search
Back to results

Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 1)

Primary Purpose

Cachexia, Non-Small Cell Lung Cancer

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Anamorelin HCl
Placebo
Sponsored by
Helsinn Therapeutics (U.S.), Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cachexia

Eligibility Criteria

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

Inclusion Criteria:

  • Documented diagnosis of unresectable Stage III or Stage IV NSCLC
  • Patients may be receiving maintenance chemotherapy
  • Patients planning to initiate a new chemotherapy and/or radiation therapy regimen may do so only within ± 14 days of randomization
  • Patients may have completed a chemotherapy and/or radiation therapy and/or have no plan to initiate a new regimen within 12 weeks from randomization; at least 14 days must elapse from the completion of the chemotherapy and/or radiation therapy prior to randomization
  • Involuntary weight loss of ≥5% body weight within 6 months prior to screening or a screening body mass index (BMI) <20 kg/m2
  • Body mass index ≤30 kg/m2
  • Life expectancy of >4 months at time of screening
  • ECOG performance status ≤2
  • Adequate hepatic function, defined as AST and ALT levels ≤5 x upper limit of normal
  • Adequate renal function, defined as creatinine ≤2 x upper limit of normal, or calculated creatinine clearance >30 ml/minute
  • Ability to understand and comply with the procedures for the HGS evaluation
  • If a woman of childbearing potential or a fertile man, he/she must agree to use an effective form of contraception during the study and for 30 days following the last dose of study drug (an effective form of contraception is abstinence, a hormonal contraceptive, or a double-barrier method)
  • Must be willing and able to give signed informed consent and, in the opinion of the Investigator, to comply with the protocol tests and procedures

Exclusion Criteria:

  • Other forms of lung cancer (e.g., small cell, mesothelioma)
  • Women who are pregnant or breast-feeding
  • Known HIV, hepatitis (B&C), or active tuberculosis
  • Had major surgery (central venous access placement and tumor biopsies are not considered major surgery) within 4 weeks prior to randomization; patients must be well recovered from acute effects of surgery prior to screening; patients should not have plans to undergo major surgical procedures during the treatment period
  • Currently taking prescription medications intended to increase appetite or treat weight loss; these include, but are not limited to, testosterone, androgenic compounds, megestrol acetate, methylphenidate, and dronabinol
  • Inability to readily swallow oral tablets; patients with severe gastrointestinal disease (including esophagitis, gastritis, malabsorption, or obstructive symptoms) or intractable or frequent vomiting are excluded
  • Has an active, uncontrolled infection
  • Has uncontrolled diabetes mellitus
  • Has untreated clinically relevant hypothyroidism
  • Has known or symptomatic brain metastases
  • Receiving strong CYP3A4 inhibitors within 14 days of randomization
  • Receiving tube feedings or parenteral nutrition (either total or partial); patients must have discontinued these treatments for at least 6 weeks prior to Day 1, and throughout the study duration
  • Other clinical diagnosis, ongoing or intercurrent illness that in the Investigator's opinion would prevent the patient's participation
  • Has had previous exposure to Anamorelin HCl
  • Patients actively receiving a concurrent investigational agent

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

100 mg QD

Placebo

Arm Description

Anamorelin HCL 100 mg will be administered daily

Placebo tablets identical in appearance to active tablets; oral administration once daily

Outcomes

Primary Outcome Measures

Change in Lean Body Mass
Change in Lean Body Mass (LBM) from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.
Change in Handgrip Strength
Change in Handgrip Strength (HGS) of the non-dominant hand from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.

Secondary Outcome Measures

Change in A/CS Domain Score
The Functional Assessment of Anorexia/Cachexia Treatment (FAACT) Additional Concerns Subscale (A/CS domain) is a 12-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 12-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the A/CS domain ranges from 0 (worst) to 48 (best).
Change in FACIT-F Fatigue Domain Score
The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) fatigue domain is a 13-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 13-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the FACIT-F fatigue domain ranges from 0 (worst) to 52 (best).
Change in Body Weight
Change in body weight (BW) from baseline overall (i.e., over 12 weeks) for the MITT Population.

