Efficacy of Two Antiemetic Regimens in Patients Receiving Radiotherapy and Concomitant Weekly Cisplatin (GAND-emesis)
A Multinational, Randomized, Double-blind, Placebo-controlled Study to Investigate the Efficacy and Tolerability of Palonosetron and Dexamethasone Plus Fosaprepitant or Placebo in Patients Receiving Radiotherapy and Weekly Cisplatin.
GAND-emesis is a multinational, randomized, double-blind, placebo-controlled, parallel-group study to investigate the efficacy and tolerability of a neurokinin1 receptor antagonist (fosaprepitant dimeglumine) in combination with an antiemetic (anti-nausea-and-vomiting) control regimen (palonosetron and dexamethasone) in patients with a gynaecological cancer diagnosis, who are scheduled to receive radiotherapy and weekly chemotherapy.
The study aims at investigating if a three-drug antiemetic regimen is superior to a two-drug regimen (standard treatment) in preventing nausea and vomiting in patients receiving radiotherapy and weekly chemotherapy. A pilot study demonstrated that approximately 50% of patients will experience nausea and vomiting when offered a two-drug antiemetic regimen, and it is expected that addition of a third drug (a neurokinin1 receptor antagonist) can increase the proportion of patients with no vomiting in the course of combined chemo-radiotherapy.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Adelaide SA, Australia, 5000
- RAH Cancer Centre, Royal Adelaide Hospital
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-
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Aarhus, Denmark, 8000
- Department of Oncology
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Copenhagen, Denmark, 2100
- Rigshospitalet, Finsen Centret
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Herlev, Denmark, 2730
- Herlev Hospital
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Odense, Denmark, 5000
- Department of Oncology, Odense University Hospital
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Berlin, Germany
- Vivantes Klinikum Neukölln
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Kiel, Germany, 24105
- Universitatsklinikum Schleswig Holstein
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Oslo, Norway, 0310
- The Norwegian Radium Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria: (abbreviated)
- The patient has a diagnosis cervical cancer.
- The patient understands the nature and purpose of this study and the study procedures and has signed informed consent.
- The patient is aged > 18 years.
- The patient must be both chemo- and radiotherapy (RT) naïve. NB: previously low voltage RT or electron RT for non-melanoma skin cancers is allowed.
- The patient is scheduled to receive fractionated radiotherapy and concomitant weekly cisplatin at a dose of ≥ 40 mg/m2 for at least five weeks.
- Brachy therapy is scheduled to be initiated after the third cycle of weekly cisplatin, and preferentially after the fifth week of treatment.
- Chemotherapy with an emetic risk potential of minimal or mild (up to 30%) is allowed on days 1-4 (see ref. 14).
- The patient has a WHO Performance Status of ≤ 2.
Exclusion Criteria: (abbreviated)
- The patient has a current malignant diagnosis other than cervical cancer, with exception of non-melanoma skin cancers.
- The patient is aged < 18 years.
- The patient is scheduled to receive less than five weeks of fractionated radiotherapy and concomitant weekly cisplatin.
- Brachy therapy is planned to be initiated before the third cycle of weekly cisplatin.
- The patient has been previously treated with radiotherapy, and/or chemotherapy, with exception of treatment with low voltage RT or electron RT for non-melanoma skin cancers .
- The patient has a WHO Performance Status of > 2.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Fosaprepitant dimeglumine
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Addition of fosaprepitant dimeglumine 150 mg IV single dose weekly (before chemotherapy) to dexamethasone and palonosetron.
Other Names:
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Placebo Comparator: Saline water
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Saline water
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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To compare fosaprepitant dimeglumine, palonosetron, and dexamethasone with palonosetron, dexamethasone, and placebo with respect to efficacy; the proportion of subjects with no vomiting during five weeks of radiotherapy and concomitant weekly cisplatin.
Time Frame: 35 days
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35 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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To compare the fosaprepitant dimeglumine regimen and the control regimen in terms of the proportion of subjects with complete response in the 7 days following initiation of radiotherapy and concomitant weekly cisplatin.
Time Frame: 7 days
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7 days
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To compare the fosaprepitant dimeglumine regimen and the control regimen in terms of the proportion of subjects with no significant nausea during five weeks of fractionated radiotherapy and concomitant weekly cisplatin at a dose of ≥ 40 mg/m2.
Time Frame: 35 days
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35 days
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To compare the fosaprepitant dimeglumine regimen and the control regimen with respect to complete response in the 35 days following initiation of fractionated radiotherapy and concomitant weekly cisplatin at a dose of ≥ 40 mg/m2.
Time Frame: 35 days
|
35 days
|
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To compare the fosaprepitant dimeglumine regimen and the control regimen in terms of the proportion of subjects with no nausea during five weeks (35 days) of fractionated radiotherapy and concomitant weekly cisplatin at a dose of ≥ 40 mg/m2.
Time Frame: 35 days
|
35 days
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To compare the fosaprepitant dimeglumine regimen and the control regimen in terms of the number of days to first emetic episode.
Time Frame: 0-35 days
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0-35 days
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To compare quality of life using the FLIE questionnaire.
Time Frame: 0-35 days
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0-35 days
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To compare tolerability of both regimens.
Time Frame: 0-35 days
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0-35 days
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Jorn Herrstedt, MD, DMSci, Odense University Hospital
- Principal Investigator: Christina Ruhlmann, MD, Odense University Hospial
- Principal Investigator: Dorothy Keefe, MD, FRACP, Royal Adelaide Hospital
- Principal Investigator: Petra Feyer, MD, DMSci, Vivantes Klinikum Neukölln in Berlin
- Principal Investigator: Thomas Broe Christensen, MD, PhD, Herlev Hospital
- Principal Investigator: Gunnar Kristensen, MD, PhD, Norwegian Radium Hospital
- Principal Investigator: Henrik Roed, MD, DMSci, The Finsen Centre, Copenhagen University Hospital
- Principal Investigator: Felix Hilpert, MD, DMSci, University Hospital Schleswig-Holstein
- Principal Investigator: Jacob C Lindegaard, MD, Department of Oncology,Aarhus University Hospital, Aarhus, Denmark
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Signs and Symptoms, Digestive
- Vomiting
- Genital Neoplasms, Female
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Serotonin Agents
- Serotonin Antagonists
- Serotonin 5-HT3 Receptor Antagonists
- Neurokinin-1 Receptor Antagonists
- Dexamethasone
- Palonosetron
- Aprepitant
- Fosaprepitant
Other Study ID Numbers
Other Study ID Numbers
- GAND-emesis
- 2009-014691-21 (EudraCT Number)
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