E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Breakthrough pain in opioid tolerant cancer patients. |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to show that Fentanyl TAIFUN® treatment with a titrated, successful dose provides efficacious and fast pain relief without major safety concerns in cancer patients with breakthrough pain receiving maintenance opioid therapy. The primary efficacy evaluation will be based on the time-weighted sum of pain intensity difference up to 30 minutes (SPID30) and time to significant pain relief. Superiority of the investigational product compared to placebo will be shown.
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are - to estimate the proportion of patients that can be titrated to an effective dose of Fentanyl TAIFUN® - to evaluate the efficacy of Fentanyl TAIFUN® through other secondary efficacy variables - to evaluate the safety of Fentanyl TAIFUN®, primarily through the adverse event profile |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Age 18 years or older. 2. A medically documented diagnosis of cancer. 3. Use of a fixed around-the-clock dose of an opioid or a fixed combination of opioids as maintenance therapy for pain relief with a dose equivalent of at least 60 mg of oral morphine/day, or at least 25 µg of transdermal fentanyl/hour, or at least 30 mg of oral oxycodone daily or at least 8 mg of oral hydromorphone daily. Patients must be taking current opioid treatment for at least 7 days prior to the first dose of study medication. 4. Current use of medication for BTP. 5. At least one BTP episode per day with peak intensity of at least 4 on the numerical pain scale (NPS) at pain onset; no more than 4 BTP episodes per day. 6. The flow rate of inhalation of at least 20 L/min assessed by inspiratory flow meter (the highest of two readings will be used). 7. Karnofsky Performance Status 40 or better. 8. Written informed consent.
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E.4 | Principal exclusion criteria |
1. Uncontrolled or rapidly increasing BTP. 2. Symptomatic intracranial tumors or cerebral metastases. 3. Persistent, symptomatic asthma despite medication, as defined by daily symptoms, frequent exacerbations, frequent nocturnal asthma symptoms, predicted FEV1 ≤ 60% or personal best PEFR ≤ 60%. 4. Patients unable to use the inhaler (e.g. based on the use of training inhaler). 5. Inadequate lung function, as defined by PEFR < 60 %. 6. Hypersensitivities, allergies or contraindications to fentanyl or any compounds in the study medication. 7. A recent history of alcohol or substance abuse (in the past 1 year). 8. Chemotherapy with a drug not used before in this patient within 30 days of the beginning of the titration phase. 9. Radiotherapy to the thorax or the BTP target areas within 30 days of the beginning of the titration phase. 10. Cognitive impairment or any neurological or psychiatric disease which could compromise the ability of the patient to complete the assessments. 11. Participation in a prior clinical study with Fentanyl TAIFUN®. 12. Participation in any clinical study with experimental drug within 30 days of the study medication. 13. Any clinical condition (e.g. severe hepatic impairment) or medical history which, in the opinion of the investigator would not allow for the safe completion of the study or the safe administration of the study drug (e.g. elderly or cachectic patient on the lowest dose of maintenance opioid therapy). 14. Pre-menopausal women (last menstruation < 1 year prior to the screening visit) who: - are not surgically sterile and/or - have a positive pregnancy test at baseline visit and/or - are of childbearing potential and are not practicing an acceptable means of birth control or do not plan to continue using this method throughout the study and/or are nursing.
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E.5 End points |
E.5.1 | Primary end point(s) |
To show that Fentanyl TAIFUN® treatment with a titrated, successful dose provides efficacious and fast pain relief without major safety concerns in cancer patients with breakthrough pain receiving maintenance opioid therapy. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 28 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |