Non-small Cell Lung Cancer Clinical Trial
Official title:
Phase II, Double-blind, Placebo-controlled, Crossover Study Evaluating a 5HT3 Antagonist Plus Dexamethasone With or Without Fosaprepitant in Patients With Advanced NSCLC Receiving Carboplatin Based Chemotherapy
This study evaluates the addition of fosaprepitant to currently available antiemtic treatments of carboplatin chemotherapy-induced nausea and vomiting in advanced non-small cell lung cancer patients. Half of the patients will receive fosaprepitant in their first chemotherapy cycle, and a placebo on their second chemotherapy cycle. The other half of the patients will begin their first chemotherapy cycle.
The addition of aprepitant to 5HT-3 antagonist and steroid is approved for the prevention of
acute and delayed nausea for highly emetogenic chemotherapy (HEC). The use of oral
aprepitant 3 day regimen has been evaluated in moderately emetogenic chemotherapy. However,
its use has not been explored in carboplatin containing combination regimens in advanced
non-small cell lung cancer (NSCLC). An equivalency study compared fosaprepitant, a 1-day
intravenous formulation of aprepitant, with oral aprepitant. Findings demonstrate
equivalence between the agents for complete response and both emesis and nausea control.
Fosaprepitant was endorsed by the ASCO Update Committee as an acceptable NK1 receptor
antagonist. However, there has been no evaluation of this iv formulation with moderately
emetogenic chemotherapy and specifically carboplatin containing regimens in NSCLC.
Therefore, the investigators propose a double-blind, randomized placebo controlled
cross-over phase II study assessing the role of fosaprepitant in the prevention of nausea
and emesis in patients receiving carboplatin based chemotherapy for advanced NSCLC.
Patients will be treated with Emend/ placebo administered intravenously on day 1 of cycles 1
of carboplatin based chemotherapy with crossover to the alternate agent (placebo/ Emend) on
day 1 of cycle 2 with each cycle being 21 days. Fosaprepitant will be administered
intravenously on day 1 of either cycle 1 or cycle 2 prior to carboplatin based chemotherapy.
Placebo will be administered as the alternative agent. Study team and the subject will be
blinded to fosaprepitant versus placebo.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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