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    Clinical Trial Results:
    ONO-7436 Phase III Study–A multicenter, open-label, uncontrolled study for the prevention of chemotherapy-induced nausea and vomiting

    Summary
    EudraCT number
    2018-000662-11
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    17 Feb 2011

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Jul 2018
    First version publication date
    15 Jul 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    0869-206
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    Merck Protocol Number: MK-0869-206, Ono Pharmaceutical Co., Ltd. Protocol Number: ONO 7436-03
    Sponsors
    Sponsor organisation name
    Merck Sharp & Dohme Corp.
    Sponsor organisation address
    2000 Galloping Hill Road, Kenilworth, NJ, United States, 07033
    Public contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    Scientific contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    17 Feb 2011
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    17 Feb 2011
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The objective of the study was to evaluate the safety, efficacy, and pharmacokinetics of aprepitant (MK-0869/ONO-7436) for the prevention of chemotherapy-induced nausea and vomiting (CINV) in pediatric Japanese participants 12-18 years of age with malignant tumor who are scheduled to receive chemotherapy including any of cisplatin, cyclophosphamide, or carboplatin.
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    08 Sep 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Japan: 22
    Worldwide total number of subjects
    22
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    20
    Adults (18-64 years)
    2
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Japanese participants aged 12-18 years with malignant tumor that is confirmed by cytological or histological examination, who were scheduled to receive chemotherapy including any of cisplatin, cyclophosphamide, or carboplatin.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Aprepitant 125/80
    Arm description
    Participants received aprepitant 125 mg administered orally (PO) plus dexamethasone 4 mg intravenously (IV) and Granisteron 40 mcg/kg administered IV on Day 1 prior to chemotherapy. On Days 2 and 3, participants received aprepitant 80 mg administered PO and dexamethasone 4 mg IV. Granisteron 40 mcg/kg was administered IV on chemotherapy days if highly or moderately emetogenic therapy was administered on Days 1-5.
    Arm type
    Experimental

    Investigational medicinal product name
    aprepitant
    Investigational medicinal product code
    Other name
    EMEND® MK-0869 ONO-7436
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Aprepitant 125 mg was administered orally once a day (QD) on Day 1 prior to chemotherapy followed by 80 mg administered orally QD on Days 2 and 3.

    Investigational medicinal product name
    Dexamethasone
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Dexamethasone 4 mg was administered intravenously (IV) once a day on Days 1, 2 and 3 approximately 30 minutes prior to the start of chemotherapy.

    Investigational medicinal product name
    Granisteron
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Granisteron 40 mcg/kg was administered on Day 1 approximately 30 minutes prior to the start of chemotherapy. In addition if highly or moderately emetogenic therapy was administered on Days 1-5 granisetron 40 mcg/kg was also administered IV on chemotherapy days.

    Number of subjects in period 1
    Aprepitant 125/80
    Started
    22
    Completed
    22

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Aprepitant 125/80
    Reporting group description
    Participants received aprepitant 125 mg administered orally (PO) plus dexamethasone 4 mg intravenously (IV) and Granisteron 40 mcg/kg administered IV on Day 1 prior to chemotherapy. On Days 2 and 3, participants received aprepitant 80 mg administered PO and dexamethasone 4 mg IV. Granisteron 40 mcg/kg was administered IV on chemotherapy days if highly or moderately emetogenic therapy was administered on Days 1-5.

    Reporting group values
    Aprepitant 125/80 Total
    Number of subjects
    22 22
    Age Categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    20 20
        Adults (18-64 years)
    2 2
        From 65-84 years
    0 0
        85 years and over
    0 0
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    15.2 ( 1.7 ) -
    Gender Categorical
    Units: Subjects
        Female
    9 9
        Male
    13 13

    End points

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    End points reporting groups
    Reporting group title
    Aprepitant 125/80
    Reporting group description
    Participants received aprepitant 125 mg administered orally (PO) plus dexamethasone 4 mg intravenously (IV) and Granisteron 40 mcg/kg administered IV on Day 1 prior to chemotherapy. On Days 2 and 3, participants received aprepitant 80 mg administered PO and dexamethasone 4 mg IV. Granisteron 40 mcg/kg was administered IV on chemotherapy days if highly or moderately emetogenic therapy was administered on Days 1-5.

