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NCT00601172

A Study Of IV Casopitant For The Prevention Of Chemotherapy Induced Nausea And Vomiting.

Completed Phase 3 Results posted Last updated 17 January 2018
What this trial tests

Phase 3 trial testing Casopitant in Nausea and Vomiting, Chemotherapy-Induced in 710 participants. Completed in 13 April 2009.

Timeline
10 March 2008
Primary endpoint
13 April 2009
13 April 2009

Quick facts

Lead sponsorGlaxoSmithKline
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposesupportive care
Enrollment710
Start date10 March 2008
Primary completion13 April 2009
Estimated completion13 April 2009
Sites96 locations across Italy, Slovakia, Russia, Belgium, Germany, Hungary, South Korea, Canada

Drugs / interventions tested

Conditions studied

Sponsor

GlaxoSmithKline — full company profile →

Who can join

18 and older, any sex, with Nausea and Vomiting, Chemotherapy-Induced. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Participants Who Achieved a Complete Response in the Overall Phase (0-120 Hours) Following Initiation of the First Cycle of an Oxaliplatin Based Moderately Emetogenic Chemotherapy (MEC) Regimen Primary · 0 to 120 hours in the first cycle of chemotherapy

Complete response was defined as no vomiting, no retching and no use of anti-emetic rescue medication. Participants who vomited or retched or received rescue medication in the acute phase (0- 24 hours) following administration of oxaliplatin were also considered as complete response failures in the subsequent delayed (24-120 hour) time period, irrespective of actual response in the delayed phase. However, participants who vomited or retched or received rescue medication in the delayed (24-120 hours) phase were not considered as failures in the acute (0-24 hours) phase. The overall phase began

GroupValue95% CI
Placebo85
Casopitant 90 mg86
Percentage of Participants Who Achieved a Complete Response in the Acute Phase of Cycle 1 Secondary · 0 to 24 hours in the first cycle of chemotherapy

Complete response was defined as no vomiting, no retching and no use of anti-emetic rescue medication. Participants who vomited or retched or received rescue medication in the acute phase (0- 24 hours) following administration of oxaliplatin were also considered as complete response failures in the subsequent delayed (24-120 hour) time period, irrespective of actual response in the delayed phase. However, participants who vomited or retched or received rescue medication in the delayed (24-120 hours) phase were not considered as failures in the acute (0-24 hours) phase. Percentage of participan

GroupValue95% CI
Placebo96
Casopitant 90 mg97
Percentage of Participants Who Achieved a Complete Response in the Delayed Phase of Cycle 1 Secondary · 24 to 120 hours (delayed phase) in the first cycle of chemotherapy

Complete response was defined as no vomiting, no retching and no use of anti-emetic rescue medication. Participants who vomited or retched or received rescue medication in the acute phase (0- 24 hours) following administration of oxaliplatin were also considered as complete response failures in the subsequent delayed (24-120 hour) time period, irrespective of actual response in the delayed phase. However, participants who vomited or retched or received rescue medication in the delayed (24-120 hours) phase were not considered as failures in the acute (0-24 hours) phase. Percentage of participan

GroupValue95% CI
Placebo85
Casopitant 90 mg86
Percentage of Participants Who Achieved a Complete Response in the Overall Phase of Cycle 2 Secondary · 0 to 120 hours in the second cycle of chemotherapy

Complete response was defined as no vomiting, no retching and no use of anti-emetic rescue medication. Participants who vomited or retched or received rescue medication in the acute phase (0- 24 hours) following administration of oxaliplatin were also considered as complete response failures in the subsequent delayed (24-120 hour) time period, irrespective of actual response in the delayed phase. However, participants who vomited or retched or received rescue medication in the delayed (24-120 hours) phase were not considered as failures in the acute (0-24 hours) phase. The overall phase began

GroupValue95% CI
Placebo84
Casopitant 90 mg90
Maximum Nausea Score, Assessed by a Visual Analogue Scale (VAS) Secondary · 0 to 24 hours, 24 to 120 hours and 0 to 120 hours in the first cycle of chemotherapy

VAS was used to assess severity of nausea. The participants rated the severity of nausea by marking a line on a 100 millimeter (mm) (0 to 100 mm) long scale. A line placed on the extreme left, that is 0 mm indicated no nausea and extreme right that is 100 mm indicated nausea as bad as it can be. This scale has no subscales. The participant perception of their symptoms was measured using the VAS.

