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A Study to Evaluate the Efficacy and Safety of Anamorelin HCl for the Treatment of Malignancy Associated Weight Loss and Anorexia in Adult Patients With Advanced Non-Small Cell Lung Cancer (NSCLC) - 2

14 septembre 2026 mis à jour par: Helsinn Healthcare SA

Une étude multicentrique de phase 3 randomisée, en double aveugle, contrôlée par placebo pour évaluer l'efficacité et l'innocuité de l'Anamorelin HCl pour le traitement de la perte de poids et de l'anorexie associées à la malignité chez les patients adultes atteints d'un cancer du poumon non à petites cellules (NSCLC) avancé

The goal of this clinical trial was to compare the efficacy and safety of anamorelin HCl (the investigational drug) to that of placebo (tablet with no drug) in patients with advanced non-small cell lung cancer and cachexia (cancer-related weight loss). The main question it aimed to answer was as follows: Do patients who receive anamorelin HCl gain more body weight and show more improvement in anorexia symptoms than those who receive placebo.

Approximately 316 patients were to be enrolled in the study. Of these patients, an equal number were to be assigned to each treatment group (anamorelin HCl or placebo). Participants were to take their assigned study drug by mouth once daily for a total of 24 weeks. During this treatment period, the patients were to visit the clinical study site every 3 weeks for health and other study-related assessments. Two weeks after the last treatment, patients were to receive a follow-up phone call.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

The study was a multicenter, randomized, double-blind, parallel-group, placebo-controlled study to evaluate the efficacy and safety of anamorelin HCl. It was planned that approximately 316 patients with advanced NSCLC with cachexia were to be randomized 1:1 to anamorelin HCl 100 mg or placebo (158 patients per treatment group). The study treatment was to be taken orally once daily for a total of 24 weeks. Patients were instructed to take the study drug at least 1 hour before their first meal of the day.

Central randomization was stratified by line of systemic anti-cancer treatment (first line vs second line vs third line or higher), by type of anti-cancer therapy (immunotherapy vs non-immunotherapy), and by baseline score of 5 IASS (≤10 vs >10). Patients who had never received anti-cancer treatment prior to entering the study but who met all eligibility criteria were eligible to enter the study and were assigned to receive first line treatment in the Interactive Web Response System (IWRS).

Patients were to visit the site every 3 weeks for the study Treatment Period of 24 weeks. A follow-up telephone visit was to be scheduled at Week 26. Thus, patients were enrolled in the study for a maximum duration of 27 weeks (including a 1-week Screening Period, a 24-week Treatment Period, and a 2-week Follow-up Period). Each patient was scheduled to have a total of 10 planned visits plus 1 telephone contact for the Follow-up Visit.

Type d'étude

Interventionnel

Inscription (Réel)

318

Phase

  • Phase 3

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Australie
      • Bedford Park, Australie, 5042
        • Flinders Medical Centre
      • Fitzroy, Australie, 3065
        • St Vincent's Hospital Melbourne
      • North Geelong, Australie, 3215
        • Barwon Health, The McKellar Centre
      • Parkville, Australie, 3050
        • The Royal Melbourne Hospital
      • Southport, Australie, 4215
        • Gold Coast University Hospital
    • South Australia
      • Elizabeth Vale, South Australia, Australie, 5112
        • Calvary Central Districts Hospital
  • Belgique
      • Brussels, Belgique, 1200
        • Saint Luc University Hospital
      • Brussels, Belgique, 1000
        • Jules Bordet Institut
      • Charleroi, Belgique, 6000
        • Charleroi Grand Hospital (GHDC)
      • Edegem, Belgique, 2650
        • University Hospital Antwerp (UZA)
      • Roeselare, Belgique, 8800
        • General Hospital Delta
  • Croatie
      • Pula, Croatie, 52 100
        • General Hospital Pula
      • Split, Croatie, 21000
        • University Hospital Center Split
      • Zagreb, Croatie, 10000
        • University Hospital Center Zagreb
  • Pologne
      • Grudziądz, Pologne, 86-300
        • Wladyslaw Bieganski Regional Specialist Hospital, Clinical Oncology Department
      • Katowice, Pologne, 40-060
        • "VEGAMED" Non-Public Healthcare Facility
      • Lodz, Pologne, 90-302
        • MSF Institute Ltd. Santa Familia Medical Institute
      • Poznan, Pologne, 60-693
        • MED - POLONIA Ltd.
      • Prabuty, Pologne, 82-550
        • Specialist Hospital in Prabuty sp. z o.o. [limited liability company], Department of Pulmonology
      • Warsaw, Pologne, 02-781
        • Maria Skfodowska-Curie Institute of Oncology, Department of Lung and Thoracic Cancers
      • Wieliszew, Pologne, 05-135
        • Mazovian Oncology Hospital, Oncology Outpatient Clinic
  • Roumanie
      • Bucharest, Roumanie, 022328
        • Alexandru Trestioreanu Institute of Oncology
    • Cluj
      • Cluj-Napoca, Cluj, Roumanie, 400015
        • "Prof. Dr. Ion Chiricuta" Institute of Oncology, Medical Oncology Department
    • Dolj
      • Craiova, Dolj, Roumanie, 200347
        • "Sf. Nectarie" Oncology Center, Medical Oncology Department
    • Maramureş
      • Baia Mare, Maramureş, Roumanie, 430291
        • SC Oncopremium Team SRL, Medical Oncology Department
    • Murers
      • Târgu Mureş, Murers, Roumanie, 540156
        • Topmed Medical Center, Medical Oncology Department
    • Suceava
      • Suceava, Suceava, Roumanie, 720237
        • Sf. Ioan cel Nou Country Emergency Hospital, Oncology Department
    • Timiș County
      • Timișoara, Timiș County, Roumanie, 300239
        • S.C. Oncomed SRL, Medical Oncology Department
  • Russie
      • Kazan', Russie, 420029
        • Republican Clinical Oncology Center
      • Pyatigorsk, Russie, 357502
        • Pyatigorsk Interdistric Oncology Center
      • Saint Petersburg, Russie, 196247
        • Oncology Center of Moskovskiy District
      • Saint Petersburg, Russie, 197082
        • AV Medical Group
      • Saint Petersburg, Russie, 197183
        • Palliative Care Center Devita
      • Saint Petersburg, Russie, 198255
        • City Clinical Oncology Center
      • Samara, Russie, 443031
        • Samara Regional Clinical Oncology Center
      • Saransk, Russie, 430032
        • Ogaryov Mordovia National Research State University, Republican Oncology Center
      • Sochi, Russie, 354057
        • Oncology Center #2
      • Volgograd, Russie, 400138
        • Volgograd Regional Clinical Oncology Center
  • Ukraine
    • Kharkiev
      • Kharkiv, Kharkiev, Ukraine, 61070
        • Communal Non-Profit Enterprise "Regional Center of Oncology"
    • Kharkiev Region
      • Kharkiv, Kharkiev Region, Ukraine, 61166
        • Publ Non- Profit Ent. under Kharkiv Reg. Council
    • Kyviv
      • Kyiv, Kyviv, Ukraine, 3039
        • Medical Center "VERUM" Limited Liability Company
    • Poltava Oblast
      • Poltava, Poltava Oblast, Ukraine, 36011
        • Public Entreprise "Poltava Regional Clinical Oncology Center under Poltava Regional Council"
    • Ukraine
      • Dnipro, Ukraine, Ukraine, 49055
        • Medical Center "MEDICAL PLAZA" of the Limited Liability Company "EKODNIPRO"
      • Kyiv, Ukraine, Ukraine, 03037
        • Private Enterprise "First Private Clinic"
      • Ternopil, Ukraine, Ukraine, 46023
        • Public Non-Profit Enterprise 'Ternopil Regional Clinical Oncology Center'' under Temopil Regional Council
      • Zaporizhzhya, Ukraine, Ukraine, 69059
        • Medical Center of Limited Liability Company "ONCOLIFE"
  • États-Unis
    • Arizona
      • Tucson, Arizona, États-Unis, 85719
        • The University of Arizona Cancer Center - North Campus
    • California
      • Anaheim, California, États-Unis, 92801
        • Pacific Cancer Medical Center, Inc
      • Bakersfield, California, États-Unis, 93309
        • CBCC Global Research Inc
      • Fountain Valley, California, États-Unis, 92708
        • Compassionate Care Research Group, Inc., at Compassionate Cancer Care Medical Group, Inc.
      • Greenbrae, California, États-Unis, 94904
        • Marin Cancer Care
    • Connecticut
      • Waterbury, Connecticut, États-Unis, 06708
        • Smilow Cancer Hospital at Yale-New Haven
    • Florida
      • Winter Haven, Florida, États-Unis, 33881
        • Bond & Steele Clinic P.A.
    • Illinois
      • Skokie, Illinois, États-Unis, 60077
        • Presence Infusion Care
    • Iowa
      • Sioux City, Iowa, États-Unis, 51101
        • Siouxland Regional Cancer Center dba June E.Nylen Cancer Center
    • Kansas
      • Wichita, Kansas, États-Unis, 67214
        • Cancer Center of Kansas
    • Michigan
      • Grand Rapids, Michigan, États-Unis, 49503
        • Cancer and Hematology Centers of Western Michigan
    • New Hampshire
      • Lebanon, New Hampshire, États-Unis, 03756
        • Dartmouth-Hitchcock Medical Center
    • New Jersey
      • Brick, New Jersey, États-Unis, 08724
        • New Jersey Hematology Oncology Associates Inc
      • Flemington, New Jersey, États-Unis, 08822
        • Hunterdon Hematology Oncology LLC
    • New York
      • Nyack, New York, États-Unis, 10960
        • Hematology Oncology Center at Nyack Hospital
      • Rochester, New York, États-Unis, 14642
        • University of Rochester, Medical Center
    • North Carolina
      • Durham, North Carolina, États-Unis, 27710
        • Duke Cancer Center
    • Ohio
      • Toledo, Ohio, États-Unis, 43623
        • Toledo Clinic Cancer Center-Toledo
    • Texas
      • Houston, Texas, États-Unis, 77030-4009
        • The University of Texas MD Anderson Cancer Center