    Subject analysis set title
    Aprepitant 125/80 Efficacy Cohort
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The efficacy analysis was in all participants who completed at least 1 dose of study drug.

    Subject analysis set title
    Aprepitant 125/80 Safety Cohort
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety analysis was in all participants who completed at least 1 dose of study drug.

    Subject analysis set title
    Aprepitant 125/80 PK Cohort
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    The PK analysis was in all participants who completed at least 1 dose of study drug according to protocol and had adequate data available for the PK parameter being analyzed.

    Primary: Percentage of Participants Who Experience a Complete Response During the Overall Phase (0 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants Who Experience a Complete Response During the Overall Phase (0 to 120 hours post initiation of chemotherapy) [1]
    End point description
    Complete response was defined as no vomiting and no use of rescue medication following the initiation of emetogenic chemotherapy. A vomiting episode was specified as one or more continuous vomits (expulsion of stomach contents through the mouth) or retching/dry heaves (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes were separated by the absence of vomiting and retching for at least one minute. The date, time, and number of vomiting episodes were recorded by participants in diaries at the time of occurrence. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with vomiting and no use of rescue medication in the overall phase, defined as the time period of 0 to120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Primary
    End point timeframe
    0 to 120 hours post initiation of chemotherapy
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses were planned for this endpoint.
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    45.5 (24.4 to 67.8)
    No statistical analyses for this end point

    Primary: Percentage of Participants Who Experience a Complete Response During the Acute Phase (0 to 24 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants Who Experience a Complete Response During the Acute Phase (0 to 24 hours post initiation of chemotherapy) [2]
    End point description
    Complete response was defined as no vomiting and no use of rescue medication following the initiation of emetogenic chemotherapy. A vomiting episode was specified as one or more continuous vomits (expulsion of stomach contents through the mouth) or retching/dry heaves (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes were separated by the absence of vomiting and retching for at least one minute. The date, time, and number of vomiting episodes were recorded by participants in diaries at the time of occurrence. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with vomiting and no use of rescue medication in the acute phase, defined as the time period of 0 to 24 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Primary
    End point timeframe
    0 to 24 hours post initiation of chemotherapy
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses were planned for this endpoint.
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    68.2 (45.1 to 86.1)
    No statistical analyses for this end point

    Primary: Percentage of Participants Who Experience a Complete Response During the Delayed Phase (>24 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants Who Experience a Complete Response During the Delayed Phase (>24 to 120 hours post initiation of chemotherapy) [3]
    End point description
    Complete response was defined as no vomiting and no use of rescue medication following the initiation of emetogenic chemotherapy. A vomiting episode was specified as one or more continuous vomits (expulsion of stomach contents through the mouth) or retching/dry heaves (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes were separated by the absence of vomiting and retching for at least one minute. The date, time, and number of vomiting episodes were recorded by participants in diaries at the time of occurrence. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with vomiting and no use of rescue medication in the delayed phase, defined as the time period of >24 to120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Primary
    End point timeframe
    >24 to 120 hours post initiation of chemotherapy
    Notes
    [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses were planned for this endpoint.
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    59.1 (36.4 to 79.3)
    No statistical analyses for this end point

    Primary: Percentage of Participants Who Experience One or More Drug-related AE

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    End point title
    Percentage of Participants Who Experience One or More Drug-related AE [4]
    End point description
    A drug-related AE was an AE that was determined by the investigator to be related to the treatment. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants who experienced at least one drug-related AE was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Primary
    End point timeframe
    up to 15 days after the start of study treatment
    Notes
    [4] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses were planned for this endpoint.
    End point values
    Aprepitant 125/80 Safety Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    4.5 (0.1 to 22.8)
    No statistical analyses for this end point

