Study of BEMA™ Fentanyl in the Treatment of Breakthrough Pain in Cancer Subjects

NCT00293033 | Completed Phase 3 Results

• 1 other identifier: FEN-201
• Study Type: interventional
• Target: 152
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to evaluate the efficacy of BEMA Fentanyl (Onsolis) at any dose in the management of breakthrough pain in cancer subjects on background opioid therapy. The standard of care for these breakthrough pain episodes is a rapid onset, short acting analgesic with minimal associated sleepiness. Oral morphine, oxycodone and hydromorphone are routinely used, but because of slow and variable oral absorption, the pain control is not the best with these products. Oral transmucosal fentanyl citrate (OTFC) has been used successfully in treating breakthrough pain episodes associated with cancer. OTFC is a lozenge of fentanyl on a stick and is administered by continuously swabbing the interior of the subject's mouth until the product is dissolved (approximately 15 to 30 minutes). The buccal route of administration avoids the delay and variability associated with oral absorption.

Conditions

Pain; Cancer

Keywords

Breakthrough Pain in Patients with Cancer

Outcome Measures

Primary Outcomes (1)

• Summary of Pain Intensity Differences (SPID)

  Pain intensity (using an 11-point \[0 = no pain to 10 = worst pain\] numeric scale) was recorded at 0, 5, 10, 15, 30, 45, and 60 minutes after dosing. Pain intensity difference (PID) was defined as the baseline pain score minus the pain score of each time point. The primary endpoint was the Summary of Pain Intensity Differences at 30 minutes after dosing (SPID 30) in ITT population for Onsolis versus placebo during double-blind period of study. SPID was calculated as a weighted sum of the PID of all time points at or before time point of interest.Range of possible SPID values is -10X time point (minutes) to 10X time point (minutes). Higher value indicates a better outcome.

  0-30 minutes

Secondary Outcomes (45)

• SPID

  0-5 minutes

• SPID

  0-10 minutes

• SPID

  0-15 minutes

• SPID

  0-45 minutes

• SPID

  0-60 minutes

Other Outcomes (4)

• SPID in Neuropathic Pain Subpopulation

  15 minutes

• SPID in Neuropathic Pain Subpopulation

  30 minutes

• SPID in Neuropathic Pain Subpopulation

  45 minutes

Study Arms (2)

Placebo

PLACEBO COMPARATOR

Placebo

Drug: BEMA™; Drug: Placebo

BEMA™ Fentanyl

EXPERIMENTAL

BioErodible MucoAdhesive (BEMA) Fentanyl

Drug: BEMA™

Interventions

BEMA™ DRUG

BioDelivery Sciences International, Inc. (BDSI) has developed BioErodible MucoAdhesive (BEMA) Fentanyl, an alternative product to OTFC that does not require the subject to continuously paint the inside of the mouth with the dosage form. The BDSI product is a small soluble film that is placed against the mucosal membrane inside the mouth. The mucoadhesive polymers in the film readily adhere to the mucosal membrane (within 5 seconds) when moistened. The components of the film are water soluble, so the entire dosage form dissolves within 30 minutes of application.

Also known as: Onsolis (fentanyl buccal soluble film)

BEMA™ Fentanyl; Placebo

Placebo DRUG

Placebo

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male or non-pregnant and non-lactating female. A female of child-bearing potential is eligible to participate in this study if she is using an acceptable method of birth control.
• years or older
• Patient must have pain associated with cancer or cancer treatment.
• Patient must be on a stable current regimen of oral opioids equivalent to 60 - 1000 mg/day of oral morphine or 50 - 300 µg/hr of transdermal fentanyl (e.g. oxycodone 30 mg, methadone 20 mg, and hydromorphone 7.5 mg).
• Regularly experiences 1 - 4 breakthrough pain episodes per day that require additional opioids for pain control
• At least partial relief of breakthrough pain by use of opioid therapy
• Subject must be able to self-administer the study medication correctly.
• Subject must be willing and able to complete the electronic diary card with each pain episode.
• Signed consent must be obtained at screening prior to any procedures being performed.

You may not qualify if:

• Psychiatric/cognitive or neurological impairment that would limit the subject's ability to understand or complete the diary
• Cardiopulmonary disease that, in the opinion of the investigator, would significantly increase the risk of respiratory depression
• Recent history or current evidence of alcohol or other drug substance (licit or illicit) abuse
• Rapidly escalating pain that the investigator believes may require an increase in the dosage of background pain medication during the study
• Moderate (Grade 3) to severe (Grade 4) mucositis (Subjects with less than moderate mucositis are permitted and must be instructed to not apply the BEMA disc at a site of inflammation.)
• Strontium 89 therapy within the previous 6 months
• Any other therapy prior to the study that the investigator considers could alter pain or the response to pain medication.
• Use of an investigational drug within 4 weeks preceding this study
• History of hypersensitivity or intolerance to fentanyl
• Regularly more than 4 episodes per day
• Eastern Cooperative Oncology Group (ECOG) performance status of 4 or 5
• Subject is pregnant, actively trying to become pregnant, breast feeding or not using adequate contraceptive measures

Sponsors & Collaborators

• BioDelivery Sciences International: lead

Study Sites (1)

PPD Development

Wilmington, North Carolina, 28412, United States

Location

MeSH Terms

Conditions

Pain; Neoplasms

Interventions

Fentanyl

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Piperidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds

Limitations and Caveats

There were no limitations or caveats.

Results Point of Contact

• Title: Larry Gever, PharmD, Director, Medical Affairs
• Organization: Meda Pharmaceuticals Inc.

larry.gever@meda.us

732-564-2400

Study Officials

• Andrew Finn, PharmD

  BioDelivery Sciences International

  STUDY CHAIR

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 15, 2006
• First Posted: February 17, 2006
• Study Start: February 1, 2006
• Primary Completion: April 1, 2007
• Study Completion: April 1, 2007
• Last Updated: November 18, 2019
• Results First Posted: October 21, 2019

Record last verified: 2019-11

Locations

US (1)