Malignant Glioma Clinical Trial
Official title:
Phase II Randomized Cross-over Study to Evaluate Patient Satisfaction, Efficacy and Compliance of Granisetron Patch vs. Ondansetron in Malignant Glioma Patients Receiving Standard Radiotherapy (RT) and Concomitant Temozolomide (TMZ)
The purpose of this study is to assess patient satisfaction, the efficacy and compliance of
granisetron patch versus ondansetron pills for radiation induced nausea and vomiting in
malignant glioma patients receiving six weeks of radiation therapy (RT) and concomitant
temozolomide (TMZ). Use of the patch may benefit brain tumor patients by increasing
compliance.
All eligible adult malignant glioma subjects should receive a planned total dose of 54-60 GY
of radiation and 75 mg/m2 of daily TMZ for a total of six weeks. Subjects will be randomized
to receive either granisetron patch or ondansetron for three weeks. Weeks 3-6, they will
received the other medication. The granisetron transdermal delivery system (supplied as a 52
cm^2 patch containing 34.3 mg of granisetron - 3.1 mg/day) is applied once per week 24 hours
before the weekly radiation and chemotherapy, while the ondansetron 8 mg oral tablet is
taken once a day 30-60 minutes prior to each dose of chemotherapy. Subjects will fill out
questionnaires regarding the effectiveness of the medication and their satisfaction, and
which anti-emetic they prefer.
Safety will be assessed throughout the six weeks of radiation by the clinical research nurse
using the Common Toxicity Criteria for Adverse Events (CTCAE), version 4.0. All subjects who
receive both ondansetron and Granisetron Transdermal Delivery System (GTDS) treatment will
be included in analyses of treatment preference. However, all other efficacy and safety
analyses will include all subjects who received ondansetron or GTDS.
The primary objective of this study is to assess whether malignant glioma patients receiving
radiation therapy and concomitant TMZ are more satisfied with ondansetron or granisetron
patch for the prevention of nausea and vomiting. The secondary objectives are 1) to compare
the efficacy and compliance of granisetron patch and ondansetron in the prevention of nausea
and vomiting during the 6 weeks of RT and concomitant TMZ, and 2) to assess the safety of
the granisetron patch in preventing radiation induced nausea and vomiting in primary glioma
patients receiving RT and TMZ.
All eligible subjects should receive a planned total dose of 54-60 GY of radiation and 75
mg/m2 of temozolomide daily for a total of six weeks. Subjects will be randomized to receive
one of two treatment sequences of antiemetic therapy for the prevention of nausea and
vomiting associated with RT and concomitant TMZ. Sequence #1 involves administration of
ondansetron for 3 weeks followed by the use of granisetron patch for 3 weeks; whereas
sequence #2 involves the use of the granisetron patch for 3 weeks followed by 3 weeks of
ondansetron. Toxicity will be assessed each week of radiation therapy based on the Common
Toxicity Criteria for Adverse Events (CTCAE), version 4.0. The subject will be asked to
complete the modified MASCC Antiemesis Tool (MAT) questionnaire at baseline, and on days 2,
4, and 7 of each week of radiation therapy, as well as to record the use of all study
medication and any antiemetic rescue medication taken daily. At the end of the weeks 3 & 6,
the subject will be asked to fill out a Treatment Satisfaction Questionnaire for Medication
and will be asked at the end of week 6 to choose which antiemetic they prefer.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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