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Signed written informed consent

  2. Female or male ≥18 years of age

  3. Documented histologic or cytologic diagnosis of American Joint Committee on Cancer (AJCC) Stage III or IV NSCLC. Stage III patient must have unresectable disease

  4. Body mass index < 20 kg/m2 with involuntary weight loss of >2% within 6 months prior to screening

  5. Ongoing problems with appetite/eating associated with the underlying cancer, as determined by having score of ≤ 17 points on the 5-item Anorexia Symptom Scale and ≤ 37 points on the 12-item FAACT A/CS

  6. Patient receiving or not receiving systemic anti-cancer treatment at the time of screening are eligible to participate. Systemic anti-cancer treatment includes first, second, third treatment line with chemotherapy/radiation therapy, immunotherapy or targeted therapy.

    Patient not receiving systemic anti-cancer treatment is eligible if:

    1. Not planning to receive anti-cancer treatment and/or at least 14 days must be elapsed from the completion of prior treatment at the day of screening, in case underwent previous cycle OR
    2. Planning to receive anti-cancer treatment within 14 days from randomization and/or at least 14 days must be elapsed from the completion of prior treatment at the day of screening, in case underwent previous cycle OR
    3. Patient on palliative care treatment

  7. ECOG performance status 0,1 or 2 at screening

  8. AST (SGOT) and ALT (SGPT) ≤ 3 x ULN or if hepatic metastases are present ≤ 5 x ULN

  9. Adequate renal function, defined as creatinine ≤2 ULN, or calculated creatinine clearance >30 ml/minute

  10. Female patient shall be: a) of non-childbearing potential or b) of childbearing potential using reliable contraceptive measures and having a negative urine pregnancy test within 24 hours prior to first dose of investigational product.

