Prevention of Hypersensitivity Reactions to Paclitaxel
Conditions
Keywords
Hypersensitivity, drug
Brief summary
This is a prospective, randomized, unicentric, two-arm, parallel, controlled, and double blind pilot study. The purpose of this pilot study is to assess the feasibility of a trial designed to compare the quality of life of patients taking dexamethasone in two different ways to prevent hypersensitivity reactions to paclitaxel. Dexamethasone given intravenously (IV) 30 minutes before paclitaxel could improve quality of life, could adequately prevent hypersensitivity reactions to paclitaxel and could reduce adverse effects compared to dexamethasone given orally 12 hours and 6 hours before paclitaxel.
Detailed description
Primary objective: To assess the feasibility of a randomized, parallel, two-arm, controlled and double blind trial designed to compare the quality of life of patients taking dexamethasone 20 mg IV 30 minutes before paclitaxel with those taking a standard dose of dexamethasone, 20 mg orally 12 hours and 6 hours before paclitaxel, in patients taking paclitaxel every two to three weeks for a minimum of two cycles in order to estimate a sample size. Secondary objectives: Between the two study groups, to compare: * Quality of life during the first two cycles of chemotherapy; * Efficacy of dexamethasone in preventing acute hypersensitivity reactions to paclitaxel in the first two cycles of chemotherapy; * Adverse effects associated with dexamethasone on a daily basis during the first seven days of the first two cycles of chemotherapy. Eligible patients will be randomized in a 1:1 ratio to one of the two study groups.
Interventions
DRUGDexamethasone per os
DRUGMatching placebo for dexamethasone IV
DRUGDexamethasone IV
DRUGMatching placebo for dexamethasone per os
Sponsors
Centre hospitalier de l'Université de Montréal (CHUM)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient treated at the outpatient clinic or admitted to the oncology unit of Notre-Dame Hospital between February 4, 2013 and July 19, 2013; * Patient diagnosed with cancer; * Patient starting a chemotherapy containing paclitaxel every two to three weeks for a minimum of two cycles; * Patient aged 18 years and over; * Patient able to give free and informed consent and who agrees to participate by signing the consent form; * Patient able to complete the questionnaire on quality of life EORTC QLQ-C30 and the personal logbook.
Exclusion criteria
* Patient unable to speak English or French; * Patient who has previously received paclitaxel; * Patient receiving a prescription of paclitaxel bound to albumin; * Patient is currently under treatment with systemic corticosteroids or has received systemic corticosteroids during the last week; * Patient in another research protocol evaluating a different chemotherapy regimen; * Patient who had an allergic reaction to taxanes; * Patient with severe intolerance to lactose; * Patient with an allergy or a severe intolerance to products containing castor oil (eg.: cyclosporine and vitamin K).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life assessed by the self-administered quality of life core questionnaire (QLQ-C30) version 3.0 from the European Organisation for Research and Treatment in Cancer (EORTC) | Day before chemotherapy (Day 0) of the first cycle of chemotherapy | Comparison of the scores according to the EORTC Scoring Manual. |
| Quality of life assessed by the self-administered questionnaire QLQ-C30 version 3.0 from the EORTC | Day 6 of the first cycle of chemotherapy | Comparison of the scores according to the EORTC Scoring Manual. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acute hypersensitivity reactions assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.03 | During the administration of paclitaxel (Day 1) of the first cycle of chemotherapy | Proportion of participants that had acute hypersensitivity reactions. Adverse events selected: allergic reaction, anaphylaxis, dyspnea, chest pain, hypertension, back pain and abdominal pain. |
| Acute hypersensitivity reactions assessed by the NCI CTCAE version 4.03 | During the administration of paclitaxel (Day 1) of the second cycle of chemotherapy | Proportion of participants that had acute hypersensitivity reactions. Adverse events selected: allergic reaction, anaphylaxis, dyspnea, chest pain, hypertension, back pain and abdominal pain. |
| Use of rescue medication | During the administration of paclitaxel (Day 1) of the first cycle of chemotherapy | Proportion of participants that needed rescue medication |
| Adverse effects self-assessed by a personal logbook | Assessed on a daily basis from Day 1 to Day 7 of the first cycle of chemotherapy | Proportion of participants with adverse effects |
Countries
Canada
Outcome results
None listed