Granisetron Transdermal Patch for Prophylaxis of Delayed CINV

NCT04912271 | Unknown Phase 3

• 1 other identifier: YBCSG-21-04
• Study Type: interventional
• Target: 140
• Locations: 0 countries
• Sites: N/A

Brief Summary

Transdermal granisetron has been shown to as effective as oral/ intravenous granisetron when administered with or without dexamethasone. However, it has not been evaluated specifically against the delayed response of chemotherapy-induced nausea and vomiting (CINV) in comparison with palonosetron, as the complete response for the delayed phase was not reported in the comparative study by Seol et al (Support Care Cancer 2016;24:945-952). Thus, transdermal granisetron needs to be compared with palonosetron as part of dual and triple therapy in the delayed phase of CINV. This investigator-initiated study aims to compare the efficacy of granisetron transdermal patch and palonosetron combined with NK-1 receptor antagonist and dexamethasone in the prevention of delayed CINV in Chinese breast cancer patients who received high emetic or moderate emetic chemotherapy.

Conditions

Chemotherapy-induced Nausea and Vomiting (CINV)

Keywords

delayed CINV; granisetron transdermal delivery system

Outcome Measures

Primary Outcomes (1)

• complete response (CR) in delay phase of CINV

  To compare the complete response (CR) of Granisetron transdermal patch to Palonosetron (complete response is defined as no vomiting and no rescue medication) in delay phase of CINV

  From 24 hours after initiating administration of chemotherapy agents to day 7 (24-168 hours)

Secondary Outcomes (4)

• complete response (CR) in the acute and overall phase of CINV

  From 24 hours after initiating administration of chemotherapy agents to day 7 (24-168 hours)

• complete control (CC) in delay phase of CINV

  From 24 hours after initiating administration of chemotherapy agents to day 7 (24-168 hours)

• complete control (CC) in the acute and overall phase of CINV

  From initiating administration of chemotherapy agents to day 1 (0-24 hours) and day 7 (0-168 hours)

• Patients' satisfaction with antiemetic therapy (assessed using a 10-cm visual analog scale at the time of patch removal

  7 days

Study Arms (2)

Granisetron transdermal patch (other name: sancuso), aprepitant or fosaprepitant, dexamethasone

EXPERIMENTAL

Patients received granisetron transdermal patch plus dexamethasone followed by oral aprepitant or fosaprepitant infusion Granisetron transdermal patch Aprepitant 125 mg PO D1, 80 mg PO D2-D3; Fosaprepitant 150 mg IV D1 Dexamethasone 7.5-10 mg IV/PO D1

Drug: Granisetron transdermal patch; Drug: Aprepitant; Drug: Fosaprepitant; Drug: Dexamethasone

Palonosetron, aprepitant or fosaprepitant, dexamethasone

ACTIVE COMPARATOR

Patients received intravenous palonosetron plus dexamethasone followed by oral aprepitant or fosaprepitant infusion Palonosetron 0.25 mg IV D1 Aprepitant 125 mg PO D1, 80 mg PO D2-D3; Fosaprepitant 150 mg IV D1 Dexamethasone 7.5-10 mg IV/PO D1

Drug: Palonosetron; Drug: Aprepitant; Drug: Fosaprepitant; Drug: Dexamethasone

Interventions

Granisetron transdermal patch DRUG

Granisetron transdermal delivery system (GTDS) is the first 5-HT3 drug to be transdermally delivered and represents a convenient alternative to oral and intravenous antiemetics for the treatment of chemotherapy-induced nausea and vomiting.

Also known as: sancuso

Granisetron transdermal patch (other name: sancuso), aprepitant or fosaprepitant, dexamethasone

Palonosetron DRUG

Palonosetron is a second-generation 5-HT3 receptor antagonist with proposed higher efficacy and sustained action for prophylaxis of postoperative nausea and vomiting (PONV).

Palonosetron, aprepitant or fosaprepitant, dexamethasone

Aprepitant DRUG

Aprepitant is a licensed treatment for nausea and vomiting, which blocks substance P activation of NK-1 (neurokinin 1) receptors.

Granisetron transdermal patch (other name: sancuso), aprepitant or fosaprepitant, dexamethasone; Palonosetron, aprepitant or fosaprepitant, dexamethasone

Fosaprepitant DRUG

Fosaprepitant is a neurokinin-1 receptor antagonist, approved for the prevention of chemotherapy-induced nausea and vomiting.

