The purpose of this study is to evaluate the safety of darbepoetin alfa, inclusive of the effects on survival and cancer progression, and the necessity of blood transfusions.
ID
Source
Brief title
Condition
- Red blood cell disorders
- Miscellaneous and site unspecified neoplasms benign
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
To demonstrate non-inferiority of overall survival (OS) when comparing subjects
on
darbepoetin alfa treated to a hemoglobin ceiling of 12.0 g/dL to subjects
treated with
placebo
Secondary outcome
To demonstrate non-inferiority of progression free survival (PFS) when comparing
subjects on darbepoetin alfa treated to a hemoglobin ceiling of 12.0 g/dL to
subjects
treated with placebo
• To demonstrate superiority in reducing the incidence of red blood cell (RBC)
transfusions when comparing subjects on darbepoetin alfa treated to a hemoglobin
ceiling of 12.0 g/dL to subjects treated with placebo
• To assess other safety and efficacy parameters in subjects on darbepoetin alfa
treated to a hemoglobin ceiling of 12.0 g/dL compared to subjects treated with
placebo
Background summary
In this study, the study medication darbepoetin alfa is evaluated for the
treatment of patients with non-small cell lung cancer. Darbepoetin alfa is
approved for the treatment of anaemia in chronic renal failure in the United
States, Canada, Australia, the European Union, Israel and many other countries
worldwide. It is also approved for the treatment of anaemia caused by
chemotherapy, in patients with non-¬myeloid, malignant tumours (cancer that
does not originate in the bone marrow).
Approximately 3000 subjects are to be recruited for this study, at about 500
study sites in North-America, Europe, Latin-America, Australia, Asia and Africa.
Red blood cells are important because they contain haemoglobin, which
transports oxygen in the body to the tissues and organs. Chemotherapy, which is
used for the treatment of cancer, often causes anaemia. Severe anaemia can
cause physical weakness (fatigue), shortness of breath, pale skin and rapid
heartbeat. The treatment of severe anaemia by increasing the number of red
blood cells in your body, may lead to reducing these symptoms or make them
disappear. Darbepoetin alfa is a medicine from the group of erythropoietic
stimulating agents (ESA); they increase the production of red blood cells. The
other ESAs include the medicines epoetin beta and epoetin alfa
Study objective
The purpose of this study is to evaluate the safety of darbepoetin alfa,
inclusive of the effects on survival and cancer progression, and the necessity
of blood transfusions.
Study design
The study consists of a screening period, a treatment period, a follow-up visit
to evaluate the safety and a long-term follow-up period.
During this study, darbepoetin alfa or placebo will be injected under the skin
(subcutaneously) once every 3 weeks, in a dosage of 500 microgram (µg).
The patient has a 2 in 3 chance (67%) that he/she will receive darbepoetin alfa
once every 3 weeks and a 1 in 3 chance (33%) that he/she will receive a placebo
once every 3 weeks.
The treatment with the study medicine will be started in the event that the
haemoglobin level in the patients blood is less than or equal to 6.8 mmol/L and
will be withheld in the event that this level exceeds 7.4 mmol/L.
The patient needs to come every three weeks to the clinic till disease
progression.
After progression of the disease has occurred, the patient will start with the
part of the study in which the long-term follow-up will take place. The patient
will visit the clinic once every three months and the study staff will collect
only a limited amount of information about the treatment and about any
medications the patient uses until the end of the study. In the event that the
patient is unable to come for these visits, the doctor may call to obtain this
information from the patient.
Intervention
The Change of 2 out of 3 (67%) of receiving 1 x every 3 weeks darbepoëtine
alfa, and the change of 1 out of 3 (33%) receiving placebo every 3 weeks.
Study burden and risks
During screening the following tests will be done: bloodsamples, CT scan or
MRI, physical examination.
During the treatment phase; expected duration is 12 weeks (4 cycli), the
patient will visit the clinic once every three weeks to receive medication and
to collect bloodsamples. Imaging scans will be carried out once every 9 weeks
until progression of the disease occurs
De risks for the patient are limited.
If the patient experiences no profit of the treatment and if there is an
unacceptable situation (for patient or research worker) it can be decided to
stop the research at any time.
