Ph 3 Safety/Efficacy Study of Rolapitant for Prevention of CINV in Subjects Receiving Moderately Emetogenic Chemotherapy - Full Text View

Purpose

This is a Phase 3, multicenter, randomized, parallel-group, double-blind, active-controlled study of rolapitant in subjects receiving MEC. Rolapitant or placebo will be administered prior to the initiation of chemotherapy on Day 1 with granisetron and dexamethasone. Subjects will record all events of emesis and the use of rescue medication for established nausea and/or vomiting, and will indicate the severity of nausea they experienced in each of the previous 24 hours in the Nausea and Vomiting (NV) Subject Diary prior to the MEC administration through Day 6 in Cycle 1. Health-related quality of life will be measured by the FLIE Questionnaire on Day 6 of Cycle 1. Safety and tolerability will be assessed by clinical review of adverse events (AEs), physical examination, electrocardiograms (ECGs), and safety laboratory values. All subjects are expected to complete Cycle 1 and will have the option of participating in up to five additional cycles.

Condition	Intervention	Phase
Chemotherapy-induced Nausea and Vomiting	Drug: Rolapitant Drug: Granisetron Drug: Dexamethasone Drug: Placebo	Phase 3


Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Prevention
Official Title:	Phase 3, Multicenter, Randomized, Double Blind, Active-Controlled Study of the Safety and Efficacy of Rolapitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting (CINV) in Subjects Receiving Moderately Emetogenic Chemotherapy

Resource links provided by NLM:

MedlinePlus related topics: Nausea and Vomiting

Drug Information available for: Dexamethasone Dexamethasone sodium phosphate Dexamethasone acetate Granisetron hydrochloride Granisetron Rolapitant

U.S. FDA Resources

Further study details as provided by Tesaro, Inc.:

Primary Outcome Measures:

No Emetic Episodes and No Rescue Medication [ Time Frame: >24 to 120 hours post chemotherapy ] [ Designated as safety issue: No ]
The primary objective of this study is to determine whether administration of rolapitant with granisetron and dexamethasone improves CINV in the delayed phase (>24 to 120 hours) of CINV compared with administration of placebo with granisetron and dexamethasone in subjects receiving MEC. The primary outcome will be based on complete response (defined as no emesis and no rescue medication) in the delayed phase (>24 to 120 hours).

Secondary Outcome Measures:

Acute Phase Response [ Time Frame: 0 to 24 hours ] [ Designated as safety issue: No ]
To determine the effect of rolapitant on complete response rates in the acute (0 to 24 hours) phase of CINV.
Overall Response Rate [ Time Frame: 0 to 120 hours ] [ Designated as safety issue: No ]
To determine the effect of rolapitant on complete response rate in the overall (0 to 120 hours) phase of CINV.


Enrollment:	1369
Study Start Date:	February 2012
Study Completion Date:	February 2014
Primary Completion Date:	February 2014 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Placebo Comparator: Placebo + Granisetron + Dexamethasone Day 1: Placebo + Granisetron (2 mg PO)+ Dexamethasone (20 mg PO) Days 2-3: Granisetron (2 mg PO) will be administered orally.	Drug: Granisetron 2 mg PO Other Names: Kytril Granisol Drug: Dexamethasone 20 mg PO Other Name: Decadron Drug: Placebo (4 X 0 mg capsules) 0 mg PO Other Name: Placebo to match Rolapitant
Experimental: Rolapitant Day 1: Rolapitant (200 mg PO) + Granisetron (2 mg PO)+ Dexamethasone (20 mg PO) Days 2-3: Granisetron (2 mg PO) will be administered orally.	Drug: Rolapitant (4 X 50 mg capsule) 200 mg PO Other Name: Varubi Drug: Granisetron 2 mg PO Other Names: Kytril Granisol Drug: Dexamethasone 20 mg PO Other Name: Decadron

Detailed Description:

