Cancer PainPhase 4NCT00842829
Study of Breakthrough Cancer Pain: Assessment of Fentanyl Buccal Tablets Titration and Treatment in Opioid-Tolerant Patients
A Phase 4 study testing Fentanyl Buccal Tablet (FBT) in people with Cancer Pain and Breakthrough Pain, run by Cephalon at 123 sites in 7 countries.
Trial summary
Breakthrough cancer pain (BTcP) is a common problem in patients with cancer. Fentanyl Buccal Tablet (FBT) is used for the treatment of BTP in adults with cancer who are already receiving maintenance opioid therapy for chronic cancer pain. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Cancer Pain, Breakthrough Pain
- What is being tested?
- Fentanyl Buccal Tablet (FBT)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 330 participants
- Where
- 123 sitesin 7 countries
- Study dates
- Jan 2009to May 2011
- Phase
- Phase 4
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- The patient is willing to provide written informed consent to participate in this study.
- The patient can be either an out-patient or an in-patient.
- The patient has a histologically documented diagnosis of cancer.
- The patient has stable background pain due to cancer.
- The patient experiences up to 4 BTcP episodes per 24 hours.
- As maintenance opioid therapy, the patient is currently taking 1 of the following: at least 60 mg of oral morphine/day, at least 25 mcg of transdermal fentanyl/hour, at least 30 mg of oxycodone/day, at least 8 mg of hydromorphone/day, of an equianalgesic dose of another opioid for a week or longer before administration of the first dose of study drug.
- Women of childbearing potential, using a medically accepted, highly effective method of birth control and agree to continued use of this method for the duration of the study.
- The patient must be willing and able to successfully self-administer the study drug and to fill in study documents.
Who cannot join
- The patient is without maintenance opioid therapy.
- The patient has uncontrolled or rapidly escalating pain as determined by the investigator.
- The patient has known or suspected hypersensitivities, allergies, or other contraindications to the active drug or to any of the excipients of the study drug.
- The patient has respiratory depression or chronic obstructive pulmonary disease, or any other medical condition predisposing to respiratory depression.
- The patient has medical or psychiatric disease that, in the opinion of the investigator, would compromise collected data.
- The patient is expected to have surgery during the study.
Show all 10Show fewer
- The patient is pregnant or lactating.
- The patient has participated in a study involving an investigational drug in the prior 30 days.
- The patient has received a monoamine oxidase inhibitor (MAOI) within 14 days before the first treatment with study drug.
- The patient has any other medical condition or is receiving concomitant medication/therapy (e.g., regional nerve block) that could, in the opinion of the investigator, compromise the patient's safety or compliance with the study protocol, or compromise collected data.
Trial locations and contacts
123 sites in 7 countries.
123 sites in 7 countries
Germany31 sites
Investigational Site
Bad Honnef, 53604
Investigational Site
Bad Lippspringe, 33175
Investigational Site
Berlin, 10435
Investigational Site
Berlin, 13353
Investigational Site
Berlin, 13585
Investigational Site
Berlin, 14089
Investigational Site
Böhlen, 04564
Investigational Site
Bonn, 53111
Investigational Site
Dresden, 01307
Investigational Site
Duisburg, 47055
Investigational Site
Duisburg, 47166
Investigational Site
Erfurt, 99084
Investigational Site
Freiburg im Breisgau, 79108
Investigational Site
Geesthacht, 21502
Investigational Site
Greifenstein, 35753
Investigational Site
Hanover, 30625
Investigational Site
Herne, 44623
Investigational Site
Hildesheim, 31135
Investigational Site
Jena, 07747
Investigational Site
Kassel, 34117
Investigational Site
Leipzig, 04107
Investigational Site
Lohsa, 02999
Investigational Site
Lünen, 44534
Investigational Site
Mainz, 55131
Investigational Site
Mülhausen, 99974
Investigational Site
Munich, 80637
Investigational Site
Munich, 81377
Investigational Site
Neustadt, 01844
Investigational Site
Rostock, 18059
Investigational Site
Weiden, 92637
Investigational Site
Würselen, 52146
Italy24 sites