    Notes:

    1. Female patient of non-childbearing potential are defined as being in post-menopausal state since at least 1 year; or having documented surgical sterilization or hysterectomy at least 3 months before study participation.
    2. Reliable contraceptive measures include implants, injectables, combined oral contraceptives, intrauterine devices, vasectomized partner or complete (long term) sexual abstinence.

  11. The patient must be willing and able to comply with the protocol tests and procedures All inclusion criteria will be checked at screening visit (Visit 1).

Exclusion Criteria:

  1. Patient with other forms of lung cancer (e.g., small cell, neuroendocrine tumors)

  2. Woman who is pregnant or breast-feeding

  3. Reversible causes of reduced food intake, as determined by the Investigator. These causes may include but are not limited to:

    1. NCI CTCAE Grade 3 or 4 oral mucositis,
    2. NCI CTCAE Grade 3 or 4 GI disorders [nausea, vomiting, diarrhea, and constipation],
    3. mechanical obstructions making patient unable to eat, or
    4. severe depression

  4. Patient undergoing major surgery (central venous access placement and tumor biopsies are not considered major surgery) within 4 weeks prior to randomization. Patient must be well recovered from acute effects of surgery prior to screening. Patient should not have plans to undergo major surgical procedures during the treatment period

  5. Patient currently taking androgenic compounds (including but not limited to testosterone, testosterone-like agents, oxandrolone, megestrol acetate, corticosteroids, olanzapine, mirtazapine (however, long-term use of mirtazapine for depression for at least four weeks prior to screening is allowed), dronabinol or marijuana (cannabis) or any other prescription medication or off-label products intended to increase appetite or treat unintentional weight loss

  6. Patient with pleural effusion requiring thoracentesis, pericardial effusion requiring drainage, edema or evidence of ascites

  7. Patient with uncontrolled or significant cardiovascular disease, including:

    1. History of myocardial infarction within the past 3 months
    2. A-V block of second or third degree (may be eligible if currently have a pacemaker)
    3. Unstable angina
    4. Congestive heart failure within the past 3 months, if defined as NYHA class III-IV
    5. Any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, Wolff-Parkinson-White (WPW) syndrome, or torsade de pointes)
    6. Uncontrolled hypertension (blood pressure >150 mm Hg systolic and >95 mm Hg diastolic)
    7. Heart rate < 50 beats per minute on pre-entry electrocardiogram and patient is symptomatic

  8. Patient on drugs that may prolong the PR or QRS interval durations, such as any of the antiarrhythmic medications Class I (Fast sodium (Na) channel blockers)

  9. Patient unable to readily swallow oral tablets

  10. Patient with severe gastrointestinal disease (including esophagitis, gastritis, malabsorption)

  11. Patient with history of gastrectomy

  12. Patient with uncontrolled diabetes mellitus or unmonitored diabetes mellitus

  13. Patient with cachexia caused by other reasons, as determined by the investigator such as:

    1. Severe COPD requiring use of home O2,
    2. New York Heart Association (NYHA) class III-IV heart failure
    3. AIDS
    4. Uncontrolled thyroid disease

  14. Patient receiving strong CYP3A4 inhibitors within 14 days of randomization

  15. Patient currently receiving tube feedings or parenteral nutrition (either total or partial).

  16. Current excessive alcohol or illicit drug use

  17. Any condition, including the presence of laboratory abnormalities, which in the Investigator's opinion, places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study

  18. Enrollment in a previous study with anamorelin HCl

  19. Patient actively receiving a concurrent investigational agent, or having received an investigational agent within 28 days of Day 1 All exclusion criteria will be checked at screening visit (Visit 1).

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Quadruple

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 100 mg anamorelin HCl

100 mg anamorelin HCl (administered as film-coated tablets in fasted condition) was to be taken orally once daily for a total of 24 weeks
Médicament: anamorelin HCl

100 mg anamorelin HCl (administered as 100 mg tablets in the fasted condition)
Comparateur placebo: Placebo

Placebo (administered as matching placebo tablets in fasted condition) was to be taken orally once daily for a total of 24 weeks
Médicament: Placebo Oral Tablet

Placebo (administered as matching placebo tablets in the fasted condition)

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Mean Change From Baseline in Body Weight Over 12 Weeks
Délai: Mean change from baseline over 12 weeks.

