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Ph3 Safety/Efficacy Study of Rolapitant for the Prevention of CINV in Subjects Receiving Highly Emetogenic Chemotherapy

Phase 3, Multicenter, Randomized, Double Blind, Active-Controlled Study of the Safety & Efficacy of Rolapitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting (CINV) in Subjects Receiving Highly Emetogenic Chemotherapy (HEC)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01499849
Enrollment
532
Registered
2011-12-26
Start date
2012-02-29
Completion date
2014-05-31
Last updated
2016-05-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chemotherapy-induced Nausea and Vomiting

Keywords

Rolapitant, Nausea, Vomiting, CINV, Chemotherapy

Brief summary

This is a Phase 3, multicenter, randomized, parallel-group, double-blind, active-controlled study of rolapitant in subjects receiving HEC. Rolapitant or placebo will be administered prior to initiation of chemotherapy on Day 1 with granisetron and dexamethasone. Subjects will record all events of emesis and use of rescue medication for established nausea and/or vomiting, and will indicate the severity of nausea they experienced in each of the previous 24 hours in the Nausea and Vomiting (NV) Subject Diary prior to HEC administration through Day 6 of Cycle 1. Health-related quality of life will be measured by the FLIE Questionnaire on Day 6 of Cycle 1. Safety and tolerability will be assessed by clinical review of adverse events (AEs), physical examinations, electrocardiograms (ECGs), and safety laboratory values. All subjects are expected to complete Cycle 1 and will have the option of participating in up to five additional cycles.

Detailed description

This is a Phase 3, multicenter, randomized, parallel-group, double-blind, active-controlled study of rolapitant in subjects receiving HEC (≥60 mg/m2 of cisplatin-based chemotherapy). Study drug will be administered 1 - 2 hours prior to initiation of chemotherapy on Day 1. Granisetron and dexamethasone will be administered approximately 30 minutes before initiation of chemotherapy on Day 1,except in patients receiving taxanes as part of cisplatin-based chemotherapy. Subjects will record all events of emesis and use of rescue medication for established nausea and/or vomiting and will indicate the severity of nausea they experienced in each of the previous 24 hours in the NV Subject Diary prior to HEC administration through Day 6 in Cycle 1. Dexamethasone 8 mg twice daily (part of study regimen) on Days 2 through 4 is NOT considered rescue therapy. Health-related quality of life will be measured by the FLIE Questionnaire on Day 6 of Cycle 1. Safety and tolerability will be assessed by clinical review of AEs, physical examinations including complete neurological assessment, vital signs,electrocardiograms (ECGs), and safety laboratory values including BUN andcreatinine. All subjects are expected to complete Cycle 1 and will have the option of participating in up to five additional cycles. The study will investigate the efficacy of rolapitant for the treatment of CINV during an initial chemotherapy cycle (Cycle 1). Safety analyses will include data from Cycle 1 and from subsequent cycles. At the Screening Visit, blood samples may be collected and stored in this study and maybe analyzed for future biomarker research related to safety and efficacy. Analysis of these samples may include DNA, RNA, or protein markers. The biomarker blood samples will be stored for up to 2 years post study completion. In addition, PK samples will be collected from subjects enrolled in selected sites.

Interventions

(4 X 50 mg capsules) 200 mg PO

DRUGGranisetron

10 mcg/kg IV

DRUGdexamethasone

20 mg PO and 8 mg PO

DRUGPlacebo

(4 X 0 mg capsules) 0 mg PO

Sponsors

Tesaro, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* 18 years of age or older, of either gender, and of any race * has never been treated with cisplatin and is to receive the first course of cisplatin-based chemotherapy (≥60 mg/m2) * Karnofsky performance score of ≥60 * Predicted life expectancy of ≥4 months * Adequate bone marrow, kidney, and liver function

Exclusion criteria

* Contraindication to cisplatin, granisetron, or dexamethasone * Is pregnant or breast feeding * Has previously received cisplatin or subject is planning to receive multiple days of cisplatin in a single cycle * Has taken the following agents within the last 48 hours 5-HT3 antagonists,Phenothiazines,Benzamides,Domperidone,Cannabinoids,NK1 antagonist, Benzodiazepines * Scheduled to receive any other chemotherapeutic agent with an emetogenicity level of 4 or above (Hesketh Scale) from Day 2 through Day 6, except on Day 1. * Scheduled to receive any radiation therapy to the abdomen or pelvis from Day -5 through Day 6 * Has received systemic corticosteroids or sedative antihistamines within 72 hours of Day 1 of the study except as premedication for chemotherapy (e.g., taxanes, pemetrexed) * symptomatic primary or metastatic CNS disease. * Has ongoing vomiting, retching, clinically significant nausea caused by any etiology, or has a history of anticipatory nausea and vomiting. * Has vomited and/or has had dry heaves/retching within 24 hours prior to the start of cisplatin-based chemotherapy on Day 1 in Cycle 1.

