Pancreatic Cancer Non-resectablePhase 3NCT03984214
Efficacy and Safety of Dronabinol in the Improvement of Chemotherapy-induced and Tumor-related Symptoms in Advanced Pancreatic Cancer
A Phase 3 study testing Dronabinol in Oral Dosage Form in people with Pancreatic Cancer Non-resectable and Chemotherapy-induced Nausea and Vomiting, run by Arbeitsgemeinschaft medikamentoese Tumortherapie at 11 sites in 2 countries.
Trial summary
Aim of this phase III trial is to investigate the efficacy and safety of dronabinol (orally administered tetrahydrocannabinol (THC)) as adjuvant therapy to first-line standard chemotherapy in patients with metastatic pancreatic cancer for improvement of chemotherapy- and tumor-related symptoms applicated by individual… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pancreatic Cancer Non-resectable, Chemotherapy-induced Nausea and Vomiting, Pancreatic Cancer Metastatic
- What is being tested?
- Dronabinol in Oral Dosage Form
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 109 participants
- Where
- 11 sitesin 2 countries
- Study dates
- 16 Dec 2019to 25 Sep 2024
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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
- Male and female subjects aged ≥18
- Patients with diagnosis of locally advanced, inoperable or metastatic pancreatic cancer, eligible for first-line chemotherapy with FOLFIRINOX or gemcitabine+Abraxane®
- According to investigator life expectancy of > 4 months at screening
- Female patients must either be post-menopausal or surgically sterilized or use a highly effective method of birth control (hormonal contraceptives, intra-uterine devices, or diaphragms with spermicide) for the duration of the study and/or must have a negative pregnancy test (female patients with childbearing potential only)
- Willing and able to provide written informed consent.
- Written informed consent given prior to any trial-related procedure not part of the normal medical practice.
Who cannot join
- Patients who are members of the staff of the trial center, staff of the sponsor or CRO, the investigator him/herself or close relatives of the investigator.
- Simultaneous participation in another interventional clinical trial, participation in another trial with less than 30 days or five half-lives of the IMP (whatever is longer) to screening, or previous participation in this trial.
- Ineligible for chemotherapy treatment with FOLFIRINOX or gemcitabine+Abraxane®
- Use of dronabinol or cannabis-based medicine with THC as constituent within 6 months before screening. A urine drug test will be performed during screening phase.
- Use of marihuana within the last 4 weeks and unwillingness to abstain for the duration of the study. A urine drug test will be performed during screening phase.
- Currently receiving chemotherapy or anticipated use of chemotherapy due to any condition not related to locally advanced or metastatic pancreatic cancer
Show all 17Show fewer
- History of or existing cardiac diseases or pathological findings (e.g. chronic insufficiency NYHA III/IV, severe arrhythmia, unstable angina pectoris, myocardial infarction within the past 6 months, significant QT-prolongation etc.), which in the opinion of the investigator might interfere with the safety or tolerability of the study treatment. An ECG has to be done to exclude pathological findings and must not be older than 3 months before screening or if none is available, has to be performed during the screening phase and assessed prior to randomization
- Clinically relevant, severe pulmonary diseases, uncontrolled hypertension, or poorly controlled diabetes
- History of or existing relevant CNS and/or psychiatric disorders (e.g. schizophrenia, psychosis, manic and/or depressive disorders, suicidal ideations, etc) which might interfere with the safety or tolerability of the study treatment. Patients with reactive depression are not excluded from participation.
- Known current or past (within the last year prior to screening) alcohol, narcotics or drug abuse
- Pregnancy or breast feeding
- Known allergy to cannabinoids and other constituents of the investigational medicinal product
- Intake of prohibited concomitant medication
- Any other substantial medical condition that in the opinion of the investigator could create undue risk to the subject or could affect adherence with the trial protocol
- Legal incapacity, limited legal capacity or any other condition which makes the subject unable to understand the subject information and informed consent form (ICF)
- Patients unable or unwilling to waive driving motor vehicles or using machines especially during titration period
- Unable or unwilling to comply with the protocol regulations
Trial locations and contacts
11 sites in 2 countries.