    Primary: Percentage of Participants Who Discontinued Study Drug Due to a Drug-related AE

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    End point title
    Percentage of Participants Who Discontinued Study Drug Due to a Drug-related AE [5]
    End point description
    The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants who discontinued study treatment due to a drug-related AE was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Primary
    End point timeframe
    up to 5 days
    Notes
    [5] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses were planned for this endpoint.
    End point values
    Aprepitant 125/80 Safety Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    0.0 (0.0 to 15.4)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Who Experience Total Control During the Overall Phase (0 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants Who Experience Total Control During the Overall Phase (0 to 120 hours post initiation of chemotherapy)
    End point description
    Total control was defined as no vomiting, no nausea, and no use of rescue medication following the initiation of emetogenic chemotherapy. A vomiting episode was specified as one or more continuous vomits (expulsion of stomach contents through the mouth) or retching/dry heaves (an attempt to vomit that is not productive of stomach contents). Distinct vomiting episodes were separated by the absence of vomiting and retching for at least one minute. The date, time, and number of vomiting episodes were recorded by participants in diaries at the time of occurrence. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no vomiting, no nausea, and no use of rescue medication in the overall phase, defined as the time period of 0 to120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    0 to 120 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    40.9 (20.7 to 63.6)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Vomiting During the Overall Phase (0 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants with No Vomiting During the Overall Phase (0 to 120 hours post initiation of chemotherapy)
    End point description
    Vomiting was assessed, regardless of rescue medicine use for treatment of emergent nausea and vomiting, following chemotherapy. A vomiting episode was specified as one or more continuous vomits (expulsion of stomach contents through the mouth) or retching/dry heaves (an attempt to vomit that is not productive of stomach contents). Vomiting episodes were separated by the absence of vomiting/retching for ≥1 minute. The date, time, and number of vomiting episodes were recorded by participants in diaries at the time of occurrence. Rescue medication was permitted for emergent nausea or vomiting but not as preventive medication. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no vomiting episodes in the overall phase, defined as the time period of 0-120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    0 to 120 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    63.6 (40.7 to 82.8)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Vomiting During the Acute Phase (0 to 24 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants with No Vomiting During the Acute Phase (0 to 24 hours post initiation of chemotherapy)
    End point description
    Vomiting was assessed, regardless of rescue medicine use for treatment of emergent nausea and vomiting, following chemotherapy. A vomiting episode was specified as one or more continuous vomits (expulsion of stomach contents through the mouth) or retching/dry heaves (an attempt to vomit that is not productive of stomach contents). Vomiting episodes were separated by the absence of vomiting/retching for ≥1 minute. The date, time, and number of vomiting episodes were recorded by participants in diaries at the time of occurrence. Rescue medication was permitted for emergent nausea or vomiting but not as preventive medication. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no vomiting episodes in the acute phase, defined as the time period of 0-24 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    0 to 24 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    72.7 (49.8 to 89.3)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Vomiting During the Delayed Phase (>24 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants with No Vomiting During the Delayed Phase (>24 to 120 hours post initiation of chemotherapy)
    End point description
    Vomiting was assessed, regardless of rescue medicine use for treatment of emergent nausea and vomiting, following chemotherapy. A vomiting episode was specified as one or more continuous vomits (expulsion of stomach contents through the mouth) or retching/dry heaves (an attempt to vomit that is not productive of stomach contents). Vomiting episodes were separated by the absence of vomiting/retching for ≥1 minute. The date, time, and number of vomiting episodes were recorded by participants in diaries at the time of occurrence. Rescue medication was permitted for emergent nausea or vomiting but not as preventive medication. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no vomiting episodes in the delayed phase, defined as the time period of >24-120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    >24 to 120 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    72.7 (49.8 to 89.3)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Use of Rescue Therapy During the Overall Phase (0 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants with No Use of Rescue Therapy During the Overall Phase (0 to 120 hours post initiation of chemotherapy)
    End point description
    Rescue therapy was allowed for treatment of emergent nausea and vomiting following the initiation of emetogenic chemotherapy but was restricted to permitted medications only. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no use of rescue therapy in the overall phase, defined as the time period of 0 to 120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    0 to 120 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    59.1 (36.4 to 79.3)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Use of Rescue Therapy During the Acute Phase (0 to 24 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants with No Use of Rescue Therapy During the Acute Phase (0 to 24 hours post initiation of chemotherapy)
    End point description
    Rescue therapy was allowed for treatment of emergent nausea and vomiting following the initiation of emetogenic chemotherapy but was restricted to permitted medications only. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no use of rescue therapy in the acute phase, defined as the time period of 0 to 24 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    0 to 24 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    81.8 (59.7 to 94.8)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Use of Rescue Therapy During the Delayed Phase (>24 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants with No Use of Rescue Therapy During the Delayed Phase (>24 to 120 hours post initiation of chemotherapy)
    End point description
    Rescue therapy was allowed for treatment of emergent nausea and vomiting following the initiation of emetogenic chemotherapy but was restricted to permitted medications only. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no use of rescue therapy in the delayed phase, defined as the time period of >24 to 120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    >24 to 120 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    72.7 (49.8 to 89.3)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Nausea During the Overall Phase (0 to 120 hours post initiation of chemotherapy)

