Advanced Cancer, Pain
Conditions
Keywords
Cancer pain, Opioid therapy, Inadequate analgesia, Optimized chronic opioid therapy
Brief summary
This 9-week study aimed to determine the efficacy, safety and tolerability of nabiximols (Sativex®) as an adjunctive treatment, compared with placebo in relieving uncontrolled persistent chronic pain in participants with advanced cancer. Eligible participants were not required to stop any of their current treatments or medications.
Detailed description
This 9-week, multi-center, double-blind, randomized, placebo-controlled study aimed to determine the efficacy, safety and tolerability of nabiximols, administered as an adjunctive treatment for 5 weeks, versus placebo. Eligible participants had advanced cancer, with a clinical diagnosis of cancer related pain which was not wholly alleviated by their current optimized opioid treatment. Qualifying participants entered the study at screening and commenced a 5 to 14 day eligibility period. During this period, eligible participants had 3 consecutive days where pain severity remained within defined parameters, break-through opioid usage had not exceeded an average of 4 episodes per day, and maintenance opioid medication and dose had not changed. Eligible participants returned for randomization on Day 1 and were randomized to either the nabiximols or placebo treatment arm using a 1:1 allocation ratio. Participants began an initial titration period that lasted up to 14 days. The titration schedule required dosing to a minimum of 3 sprays per day, after which participants were allowed to individualize their dose (3 to 10 sprays per day) until Day 14 when that dose was then fixed for the remainder of the study. Participants returned at Day 22 and Day 36 (end of the randomized treatment period), or earlier if they terminated prematurely from the study. After the end of the 5-week treatment period, participants were offered the option of entering an open-label extension (OLE) study; a safety follow up visit (up to Day 43) was not required if the participant entered the OLE on Day 36. Participants who entered the OLE, up to 7 days after study completion had their follow-up assessments performed on the same day as their first OLE study visit. Participants that did not enter the OLE study had a safety follow up visit 14 days after treatment completion, which could be via telephone.
Interventions
DRUGNabiximols
Sponsors
Otsuka Pharmaceutical Development & Commercialization, Inc.
GW Pharmaceuticals Ltd
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(abbreviated): * The participant had advanced cancer for which there was no known curative therapy * The participant had a clinical diagnosis of cancer related pain, which was not wholly alleviated with their current optimized opioid treatment * The participant received an optimized maintenance dose of Step 3 opioid therapy, preferably with a sustained release preparation, but also allowing a regular maintenance dose of around the clock use of immediate release preparations * The participant received a daily maintenance dose Step 3 opioid therapy of less than or equal to a total daily opioid dose of 500 mg/day of morphine equivalence (including maintenance and break-through opioids) * The participant was using no more than one type of break-through opioid analgesia
Exclusion criteria
(abbreviated): * The participant had any planned clinical interventions that would have affected their pain (for example, chemotherapy or radiation therapy where, in the clinical judgment of the investigator, these would be expected to affect pain) * The participant was using or had used cannabis or cannabinoid-based medications within 30 days of study entry and is unwilling to abstain for the duration of the study * The participant had experienced myocardial infarction or clinically significant cardiac dysfunction within the last 12 months or had a cardiac disorder that, in the opinion of the investigator, would have put the participant at risk of a clinically significant arrhythmia or myocardial infarction * The participant had significantly impaired renal function * The participant had significantly impaired hepatic function * Female participants of child-bearing potential and male participants whose partner was of child-bearing potential, unless willing to ensure that they or their partner used effective contraception, for example, oral contraception, double barrier, intra-uterine device, during the study and for 3 months thereafter (however, a male condom was not to be used in conjunction with a female condom as this may not have proven effective)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percent Improvement From Baseline In Mean NRS Average Pain At End Of Treatment | Baseline, End of Treatment (Day 36) | Participants indicated level of pain in the last 24 hours on an 11-point Numerical Rating Scale (NRS), where a score of 0 was no pain and 10 was pain as bad as you can imagine. Baseline = mean score from first day of 3-day eligibility period through to the day before first dose of study drug. End of Treatment = mean score over last (up to) 7 days to the final pain score at End of Treatment or up until Day 35, whichever is earlier, or final score available (prematurely terminated). Percentage improvement from baseline (Imp%) was calculated as: Imp% = (Baseline pain NRS mean - End of Treatment pain NRS mean)/Baseline pain NRS mean \* 100. For participants who died or withdrew due to disease progression, Imp% values were used. For participants who died or withdrew unrelated to disease progression before end of Week 5 (no diary data from Day 33 onwards), Imp% was zero for participants whose Imp% value was positive and it was Imp% for participants whose Imp% value was not positive. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline In Mean NRS Worst Pain At End Of Treatment | Baseline, End of Treatment (Day 36) | Participants indicated the level of worst pain experienced in the last 24 hours on an 11-point NRS, where a score of 0 indicated no pain and a score of 10 indicated pain as bad as you can imagine. Change in mean NRS worst pain was calculated as: End of Treatment NRS worst pain score - Baseline NRS worst pain score. A negative value indicates an improvement in worst pain score from Baseline. |
| Change From Baseline In Mean Sleep Disruption NRS At End Of Treatment | Baseline, End of Treatment (Day 36) | Participants indicated the level of sleep disruption experienced in the last 24 hours on an 11-point NRS, where a score of 0 indicated did not disrupt sleep and a score of 10 indicated completely disrupted (unable to sleep at all). Change in mean sleep disruption NRS was calculated as: End of Treatment sleep disruption NRS score - Baseline sleep disruption NRS score. A negative value indicates an improvement in sleep disruption score from Baseline. |
| Subject Global Impression Of Change At Last Visit (Up To Day 36) | Last Visit (up to Day 36) | The Subject Global Impression of Change (SGIC) was used to assess the overall status of the participant related to their cancer pain, with the markers very much improved, much improved, slightly improved, no change, slightly worse, much worse, or very much worse. The SGIC was assessed at Day 36 or at which a participant's last evaluation was performed, such as in the case of early termination. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36. |
| Physician Global Impression Of Change At Last Visit (Up To Day 36) | Last Visit (up to Day 36) | The Physician Global Impression of Change (PGIC) was used by the treating physician (investigator/sub-investigator) to assess if there was any change in the general functional abilities of the participant since prior to commencement of study medication, with the markers: Very much worse, Much worse, Slightly worse, No change, Slightly improved, Much improved, Very much improved. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36. |
| Change From Baseline In Mean NRS Average Pain At End Of Treatment | Baseline, End Of Treatment (Day 36) | Participants indicated the level of pain experienced in the last 24 hours on an 11-point NRS, where a score of 0 indicated no pain and a score of 10 indicated pain as bad as you can imagine. Change in mean NRS average pain was calculated as: End of Treatment NRS average pain score - Baseline NRS average pain score. A negative value indicates an improvement in average pain score from Baseline. |
| Change From Baseline In Daily Total Opioid Use (Morphine Equivalent) At End Of Treatment | Baseline, End of Treatment (Day 36) | The total daily opioid use (in morphine equivalence) was the sum of morphine equivalents of daily maintenance dose and break-through dose. Change in daily total opioid use was calculated as: End of Treatment daily total opioid use - Baseline daily total opioid use. A negative value indicates a decrease in use from Baseline. |
| Change From Baseline In Daily Maintenance Opioid Dose (Morphine Equivalent) At End of Treatment | Baseline, End of Treatment (Day 36) | The prescribed daily quantity of opioid maintenance dose was calculated as the product of dose per use and daily frequency of use. Participants were asked: Have you used your maintenance dose painkiller today as prescribed? If the participant answered No to the question, the daily opioid maintenance dose usage on that day was set to 0. Change in daily maintenance opioid dose was calculated as: End of Treatment daily maintenance opioid dose - Baseline daily maintenance opioid dose. A negative value indicates a decrease in dose from Baseline. |