11 sites in 2 countries
Austria8 sites
KABEG-Klinikum Klagenfurt am Woerthersee, Abteilung f. Anaesthesie u. Intensivmedizin
Klagenfurt, 9020
LKH Hochsteiermark - Standort Leoben Abteilung für Innere Medizin und Hämatologie und internistische Onkologie
Leoben, 8700
IIIrd Medical Department, Private Medical University Hospital Salzburg
Salzburg, State of Salzburg, 5020
Krankenhaus d. Barmherzigen Brüder, Abt. f. Innere Medizin
Sankt Veit an der Glan, 9300
Pyhrn-Eisenwurzen Klinikum Steyr, Interne Medizin II
Steyr, A-4400
Hanusch Krankenhaus der Wiener Gebietskrankenkasse
Vienna, State of Vienna, 1140
Klinikum Wels-Grieskirchen GmbH, Abteilung für Innere Medizin IV
Wels, Upper Austria, 4600
KH Zams, Innere Medizin, Internistische Onkologie u. Haematologie
Zams, 6511
Germany3 sites
Universitätsmedizin Göttingen Abt. f. Gastroenterologie, gastrointestinale Onkologie u. Endokrinologie
Göttingen, 37075
München Klinik Neuperlach
München, 81737
Marienhospital Onkologie, Hämatologie, Palliativmedizin
Stuttgart, 07199
About this study
Official title: Multicenter, Randomized, Double-blind, Placebo-controlled, Phase III Clinical Trial to Investigate the Efficacy and Safety of Dronabinol in the Improvement of ChemOthErapy-induced and Tumor-Related Symptoms in Patients With Locally Advanced or Metastatic Pancreatic Cancer During First-line Chemotherapy (DIsCOvER)
Aim of this phase III trial is to investigate the efficacy and safety of dronabinol (orally administered tetrahydrocannabinol (THC)) as adjuvant therapy to first-line standard chemotherapy in patients with metastatic pancreatic cancer for improvement of chemotherapy- and tumor-related symptoms applicated by individual titration up to the maximum tolerated dose.
Read the detailed description
Patients with pancreatic cancer suffer from multiple symptoms related to the tumor itself or induced by the chemotherapy. The available supportive therapy is still not able to relief all symptoms that are caused by the malignancy itself as well as by the antineoplastic therapy.
Additionally, anorexia and weight loss, that often result in increased morbidity and mortality in this patient population as well as in psycho-social burden and suffering in patients and their relatives, are unmet needs in pancreatic cancer patients.
Therapeutic approaches focus on treating the malignancy itself, additional nutritional support and physical examination might prevent patients from further side effects such as sarcopenia.
During the last decades a number of appetite-modulating drugs have been under clinical investigation. A number of studies focused on the endocannabinoid system, which is involved amongst others in appetite-modulating, antiemetic, analgesic and anti-inflammatory processes.
As dronabinol is already used as magistral formulation, its beneficial effect has often been observed in these patients in the clinical routine, especially in patients with therapy-refractory nausea and emesis. Due to its broad efficacy it might be of benefit for patients suffering from malignancy. Thus, investigators want to evaluate the efficacy of dronabinol in the improvement of chemotherapy-induced and tumor-related symptoms in advanced pancreatic patients during systemic first-line chemotherapy. However, data on optimal dosage are conflicting yet.
In detail, investigators want to study whether dronabinol has a positive influence on quality of life and whether symptoms caused by the tumor or by the chemotherapy itself might be palliated by dronabinol. Beneficial and potential harmful side effects and the personal perception of advanced pancreatic cancer patients will be documented.
