher believes may confound the results of the study or expose the patient to unnecessary risk;
  8. Patients were treated with moderate or highly emetogenic chemotherapy within 6 days prior to the initial of cisplatin infusion and/or 6 days after cisplatin infusion;
  9. Patients were scheduled to receive radiation therapy to the abdomen or pelvis within a week of treatment;
  10. Absolute neutrophil count<1,500 cells/ L, white blood cell count<3,000 cells/ L, platelet count<100,000 cells/ L, aspartate aminotransferase and alanine aminotransferase>2.5 upper limit of normal (ULN), bilirubin > 1.5 ULN, and creatinine > 1.5 ULN;
  11. Patients were pregnant or breastfeeding;
  12. Patients had suffered from vomiting or nausea in the 24 hours before treatment;
  13. Patients were known to be at risk for narrow angle glaucoma;
  14. Patients who are taking or have used CYP3A4 inducers within 30 days before the first day of treatment, which will affect the efficacy of the treatment drugs according to the researcher's evaluation, can not be enrolled;
  15. Patients who are taking or have used CYP3A4 substrates and inhibitors within 7 days before the first day of treatment will significantly increase the treatment drug-related adverse events according to the researcher's evaluation, can not be enrolled;
  16. Within 48 hours before the first day of treatment, patients used the following antiemetic agents: 5-hydroxytryptamine 3 receptor antagonists (such as ondansetron), phenothiazines (such as prochlorperazine), benzophenones (such as haloperidol), benzamide (such as metoclopramide), domperidone, cannabinoids, herbs with potential antiemetic effects, scopolamine, and cyclizine, etc;
  17. Patients began to receive benzodiazepines or opioids within 48 hours prior to the first day of the study (except for triazolam, temazepam or midazolam single dose daily);
  18. Patients had symptomatic primary or metastatic central nervous system malignancies;
  19. Patients had concomitant diseases that could not take dexamethasone for 5 days, such as systemic fungal infection or uncontrolled diabetes mellitus;
  20. Patients were not allowed to receive any dose of systemic glucocorticoid therapy within 72 hours before the first day except those prescribed in the protocol; however, local and inhaled corticosteroids were allowed;
  21. Patients had a history of hypersensitivity to fosaprepitant meglumine, olanzapine, ondansetron or dexamethasone;
  22. Patients had been treated with neurokinin-1 receptor antagonist in the past;

Sites / Locations

  • Beijing Cancer Hospital
  • Cancer Hospital Chinese Academy of Medical Sciences
  • Hunan Cancer Hospital
  • Sichuan Cancer Hospital& Institute
  • The First Affiliated Hospital of Chongqing Medical University
  • Sun Yat-sen University Cancer Center
  • Harbin Medical University Cancer Hospital
  • Anhui Provincial Cancer Hospital
  • Yunnan Cancer Hospital
  • Jiangxi Cancer Hospital
  • Guangxi Medical University Affiliated Tumor Hospital
  • Ningbo Medical Center Lihuili Hospital
  • Shanghai Sixth People's Hospital Affiliated to Shanghai JiaoTong University
  • Liaoning Cancer Hospital & Institute
  • Fourth Hospital of Hebei Medical University
  • The First Affiliated Hospital of Soochow University
  • Tianjin Medical University General Hospital
  • Henan Cancer Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

olanzapine plus fosaprepitant-based triple regimen

Placebo plus fosaprepitant-based triple regimen

Arm Description

Olanzapine(5mg p.o. d1-d5)plus fosaprepitant(150mg i.v. d1-d3) plus ondansetron(8mg i.v. d1-d3)and dexamethasone(6mg p.o. d1-d5) before undergoing chemotherapy.

Placebo plus fosaprepitant(150mg i.v. d1-d3) plus ondansetron(8mg i.v. d1-d3)and dexamethasone(6mg p.o. d1-d5) before undergoing chemotherapy.