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    End point title
    Percentage of Participants with No Nausea During the Overall Phase (0 to 120 hours post initiation of chemotherapy)
    End point description
    In this study, nausea was defined as significant nausea that may interfere with usual daily activities. Nausea was determined by an investigator inquiry. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants with no nausea in the overall phase, defined as the time period of 0 to 120 hours post initiation of chemotherapy, was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    0 to 120 hours post initiation of chemotherapy
    End point values
    Aprepitant 125/80 Efficacy Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    50.0 (28.2 to 71.8)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Who Experience One or More Adverse Events (AE)

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    End point title
    Percentage of Participants Who Experience One or More Adverse Events (AE)
    End point description
    An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have to have a causal relationship to the treatment. An AE was any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product/protocol-specified procedure, whether or not considered related to the medicinal product/protocol-specified procedure. Any worsening of a preexisting condition temporally associated with the use of the product was also an AE. The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants who experienced at least one AE was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    up to 15 days after the start of study treatment
    End point values
    Aprepitant 125/80 Safety Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    100.0 (84.6 to 100.0)
    No statistical analyses for this end point

    Secondary: Observed Maximum Concentration (Cmax) of Aprepitant

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    End point title
    Observed Maximum Concentration (Cmax) of Aprepitant
    End point description
    Blood samples were obtained at specified time points for the pharmacokinetic (PK) analysis of Cmax of aprepitant. Aprepitant concentrations were calculated using non-compartment analysis methods. The endpoint analysis was in all participants who completed at least 1 dose of study drug according to protocol and had adequate data available for the PK parameter being analyzed. The Cmax of aprepitant after oral administration is presented.
    End point type
    Secondary
    End point timeframe
    Day 1: 1, 2, 3, 5, 9, and 11 hours postdose; Day 2: predose; Days 3 and 4: predose and 24 hours postdose
    End point values
    Aprepitant 125/80 PK Cohort
    Number of subjects analysed
    22
    Units: ng/mL
        arithmetic mean (standard deviation)
    2350 ( 920 )
    No statistical analyses for this end point

    Secondary: Time to Maximum Concentration (Tmax) of Aprepitant

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    End point title
    Time to Maximum Concentration (Tmax) of Aprepitant
    End point description
    Blood samples were obtained at specified time points for the PK analysis of Tmax of aprepitant. Aprepitant concentrations were calculated using non-compartment analysis methods. The endpoint analysis was in all participants who completed at least 1 dose of study drug according to protocol and had adequate data available for the PK parameter being analyzed. The Tmax of aprepitant after oral administration is presented.
    End point type
    Secondary
    End point timeframe
    Day 1: 1, 2, 3, 5, 9, and 11 hours postdose; Day 2: predose; Days 3 and 4: predose and 24 hours postdose
    End point values
    Aprepitant 125/80 PK Cohort
    Number of subjects analysed
    22
    Units: hours
        arithmetic mean (full range (min-max))
    5.0 (2.0 to 24.0)
    No statistical analyses for this end point