- Conditions
- Pancreatic Cancer Non-resectable, Chemotherapy-induced Nausea and Vomiting, Pancreatic Cancer Metastatic
- Being tested
- Dronabinol in Oral Dosage Form, Placebo in Oral Dosage Form
- Keywords
- Dronabinol, THC, Placebo, Pancreatic Cancer, Chemotherapy-induced Nausea and Vomiting, Tumor related symptoms, Quality of life, EORTC QLQ-C30, FOLFIRINOX, Abraxane, Gemcitabine
- Medical subject headings
- Vomiting, Pancreatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dronabinol in Oral Dosage FormDrug
Also called BX-1
Titration period for 4 weeks: titration according to tolerability from 2.5 mg (3 x 1 droplet) up to 30 mg (3 x 12 droplets) per day; dose increased by 2.5 mg (3 x 1 droplet) every other day Maintenance period for 12 weeks: individually tolerated maximum dose (up to 30 mg ≙ 3 x 12 droplets) at end of titration period will be continued for maintenance treatment Tapering period for 2 weeks: dose is decreased every other day by 5 mg (3 x 2 droplets) Safety follow-up: 4 weeks after end of treatment
Placebo in Oral Dosage FormDrug
Titration period for 4 weeks: titration according to tolerability from 3 x 1 droplet up to 3 x 12 droplets per day; dose increased by 3 x 1 droplet every other day Maintenance period for 12 weeks: individually tolerated maximum dose (up to 3 x 12 droplets) at end of titration period will be continued for maintenance treatment Tapering period for 2 weeks: dose is decreased every other day by 3 x 2 droplets Safety follow-up: 4 weeks after end of treatment
| Study group | Role | What they receive |
|---|---|---|
| Dronabinol | Active comparator | BX-1 contains 25 mg dronabinol/ml (2.5% delta-9-trans-tetrahydrocannabinol = THC), oral solution; three applications per day from 2.5 mg (3 x 1 droplet) up to 30 mg (3 x 12 droplets) Receives: Drug: Dronabinol in Oral Dosage Form |
| Placebo | Placebo comparator | Placebo: oral solution with cannabis flavor without active substance and otherwise identical to active comparator, three applications per day from 3 x 1 droplet up to 3 x 12 droplets Receives: Drug: Placebo in Oral Dosage Form |
What is being measured
The primary outcome is the main question the study is designed to answer.
Standardized area under the curve of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score over the on-treatment period.
The EORTC-QLQ-C30 is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials.
The validated QLQ-C30 summary score is calculated as mean score of the 13 of the 15 EORTC QLQ-C30 scales (v3.0), based on 27 of 30 items (the Financial Impact scale and Quality of Life score are not included). A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems. A high score for a functional scale (physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning) represents a high / healthy level of functioning. Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points.
A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Measured: Prior to treatment start until end of 16 weeks maintenance treatment
Secondary outcomes (23)
Standardized area under the curve of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score over the maintenance period
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials.
The validated QLQ-C30 summary score is calculated as mean score of items. A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems.
Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Measured: After 4 weeks of treatment until week 16
Change of European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score from baseline to summary score over the maintenance period
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials.
The validated QLQ-C30 summary score is calculated as mean score of items. A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems.
Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Measured: From treatment start until week 16
Symptom scales of European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems.
Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Measured: At baseline and 2-weekly until end of treatment at week 18
Global quality of life of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials.
The validated QLQ-C30 summary score is calculated as mean score of items. A high score for the global health status (overall health during the past week) and global QoL (overall quality of life during the past week) represents a high QoL.
Scores: 1 - 7, 1 = very poor and 7 = excellent. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Measured: At baseline and 2-weekly until end of treatment at week 18
Functional scales of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials. A high score for a functional scale (physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning) represents a high / healthy level of functioning.
Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points.
A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Measured: At baseline and 2-weekly until end of treatment at week 18
Mean change from baseline of the Glasgow Prognostic Score
Change of serum levels of the score-defining biomarkers C-reactive protein (CRP) and albumin. Prognostic scores; 0 (CRP ≥ 10 mg/l), 1 (CRP > 10 mg/l and albumin ≥ 35 g/l), 2 CRP > 10 mg/l and albumin < 35g/l). Score 0 indicates good prognosis, score 1 intermediate prognosis and score 2 poor prognosis.
