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Aprepitant or Ondansetron in Treating Nausea and Vomiting Caused By Opioids in Patients With Cancer

This study has been withdrawn prior to enrollment.
(slow accrual)
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Barbara Murphy, MD, Vanderbilt-Ingram Cancer Center Identifier:
First received: July 10, 2007
Last updated: March 29, 2013
Last verified: March 2013

RATIONALE: Antiemetic drugs, such as aprepitant and ondansetron, may help lessen nausea and vomiting caused by opioids. It is not yet known whether aprepitant is more effective than ondansetron in treating nausea and vomiting caused by opioids in patients with cancer.

PURPOSE: This randomized clinical trial is studying aprepitant to see how well it works compared to ondansetron in treating nausea and vomiting caused by opioids in patients with cancer.

Condition Intervention
Myeloproliferative Disorders Leukemia Lymphoma Lymphoproliferative Disorder Multiple Myeloma and Plasma Cell Neoplasm Myelodysplastic Syndromes Nausea and Vomiting Solid Tumor Drug: aprepitant Drug: ondansetron hydrochloride

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: A Pilot Study of Aprepitant Versus Ondansetron for the Treatment of Opioid Induced Nausea and Vomiting

Resource links provided by NLM:

Genetic and Rare Diseases Information Center resources: Multiple Myeloma Lymphosarcoma B-cell Lymphoma Diffuse Large B-Cell Lymphoma Polycythemia Vera Myeloid Leukemia Acute Myeloid Leukemia Acute Non Lymphoblastic Leukemia Acute Lymphoblastic Leukemia Myelodysplastic Syndromes Mantle Cell Lymphoma Mycosis Fungoides Burkitt Lymphoma Chronic Myelomonocytic Leukemia Chronic Lymphocytic Leukemia Leukemia, B-cell, Chronic Cutaneous T-cell Lymphoma Follicular Lymphoma Marginal Zone Lymphoma Waldenstrom Macroglobulinemia Lymphoma, Large-cell Angioimmunoblastic T-cell Lymphoma Angioimmunoblastic Lymphadenopathy With Dysproteinemia Chronic Myeloid Leukemia Leukemia, T-cell, Chronic Adult T-cell Leukemia/lymphoma Hodgkin Lymphoma Primary Central Nervous System Lymphoma Chronic Myeloproliferative Disorders Myelodysplastic/myeloproliferative Disease Extranodal Nasal NK/T Cell Lymphoma Large Granular Lymphocyte Leukemia Aggressive NK Cell Leukemia Essential Thrombocythemia Myelofibrosis Lymphoma AIDS Related Primary Effusion Lymphoma Anaplastic Large Cell Lymphoma Lymphoblastic Lymphoma Sezary Syndrome Lymphomatoid Granulomatosis Plasmablastic Lymphoma Lymphoma, Large-cell, Immunoblastic Hairy Cell Leukemia Chronic Neutrophilic Leukemia Anaplastic Plasmacytoma
U.S. FDA Resources

Further study details as provided by Barbara Murphy, MD, Vanderbilt-Ingram Cancer Center:

Primary Outcome Measures:
  • Control of nausea and vomiting [ Time Frame: Day 1 and Day 7 ]

Secondary Outcome Measures:
  • Quality of life [ Time Frame: Day 1 and Day 7 ]
  • Pain control [ Time Frame: Day 1 and Day 7 ]
  • Mood [ Time Frame: Day 1 and Day 7 ]
  • Global satisfaction [ Time Frame: Day 1 and Day 7 ]

Enrollment: 0
Study Start Date: August 2007
Study Completion Date: March 2008
Primary Completion Date: January 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: ARM A Drug: aprepitant
125 mg orally for 7 days
Other Name: EMEND
Experimental: ARM B Drug: ondansetron hydrochloride
24 mg orally for 7 days
Other Name: Zofran

Detailed Description:



  • To evaluate the efficacy of aprepitant as monotherapy for opioid-induced nausea and vomiting (OINV) in comparison to ondansetron hydrochloride in patients who have failed at least one prior anti-emetic agent/regimen.


  • To determine whether control of OINV improves quality of life.
  • To determine if control in OINV decreases pain.
  • To determine if control in OINV improves mood.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

  • Arm A: Patients receive aprepitant orally once daily for 7 days in the absence of unacceptable toxicity or persistent grade 4 nausea and vomiting.
  • Arm B: Patients receive ondansetron hydrochloride orally 3 times daily for 7 days in the absence of unacceptable toxicity or persistent grade 4 nausea and vomiting.

