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Pilocarpine in Treating Vaginal Dryness in Patients With Breast Cancer

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赞助商
Alliance for Clinical Trials in Oncology
合作者
National Cancer Institute (NCI)

关键词

抽象

RATIONALE: Pilocarpine may decrease vaginal dryness and improve quality of life in patients with breast cancer It is not yet known whether pilocarpine is more effective than a placebo in treating vaginal dryness in patients with breast cancer.
PURPOSE: This randomized phase III trial is studying pilocarpine to see how well it works compared to a placebo in treating vaginal dryness in patients with breast cancer.

描述

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to age (18 to 45 vs 46 to 55 vs 56 to 65 vs > 65), concurrent tamoxifen therapy (yes vs no vs unknown [e.g., on a blinded clinical study]), concurrent aromatase inhibitor therapy (yes vs no vs unknown [e.g., on a blinded clinical study]), and perception of severity of vaginal symptoms at baseline (mild vs moderate vs severe). Patients are randomized to 1 of 4 treatment arms. The primary and secondary objectives of the study are described below.

OBJECTIVES:

Primary

- Determine the effectiveness of pilocarpine hydrochloride for alleviation of vaginal dryness in patients with breast cancer.

Secondary

- Evaluate any toxicities arising from pilocarpine hydrochloride in these patients.

- Evaluate quality of life of these patients treated with pilocarpine hydrochloride.

Quality of life was assessed at baseline and then weekly for 6 weeks.

日期

最后验证: 06/30/2016
首次提交: 06/21/2006
提交的预估入学人数: 06/21/2006
首次发布: 06/22/2006
上次提交的更新: 07/11/2016
最近更新发布: 08/11/2016
首次提交结果的日期: 07/15/2014
首次提交质量检查结果的日期: 09/23/2014
首次发布结果的日期: 09/29/2014
实际学习开始日期: 11/30/2006
预计主要完成日期: 06/30/2009
预计完成日期: 11/30/2012

状况或疾病

Breast Cancer
Vaginal Dryness

干预/治疗

Drug: pilocarpine hydrochloride

Other: placebo

相 3

手臂组

干预/治疗
Experimental: Arm I
Patients receive oral pilocarpine hydrochloride once a day for 3 days, twice a day for 3 days, three times a day for 3 days, and then 4 times a day for up to 6 weeks in the absence of unacceptable toxicity.
Experimental: Arm II
Patients receive oral pilocarpine hydrochloride once a day for 3 days and then twice a day for up to 6 weeks in the absence of unacceptable toxicity.
Placebo Comparator: Arm III
Patients receive oral placebo once a day for 3 days, twice a day for 3 days, three times a day for 3 days, and then 4 times a day for up to 6 weeks in the absence of unacceptable toxicity.
Placebo Comparator: Arm IV
Patients receive oral placebo once a day for 3 days and then twice a day for up to 6 weeks in the absence of unacceptable toxicity.

资格标准

有资格学习的年龄 18 Years 至 18 Years
有资格学习的性别Female
接受健康志愿者
标准

Required Characteristics:

1. Adult post menopausal women or women with no childbearing potential (≥ 18 years) with a history of breast cancer (currently no evidence of disease) or women who do not want to take vaginal estrogen for a fear of an increased risk of breast cancer. Postmenopausal status will be determined by the primary physician.

2. Significant vaginal complaints defined as persistent vaginal dryness and/or itching of sufficient severity to make a patient desire therapeutic intervention. Symptoms should have been present ≥ 2 months prior to randomization.

3. Life expectancy > 6 months

4. Ability to complete questionnaire(s) by themselves or with assistance.

Contraindications:

1. Initiation or discontinuation of tamoxifen or aromatase inhibitors ≤2 months prior to randomization or plans to initiate or discontinue any of these medications during the 6-week study.

2. Active vaginal infection

3. Concurrent chemotherapy

4. Acute iritis

5. Current or past use of pilocarpine (regardless of purpose)

6. Planned use of any vaginal preparations during the study period (including any over the counter or herbal preparations). Note: Lubricants used during sexual intercourse are permitted.

7. Use of any vaginal preparations ≤ 1 week prior to study entry (Exception: If patient has used vaginal preparations during the previous week but will stop, then they can be placed on study with plans to start with pretreatment questionnaire one week later). Note: Lubricants used during sexual intercourse are permitted.

8. Current (≤ 4weeks prior to randomization), or planned during the study period, use of any estrogen product.

9. A diagnosis of asthma, COPD, CAD or narrow angle glaucoma, or known cholelithiasis.

10. Hepatic or renal insufficiency defined as a history of an elevation of SGOT ≥1.5 x ULN or creatinine ≥ 1.5 x ULN within the past year.

11. Concurrent use of other anticholinergics

12. Use of pharmacologic soy preparations

13. Known history of cardiac arrhythmia. (Patients with occasional PVC's or PAC's that do not require treatment are eligible.)

14. Prior or concurrent pelvic radiation therapy

15. Prior radical pelvic surgery (TAH/BSO is allowed)

16. Use of beta adrenergic antagonists

17. Diagnosis of any of the following conditions:

- Vulvar and vaginal dysplasia

- Essential vulvodynia

- Vulvar vestibulitis

- Vaginal prolapse

- Bartholin cyst/abscess

- History of Bartholin gland surgery

- Lichen sclerosis

- Lichen planus of the vulvovaginal region

- Desquamative vaginitis

结果

主要结果指标

1. Average Vaginal Dryness Scores Via Area Under the Curve (AUC) Summary Statistics [Baseline to Week 6]

Vaginal dryness was measured by the numerical analogue scale at baseline and through the six weeks of treatment. The item scores was transformed into 0 to 100 scales with 0=poor quality of life (QOL) and 100=best possible QOL. The average AUC values were calculated by dividing 6 from AUC values for participants who completed item on all 6 weeks. If a participant completed the item at baseline, week 1, 2 and 3 but did not complete the item at week 4 to week 6, the AUC values of the item was prorated, which is (((AUC values * 6) / 3) / 6). The average pro-rated AUC for vaginal dryness scores was compared in each of the Pilocarpine arms against the collective placebo arm.

次要成果指标

1. Toxicity as Measured by Common Terminology Criteria for Adverse Events (CTCAE) 3.0 [End of 6 weeks]

CTCAE Grading: Grade 1=Mild, Grade 2=Moderate, Grade 3=Severe, Grade 4=Life-threatening, Grade 5=Death.

2. Average AUC Summary Statistics for the Impact of Vaginal Dryness for Activities of Daily Living [Baseline to Week 6]

The impact of vaginal dryness for activities of daily living (ADL) were measured by the numerical analogue scales at baseline and through the six weeks of treatment. The item scores was transformed into 0 to 100 scales with 0=poor quality of life (QOL) and 100=best possible QOL. The average AUC values were calculated by dividing 6 from AUC values for participants who completed item on all 6 weeks. If a participant completed the item at baseline, week 1, 2 and 3 but did not complete the item at week 4 to week 6, the AUC values of the item was prorated, which is (((AUC values * 6) / 3) / 6). The average pro-rated AUC scores was compared in each of the Pilocarpine arms against the collective placebo arm.

3. Change From Baseline to Week 6 on the Impact of Vaginal Dryness for Activities of Daily Living Scores [Baseline and Week 6]

The impact of vaginal dryness for activities of daily living (ADL) were measured by the numerical analogue scales at baseline and through the six weeks of treatment. The item scores was transformed into 0 to 100 scales with 0=poor quality of life (QOL) and 100=best possible QOL. The change from baseline scores was calculated by subtracting the baseline item scores from the scores at 6 week.

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