Outcomes

Primary Outcome Measures

Complete response (CR) during overall phase
To compare olanzapine plus fosaprepitant regimen with placebo plus fosaprepitant regimen with respect to efficacy; complete response (CR) defined as no vomiting and no use of rescue therapy during overall phase (day 1 to day 8) after highly emetogenic chemotherapy initiation)

Secondary Outcome Measures

Complete response (CR) during acute phase
Complete response (CR) during delayed phase
No significant nausea during overall phase using questionnaire
No significant nausea during acute phase using questionnaire
No significant nausea during delayed phase using questionnaire
To compare quality of life using the functional living index-emesis questionnaire
To compare olanzapine plus fosaprepitant regimen with placebo plus fosaprepitant regimen in terms of the number of days to first emetic episode.
To compare the number of participants with treatment-related adverse events as assessed by CTCAE v4.0
To compare the change of score using Hospital Anxiety and Depression Scale
Hospital Anxiety and Depression Scale includes two subscales: anxiety and depression, with 7 items for anxiety (a) and depression (d) respectively. Each item is divided into four grades of 0-3. The higher the score is, the more serious the anxiety and depression are.

Full Information

First Posted
August 25, 2020
Last Updated
August 28, 2020
Sponsor
Sun Yat-sen University
Collaborators
Jiangsu Hansoh Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04536558
Brief Title
Olanzapine Plus Fosaprepitant Standard Antiemetic Therapy in the Prevention of Chemotherapy-induced Nausea and Vomiting in Patients Receiving High Emetic Risk Multi-day Chemotherapy: a Multicenter, Randomized, Double-blind, Placebo-controlled, Phase 3 Study
Acronym
OFFER
Official Title
Olanzapine Plus Fosaprepitant Standard Antiemetic Therapy in the Prevention of Chemotherapy-induced Nausea and Vomiting in Patients Receiving High Emetic Risk Multi-day Chemotherapy: a Multicenter, Randomized, Double-blind, Placebo-controlled, Phase 3 Study(OFFER)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Unknown status
Study Start Date
October 1, 2020 (Anticipated)
Primary Completion Date
February 1, 2021 (Anticipated)
Study Completion Date
March 30, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University
Collaborators
Jiangsu Hansoh Pharmaceutical Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a multicenter, randomized, controlled, double-blind, phase III study.
Detailed Description
This is a multicenter, randomized, controlled, double-blind, phase III study assessing the efficacy and safety of Olanzapine plus fosaprepitant plus ondansetron and dexamethasone versus fosaprepitant plus ondansetron and dexamethasone in the prevention of chemotherapy-induced nausea and vomiting in patients receiving high emetic risk multi-day chemotherapy. Eligible patients will be randomized to receive either olanzapine plus fosaprepitant standard antiemetic therapy or fosaprepitant standard antiemetic therapy in a 1:1 ratio.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumor Patients Receiving High Emetic Risk Multi-day Chemotherapy