Patients complete the following questionnaires: Functional Assessment of Cancer Therapy-General (FACT-G); Center for Epidemiologic Studies Depression Scale (CES-D); and Brief Pain Index (BPI) at baseline and on day 7. Patients also complete symptom diaries documenting the following: number of episodes (an emetic episode is defined as a simple vomit or retch, or any number of continuous vomits or retches; distinct episodes that are separated by at least 1 minute) of vomiting or retching including the date and time; worst and average degree of nausea (recorded every 2 hours while awake during the first 24 hours after treatment and every 8 hours on days 1-7); and adverse events other than episodes of vomiting and nausea.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • History of malignancy (including hematological malignancies)
  • Has pain requiring opioid analgesics
  • Nausea and vomiting (associated with opioid analgesic use) that is unrelieved by at least one standard antiemetic regimen (including 5HT3 antagonist and dexamethasone combination therapy)

    • Patients who have failed ondansetron hydrochloride for treatment of opioid-induced nausea and vomiting will be excluded from the study


  • ECOG performance status 0-2
  • Able to assess severity of nausea and vomiting and document it in the diary
  • Women must not be pregnant or lactating
  • Women of childbearing potential and sexually active males are strongly advised to use an accepted and effective method of contraception
  • Urine pregnancy test will be given to women of childbearing age
  • No concerns about compliance with medication regimen or medical follow-up (patient must be able to tolerate oral dosing)
  • No severe or chronic illness or other causes of nausea and vomiting, that in judgment of the treating physician, will place patient at risk
  • No severe gastrointestinal obstruction or active peptic ulcer disease
  • Serum ALT and AST < 2 times upper limit of normal (ULN)
  • Serum bilirubin < 2 times ULN
  • Serum alkaline phosphatase < 2 times ULN


  • No surgery within the past 7 days
  • No chemotherapy within the past 7 days
  • No total or lower body radiation therapy within the past 7 days
  • Patient may not be scheduled to undergo total body irradiation or lower body irradiation, chemotherapy, or surgery during study participation
  • Patient must not be taking warfarin
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00499668

Sponsors and Collaborators
Vanderbilt-Ingram Cancer Center
National Cancer Institute (NCI)
Study Chair: Barbara A. Murphy, MD Vanderbilt-Ingram Cancer Center
  More Information

Responsible Party: Barbara Murphy, MD, Professor of Medicine; Director, Cancer Supportive Care Program; Director, Head and Neck Research Program; Medical Oncologist, Vanderbilt-Ingram Cancer Center Identifier: NCT00499668     History of Changes
Other Study ID Numbers: VICC SUPP 0513
Study First Received: July 10, 2007
Last Updated: March 29, 2013

Keywords provided by Barbara Murphy, MD, Vanderbilt-Ingram Cancer Center:
AIDS-related lymphoma
unspecified adult solid tumor, protocol specific
nausea and vomiting
chronic myelogenous leukemia
chronic eosinophilic leukemia
chronic idiopathic myelofibrosis
chronic neutrophilic leukemia
essential thrombocythemia
polycythemia vera
adult acute lymphoblastic leukemia
adult acute myeloid leukemia
acute undifferentiated leukemia
mast cell leukemia
adult T-cell leukemia/lymphoma
T-cell large granular lymphocyte leukemia
chronic lymphocytic leukemia
hairy cell leukemia
prolymphocytic leukemia
adult Hodgkin lymphoma
anaplastic large cell lymphoma
angioimmunoblastic T-cell lymphoma
cutaneous B-cell non-Hodgkin lymphoma
cutaneous T-cell non-Hodgkin lymphoma
mycosis fungoides/Sezary syndrome
adult grade III lymphomatoid granulomatosis
adult nasal type extranodal NK/T-cell lymphoma
Waldenstrom macroglobulinemia
adult Burkitt lymphoma
adult diffuse large cell lymphoma
adult diffuse mixed cell lymphoma

Additional relevant MeSH terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Myelodysplastic Syndromes
Myeloproliferative Disorders
Lymphoproliferative Disorders
Neoplasms by Histologic Type
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Pathologic Processes
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Bone Marrow Diseases
Precancerous Conditions
Signs and Symptoms, Digestive
Signs and Symptoms processed this record on September 19, 2017