Intravenous Palonosetron With Radiotherapy and Concomitant Temozolomide
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Purpose
1. Purpose and objective:
- To determine the safety and tolerability of palonosetron in the prevention of radiation induced nausea and vomiting (RINV) in primary glioma patients receiving radiation (RT) and concomitant temozolomide (TMZ).
- To determine the efficacy of palonosetron in primary glioma patients receiving six weeks of RT and concomitant TMZ
- To evaluate the effect s of palonosetron on the quality of life of primary glioma patients receiving six weeks of RT and Concomitant TMZ.
2. Study activities and Population group: We will conduct a phase II single arm trial of Palonosetron (PALO) for the prevention of RINV in primary malignant glioma patients receiving radiation therapy (RT) and concomitant temozolomide (TMZ). All eligible patients should receive a planned total dose of 54-60 GY of radiation and 75 mg/m2 of daily temozolomide for a total of six weeks of treatment. For each week of radiation patients will receive a single 0.25 mg intravenous dose of palonosetron 30 minutes before each week of radiation fraction. This schedule will be repeated for each week of radiation for a total of 6 weeks. Forty subjects with gliomas will participate.
3. Data analysis and risk/safety issues: The frequency of toxicity will be summarized by type and the most severe grade experienced. The complete response rate, defined as the proportion of patients with no emetic episode or use of rescue medication while receiving radiation and concomitant temozolomide, will be estimated with a 95% confidence interval. Logistic regression will be used to explore the effect of age, sex, the use of glucocorticoids and anti convulsants, on the complete response rate.
| Condition | Intervention | Phase |
|---|---|---|
|
Malignant Glioma |
Drug: Palonosetron (PALO) |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Phase II Study to Evaluate the Efficacy and Safety of Intravenous Palonosetron in Primary Glioma Patients Receiving Standard Radiotherapy and Concomitant Temozolomide |
- To determine the safety and tolerability of intravenous palonosetron in the prevention of radiation induced nausea and vomiting (RINV) in primary glioma patients receiving radiation (RT) and concomitant temozolomide (TMZ) [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
- Efficacy will be assessed daily based on number of emetic episodes (vomiting and retching), use of rescue medication and intensity and duration of nausea and vomiting. [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
| Enrollment: | 40 |
| Study Start Date: | August 2009 |
| Study Completion Date: | December 2012 |
| Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Palonosetron
Single Arm trial of Palonosetron for the prevention of RINV in primary malignant glioma patients receiving radiation therapy (RT) and concomitant temozolomide (TMZ)
|
Drug: Palonosetron (PALO)
Eligible patients should receive a planned total dose of 54-60 GY of radiation and 75 mg/m2 of daily temozolomide for a total of six weeks of treatment. For each week of radiation patients will receive a single 0.25 mg intravenous dose of palonosetron 30 minutes before each week of radiation fraction. This schedule will be repeated for each week of radiation for a total of 6 weeks.
Other Name: Aloxi
|
Detailed Description:
We will conduct a phase II single arm trial of Palonosetron (PALO) for the prevention of RINV in primary malignant glioma patients receiving radiation therapy (RT) and concomitant temozolomide (TMZ). All eligible patients should receive a planned total dose of 54-60 GY of radiation and 75 mg/m2 of daily temozolomide for a total of six weeks of treatment. For each week of radiation patients will receive a single 0.25 mg intravenous dose of palonosetron approximately 30 minutes before each week of radiation fraction. This schedule will be repeated for each week of radiation for a total of 6 weeks. After the start of radiation the type of rescue medication will be up to the investigator's discretion (however given the results of recent published phase II study by Navari et. al. we recommend using olanzepine for rescue medication). All patients will be given written informed consent.
Eligibility| Ages Eligible for Study: | 18 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age ≥ 18 years;
- Karnofsky ≥ 60%;
- Hematocrit > 29%, ANC > 1,000 cells/*1, platelets > 100,000 cells/*I;
- Serum creatinine < 1.4 mg/dl; serum SGOT and bilirubin < 1.5 times upper limit of normal;
- For patients on corticosteroids, they must have been on a stable dose for 1 week prior to entry, and the dose should not be escalated over entry dose level, if clinically possible;
- Signed informed consent approved by the Institutional Review Board prior to patient entry;
- If sexually active, patients w8ill take contraceptive measures for the duration of the treatments.
Exclusion Criteria:
- Pregnancy or breastfeeding;
- Co-medication that may interfere with study results; e.g. immuno-suppressive agents other than corticosteroids;
- Inability or unwillingness to cooperate with the study procedures;
- Prophylactic medication for the prevention of nausea and vomiting 24 hours prior to the start of radiation therapy through the full course of radiation therapy is prohibited, with the exception of the study drug. Corticosteroids will be allowed for treatment of cerebral swelling. Rescue medication for treatment of nausea and vomiting is permitted after radiation therapy at the discretion of the investigator. The agent, dose, and time of administration will be recorded in the patient diary;
- Previous participation in any clinical trial involving palonosetron;
- Any vomiting, retching, or NCI Common Toxicity Criteria version 3.0 grade 2-4 nausea in the 24 hours preceding radiation and chemotherapy;
- Ongoing vomiting from any organic etiology;
- Will receive radiotherapy of upper abdomen within one week prior to or during the study;
- Received palonosetron within 14 days prior to study enrollment;
- Prior and Concomitant Medications for Prevention/Treatment of Nausea and Vomiting;
- Prior and Concomitant Cancer Chemotherapy and Radiotherapy.
Contacts and Locations| United States, North Carolina | |
| The Preston Robert Tisch Brain Tumor Center at Duke | |
| Durham, North Carolina, United States, 27710 | |
| Principal Investigator: | Mary Lou Affronti, RN, MSN, ANP | Duke University Health System |
More Information
No publications provided
| Responsible Party: | Duke University |
| ClinicalTrials.gov Identifier: | NCT00900757 History of Changes |
| Other Study ID Numbers: | Pro00015573, P50NS020023 |
| Study First Received: | May 11, 2009 |
| Last Updated: | January 16, 2013 |
| Health Authority: | United States: Food and Drug Administration United States: Institutional Review Board |
Keywords provided by Duke University:
|
Primary Glioma Palonosetron Standard Radiotherapy Temozolomide |
Additional relevant MeSH terms:
|
Glioma Neoplasms, Neuroepithelial Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms, Glandular and Epithelial Neoplasms, Nerve Tissue Temozolomide Palonosetron |
Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antineoplastic Agents Therapeutic Uses Serotonin Antagonists Serotonin Agents Neurotransmitter Agents Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 19, 2013