| Change From Baseline In Daily Break-through Opioid Dose (Morphine Equivalent) At End Of Treatment | Baseline, End of Treatment (Day 36) | Daily break-through opioid dose usage was calculated as the product of prescribed dose per use, and the number of uses per day. If participants took more than 1 different break-through opioid for more than 1 day, the sum of morphine equivalents dose usages for each break-through opioid was calculated for the summary. Change in daily break-through opioid dose was calculated as: End of Treatment daily break-through opioid dose - Baseline daily break-through opioid dose. A negative value indicates a decrease in dose from Baseline. |
| Change From Baseline In NRS Constipation At Last Visit (Up To Day 36) | Baseline, Last Visit (up to Day 36) | Participants indicated level of constipation on an 11-point NRS, where a score of 0 was no constipation, and 10 was constipation as bad as you can imagine. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36. Change in NRS constipation score was calculated as: Last Visit NRS constipation score - Baseline NRS constipation score. A negative value indicates improvement in condition from Baseline. |
| Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Last Visit (up to Day 36) | The Patient Satisfaction Questionnaire (PSQ) was used to assess level of satisfaction of the participant with the study drug, with the markers Extremely satisfied, Very satisfied, Slightly satisfied, Neutral, Slightly dissatisfied, Very dissatisfied, Extremely dissatisfied. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36. |
Countries
Belgium, Bulgaria, Czechia, Germany, Hungary, Latvia, Lithuania, Poland, Puerto Rico, Romania, United Kingdom, United States
Participant flow
Pre-assignment details
Per the Statistical Analyses Plan, all randomized participants who received at least 1 dose of study drug were analyzed in the Intent-to-Treat (ITT) population as per randomized treatment group. However, if a participant randomized to placebo ever took a nabiximols dose, the participant was analyzed as nabiximols-treated in the Safety population.
Participants by arm
| Arm | Count |
|---|---|
| Nabiximols Nabiximols was self-administered by participants as a 100 μL oromucosal spray in the morning and evening, up to a maximum of 10 sprays per day, for 5 weeks. Nabiximols oromucosal spray contained THC (27 mg/mL):CBD (25 mg/mL), in ethanol:propylene glycol (50:50) excipients, with peppermint oil (0.05%) flavoring. Each 100 μL actuation delivered 2.7 mg THC and 2.5 mg CBD. | 199 |
| Placebo (GA-0034) Placebo was self-administered by participants as a 100 μL oromucosal spray in the morning and evening, up to a maximum of 10 sprays per day, for 5 weeks. Placebo oromucosal spray contained ethanol: propylene glycol (50:50) excipients, with peppermint oil (0.05%) flavoring and colorings. | 198 |
| Total | 397 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 40 | 35 |
| Overall Study | Met Withdrawal Criteria | 1 | 0 |
| Overall Study | Withdrawal by Investigator | 2 | 2 |
| Overall Study | Withdrawal by Subject | 15 | 11 |
Baseline characteristics
| Characteristic | Nabiximols | Placebo (GA-0034) | Total |
|---|---|---|---|
| Age, Continuous | 59.2 years STANDARD_DEVIATION 12 | 60.7 years STANDARD_DEVIATION 11.1 | 59.9 years STANDARD_DEVIATION 11.6 |
| Sex: Female, Male Female | 88 Participants | 95 Participants | 183 Participants |
| Sex: Female, Male Male | 111 Participants | 103 Participants | 214 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 69 / 199 | 53 / 198 |
| serious Total, serious adverse events | 47 / 199 | 43 / 198 |
Outcome results
Primary
Percent Improvement From Baseline In Mean NRS Average Pain At End Of Treatment
Participants indicated level of pain in the last 24 hours on an 11-point Numerical Rating Scale (NRS), where a score of 0 was no pain and 10 was pain as bad as you can imagine. Baseline = mean score from first day of 3-day eligibility period through to the day before first dose of study drug. End of Treatment = mean score over last (up to) 7 days to the final pain score at End of Treatment or up until Day 35, whichever is earlier, or final score available (prematurely terminated). Percentage improvement from baseline (Imp%) was calculated as: Imp% = (Baseline pain NRS mean - End of Treatment pain NRS mean)/Baseline pain NRS mean \* 100. For participants who died or withdrew due to disease progression, Imp% values were used. For participants who died or withdrew unrelated to disease progression before end of Week 5 (no diary data from Day 33 onwards), Imp% was zero for participants whose Imp% value was positive and it was Imp% for participants whose Imp% value was not positive.