0-120 hours
GroupValue95% CI
Placebo13.5± 23.3
Casopitant 90 mg16.0± 24.5
0-24 hours
GroupValue95% CI
Placebo4.3± 12.9
Casopitant 90 mg5.3± 13.3
24-120 hours
GroupValue95% CI
Placebo13.0± 22.6
Casopitant 90 mg15.3± 24.2
Percentage of Participants Who Received Rescue Medication Secondary · 0 to 24 hours, 24 to 120 hours and 0 to 120 hours in the first cycle of chemotherapy

Anti-emetic rescue medication was defined as medication that was administered specifically for the treatment of nausea and/or emesis during Days 1-6 of each cycle. The choice of rescue anti-emetic medication was left to the discretion of the investigator. Participants who required antiemetic rescue medication(s) during the 120-hour assessment period were considered treatment failures for that cycle. Percentage of participants who received rescue medication are presented.

0-120 hours
GroupValue95% CI
Placebo9
Casopitant 90 mg8
0-24 hours
GroupValue95% CI
Placebo2
Casopitant 90 mg1
24-120 hours
GroupValue95% CI
Placebo9
Casopitant 90 mg8
Percentage of Participants Who Vomited and/or Retched Secondary · 0 to 24 hours, 24 to 120 hours and 0 to 120 hours in the first cycle of chemotherapy

Vomiting was defined as the forceful expulsion of gastrointestinal contents through the mouth or nose. Retching was defined as the labored, spasmodic, rhythmic contraction of the respiratory and abdominal muscles in an attempt to vomit, that is not productive of gastrointestinal contents (also known as dry heaves). If a participant took rescue medication but there was no evidence of vomiting or retching, then the participant was considered as not having vomited. Percentage of participants who vomited and/or retched during the first 120 hours of the first cycle of chemotherapy are presented.

0-120 hours
GroupValue95% CI
Placebo11
Casopitant 90 mg10
0-24 hours
GroupValue95% CI
Placebo3
Casopitant 90 mg2
24-120 hours
GroupValue95% CI
Placebo11
Casopitant 90 mg10
Percentage of Participants Who Reported Significant Nausea, Defined as a Maximum Score >= 25 mm on the VAS Secondary · 0 to 24 hours, 24 to 120 hours and 0 to 120 hours in the first cycle of chemotherapy

VAS was used to assess severity of nausea. The participants rated the severity of nausea by marking a line on a 100 mm (0 to 100 mm) long scale. A line placed on the extreme left, that is 0 mm indicated no nausea and extreme right that is 100 mm indicated nausea as bad as it can be. This scale has no subscales. The participant perception of their symptoms was measured using the VAS. Percentage of participants who reported significant nausea, defined as a maximum score \>= 25 mm on the VAS are presented.

0-120 hours
GroupValue95% CI
Placebo19
Casopitant 90 mg21
0-24 hours
GroupValue95% CI
Placebo4
Casopitant 90 mg5
24-120 hours
GroupValue95% CI
Placebo19
Casopitant 90 mg21
Percentage of Participants Who Reported Nausea, Defined as a Maximum Score of >= 5 mm on the VAS Secondary · 0 to 24 hours, 24 to 120 hours and 0 to 120 hours in the first cycle of chemotherapy

VAS was used to assess severity of nausea. The participants rated the severity of nausea by marking a line on a 100 mm (0 to 100 mm) long scale. A line placed on the extreme left, that is 0 mm indicated no nausea and extreme right that is 100 mm indicated nausea as bad as it can be. This scale has no subscales. The participant perception of their symptoms was measured using the VAS. Percentage of participants who reported nausea, defined as a maximum score of \>= 5 mm on the VAS are presented.

0-120 hours
GroupValue95% CI
Placebo37
Casopitant 90 mg45
0-24 hours
GroupValue95% CI
Placebo12
Casopitant 90 mg15
24-120 hours
GroupValue95% CI
Placebo37
Casopitant 90 mg45
Percentage of Participants Who Achieved Complete Protection Defined as Complete Responders With no Significant Nausea Secondary · 0 to 24 hours, 24 to 120 hours and 0 to 120 hours in the first cycle of chemotherapy

Complete protection was defined as no vomiting/retching, no use of rescue medication and no significant nausea. Percentage of participants who achieved complete protection or complete responders with no significant nausea are presented.

0-120 hours
GroupValue95% CI
Placebo75
Casopitant 90 mg74
0-24 hours
GroupValue95% CI
Placebo93
Casopitant 90 mg93
24-120 hours
GroupValue95% CI
Placebo75
Casopitant 90 mg74
Percentage of Participants Who Achieved Total Control, Defined as Complete Responders Who Had no Nausea Secondary · 0 to 24 hours, 24 to 120 hours and 0 to 120 hours in the first cycle of chemotherapy

Total control was defined as no vomiting/retching, no use of rescue medication and no nausea. Percentage of participants who achieved total control or complete responders with no nausea are presented.