Measured: At baseline and at end of treatment at week 16
Amount of concomitant medication taken
Special focus on antiemetic, psychotropic and pain medication
Measured: From baseline until end of treatment at week 18
Mean time to critical weight-loss (5%)
Assessed with a standard scale
Measured: From baseline until end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Lean body mass (LBM)
Mean change of Lean body mass (LBM = Fat free mass FFM) kg
Measured: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Total body water (TBW)
Mean change of Total body water (TBW) kg
Measured: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Fat mass (FM)
Mean change of Fat mass (FM) kg
Measured: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Body cell mass (BCM)
Mean change of Body cell mass (BCM) kg
Measured: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Extracellular mass (EM)
Mean change of Extracellular mass (ECM) kg
Measured: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Phase angle (PA)
Mean change of Phase angle (PA); Phase Angle has long been linked to nutritional status. This marker is fast becoming recognised as a global health marker in total body health assessment. A higher Phase Angle could mean an increase in muscle mass (body cell mass) or a decrease in fluid, either from recovery from infection or injury (a good thing!) or a decrease in fluid from dehydration (a bad thing!). A loss of fat could also increase Phase Angle.
A lower Phase Angle could mean a loss of muscle mass (a bad thing), or an increase of fluid (rehydrating which is a good thing, or sign of inflammation or infection - a bad thing), or gaining fat (which could be a good or bad thing depending on your state of health).
Phase Angle is a direct measurement, (not a calculation using equations) of the cell membrane.
Measured: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Resistance (Rz)
Mean change of Resistance (Rz), unit ohm; the resistance reflects the water or fluid in the body
Measured: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Reactance(Xc)
Mean change of Reactance (Xc), unit ohm; reactance reflects the body cell mass.
Measured: At baseline and at end of treatment at week 16
Mean change from baseline of muscle strength
To assess physical strength of patient's handgrip strength will be measured prior and after study treatment using a hydraulic hand dynamometer; mean value of three consecutive measurements will be documented
Measured: At baseline and at end of treatment at week 16
Proportion of patients not adhering to individual baseline chemotherapy regimen
Percentage of patients who do not receive full dose of planned chemotherapy regimen and/or within scheduled time frame (interruption or delay)
Measured: From baseline until end of treatment at week 18
Chemotherapeutic dose intensity over the treatment period of 18 weeks
The total amount of applied chemotherapy over the study treatment phase is documented
Measured: From baseline until end of treatment at week 18
Frequency and severity of (serious) adverse events (S)AE
Assessed with Common Terminology Criteria for Adverse Events (NCI-CTCAE V5.0)
Measured: From baseline until safety visit at week 22
Incidence of adverse drug reactions (ARs)
Frequency and severity of ARs
Measured: From baseline until safety visit at week 22
Progression-free survival (PFS)
PFS in months; ; patients will be asked to agree on collection of data regarding PFS also after end of trial
Measured: From treatment start until the date of first documented progression or death from any cause assessed up to week 22
Overall survival (OS)
OS in months; ; patients will be asked to agree on collection of data regarding PFS also after end of trial
Measured: From treatment start until death from any cause assessed up to week 22
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jun 2019
- Study start16 Dec 2019
- Primary completion25 Sep 2024
- Study completion25 Sep 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Pancreatic Cancer Non-resectableStudies 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 109 participants (actual)
Sponsor and investigators
- Lead sponsor
- Arbeitsgemeinschaft medikamentoese Tumortherapie
- Sponsor type
- University, hospital or other
- Collaborators
- Medical University of Graz, Unidata Geodesign, Bionorica SE
- Responsible party
- Sponsor
- Investigators
- Felix Keil, Prof.MD, Principal investigator, Med. Dept. III, Hematolog and Oncology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03984214
- Sponsor's protocol ID
- AGMT_DISCOVER
- Status last verified
- Sep 2024
- First submitted
- 28 May 2019
- Last updated
- 10 Apr 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
van Amerongen G, Kanhai K, Baakman AC, Heuberger J, Klaassen E, Beumer TL, Strijers RLM, Killestein J, van Gerven J, Cohen A, Groeneveld GJ. Effects on Spasticity and Neuropathic Pain of an Oral Formulation of Delta9-tetrahydrocannabinol in Patients WithProgressive Multiple Sclerosis. Clin Ther. 2018 Sep;40(9):1467-1482. doi: 10.1016/j.clinthera.2017.01.016. Epub 2017 Feb 9.