Time frame: Baseline, End of Treatment (Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Nabiximols | Percent Improvement From Baseline In Mean NRS Average Pain At End Of Treatment | 10.7 percent improvement |
| Placebo (GA-0034) | Percent Improvement From Baseline In Mean NRS Average Pain At End Of Treatment | 4.5 percent improvement |
p-value: 0.085495% CI: [0, 8.16]Wilcoxon (Mann-Whitney)
Secondary
Change From Baseline In Daily Break-through Opioid Dose (Morphine Equivalent) At End Of Treatment
Daily break-through opioid dose usage was calculated as the product of prescribed dose per use, and the number of uses per day. If participants took more than 1 different break-through opioid for more than 1 day, the sum of morphine equivalents dose usages for each break-through opioid was calculated for the summary. Change in daily break-through opioid dose was calculated as: End of Treatment daily break-through opioid dose - Baseline daily break-through opioid dose. A negative value indicates a decrease in dose from Baseline.
Time frame: Baseline, End of Treatment (Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nabiximols | Change From Baseline In Daily Break-through Opioid Dose (Morphine Equivalent) At End Of Treatment | 0.1 mg (morphine equivalent) | Standard Deviation 22.2 |
| Placebo (GA-0034) | Change From Baseline In Daily Break-through Opioid Dose (Morphine Equivalent) At End Of Treatment | 1.8 mg (morphine equivalent) | Standard Deviation 23.6 |
Secondary
Change From Baseline In Daily Maintenance Opioid Dose (Morphine Equivalent) At End of Treatment
The prescribed daily quantity of opioid maintenance dose was calculated as the product of dose per use and daily frequency of use. Participants were asked: Have you used your maintenance dose painkiller today as prescribed? If the participant answered No to the question, the daily opioid maintenance dose usage on that day was set to 0. Change in daily maintenance opioid dose was calculated as: End of Treatment daily maintenance opioid dose - Baseline daily maintenance opioid dose. A negative value indicates a decrease in dose from Baseline.
Time frame: Baseline, End of Treatment (Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nabiximols | Change From Baseline In Daily Maintenance Opioid Dose (Morphine Equivalent) At End of Treatment | 0.2 mg (morphine equivalent) | Standard Deviation 20.9 |
| Placebo (GA-0034) | Change From Baseline In Daily Maintenance Opioid Dose (Morphine Equivalent) At End of Treatment | -1.3 mg (morphine equivalent) | Standard Deviation 38.7 |
Secondary
Change From Baseline In Daily Total Opioid Use (Morphine Equivalent) At End Of Treatment
The total daily opioid use (in morphine equivalence) was the sum of morphine equivalents of daily maintenance dose and break-through dose. Change in daily total opioid use was calculated as: End of Treatment daily total opioid use - Baseline daily total opioid use. A negative value indicates a decrease in use from Baseline.
Time frame: Baseline, End of Treatment (Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nabiximols | Change From Baseline In Daily Total Opioid Use (Morphine Equivalent) At End Of Treatment | 0.3 mg (morphine equivalent) | Standard Deviation 34.7 |
| Placebo (GA-0034) | Change From Baseline In Daily Total Opioid Use (Morphine Equivalent) At End Of Treatment | 0.6 mg (morphine equivalent) | Standard Deviation 44.8 |
Secondary
Change From Baseline In Mean NRS Average Pain At End Of Treatment
Participants indicated the level of pain experienced in the last 24 hours on an 11-point NRS, where a score of 0 indicated no pain and a score of 10 indicated pain as bad as you can imagine. Change in mean NRS average pain was calculated as: End of Treatment NRS average pain score - Baseline NRS average pain score. A negative value indicates an improvement in average pain score from Baseline.