Minervum 7061
Breda 4817 ZK
NL
Minervum 7061
Breda 4817 ZK
NL
Listed location countries
Age
Inclusion criteria
Disease Related;• Subjects with stage IV NSCLC (not recurrent or re-staged);• Expected to receive at least 2 additional cycles (at least 6 total weeks) of first line myelosuppressive cyclic chemotherapy after randomization. Subjects should not be expected to receive only maintenance chemotherapy.;Demographic;• Eastern Cooperative Oncology Group performance status of 0 or 1 as assessed within 21 days prior to randomization;• 18 years of age or older at screening.;• Life expectancy > 6 months based on the judgment of the investigator and documented during screening.;Laboratory;• Hemoglobin level <= 11.0 g/dL as assessed by the local laboratory; ;sample obtained within 7 days prior to randomization (retest in screening is acceptable).;• Adequate serum folate (>= 2 ng/mL) and vitamin B12 (>= 200 pg/mL) levels assessed by central laboratory (supplementation and retest acceptable) during screening.;Imaging;• Subjects must have had a baseline scan (CT, MRI, or PET/CT) of the chest to assess disease burden before starting on first line chemotherapy for NSCLC and those images must have been reviewed;by the investigator prior to randomization. If the scan was performed more than 28 days prior to randomization, an additional scan must be performed and reviewed by the investigator to confirm that the patient has not progressed before randomization.;Ethical;• Before any study-specific procedure, the appropriate written informed consent must be obtained from the subject or a legally accepted representative.
Exclusion criteria
Disease Related;• Known primary benign or malignant hematologic disorder which can cause anemia.;• History of, or current active cancer other than NSCLC, with the exception of curatively resected non-melanomatous skin cancer, curatively treated cervical carcinoma in situ, or other primary solid tumors curatively treated with no known active disease present and no curative treatment administered for the last 3 years.;• Received any prior adjuvant or neoadjuvant therapy for NSCLC;• Subjects with a history of brain metastasis.;• Uncontrolled hypertension (systolic BP > 160 mmHg or diastolic BP > 100 mmHg), or as determined by the investigator during screening.;• History of neutralizing antibody activity to rHuEPO or darbepoetin alfa.;• Uncontrolled angina, uncontrolled heart failure, or uncontrolled cardiac arrhythmia as determined by the investigator at screening. Subjects with known myocardial infarction within 6 months prior to randomization.;• Subjects with a history of seizure disorder taking anti-seizure medication within 30 days prior to randomization.;• Clinically significant systemic infection or uncontrolled chronic inflammatory disease (eg, rheumatoid arthritis, inflammatory bowel disease) as determined by the investigator during screening.;• Known seropositivity for HIV or diagnosis of AIDS, positive for hepatitis B surface antigen, or seropositive for hepatitis C virus.;• History of pure red cell aplasia.;• History of deep venous thrombosis or embolic event (eg, pulmonary ;embolism) within 6 months prior to randomization.;Laboratory;• Transferrin saturation < 20% and ferritin < 50 ng/mL as assessed by the ;central laboratory during screening. Subjects must have both to be ;excluded supplementation and retest acceptable).;• Abnormal renal function (serum creatinine level > 2X ULN) as assessed by ;the central laboratory during screening.;• Abnormal liver function (total bilirubin > 2X ULN or liver enzymes ALT or AST > 2.5X ULN for subjects without liver metastasis or >= 5X ULN for subjects with liver metastasis) as assessed by the central laboratory during screening. ;Subjects with documented Gilbert*s Disease may be eligible.;Medications;• Received any RBC transfusion within 28 days prior to randomization.;• Plan to receive any RBC transfusion between randomization and study day 1.;• Known previous treatment failure to ESAs (eg, rHuEPO, darbepoetin alfa).;• ESA therapy within the 28 days prior to randomization.;• Known hypersensitivity to recombinant ESAs or the excipients contained within the investigational product.;General;• Less than 30 days since receipt of any investigational product or device.;Investigational use/receipt of a medicinal product or device that has been approved by the country*s local regulatory authority for any indication is permitted.;• Subjects of reproductive potential who are pregnant, breast feeding or not willing to use effective contraceptive precautions during the study and for at least one month after the last dose of investigational product in the judgment of the investigator (including females of childbearing potential who are partners of male subjects).;• Previously randomized to this study.;• Investigator has concerns regarding the ability of the subject to give written informed consent and/or to comply with study procedures (including availability for follow-up visits).
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2007-005792-34-NL |
ClinicalTrials.gov | NCT00858364 |
CCMO | NL28191.060.09 |