Full Information

First Posted
June 30, 2011
Last Updated
September 26, 2017
Sponsor
Helsinn Therapeutics (U.S.), Inc
search

1. Study Identification

Unique Protocol Identification Number
NCT01387269
Brief Title
Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 1)
Official Title
Anamorelin HCl in the Treatment of Non-Small Cell Lung Cancer-Cachexia (NSCLC-C): A Randomized Double-Blind Placebo-Controlled Multicenter Phase III Study to Evaluate the Safety and Efficacy of Anamorelin HCl in Patients With NSCLC-C
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
July 2011 (undefined)
Primary Completion Date
January 2014 (Actual)
Study Completion Date
February 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Helsinn Therapeutics (U.S.), Inc

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The administration of Anamorelin in patients with Stage III-IV non-small cell lung cancer-cachexia (NSCLC-C) is expected to increase appetite, lean body mass, weight gain, and muscle strength.
Detailed Description
This is a randomized, double-blind, placebo-controlled, multicenter study to assess the safety and efficacy of Anamorelin in patients with non-small cell lung cancer-cachexia (NSCLC-C). The primary efficacy analysis will include the treatment difference in the change in lean body mass and physical function. Pharmacokinetic (PK) samples will also be collected at Day 43 visit for population PK.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cachexia, Non-Small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
484 (Actual)

8. Arms, Groups, and Interventions

Arm Title
100 mg QD
Arm Type
Experimental
Arm Description
Anamorelin HCL 100 mg will be administered daily
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo tablets identical in appearance to active tablets; oral administration once daily
Intervention Type
Drug
Intervention Name(s)
Anamorelin HCl
Intervention Description
Anamorelin HCl will be orally administered daily at least one hour before meal
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo tablets identical in appearance to active tablets; oral administration QD for 12 weeks, at least 1 hour before meal
Primary Outcome Measure Information:
Title
Change in Lean Body Mass
Description
Change in Lean Body Mass (LBM) from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.
Time Frame
Change in Lean Body Mass from Baseline Over 12 Weeks
Title
Change in Handgrip Strength
Description
Change in Handgrip Strength (HGS) of the non-dominant hand from baseline over 12 weeks for the ITT Population. Change from baseline over 12 weeks was defined as the average of the change from baseline at Week 6 and the change from baseline at Week 12.
Time Frame
Change in Handgrip Strength of the Non-Dominant Hand from Baseline Over 12 Weeks
Secondary Outcome Measure Information:
Title
Change in A/CS Domain Score
Description
The Functional Assessment of Anorexia/Cachexia Treatment (FAACT) Additional Concerns Subscale (A/CS domain) is a 12-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 12-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the A/CS domain ranges from 0 (worst) to 48 (best).
Time Frame
Change in FAACT A/CS Domain Score from Baseline Over 12 Weeks
Title
Change in FACIT-F Fatigue Domain Score
Description
The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) fatigue domain is a 13-item scale that is part of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Each item is answered on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The 13-items are summed together to obtain the domain score. Note that negatively phrased questions are reverse scored so that higher scores always represent improvement/less symptom burden. The total possible score for the FACIT-F fatigue domain ranges from 0 (worst) to 52 (best).
Time Frame
Change in FACIT-F Fatigue Domain Score from Baseline Over 12 Weeks
Title
Change in Body Weight
Description
Change in body weight (BW) from baseline overall (i.e., over 12 weeks) for the MITT Population.
Time Frame
Change in Body Weight from Baseline Over 12 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Documented diagnosis of unresectable Stage III or Stage IV NSCLC Patients may be receiving maintenance chemotherapy Patients planning to initiate a new chemotherapy and/or radiation therapy regimen may do so only within ± 14 days of randomization Patients may have completed a chemotherapy and/or radiation therapy and/or have no plan to initiate a new regimen within 12 weeks from randomization; at least 14 days must elapse from the completion of the chemotherapy and/or radiation therapy prior to randomization Involuntary weight loss of ≥5% body weight within 6 months prior to screening or a screening body mass index (BMI) <20 kg/m2 Body mass index ≤30 kg/m2 Life expectancy of >4 months at time of screening ECOG performance status ≤2 Adequate hepatic function, defined as AST and ALT levels ≤5 x upper limit of normal Adequate renal function, defined as creatinine ≤2 x upper limit of normal, or calculated creatinine clearance >30 ml/minute Ability to understand and comply with the procedures for the HGS evaluation If