Time frame: Baseline, End Of Treatment (Day 36)
Population: ITT Population included all participants who receive at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nabiximols | Change From Baseline In Mean NRS Average Pain At End Of Treatment | -0.8 units on a scale | Standard Deviation 1.4 |
| Placebo (GA-0034) | Change From Baseline In Mean NRS Average Pain At End Of Treatment | -0.6 units on a scale | Standard Deviation 1.5 |
Secondary
Change From Baseline In Mean NRS Worst Pain At End Of Treatment
Participants indicated the level of worst pain experienced in the last 24 hours on an 11-point NRS, where a score of 0 indicated no pain and a score of 10 indicated pain as bad as you can imagine. Change in mean NRS worst pain was calculated as: End of Treatment NRS worst pain score - Baseline NRS worst pain score. A negative value indicates an improvement in worst pain score from Baseline.
Time frame: Baseline, End of Treatment (Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nabiximols | Change From Baseline In Mean NRS Worst Pain At End Of Treatment | -0.9 units on a scale | Standard Deviation 1.4 |
| Placebo (GA-0034) | Change From Baseline In Mean NRS Worst Pain At End Of Treatment | -0.8 units on a scale | Standard Deviation 1.6 |
Secondary
Change From Baseline In Mean Sleep Disruption NRS At End Of Treatment
Participants indicated the level of sleep disruption experienced in the last 24 hours on an 11-point NRS, where a score of 0 indicated did not disrupt sleep and a score of 10 indicated completely disrupted (unable to sleep at all). Change in mean sleep disruption NRS was calculated as: End of Treatment sleep disruption NRS score - Baseline sleep disruption NRS score. A negative value indicates an improvement in sleep disruption score from Baseline.
Time frame: Baseline, End of Treatment (Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nabiximols | Change From Baseline In Mean Sleep Disruption NRS At End Of Treatment | -0.8 units on a scale | Standard Deviation 1.7 |
| Placebo (GA-0034) | Change From Baseline In Mean Sleep Disruption NRS At End Of Treatment | -0.5 units on a scale | Standard Deviation 1.6 |
Secondary
Change From Baseline In NRS Constipation At Last Visit (Up To Day 36)
Participants indicated level of constipation on an 11-point NRS, where a score of 0 was no constipation, and 10 was constipation as bad as you can imagine. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36. Change in NRS constipation score was calculated as: Last Visit NRS constipation score - Baseline NRS constipation score. A negative value indicates improvement in condition from Baseline.
Time frame: Baseline, Last Visit (up to Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nabiximols | Change From Baseline In NRS Constipation At Last Visit (Up To Day 36) | -0.6 units on a scale | Standard Deviation 2.9 |
| Placebo (GA-0034) | Change From Baseline In NRS Constipation At Last Visit (Up To Day 36) | -0.3 units on a scale | Standard Deviation 2.8 |
Secondary
Patient Satisfaction Questionnaire At Last Visit (Up To Day 36)
The Patient Satisfaction Questionnaire (PSQ) was used to assess level of satisfaction of the participant with the study drug, with the markers Extremely satisfied, Very satisfied, Slightly satisfied, Neutral, Slightly dissatisfied, Very dissatisfied, Extremely dissatisfied. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36.