Design outcomes

Primary

MeasureTime frameDescription
No Emetic Episodes and No Rescue Medication>24 to 120 hours post chemotherapyThe primary objective of this study is to determine whether administration of rolapitant with granisetron and dexamethasone improves CINV in the delayed phase (\>24 to 120 hours) of CINV compared with administration of placebo with granisetron and dexamethasone in subjects receiving HEC. The primary outcome will be based on complete response (defined as no emetic episodes and no rescue medication) in the delayed phase (\>24 to 120 hours).

Secondary

MeasureTime frameDescription
Acute Phase Response0 to 24 hoursTo determine the effect of rolapitant on complete response rates in the acute (0 to 24 hours)phase of CINV
Overall Response Rate0 to 120 hoursTo determine the effect of rolapitant on complete response rates in the overall (0 to 120 hours) phase of CINV.

Countries

United States

Participant flow

Participants by arm

ArmCount
Rolapitant + Granisetron + Dexamethasone
* Oral dose of rolapitant 180 mg (equivalent to 200 mg rolapitant hydrochloride monohydrate) 1-2 h before administration of chemotherapy * Granisetron (10 μg/kg intravenously) about 30 min before chemotherapy * Dexamethasone (20 mg orally) about 30 min before chemotherapy, and dexamethasone 8 mg orally twice daily on days 2-4
264
Placebo + Granisetron + Dexamethasone
* Matching placebo 1-2 h before administration of chemotherapy * Granisetron (10 μg/kg intravenously) about 30 min before chemotherapy * Dexamethasone (20 mg orally) about 30 min before chemotherapy, and dexamethasone 8 mg orally twice daily on days 2-4
262
Total526

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event2832
Overall StudyChemo completed or Change in Therapy7067
Overall StudyDeath57
Overall StudyDisease Progression1110
Overall StudyLack of Efficacy34
Overall StudyLost to Follow-up63
Overall StudyOther Reasons2730
Overall StudyPhysician Decision2019
Overall StudyProtocol Violation1111
Overall StudyWithdrawal by Subject4343

Baseline characteristics

CharacteristicPlacebo + Granisetron + DexamethasoneTotalRolapitant + Granisetron + Dexamethasone
Age, Continuous57.7 years
STANDARD_DEVIATION 11.15
57.3 years
STANDARD_DEVIATION 10.62
57.0 years
STANDARD_DEVIATION 10.08
Ethnicity (NIH/OMB)
Hispanic or Latino
34 Participants67 Participants33 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
228 Participants459 Participants231 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants2 Participants2 Participants
Race (NIH/OMB)
Asian
56 Participants117 Participants61 Participants
Race (NIH/OMB)
Black or African American
3 Participants5 Participants2 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
24 Participants45 Participants21 Participants
Race (NIH/OMB)
White
179 Participants357 Participants178 Participants
Sex: Female, Male
Female
112 Participants222 Participants110 Participants
Sex: Female, Male
Male
150 Participants304 Participants154 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
187 / 263198 / 263
serious
Total, serious adverse events
37 / 26354 / 263

Outcome results

Primary

No Emetic Episodes and No Rescue Medication

The primary objective of this study is to determine whether administration of rolapitant with granisetron and dexamethasone improves CINV in the delayed phase (\>24 to 120 hours) of CINV compared with administration of placebo with granisetron and dexamethasone in subjects receiving HEC. The primary outcome will be based on complete response (defined as no emetic episodes and no rescue medication) in the delayed phase (\>24 to 120 hours).

Time frame: >24 to 120 hours post chemotherapy

Population: MITT

ArmMeasureValue (NUMBER)
Rolapitant + Granisetron + DexamethasoneNo Emetic Episodes and No Rescue Medication72.7 percentage of participants
Placebo + Granisetron + DexamethasoneNo Emetic Episodes and No Rescue Medication58.4 percentage of participants
p-value: <0.00195% CI: [1.3, 2.7]Cochran-Mantel-Haenszel
Secondary

Acute Phase Response

To determine the effect of rolapitant on complete response rates in the acute (0 to 24 hours)phase of CINV

Time frame: 0 to 24 hours

Population: MITT

ArmMeasureValue (NUMBER)
Rolapitant + Granisetron + DexamethasoneAcute Phase Response83.7 percentage of participants
Placebo + Granisetron + DexamethasoneAcute Phase Response73.7 percentage of participants
p-value: 0.00595% CI: [1.2, 2.8]Cochran-Mantel-Haenszel
Secondary

Overall Response Rate

To determine the effect of rolapitant on complete response rates in the overall (0 to 120 hours) phase of CINV.

Time frame: 0 to 120 hours

Population: MITT

ArmMeasureValue (NUMBER)
Rolapitant + Granisetron + DexamethasoneOverall Response Rate70.1 percentage of participants
Placebo + Granisetron + DexamethasoneOverall Response Rate56.5 percentage of participants
p-value: 0.00195% CI: [1.3, 2.6]Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Mar 15, 2026