Granisetron transdermal patch (other name: sancuso), aprepitant or fosaprepitant, dexamethasone; Palonosetron, aprepitant or fosaprepitant, dexamethasone

Dexamethasone DRUG

Dexamethasone, one of the glucocorticoids, has been suggested as a first-line drug for preventing low-level emetogenic chemotherapy- and radiotherapy-induced nausea and vomiting.

Granisetron transdermal patch (other name: sancuso), aprepitant or fosaprepitant, dexamethasone; Palonosetron, aprepitant or fosaprepitant, dexamethasone

Eligibility Criteria

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

You may qualify if:

• Female aged ≥ 18 years;
• Pathologically confirmed breast cancer;
• The physical status score ECOG ≤ 2;
• Life expectancy of ≥3 months;
• Patients first or had already received chemotherapy;
• Patients scheduled to receive HEC/MEC chemotherapy, and the main emetic drugs will be used within a single day;
• Patients first use of granisetron transdermal patch;
• In accordance with the indication of chemotherapy and basic requirements;
• Peripheral haematology: Hb ≥8.0g/dL; absolute neutrophil count≥1.5×109/L; platelet count ≥80×109/L
• Blood biochemistry: Total bilirubin \< 1.5×ULN, ALT and AST ≤ 2.5×ULN; if liver metastasis, ALT and AST \< 5×ULN, creatinine ≤ 1.5×ULN
• Patients voluntarily participate and sign the informed consent form;
• Be able to read, understand and complete patient diaries independently.

You may not qualify if:

• Contraindicated to 5-HT receptor antagonists, NK-1 receptor antagonist or dexamethasone;
• Patients have used 5-HT receptor antagonist, NK1 receptor antagonist or any study drugs within 4 weeks before chemotherapy
• Any nausea and vomiting (II or above) within 72 hours before the start of chemotherapy;
• According to the judgment of the investigators, there are concomitant diseases (including but not limited to hypertension, severe diabetes, active infection, thyroid disease, etc.) that seriously endanger the safety of the patient or affect the completion of the study;
• Patients scheduled to receive radiotherapy of whole body, brain or upper abdomen;
• Confirmed by craniocerebral CT or MRI, patients with brain tumor lesions or patients taking drugs to treat brain tumors or epileptic symptoms;
• History of drug abuse and alcohol dependence;
• Pregnancy, lactation or intended pregnancy;
• History of allergic reactions to drugs with similar chemical structures, or to transdermal therapeutic systems, including commercial dressings such as Elastoplast®
• Unable to swallow, having intestinal obstruction, or other factors that affect the taking and absorption of the drug;
• Long-term use of any inhibitors or inducers of CYP3A4, or take these drugs within 4 weeks before the first day of chemotherapy;
• Other situations evaluated by investigators as unsuitable for enrollment.

Sponsors & Collaborators

• Fudan University: lead

Related Publications (1)

• Liu X, Meng Y, Du Y, Mu Y, Li G, Li H, Guan X, Zhang J. Granisetron Transdermal Delivery System Versus Palonosetron in the Prevention of Long-delayed Nausea and Vomiting: A Phase III Randomized Trial. Oncologist. 2026 Jan 10:oyag007. doi: 10.1093/oncolo/oyag007. Online ahead of print.

  PMID: 41520166 DERIVED

MeSH Terms

Conditions

Vomiting

Interventions

Granisetron; Palonosetron; Aprepitant; fosaprepitant; Dexamethasone

Condition Hierarchy (Ancestors)

Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Azabicyclo Compounds; Aza Compounds; Organic Chemicals; Indazoles; Pyrazoles; Azoles; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Bridged Bicyclo Compounds, Heterocyclic; Heterocyclic Compounds, Bridged-Ring; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Quinuclidines; Isoquinolines; Morpholines; Oxazines; Pregnadienetriols; Pregnadienes; Pregnanes; Steroids; Fused-Ring Compounds; Polycyclic Compounds; Steroids, Fluorinated

Central Study Contacts

Jian Zhang, MD,PhD

CONTACT

+8664175590; syner2000@163.com

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 2, 2021
• First Posted: June 3, 2021
• Study Start: June 10, 2021
• Primary Completion: June 10, 2022
• Study Completion: December 30, 2023
• Last Updated: June 3, 2021

Record last verified: 2021-06