Time frame: Last Visit (up to Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nabiximols | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Slightly Satisfied | 42 Participants |
| Nabiximols | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Slightly Dissatisfied | 22 Participants |
| Nabiximols | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Very Satisfied | 42 Participants |
| Nabiximols | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Very Dissatisfied | 11 Participants |
| Nabiximols | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Neutral | 46 Participants |
| Nabiximols | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Extremely Dissatisfied | 1 Participants |
| Nabiximols | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Extremely Satisfied | 7 Participants |
| Placebo (GA-0034) | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Extremely Dissatisfied | 5 Participants |
| Placebo (GA-0034) | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Extremely Satisfied | 3 Participants |
| Placebo (GA-0034) | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Very Satisfied | 38 Participants |
| Placebo (GA-0034) | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Slightly Satisfied | 37 Participants |
| Placebo (GA-0034) | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Neutral | 63 Participants |
| Placebo (GA-0034) | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Slightly Dissatisfied | 20 Participants |
| Placebo (GA-0034) | Patient Satisfaction Questionnaire At Last Visit (Up To Day 36) | Very Dissatisfied | 13 Participants |
Secondary
Physician Global Impression Of Change At Last Visit (Up To Day 36)
The Physician Global Impression of Change (PGIC) was used by the treating physician (investigator/sub-investigator) to assess if there was any change in the general functional abilities of the participant since prior to commencement of study medication, with the markers: Very much worse, Much worse, Slightly worse, No change, Slightly improved, Much improved, Very much improved. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36.
Time frame: Last Visit (up to Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nabiximols | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Improved | 56 Participants |
| Nabiximols | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Worse | 25 Participants |
| Nabiximols | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Much Improved | 37 Participants |
| Nabiximols | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Much Worse | 7 Participants |
| Nabiximols | Physician Global Impression Of Change At Last Visit (Up To Day 36) | No Change | 41 Participants |
| Nabiximols | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Very Much Worse | 2 Participants |
| Nabiximols | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Very much Improved | 6 Participants |
| Placebo (GA-0034) | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Very Much Worse | 4 Participants |
| Placebo (GA-0034) | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Very much Improved | 3 Participants |
| Placebo (GA-0034) | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Much Improved | 25 Participants |
| Placebo (GA-0034) | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Improved | 50 Participants |
| Placebo (GA-0034) | Physician Global Impression Of Change At Last Visit (Up To Day 36) | No Change | 75 Participants |
| Placebo (GA-0034) | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Worse | 19 Participants |
| Placebo (GA-0034) | Physician Global Impression Of Change At Last Visit (Up To Day 36) | Much Worse | 5 Participants |
Secondary
Subject Global Impression Of Change At Last Visit (Up To Day 36)
The Subject Global Impression of Change (SGIC) was used to assess the overall status of the participant related to their cancer pain, with the markers very much improved, much improved, slightly improved, no change, slightly worse, much worse, or very much worse. The SGIC was assessed at Day 36 or at which a participant's last evaluation was performed, such as in the case of early termination. Last visit refers to the last visit that a participant completed the assessment; this could be either Day 22 or Day 36.
Time frame: Last Visit (up to Day 36)
Population: The ITT Population included all participants who were randomized, received at least 1 dose of study drug, and had at least 1 efficacy endpoint. Participants were analyzed according to the treatment group they were randomized to.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nabiximols | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Much Improved | 34 Participants |
| Nabiximols | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Worse | 9 Participants |
| Nabiximols | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Improved | 60 Participants |
| Nabiximols | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Much Worse | 6 Participants |
| Nabiximols | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Very Much Improved | 5 Participants |
| Nabiximols | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Very Much Worse | 2 Participants |
| Nabiximols | Subject Global Impression Of Change At Last Visit (Up To Day 36) | No Change | 56 Participants |
| Placebo (GA-0034) | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Very Much Worse | 4 Participants |
| Placebo (GA-0034) | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Very Much Improved | 3 Participants |
| Placebo (GA-0034) | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Improved | 55 Participants |
| Placebo (GA-0034) | Subject Global Impression Of Change At Last Visit (Up To Day 36) | No Change | 72 Participants |
| Placebo (GA-0034) | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Slightly Worse | 13 Participants |
| Placebo (GA-0034) | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Much Worse | 6 Participants |
| Placebo (GA-0034) | Subject Global Impression Of Change At Last Visit (Up To Day 36) | Much Improved | 26 Participants |