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Oral Glutamine in the Prevention of Oxaliplatin-induced Neurotoxicity

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ToestandVoltooid
Sponsors
Sanofi

Sleutelwoorden

Abstract

Primary Objective:
To assess the benefit of glutamine when added to calcium-magnesium on the occurrence of grade 2, 3 and 4 peripheral sensory neuropathy (PSN) related to oxaliplatin with the National Cancer Institute-Common Terminology Criteria for Adverse Event (NCI-CTCAE) scale taking into account the time from start of oxaliplatin at which the first event occurred.
Secondary Objective:
To determine cumulative dose of oxaliplatin and time when the first occurrence of grade 2, 3 or 4 PSN.
To determine the incidence of dose-reductions, dose-delays and discontinuations of oxaliplatin due to PSN grade 3 or 4.
To assess effects of glutamine when added to calcium-magnesium on patients-reported outcomes using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity 12 items questionnaire (FACT/GOG NTX-12) subscale.
To evaluate the incidence of diarrhea. To determine Progression Free Survival (PFS) in metastatic patients.

Datums

Laatst geverifieerd: 05/31/2013
Eerste ingediend: 03/14/2010
Geschatte inschrijving ingediend: 03/14/2010
Eerst geplaatst: 03/15/2010
Laatste update ingediend: 06/19/2013
Laatste update geplaatst: 06/20/2013
Werkelijke startdatum van het onderzoek: 01/31/2010
Geschatte primaire voltooiingsdatum: 02/28/2013
Geschatte voltooiingsdatum van het onderzoek: 02/28/2013

Conditie of ziekte

Colorectal Neoplasms

Interventie / behandeling

Drug: Glutamine and calcium magnesium

Drug: Calcium and Magnesium

Fase

Fase 3

Armgroepen

ArmInterventie / behandeling
Experimental: Glutamine and calcium magnesium
Glutamine 10g p.o. 3-times a day beginning at day -2 for 7 consecutive days during each chemotherapy cycle. 1g of calcium and 1g of magnesium i.v. over 30 minutes just before the chemotherapy and repeated at the same dose after the completion of the oxaliplatine infusion. All patients will receive an oxaliplatin based chemotherapy with XELOX, FOLFOX-4 or mFOLFOX-6.
Drug: Glutamine and calcium magnesium
Per os
Active Comparator: Calcium magnesium
1g of calcium and 1g of magnesium i.v. over 30 minutes just before the chemotherapy and repeated at the same dose after the completion of the oxaliplatine infusion. All patients will receive an oxaliplatin based chemotherapy with XELOX, FOLFOX-4 or mFOLFOX-6.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie 18 Years Naar 18 Years
Geslachten die in aanmerking komen voor studieAll
Accepteert gezonde vrijwilligersJa
Criteria

Inclusion criteria:

1. Histologically- or cytologically- proven adenocarcinoma of the colon or rectum.

2. Disease either in adjuvant or 1st line metastatic setting.

3. Eastern Cooperation Oncology Group (ECOG) performance status inferior or equal to 2.

4. At least 4 weeks following any major surgical procedure(s) and recovery from any surgical sequelae.

5. Electrocardiogram (ECG) with no acute or recent changes within limit of normal range, and not presenting abnormalities contraindicating the proposed chemotherapy.

6. Adequate liver and kidney function:

- Total bilirubin inferior to 1.5 ULN

- Serum creatinine inferior to 150 umol/L

- Creatinine clearance (ClCr) superior to 45 mL/min

- ALT/AST inferior to 3 ULN

- Alkaline phosphatase inferior or equal to 2 ULN, unless liver metastases are present and documented at baseline by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans (inferior or equal to 3,5 ULN in that case).

7. Adequate hematological function:

- Neutrophils superior or equal to 1.5 x 109/L

- Platelet count superior or equal to 100 x 109/L

- Hemoglobin superior to 9 g/dL

Exclusion criteria:

1. Any condition or past medical history that contra-indicates treatment with oxaliplatin, 5-fluorouracil (5-FU), leucovorin (LV) or capecitabine as reported in the approved labeling information.

2. Previous oxaliplatin-based chemotherapy.

3. Previous or current diagnosis of PSN.

4. Concomitant treatments with drugs/ingredients reported to have a potential activity in preventing PSN: carbamazepine, amitriptyline, gabapentin, phenytoin, glutathione, alpha-lipoic acid, celecoxib, amifostine, venlafaxine, vitamin B1 (thiamine), B6 (pyridoxine).

5. History of known allergy to oxaliplatin or other platinum agents, 5-FU, LV or capecitabine.

6. History of known allergy to glutamine or to calcium-magnesium.

7. Participation in another clinical trial with any investigational drug within 30 days prior to study screening.

8. Uncontrolled intercurrent illness: e.g. high blood pressure, unstable angina, symptomatic congestive heart failure (New York Heart Association Classification III or IV),

9. Serious cardiac arrhythmia, diabetes, or active infection.

10. Concurrent active cancer originating from a primary site other than colon or rectum.

11. Presence of any symptom suggesting brain metastasis.

12. Patients who are pregnant or breast-feeding

13. Patients (males and females) with reproductive potential not implementing accepted and effective method of contraception

14. For patient who will receive Bevacizumab: Bevacizumab is contraindicated in patients with known hypersensitivity to any components of the product to Chinese hamster ovary cell product or other recombinant human or humanized antibodies

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Resultaat

Primaire uitkomstmaten

1. Occurence of peripheral sensory neuropathy (PSN) grade 2, 3 and 4 assessed by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE) [Every cycle i.e. 2 or 3 weeks according to the treatment arm]

Secundaire uitkomstmaten

1. Cumulative dose of oxaliplatin and time of onset when the first PSN grade 2, 3 or 4 occurs [Every cycle i.e. 2 or 3 weeks according to the treatment arm]

2. Dose-reduction, dose-delay and discontinuation of oxaliplatin due to PSN grade 3 or 4 [Every cycle i.e. 2 or 3 weeks according to the treatment arm]

3. Patient self-reported neurotoxicity scale for chronic peripheral neuropathy [Every cycle i.e. 2 or 3 weeks according to the treatment arm]

4. Progression Free Survival / PFS (for metastatic patients) [Every cycle i.e. 2 or 3 weeks according to the treatment arm]

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