a woman of childbearing potential or a fertile man, he/she must agree to use an effective form of contraception during the study and for 30 days following the last dose of study drug (an effective form of contraception is abstinence, a hormonal contraceptive, or a double-barrier method) Must be willing and able to give signed informed consent and, in the opinion of the Investigator, to comply with the protocol tests and procedures Exclusion Criteria: Other forms of lung cancer (e.g., small cell, mesothelioma) Women who are pregnant or breast-feeding Known HIV, hepatitis (B&C), or active tuberculosis Had major surgery (central venous access placement and tumor biopsies are not considered major surgery) within 4 weeks prior to randomization; patients must be well recovered from acute effects of surgery prior to screening; patients should not have plans to undergo major surgical procedures during the treatment period Currently taking prescription medications intended to increase appetite or treat weight loss; these include, but are not limited to, testosterone, androgenic compounds, megestrol acetate, methylphenidate, and dronabinol Inability to readily swallow oral tablets; patients with severe gastrointestinal disease (including esophagitis, gastritis, malabsorption, or obstructive symptoms) or intractable or frequent vomiting are excluded Has an active, uncontrolled infection Has uncontrolled diabetes mellitus Has untreated clinically relevant hypothyroidism Has known or symptomatic brain metastases Receiving strong CYP3A4 inhibitors within 14 days of randomization Receiving tube feedings or parenteral nutrition (either total or partial); patients must have discontinued these treatments for at least 6 weeks prior to Day 1, and throughout the study duration Other clinical diagnosis, ongoing or intercurrent illness that in the Investigator's opinion would prevent the patient's participation Has had previous exposure to Anamorelin HCl Patients actively receiving a concurrent investigational agent
Facility Information:
City
Fullerton
State/Province
California
Country
United States
City
Glendale
State/Province
California
Country
United States
City
La Jolla
State/Province
California
Country
United States
City
Riverside
State/Province
California
Country
United States
City
Orange City
State/Province
Florida
Country
United States
City
Quincy
State/Province
Illinois
Country
United States
City
Indianapolis
State/Province
Indiana
Country
United States
City
Louisville
State/Province
Kentucky
Country
United States
City
Boston
State/Province
Massachusetts
Country
United States
City
Northport
State/Province
New York
Country
United States
City
Cincinnati
State/Province
Ohio
Country
United States
City
Houston
State/Province
Texas
Country
United States
City
Brest
Country
Belarus
City
Lesnoy
Country
Belarus
City
Minsk
Country
Belarus
City
Antwerpen
Country
Belgium
City
Brussels
Country
Belgium
City
Genk
Country
Belgium
City
Liege
Country
Belgium
City
Edmonton
State/Province
Alberta
Country
Canada
City
Sault Ste. Marie
State/Province
Ontario
Country
Canada
City
Toronto
State/Province
Ontario
Country
Canada
City
Montreal
State/Province
Quebec
Country
Canada
City
Benesov
Country
Czechia
City
Brno
Country
Czechia
City
Hlucin
Country
Czechia
City
Liberec
Country
Czechia
City
Nymburk
Country
Czechia
City
Lyon Cedex
Country
France
City
Villejuif cedex
Country
France
City
Berlin
Country
Germany
City
Grosshansdorf
Country
Germany
City
Halle
Country
Germany
City
Minden
Country
Germany
City
Budapest
Country
Hungary
City
Placenza
Country
Italy
City
Rozzano
Country
Italy
City
Amsterdam
Country
Netherlands
City
Goes
Country
Netherlands
City
Maastricht
Country
Netherlands
City
Nieuwegein
Country
Netherlands
City
Grudziadz
Country
Poland
City
Katowice
Country
Poland
City
Krakow
Country
Poland
City
Lublin
Country
Poland
City
Ekaterinburg
Country
Russian Federation
City
St. Petersburg
Country
Russian Federation
City
Belgrade
Country
Serbia
City
Sremska Kamenica
Country
Serbia
City
Golnik
Country
Slovenia
City
Ljubljana
Country
Slovenia
City
Barcelona
Country
Spain
City
Cordoba
Country
Spain
City
Sevilla
Country
Spain
City
Valencia
Country
Spain
City
Dnipropetrovsk
Country
Ukraine
City
Donetsk
Country
Ukraine
City
Kharkiv
Country
Ukraine
City
Kyiv
Country
Ukraine
City
Zaporizhzhya
Country
Ukraine

12. IPD Sharing Statement

Citations:
PubMed Identifier
28472437
Citation
Currow D, Temel JS, Abernethy A, Milanowski J, Friend J, Fearon KC. ROMANA 3: a phase 3 safety extension study of anamorelin in advanced non-small-cell lung cancer (NSCLC) patients with cachexia. Ann Oncol. 2017 Aug 1;28(8):1949-1956. doi: 10.1093/annonc/mdx192.
Results Reference
derived
PubMed Identifier
26906526
Citation
Temel JS, Abernethy AP, Currow DC, Friend J, Duus EM, Yan Y, Fearon KC. Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials. Lancet Oncol. 2016 Apr;17(4):519-531. doi: 10.1016/S1470-2045(15)00558-6. Epub 2016 Feb 20.
Results Reference
derived

Learn more about this trial

Safety and Efficacy of Anamorelin HCl in Patients With Non-Small Cell Lung Cancer-Cachexia (ROMANA 1)

We'll reach out to this number within 24 hrs