This co-primary efficacy endpoint was mean change from baseline in body weight (kg) over 12 weeks in the anamorelin HCl group versus placebo group. Mean change was computed as sum of the changes from baseline over 12 weeks by the time of the last assessment (either week 12 or before in case of death), and then divided by the number of assessments (observed or imputed) from baseline up to the time of the last assessment.
Mean change from baseline over 12 weeks.
Mean Change From Baseline in 5-item Anorexia Symptom Subscale (5-IASS) Over 12 Weeks
Délai: Mean change from baseline over 12 weeks.

This co-primary efficacy endpoint was mean change from baseline in 5-IASS (points) over 12 weeks in the anamorelin HCl group versus placebo group. Mean change was computed as sum of the changes from baseline over 12 weeks by the time of the last assessment (either week 12 or before in case of death), and then divided by the number of assessments (observed or imputed) from baseline up to the time of the last assessment.

FAACT-A/CS (Functional Assessment Anorexia Cachexia Therapy) is a 12-item measure of patients' perceptions of anorexia/cachexia symptoms and concerns. From this questionnaire, the 5-item section referring to anorexia symptoms (i.e., "good appetite," "interest in food drops," "food tastes unpleasant," "get full quickly," and "difficulty eating rich/heavy foods") was used to assess 5-IASS. The range of possible scores is 0-20. Higher scores indicate lower levels of symptom burden.
Mean change from baseline over 12 weeks.

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Duration in Treatment Benefit (Weeks) From Baseline Over 12 Weeks in Body Weight (≥0 kg)
Délai: Duration of treatment benefit from baseline over 12 weeks.

The duration of treatment benefit over 12 weeks was measured as the period, or the sum of the periods, over 12 weeks (or less in case of death), in which the patient observed a change from baseline in body weight of ≥0 kg.
Duration of treatment benefit from baseline over 12 weeks.
Duration in Treatment Benefit (Weeks) From Baseline Over 12 Weeks in Body Weight (≥1.5 kg)
Délai: Duration of treatment benefit from baseline over 12 weeks.

The duration of treatment benefit over 12 weeks was measured as the period, or the sum of the periods, over 12 weeks (or less in case of death), in which the patient observed a change from baseline in body weight of ≥1.5 kg.
Duration of treatment benefit from baseline over 12 weeks.
Duration of Treatment Benefit (Weeks) From Baseline Over 12 Weeks in 5-IASS (≥0 Points)
Délai: Duration of treatment benefit from baseline over 12 weeks.

The duration of treatment benefit over 12 weeks was measured as the period, or the sum of the periods, over 12 weeks (or less in case of death), in which the patient observed a change from baseline in 5- IASS of ≥0 points.
Duration of treatment benefit from baseline over 12 weeks.
Duration of Treatment Benefit (Weeks) From Baseline Over 12 Weeks in 5-IASS (≥3 Points)
Délai: Duration of treatment benefit from baseline over 12 weeks.

The duration of treatment benefit over 12 weeks was measured as the period, or the sum of the periods, over 12 weeks (or less in case of death), in which the patient observed a change from baseline in 5- IASS of ≥3 points.
Duration of treatment benefit from baseline over 12 weeks.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Helsinn Healthcare SA

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

6 mai 2019

Achèvement primaire (Réel)

27 décembre 2022

Achèvement de l'étude (Réel)

27 décembre 2022

Dates d'inscription aux études

Première soumission

14 novembre 2018

Première soumission répondant aux critères de contrôle qualité

14 novembre 2018

Première publication (Réel)

15 novembre 2018

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

6 octobre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

14 septembre 2026

Dernière vérification

1 juin 2024

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • ANAM-17-21
  • 2018 (Subvention/contrat des NIH des États-Unis)
  • 2018-002927-40 (Numéro EudraCT)

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Oui

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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