Investigational Site
Aviano, 33081
Investigational Site
Bari, 70120
Investigational Site
Brescia, 25123
Investigational Site
Cagliari, 9121
Investigational Site
Candiolo, 10060
Investigational Site
Caserta, 81100
Investigational Site
Cosenza, 87100
Investigational Site
Florence, 50100
Investigational Site
Garbagnate Milanese, 20024
Investigational Site
Genova, 16128
Investigational Site
L’Aquila, 67100
Investigational Site
Lugo, 48022
Investigational Site
Milan, 20142
Investigational Site
Modena, 41100
Investigational Site
Naples, 80131
Investigational Site
Palermo, 90146
Investigational Site
Piacenza, 29100
Investigational Site
Pisa, 56100
Investigational Site
Roma, 133
Investigational Site
Roma, 144
Investigational Site
Roma, 161
Investigational Site
Torino, 10126
Investigational Site
Torino, 10153
Investigational Site
Verona, 37024
France22 sites
Investigational Site
Bayonne, 64100
Investigational Site
Bordeaux, 33075
Investigational Site
Caen, 14033
Investigational Site
Clichy, 92110
Investigational Site
Grenoble, 38043
Investigational Site
Le Chesnay, 78157
Investigational Site
Le Kremlin-Bicêtre, 94275
Investigational Site
Le Mans, 72018
Investigational Site
Lorient, 58107
Investigational Site
Montpellier, 34298
Investigational Site
Nevers, 58033
Investigational Site
Orléans, 45032
Investigational Site
Paris, 75010
Investigational Site
Paris, 75013
Investigational Site
Paris, 75730
Investigational Site
Pierre-Bénite, 69495
Investigational Site
Poitiers, 86021
Investigational Site
Rouen, 76031
Investigational Site
Saint-Herblain, 44805
Investigational Site
Tarbes, 65000
Investigational Site
Toulouse, 31059
Investigational Site
Villejuif, 94800
Spain22 sites
Investigational Site
A Coruña, 15006
Investigational Site
A Coruña, 15009
Investigational Site
Barcelona, 08025
Investigational Site
Barcelona, 08907
Investigational Site
Bilbao, 48013
Investigational Site
Cadiz, 11009
Investigational Site
Córdoba, 14002
Investigational Site
Granada, 18012
Investigational Site
Lleida, 28195
Investigational Site
Madrid, 28006
Investigational Site
Madrid, 28035
Investigational Site
Madrid, 28046
Investigational Site
Palma de Mallorca, 07012
Investigational Site
Pamplona, 31008
Investigational Site
Salamanca, 37007
Investigational Site
San Cristóbal de La Laguna, 38320
Investigational Site
Santander, 39008
Investigational Site
Santiago de Compostela, 15706
Investigational Site
Seville, 41009
Investigational Site
Seville, 41013
Investigational Site
Valencia, 46014
Investigational Site
Valencia, 46015
Poland16 sites
Investigational Site
Bielsko-Biala, 43300
Investigational Site
Bydgoszcz, 85796
Investigational Site
Elblag, 82300
Investigational Site
Gdansk, 80208
Investigational Site
Gdansk, 80952
Investigational Site
Gliwice, 44101
Investigational Site
Lodz, 90251
Investigational Site
Poznan, 60245
Investigational Site
Poznan, 61866
Investigational Site
Puszczykowo, 62041
Investigational Site
Szczecin, 71730
Investigational Site
Szczecin, 71740
Investigational Site
Tychy, 43100
Investigational Site
Warsaw, 02781
Investigational Site
Włocławek, 87800
Investigational Site
Wroclaw, 53413
United Kingdom7 sites
Investigational Site
Bath, BA15 2LG
Investigational Site
Dumfries, DG1 4AP
Investigational Site
London, SW3 6JJ
Investigational Site
Nottingham, NG5 1PB
Investigational Site
Plymouth, PL68DH
Investigational Site
Surrey, KT10 8NA
Investigational Site
Sutton, SM2 5PT
About this study
Official title: A European Multicenter Open-Label Study of Breakthrough Cancer Pain: Assessment of Fentanyl Buccal Tablets Titration and Treatment in Opioid-Tolerant Patients
Breakthrough cancer pain (BTcP) is a common problem in patients with cancer. Fentanyl Buccal Tablet (FBT) is used for the treatment of BTP in adults with cancer who are already receiving maintenance opioid therapy for chronic cancer pain. FBT treatment should be individually titrated to an effective dose that provides adequate analgesia and minimizes undesirable effects. To reach the safest effective dose for the individual patient as soon as possible, the dose titration process is critical. The aim of this study, conducted under pragmatic conditions in a large-scale population of cancer patients is to compare the proportion of patients reaching an effective FBT dose after titration starting with either a 100 mcg dose or a 200 mcg dose.