This is a Phase 3, multicenter, randomized, parallel-group, double-blind, active-controlled study of rolapitant in subjects receiving MEC. Rolapitant or placebo will be administered orally 1-2 hours prior to the initiation of chemotherapy on Day 1. Granisetron (2 mg PO) and dexamethasone (20 mg PO) will be administered approximately 30 minutes before initiation of chemotherapy. Subjects will continue to receive granisetron (2 mg daily) on Days 2 and 3. Subjects will record all events of emesis and the use of rescue medication for established nausea and/or vomiting, and will indicate the severity of nausea they experienced in each of the previous 24 hours in the Nausea and Vomiting (NV) Subject Diary prior to the MEC administration through Day 6 in Cycle 1. Health-related quality of life will be measured by the FLIE Questionnaire on Day 6 of Cycle 1. Safety and tolerability will be assessed by clinical review of adverse events (AEs), physical and neurological examinations, vital signs, electrocardiograms (ECGs), and safety laboratory values including BUN and creatinine. All subjects are expected to complete Cycle 1 and will have the option of participating in up to five additional cycles. Blood samples may be collected and stored in this study and may be analyzed for future biomarker research related to safety and efficacy.

Eligibility


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

Criteria

Inclusion Criteria:

18 years of age or older, of either gender, and of any race
Naïve to moderately or highly emetogenic chemotherapy, and is to receive a first course of MEC including one or more of the following agents: cyclophosphamide IV (<1500 mg/m2), doxorubicin, epirubicin, carboplatin, idarubicin, ifosfamide, irinotecan, daunorubicin, cytarabine IV (>1 g/m2).
Karnofsky performance score of ≥60
Predicted life expectancy of ≥4 months
Adequate bone marrow, kidney, and liver function

Exclusion Criteria:

Contraindication to the administration of prescribed MEC agent,granisetron, or dexamethasone
Is pregnant or breast feeding
Has taken the following agents within the last 48 hours 5-HT3 antagonists,Phenothiazines,Benzamides,Domperidone,Cannabinoids,NK1 antagonist, Benzodiazepines
Scheduled to receive any other chemotherapeutic agent with an emetogenicity level of 3 or above (Hesketh Scale) from Day -2 through Day 6, except on Day 1
Scheduled to receive any radiation therapy to the abdomen or pelvis from Day -5 through Day 6
Has received systemic corticosteroids or sedative antihistamines within 72 hours of Day 1 of the study except as premedication for chemotherapy (e.g., taxanes)
Symptomatic primary or metastatic CNS disease.
Has ongoing vomiting, retching, clinically significant nausea caused by any etiology, or has a history of anticipatory nausea and vomiting.
Has vomited and/or has had dry heaves/retching within 24 hours prior to the start of MECon Day 1 in Cycle 1.

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 ClinicalTrials.gov identifier: NCT01500226

Locations


United States, Massachusetts
TESARO Inc
Waltham, Massachusetts, United States, 02451

Sponsors and Collaborators

Tesaro, Inc.

Investigators


Study Director:	Dennis Vargo, MD	Tesaro, Inc.

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Schwartzberg LS, Modiano MR, Rapoport BL, Chasen MR, Gridelli C, Urban L, Poma A, Arora S, Navari RM, Schnadig ID. Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of moderately emetogenic chemotherapy or anthracycline and cyclophosphamide regimens in patients with cancer: a randomised, active-controlled, double-blind, phase 3 trial. Lancet Oncol. 2015 Sep;16(9):1071-8. doi: 10.1016/S1470-2045(15)00034-0. Epub 2015 Aug 10.


Responsible Party:	Tesaro, Inc.
ClinicalTrials.gov Identifier:	NCT01500226 History of Changes
Other Study ID Numbers:	TS-P04834
Study First Received:	December 22, 2011
Results First Received:	October 2, 2015
Last Updated:	February 2, 2016
Health Authority:	United States: Food and Drug Administration

Keywords provided by Tesaro, Inc.:


Rolapitant Nausea Vomiting CINV Chemotherapy

Additional relevant MeSH terms:


Nausea Vomiting Signs and Symptoms, Digestive Signs and Symptoms Dexamethasone acetate Dexamethasone Granisetron Dexamethasone 21-phosphate BB 1101 8-((1-(3,5-bis(trifluoromethyl)phenyl)ethoxy)methyl)-8-phenyl-1,7-diazaspiro(4,5)decan-2-one Emetics Anti-Inflammatory Agents Antiemetics Autonomic Agents Peripheral Nervous System Agents	Physiological Effects of Drugs Gastrointestinal Agents Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal Antineoplastic Agents Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Serotonin Antagonists Serotonin Agents Neurotransmitter Agents Neurokinin-1 Receptor Antagonists

ClinicalTrials.gov processed this record on September 29, 2016