0-120 hours
GroupValue95% CI
Placebo61
Casopitant 90 mg54
0-24 hours
GroupValue95% CI
Placebo88
Casopitant 90 mg83
24-120 hours
GroupValue95% CI
Placebo61
Casopitant 90 mg54
Percentage of Participants Whose Daily Life Activities Were Impacted in the Overall Phase of Cycle 1, Assessed by Functional Living Index-Emesis (FLIE) Questionnaire Secondary · 0 to 120 hours in the first cycle of chemotherapy

FLIE questionnaire specifically addresses the impact of nausea and vomiting on daily activities (physical, social and emotional function, ability to enjoy meals). It consists of 18 items with questions divided into two domains: Nausea (questions 1-9) and Vomiting (questions 10-18). Each item is scored on a VAS with 7 hatch marks. The scale is anchored at 1 (Not at all) and 7 (A great deal). For questions 1,2,4,5,7,8-10,12-14,16 and 17 the final score was calculated by subtracting the initial score from 100 for questions 3,6,11,15 and 18 the final score was the one provided in the dataset. The

Nausea impact
GroupValue95% CI
Placebo21.3
Casopitant 90 mg23.7
Vomiting impact
GroupValue95% CI
Placebo12.5
Casopitant 90 mg11.5

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to 35 days.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Placebo
Serious: 23/352 (7%)
Deaths: 5/352
Casopitant 90 mg
Serious: 26/355 (7%)
Deaths: 4/355

Serious adverse events (40 terms)

ReactionSystemPlaceboCasopitant 90 mg
DiarrhoeaGastrointestinal disorders
Pulmonary embolismRespiratory, thoracic and mediastinal disorders
Intestinal obstructionGastrointestinal disorders
IleusGastrointestinal disorders
Abdominal painGastrointestinal disorders
Deep vein thrombosisVascular disorders
ThrombosisVascular disorders
PneumoniaInfections and infestations
InfectionInfections and infestations
NeutropeniaBlood and lymphatic system disorders
PyrexiaGeneral disorders
Rectal haemorrhageGastrointestinal disorders
ConstipationGastrointestinal disorders
Duodenal ulcerGastrointestinal disorders
GastritisGastrointestinal disorders
Gastrointestinal obstructionGastrointestinal disorders
Hypertensive crisisVascular disorders
HypotensionVascular disorders
Hypovolaemic shockVascular disorders
Orthostatic hypotensionVascular disorders
Venous thrombosisVascular disorders
Angina unstableCardiac disorders
Angina pectorisCardiac disorders
Atrial fibrillationCardiac disorders
Atrioventricular block completeCardiac disorders
Other adverse events (18 terms — click to expand)

ReactionSystemPlaceboCasopitant 90 mg
NeutropeniaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
FatigueGeneral disorders
Peripheral sensory neuropathyNervous system disorders
ConstipationGastrointestinal disorders
ThrombocytopeniaBlood and lymphatic system disorders
ParaesthesiaNervous system disorders
VomitingGastrointestinal disorders
Neuropathy peripheralNervous system disorders
AnorexiaMetabolism and nutrition disorders
AnaemiaBlood and lymphatic system disorders
HeadacheNervous system disorders
LeukopeniaBlood and lymphatic system disorders
StomatitisGastrointestinal disorders
Abdominal painGastrointestinal disorders
DyspepsiaGastrointestinal disorders
HypertensionVascular disorders

Most-reported serious reactions: Diarrhoea, Pulmonary embolism, Intestinal obstruction, Ileus, Abdominal pain, Deep vein thrombosis, Thrombosis, Pneumonia.

Data from ClinicalTrials.gov NCT00601172 adverse events section.

Sponsor's own description

This a Phase III trial designed to determine if IV casopitant plus dexamethasone and ondansetron is more effective in the prevention of vomiting and nausea then dexamethasone and ondansetrone alone following the administration of moderately emetogenic oxaliplatin-based chemotherapy.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Antiemetics for adults for prevention of nausea and vomiting caused by moderately or highly emetogenic chemotherapy: a network meta-analysis.
    Piechotta V, Adams A, Haque M, Scheckel B, et al · · 2021 · cited 41× · PMID 34784425 · DOI 10.1002/14651858.cd012775.pub2

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