- Conditions
- Cancer Pain, Breakthrough Pain
- Being tested
- Fentanyl Buccal Tablet (FBT)
- Keywords
- Breakthrough Cancer Pain
- Medical subject headings
- Cancer Pain, Breakthrough Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Fentanyl Buccal Tablet (FBT)Drug
Also called Fentora, CEP-25608, Fentanyl citrate, Effentora
FBTs were self-administered by participants via the oral mucosa. During the open-label dose titration period, participants used 1 to 4 tablets of the 100 mcg or 200 mcg strength to individually titrate upwards to an effective dose through the range of available strengths (i.e. 100, 200, 400, 600, or 800 mcg). For the open-label treatment and continuation periods, single dose tablets at the effective dose identified during the titration period were used. The maximum dose allowed per breakthrough pain (BTP) episode was 800 mcg. On any single day, participants were not to use FBT for more than 4 BTP episodes.
| Study group | Role | What they receive |
|---|---|---|
| FBT 100 mcg | Experimental | During the Titration Period, participants took fentanyl buccal tables (FBT) with a starting dose of 100 mcg until they reached an effective dose, with a maximum dose of 800 mcg and a maximum timeframe of 7 days. Participants who reached an effective dose entered the Open-label Treatment Period, whose length depended on how long was needed to treat up to 8 episodes of breakthrough pain (BTP) with FBT (maximum of 8 days). The length of the Continuation Period (when applicable) varied from country to country, up to until FBT was commercially available in that country. Receives: Drug: Fentanyl Buccal Tablet (FBT) |
| FBT 200 mcg | Active comparator | During the Titration Period, participants took fentanyl buccal tables (FBT) with a starting dose of 200 mcg until they reached an effective dose, with a maximum dose of 800 mcg and a maximum timeframe of 7 days. Participants who reached an effective dose entered the Open-label Treatment Period, whose length depended on how long was needed to treat up to 8 episodes of breakthrough pain (BTP) with FBT (maximum of 8 days). The length of the Continuation Period (when applicable) varied from country to country, up to until FBT was commercially available in that country. Receives: Drug: Fentanyl Buccal Tablet (FBT) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants Reaching an Effective Fentanyl Buccal Tablet (FBT) Dose As Assessed by the Participant During the Titration Period
The effective dose was the dose that, for 2 consecutive break-through pain (BTP) episodes, provided adequate analgesia within the first 30 minutes after administration of study drug and that minimized undesirable effects. The assessment was performed by the participant and was reported in the titration-period diary. The next BTP episode was used to confirm the effective dose, and if confirmed, the effective dose was used for all following BTP episodes.
Measured: Day 1 up to Day 7
Secondary outcomes (23)
Kaplan-Meier Estimates for Time to Meaningful Pain Relief As Assessed by Participants During the Treatment Period For Overall Breakthrough Pain (BTP) Episodes
Overall episode data analyzed all values of time to meaningful pain relief taken over all BTP episodes during the treatment period. If meaningful pain relief was not achieved within 60 minutes of FBT intake, or if rescue medication was taken, the event was censored. Meaningful pain relief was left to the judgment of participants, who used a stopwatch and recorded the time from treatment until pain relief in a patient diary.