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
352 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
olanzapine plus fosaprepitant-based triple regimen
Arm Type
Experimental
Arm Description
Olanzapine(5mg p.o. d1-d5)plus fosaprepitant(150mg i.v. d1-d3) plus ondansetron(8mg i.v. d1-d3)and dexamethasone(6mg p.o. d1-d5) before undergoing chemotherapy.
Arm Title
Placebo plus fosaprepitant-based triple regimen
Arm Type
Placebo Comparator
Arm Description
Placebo plus fosaprepitant(150mg i.v. d1-d3) plus ondansetron(8mg i.v. d1-d3)and dexamethasone(6mg p.o. d1-d5) before undergoing chemotherapy.
Intervention Type
Drug
Intervention Name(s)
olanzapine plus fosaprepitant-based triple regimen
Intervention Description
olanzapine 5mg p.o. on day 1-day 5, fosaprepitant 150mg i.v. on day 1 before undergoing chemotherapy. Patients received ondansetron hydrochloride(8mg, i.v. day 1-day 3) and dexamethasone(6mg, oral, day 1-day 5) at the same time, before undergoing chemotherapy.
Intervention Type
Drug
Intervention Name(s)
placebo plus fosaprepitant-based triple regimen
Intervention Description
placebo p.o. on day 1-day 5, fosaprepitant 150mg i.v. on day 1 before undergoing chemotherapy. Patients received ondansetron hydrochloride(8mg, i.v. day 1-day 3) and dexamethasone(6mg, oral, day 1-day 5) at the same time, before undergoing chemotherapy.
Primary Outcome Measure Information:
Title
Complete response (CR) during overall phase
Description
To compare olanzapine plus fosaprepitant regimen with placebo plus fosaprepitant regimen with respect to efficacy; complete response (CR) defined as no vomiting and no use of rescue therapy during overall phase (day 1 to day 8) after highly emetogenic chemotherapy initiation)
Time Frame
Day 1 to day 8 after highly emetogenic chemotherapy initiation
Secondary Outcome Measure Information:
Title
Complete response (CR) during acute phase
Time Frame
Day 1 to day 3 days after highly emetogenic chemotherapy initiation
Title
Complete response (CR) during delayed phase
Time Frame
Day 4 to day 8 after highly emetogenic chemotherapy initiation
Title
No significant nausea during overall phase using questionnaire
Time Frame
Day 1 to day 8 after highly emetogenic chemotherapy initiation
Title
No significant nausea during acute phase using questionnaire
Time Frame
Day 1 to day 3 after highly emetogenic chemotherapy initiation
Title
No significant nausea during delayed phase using questionnaire
Time Frame
Day 4 to day 8 after highly emetogenic chemotherapy initiation
Title
To compare quality of life using the functional living index-emesis questionnaire
Time Frame
From baseline to day 8 after highly emetogenic chemotherapy initiation
Title
To compare olanzapine plus fosaprepitant regimen with placebo plus fosaprepitant regimen in terms of the number of days to first emetic episode.
Time Frame
Day 1 to day 8 after highly emetogenic chemotherapy initiation
Title
To compare the number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
From baseline to day 8 after highly emetogenic chemotherapy initiation
Title
To compare the change of score using Hospital Anxiety and Depression Scale
Description
Hospital Anxiety and Depression Scale includes two subscales: anxiety and depression, with 7 items for anxiety (a) and depression (d) respectively. Each item is divided into four grades of 0-3. The higher the score is, the more serious the anxiety and depression are.
Time Frame
From baseline to day 8 after highly emetogenic chemotherapy initiation
Other Pre-specified Outcome Measures:
Title
The plasma concentration of 5-hydroxytryptamine and substance P at the baseline
Description
To explore the relationship between plasma concentration of 5-hydroxytryptamine、substance P and efficacy
Time Frame
From baseline to day 8 after highly emetogenic chemotherapy initiation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: (abbreviated) Male and female patients aged ≥ 18 and ≤ 75 years old; Patients were diagnosed with histologically or cytology confirmed solid malignant tumors; Patients have a Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2; Patients were predicted life expectancy of ≥ 3 months; Patients who were scheduled for 3 days of cisplatin based chemotherapy. Exclusion Criteria: (abbreviated) Patients were mentally disable or suffered from emotional disorders; Patients were current illicit drug use, including alcohol abuse; Patients scheduled administration of stem cell rescue therapy during cisplatin chemotherapy; Patients have participated in other clinical trials in the past 4 weeks; Patients were treated with chemotherapy including ordinary paclitaxel(using castor oil as a solvent); Patients with active infections (e.g., pneumonia) or any uncontrolled disease (e.g., diabetic ketoacidosis, gastrointestinal obstruction) other than malignant tumors, and the researchers believe that it may confound the results of the study or expose patients receiving treatment with the study drug at unnecessary risk; Patients have any disease that the researcher believes may confound the results of the study or expose the patient to unnecessary risk; Patients were treated with moderate or highly emetogenic chemotherapy within 6 days prior to the initial of cisplatin infusion and/or 6 days after cisplatin infusion; Patients were scheduled to receive radiation therapy to the abdomen or pelvis within a week of treatment; Absolute neutrophil count<1,500 cells/ L, white blood cell count<3,000 cells/ L, platelet count<100,000 cells/ L, aspartate aminotransferase and alanine aminotransferase>2.5 upper limit of normal (ULN), bilirubin > 1.5 ULN, and creatinine > 1.5 ULN; Patients