    Secondary: Area Under the Concentration-time Curve of Aprepitant From Time 0 to 24 Hours (AUC 0-24h)

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    End point title
    Area Under the Concentration-time Curve of Aprepitant From Time 0 to 24 Hours (AUC 0-24h)
    End point description
    Blood samples were obtained at specified time points for the PK analysis of AUC 0-24h of aprepitant. Aprepitant concentrations were calculated using non-compartment analysis methods. The endpoint analysis was in all participants who completed at least 1 dose of study drug according to protocol and had adequate data available for the PK parameter being analyzed. The AUC 0-24h of aprepitant after oral administration is presented.
    End point type
    Secondary
    End point timeframe
    Day 1: 1, 2, 3, 5, 9, and 11 hours postdose; Day 2: predose; Days 3 and 4: predose and 24 hours postdose
    End point values
    Aprepitant 125/80 PK Cohort
    Number of subjects analysed
    22
    Units: ng•h/mL
        arithmetic mean (standard deviation)
    28100 ( 10400 )
    No statistical analyses for this end point

    Secondary: Plasma Concentration of Aprepitant After 24 Hours (C24h)

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    End point title
    Plasma Concentration of Aprepitant After 24 Hours (C24h)
    End point description
    Blood samples were obtained at specified time points for the PK analysis of C24h of aprepitant. Aprepitant concentrations were calculated using non-compartment analysis methods. The endpoint analysis was in all participants who completed at least 1 dose of study drug according to protocol and had adequate data available for the PK parameter being analyzed. The C24h of aprepitant after oral administration is presented.
    End point type
    Secondary
    End point timeframe
    Day 1: 1, 2, 3, 5, 9, and 11 hours postdose; Day 2: predose; Days 3 and 4: predose and 24 hours postdose
    End point values
    Aprepitant 125/80 PK Cohort
    Number of subjects analysed
    22
    Units: ng/mL
        arithmetic mean (standard deviation)
    675 ( 482 )
    No statistical analyses for this end point

    Secondary: Plasma Concentration of Aprepitant After 48 Hours (C48h)

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    End point title
    Plasma Concentration of Aprepitant After 48 Hours (C48h)
    End point description
    Blood samples were obtained at specified time points for the PK analysis of C48h of aprepitant. Aprepitant concentrations were calculated using non-compartment analysis methods. The endpoint analysis was in all participants who completed at least 1 dose of study drug according to protocol and had adequate data available for the PK parameter being analyzed. The C48h of aprepitant after oral administration is presented.
    End point type
    Secondary
    End point timeframe
    Day 1: 1, 2, 3, 5, 9, and 11 hours postdose; Day 2: predose; Days 3 and 4: predose and 24 hours postdose
    End point values
    Aprepitant 125/80 PK Cohort
    Number of subjects analysed
    22
    Units: ng/mL
        arithmetic mean (standard deviation)
    492 ( 408 )
    No statistical analyses for this end point

    Secondary: Plasma Concentration of Aprepitant After 72 Hours (C72h)

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    End point title
    Plasma Concentration of Aprepitant After 72 Hours (C72h)
    End point description
    Blood samples were obtained at specified time points for the PK analysis of C72h of aprepitant. Aprepitant concentrations were calculated using non-compartment analysis methods. The endpoint analysis was in all participants who completed at least 1 dose of study drug according to protocol and had adequate data available for the PK parameter being analyzed. The C72h of aprepitant after oral administration is presented.
    End point type
    Secondary
    End point timeframe
    Day 1: 1, 2, 3, 5, 9, and 11 hours postdose; Day 2: predose; Days 3 and 4: predose and 24 hours postdose
    End point values
    Aprepitant 125/80 PK Cohort
    Number of subjects analysed
    22
    Units: ng/mL
        arithmetic mean (standard deviation)
    603 ( 608 )
    No statistical analyses for this end point