Measured: approximately Day 8-15
Number of Participants Reaching An Effective Dose As Assessed by the Participant During the Titration Period
Number of participants for which an effective dose of FBT was reached as judged by each participant. The effective dose was the dose that, for 2 consecutive break-through pain (BTP) episodes, provided adequate analgesia within the first 30 minutes after administration of study drug and that minimized undesirable effects. The assessment was performed by the participant and was reported in the titration-period diary. The next BTP episode was used to confirm the effective dose, and if confirmed, the effective dose was used for all following BTP episodes.
Measured: Day 1 up to Day 7
Breakthrough Pain (BTP) Episodes Requiring the Use of Rescue Medication During the Titration Period and the Treatment Period
The number of breakthrough pain (BTP) episodes in which the participant did not obtain effective pain relief from study medication and took a rescue medication.
Measured: Days 1 to up to Day 7 (Titration Period); approximately Day 8 up to Day 15 (Treatment Period)
Participant Assessment of Medication Performance During the Treatment Period
Participants assessed the performance of FBT at 30 minutes and 60 minutes after dosing each episode during the treatment period. For each episode, the participant answered the question 'How well did your study medication perform in controlling the breakthrough pain episode?' on a 5-point Likert-type scale (poor=0, fair=1, good=2, very good=3, and excellent=4).
Measured: approximately Day 8-15
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: General Activity
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. A negative change from baseline represents an improvement.
This subscale assesses general activity.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Mood
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. A negative change from baseline represents an improvement.
This subscale assesses mood.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Walking Ability
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. A negative change from baseline represents an improvement.
This subscale assesses walking ability.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Normal Work
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. A negative change from baseline represents an improvement.
This subscale assesses normal work.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Relations With Other People
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. A negative change from baseline represents an improvement.
This subscale assesses relations with other people.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Sleep
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. A negative change from baseline represents an improvement.
This subscale assesses sleep.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Enjoyment of Life
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. A negative change from baseline represents an improvement.
This subscale assesses enjoyment of life.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire: Global Score
Participants completed the BPI-7S questionnaire to indicate their quality of life and functional status between study time points. For each subscale, the participant rated their responses from 0=Does not interfere through to 10=Completely interferes. The Global Score is the sum of the subscales (total scale is 0-70). A negative change from baseline represents an improvement.
Measured: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Satisfied With BTP Treatment?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Satisfied with the BTP Treatment?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Does This BTP Medication Relieve Your Pain Quickly so You Can Get Back to Sleep?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Does this BTP medication relieve your pain quickly so you can get back to sleep?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Does This Medication Work Fast?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Does this medication work fast?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Does This Medication Provide Adequate Relief?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Does this medication provide adequate relief?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Is This Medication Easy to Take?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Is this medication easy to take?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Do You Find This Medication Comfortable to Take in Public?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Do you find this medication comfortable to take in public?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Do You Feel Safe Taking This Medication?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Do you feel safe taking this medication?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Do You Understand the Instructions?) at the End of the Treatment Period
Responses to the Patient Satisfaction questionnaire question, "Do you understand the instructions?", were captured on a five-point scale from 0=not at all to 4=very much.
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Ease of Use at the End of the Treatment Period
Ease of use was assessed using the question 'Did you find this treatment easy/convenient to use for treatment of your breakthrough pain episodes?'. The answer was based on a 4-point numerical scale (0=Poor, 1=Fair, 2=Easy, 3=Very Easy). This assessment was performed at the end of the Treatment Period (or early termination).
Measured: approximately Day 15 (end of Treatment Period)
Participant's Global Impression of Change at the End of the Treatment Period
Global impression of change was assessed using the question 'Since the start of the study, my overall status is?'. The answer was based on a 7-point scale (1=Very much improved, 2=Much improved, 3=Minimally improved, 4=No change, 5=Minimally worse, 6=Much worse, and 7=Very much worse). This assessment was performed at the end of the Treatment Period (or early termination).
