Dose Individualization of Pemetrexed - IMPROVE-III (IMPROVE-III)
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|ClinicalTrials.gov Identifier: NCT03655834|
Recruitment Status : Completed
First Posted : August 31, 2018
Last Update Posted : May 10, 2022
Pemetrexed is a multi-targeted folate antagonist, which is primarily indicated for the treatment of advanced non-small cell lung cancer (NSCLC) and mesothelioma. Dosing of cytotoxic agents like pemetrexed requires balancing the dual risk of sub-therapy and toxicity. Administration of pemetrexed to patients with a creatinine clearance <45 ml/min is currently not advised. Pemetrexed is dosed based on body surface area (BSA), while renal function and dose are the sole determinants for systemic exposure. This causes 3 major issues:
- In patients with renal dysfunction, BSA-based dosing may lead to haematological toxicity
- Patients have to discontinue treatment due to declining renal function, and are withheld effective treatment
- Even in patients with adequate renal function (GFR >45 ml/min) treatment may be improved by individualized dosing based on renal function, resulting in less toxicity. Also, BSA-based dosing may lead to ineffective therapy in patients with above average renal function.
The investigators aim to address these problems.
Objective: The overall main objective is to develop a safe and effective individualized dosing regimen for pemetrexed.
Study design: IMPROVE-III is an explorative microdosing study to assess the extrapolability of microdose-pharmacokinetics to the pharmacokinetics of a therapeutic dose.
Study population: IMPROVE-III includes 10 patients of IMPROVE-I and/or IMPROVE-II.
Intervention: patients will be administered a microdose with subsequent pharmacokinetic assessment.
Main study endpoints: The predictive performance of microdosing to predict full dose pharmacokinetics
|Condition or disease||Intervention/treatment||Phase|
|Non Small Cell Lung Cancer Mesothelioma||Drug: Pemetrexed||Phase 4|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||10 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Individualized Pemetrexed Dosing in Patients With Non-small Cell Lung Cancer or Mesothelioma Based on Renal Function to Improve Treatment Response|
|Actual Study Start Date :||February 1, 2019|
|Actual Primary Completion Date :||September 20, 2020|
|Actual Study Completion Date :||August 1, 2021|
Patients will be administered a microdose of pemetrexed with subsequent pharmacokinetic assessment. Afterwards the patients will continue in either IMPROVE-I or -II for second pharmacokinetic assessment
patients will be administered a microdose with subsequent pharmacokinetic assessment.
Other Name: Microdosing
- The predictive performance of microdosing to predict full dose pharmacokinetics [ Time Frame: 3 months ]Mean relative prediction error (MPE)
- The predictive performance of microdosing to predict full dose pharmacokinetics [ Time Frame: 3 months ]Root mean squared relative prediction error (RMSE)
- Exposure (AUC) after microdose [ Time Frame: 1 day ]mg*h/l
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03655834
|Jeroen Bosch Hospital|
|Antoni van Leeuwenhoek|
|Maastricht University Medical centre|
|Radboud university medical centre|
|Erasmus University Medical Centre|
|Principal Investigator:||Rob ter Heine, PhD||Radboud University Medical Center|