Germ Cell Tumors Clinical Trial
Official title:
Phase III, Double-Blind, Placebo-Controlled, Crossover Study Evaluating Aprepitant in Combination With a 5HT3 & Dexamethasone in Patients With Germ Cell Tumors Undergoing 5 Day Cisplatin-Based Chemotherapy Regimen
Aprepitant is currently approved for prophylaxis of acute and delayed CINV for highly emetogenic chemotherapy regimens, including cisplatin; however, it has not yet been studied in multiple-day chemotherapy treatment programs. This study will compare the addition of aprepitant compared to placebo administered on days 3,4,5 of chemotherapy administration for acute CINV prophylaxis with standard antiemetic prophylaxis and days 6 and 7 for delayed CINV prophylaxis in a double-blind, randomized, crossover study design.
OUTLINE: This is a multi-center trial.
Subjects will be stratified prior to randomization based on previous administration of
chemotherapy.
Subjects will randomize to aprepitant versus placebo with their first study cycle of
chemotherapy and then cross over to opposite arm with the second study cycle.
Arm A, Study Cycle 1:
Aprepitant 125mg PO day 3 then 80mg on days 4 through 7
Arm A, Study Cycle 2:
Matched placebo PO daily on days 3 through 7
Arm B, Study Cycle 1:
Matched placebo PO daily on days 3 through 7
Arm B, Study Cycle 2:
Aprepitant 125mg PO day 3 then 80mg on days 4 through 7
Cisplatin-based regimen for germ cell tumors containing 20mg/m2/day IV days 1 through 5,
first day of chemotherapy administration is day 1. Permitted treatment regimens:
Regimen 1 (BEP) Cisplatin (20mg/m2/day) IV on days 1 to 5 Etoposide (100 mg/m2/day) IV on
days 1 to 5 Bleomycin 30 U/IV on days 1, 8, 15
Regimen 2 (EP) Cisplatin (20mg/m2/day) IV on days 1 to 5 Etoposide (100 mg/m2/day) IV on
days 1 to 5
Regimen 3 (VIP) Cisplatin (20mg/m2/day) IV on days 1 to 5 Ifosfamide (1200 mg/m2/day) IV on
days 1 to 5 (with mesna uroprophylaxis at 100% ifosfamide dosing) Etoposide (75 mg/m2/day)
IV on days 1 to 5
Regimen 4 (VeIP) Cisplatin (20mg/m2/day) IV on days 1 to 5 Ifosfamide (1200 mg/m2/day) IV on
days 1 to 5 (with mesna uroprophylaxis at 100% ifosfamide dosing) Vinblastine (0.11
mg/kg/day) IV on days 1 and 2
Regimen 5 (EC) Cisplatin (20mg/m2/day) IV on days 1 to 5 Epirubicin (90 mg/m2/day) IV on day
1
Patients are treated on study for two cycles. At the completion of protocol therapy patients
will receive additional chemotherapy at the discretion of the treating investigator.
If a patient requires discontinuation of one medication or more on a regimen, the patient
must be discontinued from the study.
Performance Status:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Bilirubin < 3 x upper limit of normal
- Aspartate aminotransferase (AST, SGOT) < 3 x upper limit of normal
- Alanine aminotransferase (ALT, SGPT) < 3 x upper limit of normal
- Alk Phos < 3 x upper limit of normal
Renal:
- Serum Creatinine <2 mg/dL
Pulmonary:
- Not specified
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Prevention
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