Measured: approximately Day 15 (end of Treatment Period)
Participants With Adverse Events (AE) Summarized by Treatment Period
Participants with treatment-emergent adverse events are summarized by each treatment period. Relation to study drug was assessed by the investigator. The 'Any AE' category below includes serious adverse events.
Measured: Day 1-7 (Titration Period). Day 8-15 (Treatment Period), Days 16-688 (Continuation Period)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Feb 2009 (estimated)
- Study startJan 2009
- Primary completionMay 2011
- Study completionMay 2011
Why it stopped: Recruitment stopped at the end of the recruitment timeframe
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Cancer PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 330 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cephalon
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Sponsor's Medical Expert, Study director, Cephalon Europe
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00842829
- Sponsor's protocol ID
- C25608/4027/BP/EU
- Other IDs
- 2008-001841-24, 2008
- Status last verified
- Sep 2012
- First submitted
- 29 Jan 2009
- Last updated
- 1 Oct 2012
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Oct 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A European Multicenter Open-Label Study of Breakthrough Cancer Pain: Assessment of Fentanyl Buccal Tablets Titration and Treatment in Opioid-Tolerant Patients
- ClinicalTrials.gov ID
- NCT00842829
- Acronym / sponsor ID
- C25608/4027/BP/EU
- Conditions
- Cancer Pain, Breakthrough Pain
- Keywords
- Breakthrough Cancer Pain
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Recruitment stopped at the end of the recruitment timeframe
- Enrolment
- 330 participants (actual)
- Lead sponsor
- CephalonIndustry (pharma, biotech, devices)
- Study start
- Jan 2009
- Primary completion
- May 2011 (actual)
- Study completion
- May 2011 (actual)
- First posted
- 12 Feb 2009 (estimated)
- Results
- Posted 20 Sep 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Breakthrough cancer pain (BTcP) is a common problem in patients with cancer. Fentanyl Buccal Tablet (FBT) is used for the treatment of BTP in adults with cancer who are already receiving maintenance opioid therapy for chronic cancer pain. FBT treatment should be individually titrated to an effective dose that provides adequate analgesia and minimizes undesirable effects. To reach the safest effective dose for the individual patient as soon as possible, the dose titration process is critical. The aim of this study, conducted under pragmatic conditions in a large-scale population of cancer patients is to compare the proportion of patients reaching an effective FBT dose after titration starting with either a 100 mcg dose or a 200 mcg dose.
Study design
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| FBT 100 mcg | Experimental | Drug: Fentanyl Buccal Tablet (FBT)During the Titration Period, participants took fentanyl buccal tables (FBT) with a starting dose of 100 mcg until they reached an effective dose, with a maximum dose of 800 mcg and a maximum timeframe of 7 days. Participants who reached an effective dose entered the Open-label Treatment Period, whose length depended on how long was needed to treat up to 8 episodes of breakthrough pain (BTP) with FBT (maximum of 8 days). The length of the Continuation Period (when applicable) varied from country to country, up to until FBT was commercially available in that country. |
| FBT 200 mcg | Active comparator | Drug: Fentanyl Buccal Tablet (FBT)During the Titration Period, participants took fentanyl buccal tables (FBT) with a starting dose of 200 mcg until they reached an effective dose, with a maximum dose of 800 mcg and a maximum timeframe of 7 days. Participants who reached an effective dose entered the Open-label Treatment Period, whose length depended on how long was needed to treat up to 8 episodes of breakthrough pain (BTP) with FBT (maximum of 8 days). The length of the Continuation Period (when applicable) varied from country to country, up to until FBT was commercially available in that country. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- The patient is willing to provide written informed consent to participate in this study.
- The patient can be either an out-patient or an in-patient.
- The patient has a histologically documented diagnosis of cancer.
- The patient has stable background pain due to cancer.
- The patient experiences up to 4 BTcP episodes per 24 hours.
Key exclusion criteria (10 listed)
- The patient is without maintenance opioid therapy.