    Secondary: Percentage of Participants Who Discontinued Study Drug Due to an AE

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    End point title
    Percentage of Participants Who Discontinued Study Drug Due to an AE
    End point description
    The endpoint analysis was in all participants who completed at least 1 dose of study drug. The percentage of participants who discontinued study treatment due to an AE was calculated and presented with two-sided 95% confidence intervals calculated by the Clopper-Pearson exact method.
    End point type
    Secondary
    End point timeframe
    up to 5 days
    End point values
    Aprepitant 125/80 Safety Cohort
    Number of subjects analysed
    22
    Units: Percentage of participants
        number (confidence interval 95%)
    0 (0.0 to 15.4)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    up to 15 days after the start of study treatment
    Adverse event reporting additional description
    The safety population included all participants that received at least 1 dose of aprepitant.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    14.0
    Reporting groups
    Reporting group title
    Aprepitant 125/80 Safety Cohort
    Reporting group description
    Participants received aprepitant (MK-0869/ONO -7436) 125 mg administered orally (PO) plus dexamethasone 4 mg intravenously (IV) and Granisteron 40 mcg/kg administered IV on Day 1 prior to chemotherapy. On Days 2 and 3, participants received aprepitant (MK-0869/ONO -7436) 80 mg administered PO and dexamethasone 4 mg IV. Granisteron 40 mcg/kg was administered IV on chemotherapy days if highly or moderately emetogenic therapy was administered on further days. The safety analysis was in all participants who completed at least 1 dose of study drug.

    Serious adverse events
    Aprepitant 125/80 Safety Cohort
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 22 (9.09%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    General disorders and administration site conditions
    Mucous membrane disorder
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Aprepitant 125/80 Safety Cohort
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    22 / 22 (100.00%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Aspartate aminotransferase increased
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    3
    Blood potassium decreased
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Blood sodium decreased
         subjects affected / exposed
    5 / 22 (22.73%)
         occurrences all number
    6
    Blood urea increased
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    4
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    4 / 22 (18.18%)
         occurrences all number
    4
    Glucose urine present
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Haematocrit decreased
         subjects affected / exposed
    11 / 22 (50.00%)
         occurrences all number
    12
    Haemoglobin decreased
         subjects affected / exposed
    13 / 22 (59.09%)
         occurrences all number
    15
    Lymphocyte count decreased
         subjects affected / exposed
    18 / 22 (81.82%)
         occurrences all number
    18
    Neutrophil count decreased
         subjects affected / exposed
    21 / 22 (95.45%)
         occurrences all number
    21
    Neutrophil count increased
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Platelet count decreased
         subjects affected / exposed
    18 / 22 (81.82%)
         occurrences all number
    18
    Red blood cell count decreased
         subjects affected / exposed
    12 / 22 (54.55%)
         occurrences all number
    13
    Weight decreased
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    White blood cell count decreased
         subjects affected / exposed
    20 / 22 (90.91%)
         occurrences all number
    20
    White blood cell count increased
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Protein urine present
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 22 (18.18%)
         occurrences all number
    4
    Febrile neutropenia
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    General disorders and administration site conditions
    Malaise
         subjects affected / exposed
    11 / 22 (50.00%)
         occurrences all number
    12
    Pyrexia
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    3
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Constipation
         subjects affected / exposed
    4 / 22 (18.18%)
         occurrences all number
    5
    Nausea
         subjects affected / exposed
    10 / 22 (45.45%)
         occurrences all number
    10
    Stomatitis
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    3
    Vomiting
         subjects affected / exposed
    5 / 22 (22.73%)
         occurrences all number
    6
    Respiratory, thoracic and mediastinal disorders
    Epistaxis
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Hiccups
         subjects affected / exposed
    4 / 22 (18.18%)
         occurrences all number
    5
    Skin and subcutaneous tissue disorders
    Dermatitis
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Erythema
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Urticaria
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    11 / 22 (50.00%)
         occurrences all number
    13

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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