were pregnant or breastfeeding; Patients had suffered from vomiting or nausea in the 24 hours before treatment; Patients were known to be at risk for narrow angle glaucoma; Patients who are taking or have used CYP3A4 inducers within 30 days before the first day of treatment, which will affect the efficacy of the treatment drugs according to the researcher's evaluation, can not be enrolled; Patients who are taking or have used CYP3A4 substrates and inhibitors within 7 days before the first day of treatment will significantly increase the treatment drug-related adverse events according to the researcher's evaluation, can not be enrolled; Within 48 hours before the first day of treatment, patients used the following antiemetic agents: 5-hydroxytryptamine 3 receptor antagonists (such as ondansetron), phenothiazines (such as prochlorperazine), benzophenones (such as haloperidol), benzamide (such as metoclopramide), domperidone, cannabinoids, herbs with potential antiemetic effects, scopolamine, and cyclizine, etc; Patients began to receive benzodiazepines or opioids within 48 hours prior to the first day of the study (except for triazolam, temazepam or midazolam single dose daily); Patients had symptomatic primary or metastatic central nervous system malignancies; Patients had concomitant diseases that could not take dexamethasone for 5 days, such as systemic fungal infection or uncontrolled diabetes mellitus; Patients were not allowed to receive any dose of systemic glucocorticoid therapy within 72 hours before the first day except those prescribed in the protocol; however, local and inhaled corticosteroids were allowed; Patients had a history of hypersensitivity to fosaprepitant meglumine, olanzapine, ondansetron or dexamethasone; Patients had been treated with neurokinin-1 receptor antagonist in the past;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Li Zhang
Phone
+86 20-87342288
Email
zhangli@sysucc.org.cn
Facility Information:
Facility Name
Beijing Cancer Hospital
City
Beijing
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jian Fang
First Name & Middle Initial & Last Name & Degree
Jian Fang
Facility Name
Cancer Hospital Chinese Academy of Medical Sciences
City
Beijing
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianchun Duan
First Name & Middle Initial & Last Name & Degree
Jianchun Duan
Facility Name
Hunan Cancer Hospital
City
Changsha
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lin Wu
First Name & Middle Initial & Last Name & Degree
Lin Wu
Facility Name
Sichuan Cancer Hospital& Institute
City
Chengdou
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wenxiu Yao
First Name & Middle Initial & Last Name & Degree
Wenxiu Yao
Facility Name
The First Affiliated Hospital of Chongqing Medical University
City
Chongqing
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaopin Chen
First Name & Middle Initial & Last Name & Degree
Xiaopin Chen
Facility Name
Sun Yat-sen University Cancer Center
City
Guangdong
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Zhang
First Name & Middle Initial & Last Name & Degree
Li Zhang
Facility Name
Harbin Medical University Cancer Hospital
City
Haerbin
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Cai
First Name & Middle Initial & Last Name & Degree
Li Cai
Facility Name
Anhui Provincial Cancer Hospital
City
Hefei
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Changlu Hu
First Name & Middle Initial & Last Name & Degree
Changlu Hu
Facility Name
Yunnan Cancer Hospital
City
Kunming
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Runxiang Yang
First Name & Middle Initial & Last Name & Degree
Runxiang Yang
Facility Name
Jiangxi Cancer Hospital
City
Nanchang
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yinglan Chen
First Name & Middle Initial & Last Name & Degree
Yinglan Chen
Facility Name
Guangxi Medical University Affiliated Tumor Hospital
City
Nanning
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qitao Yu
First Name & Middle Initial & Last Name & Degree
Qitao Yu
Facility Name
Ningbo Medical Center Lihuili Hospital
City
Ningbo
Country
China
Facility Name
Shanghai Sixth People's Hospital Affiliated to Shanghai JiaoTong University
City
Shanghai
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Daliu Min
First Name & Middle Initial & Last Name & Degree
Daliu Min
Facility Name
Liaoning Cancer Hospital & Institute
City
Shenyang
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tao Sun
First Name & Middle Initial & Last Name & Degree
Tao Sun
Facility Name
Fourth Hospital of Hebei Medical University
City
Shijiazhuang
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Junfeng Liu
First Name & Middle Initial & Last Name & Degree
Junfeng Liu
Facility Name
The First Affiliated Hospital of Soochow University
City
Suzhou
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kai Chen
First Name & Middle Initial & Last Name & Degree
Kai Chen
Facility Name
Tianjin Medical University General Hospital
City
Tianjin
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Diansheng Zhong
First Name & Middle Initial & Last Name & Degree
Diansheng Zhong
Facility Name
Henan Cancer Hospital
City
Zhengzhou
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yanqiu Zhao
First Name & Middle Initial & Last Name & Degree
Yanqiu Zhao

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Olanzapine Plus Fosaprepitant Standard Antiemetic Therapy in the Prevention of Chemotherapy-induced Nausea and Vomiting in Patients Receiving High Emetic Risk Multi-day Chemotherapy: a Multicenter, Randomized, Double-blind, Placebo-controlled, Phase 3 Study

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