- The patient has uncontrolled or rapidly escalating pain as determined by the investigator.
- The patient has known or suspected hypersensitivities, allergies, or other contraindications to the active drug or to any of the excipients of the study drug.
- The patient has respiratory depression or chronic obstructive pulmonary disease, or any other medical condition predisposing to respiratory depression.
- The patient has medical or psychiatric disease that, in the opinion of the investigator, would compromise collected data.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Fentanyl Buccal Tablet (FBT)Also: Fentora, CEP-25608, Fentanyl citrate, EffentoraFBTs were self-administered by participants via the oral mucosa. During the open-label dose titration period, participants used 1 to 4 tablets of the 100 mcg or 200 mcg strength to individually titrate upwards to an effective dose through the range of available strengths (i.e. 100, 200, 400, 600, or 800 mcg). For the open-label treatment and continuation periods, single dose tablets at the effective dose identified during the titration period were used. The maximum dose allowed per breakthrough pain (BTP) episode was 800 mcg. On any single day, participants were not to use FBT for more than 4 BTP episodes. | Drug | FBT 100 mcg, FBT 200 mcg |
Primary outcome
Percentage of Participants Reaching an Effective Fentanyl Buccal Tablet (FBT) Dose As Assessed by the Participant During the Titration Period
Time frame: Day 1 up to Day 7
The effective dose was the dose that, for 2 consecutive break-through pain (BTP) episodes, provided adequate analgesia within the first 30 minutes after administration of study drug and that minimized undesirable effects. The assessment was performed by the participant and was reported in the titration-period diary. The next BTP episode was used to confirm the effective dose, and if confirmed, the effective dose was used for all following BTP episodes.
23 secondary outcomes
Kaplan-Meier Estimates for Time to Meaningful Pain Relief As Assessed by Participants During the Treatment Period For Overall Breakthrough Pain (BTP) Episodes
Time frame: approximately Day 8-15
Number of Participants Reaching An Effective Dose As Assessed by the Participant During the Titration Period
Time frame: Day 1 up to Day 7
Breakthrough Pain (BTP) Episodes Requiring the Use of Rescue Medication During the Titration Period and the Treatment Period
Time frame: Days 1 to up to Day 7 (Titration Period); approximately Day 8 up to Day 15 (Treatment Period)
Participant Assessment of Medication Performance During the Treatment Period
Time frame: approximately Day 8-15
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: General Activity
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Mood
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Walking Ability
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Normal Work
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Relations With Other People
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Sleep
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire Subscale: Enjoyment of Life
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Change From Baseline to End of Treatment Period (Approximately Day 15) in the Brief Pain Inventory 7-item (BPI-7S) Questionnaire: Global Score
Time frame: Day 0 (baseline), approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Satisfied With BTP Treatment?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Does This BTP Medication Relieve Your Pain Quickly so You Can Get Back to Sleep?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Does This Medication Work Fast?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Does This Medication Provide Adequate Relief?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Is This Medication Easy to Take?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Do You Find This Medication Comfortable to Take in Public?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Do You Feel Safe Taking This Medication?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Satisfaction (Do You Understand the Instructions?) at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Assessment of Ease of Use at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participant's Global Impression of Change at the End of the Treatment Period
Time frame: approximately Day 15 (end of Treatment Period)
Participants With Adverse Events (AE) Summarized by Treatment Period
Time frame: Day 1-7 (Titration Period). Day 8-15 (Treatment Period), Days 16-688 (Continuation Period)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Oct 2012.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Sponsor's Medical Expert study director
Cephalon Europe
123 sites in 7 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Fentanyl Buccal Tablet (FBT) in people with Cancer Pain and Breakthrough Pain, run by Cephalon at 123 sites in 7 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 1 Oct 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 123 sites in Germany, Italy, France, Spain, Poland and 2 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 20 Sep 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of Participants Reaching an Effective Fentanyl Buccal Tablet (FBT) Dose As Assessed by the Participant During the Titration Period (time frame: Day 1 up to Day 7). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Oct 2012.