PubMed 28189366Davis MP. Cannabinoids for Symptom Management and Cancer Therapy: The Evidence. J Natl Compr Canc Netw. 2016 Jul;14(7):915-22. doi: 10.6004/jnccn.2016.0094.
PubMed 27407130Cannabis-In-Cachexia-Study-Group; Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T. Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol. 2006 Jul 20;24(21):3394-400. doi: 10.1200/JCO.2005.05.1847.
PubMed 16849753Turgeman I, Bar-Sela G. Cannabis Use in Palliative Oncology: A Review of the Evidence for Popular Indications. Isr Med Assoc J. 2017 Feb;19(2):85-88.
PubMed 28457056Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, Pundaleeka S, Kardinal CG, Fitch TR, Krook JE, Novotny PJ, Christensen B. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol. 2002 Jan 15;20(2):567-73. doi: 10.1200/JCO.2002.20.2.567.
PubMed 11786587
Study at a glance
From the registry record, last updated by the sponsor on 10 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Multicenter, Randomized, Double-blind, Placebo-controlled, Phase III Clinical Trial to Investigate the Efficacy and Safety of Dronabinol in the Improvement of ChemOthErapy-induced and Tumor-Related Symptoms in Patients With Locally Advanced or Metastatic Pancreatic Cancer During First-line Chemotherapy (DIsCOvER)
- ClinicalTrials.gov ID
- NCT03984214
- Acronym / sponsor ID
- AGMT_DISCOVER
- Conditions
- Pancreatic Cancer Non-resectable, Chemotherapy-induced Nausea and Vomiting, Pancreatic Cancer Metastatic
- Keywords
- Dronabinol, THC, Placebo, Pancreatic Cancer, Chemotherapy-induced Nausea and Vomiting, Tumor related symptoms, Quality of life, EORTC QLQ-C30
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 109 participants (actual)
- Lead sponsor
- Arbeitsgemeinschaft medikamentoese TumortherapieUniversity, hospital or other
- Collaborators
- Medical University of Graz, Unidata Geodesign, Bionorica SE
- Study start
- 16 Dec 2019 (actual)
- Primary completion
- 25 Sep 2024 (actual)
- Study completion
- 25 Sep 2024 (actual)
- First posted
- 12 Jun 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Aim of this phase III trial is to investigate the efficacy and safety of dronabinol (orally administered tetrahydrocannabinol (THC)) as adjuvant therapy to first-line standard chemotherapy in patients with metastatic pancreatic cancer for improvement of chemotherapy- and tumor-related symptoms applicated by individual titration up to the maximum tolerated dose.
Detailed description
Patients with pancreatic cancer suffer from multiple symptoms related to the tumor itself or induced by the chemotherapy. The available supportive therapy is still not able to relief all symptoms that are caused by the malignancy itself as well as by the antineoplastic therapy.
Additionally, anorexia and weight loss, that often result in increased morbidity and mortality in this patient population as well as in psycho-social burden and suffering in patients and their relatives, are unmet needs in pancreatic cancer patients.
Therapeutic approaches focus on treating the malignancy itself, additional nutritional support and physical examination might prevent patients from further side effects such as sarcopenia.
During the last decades a number of appetite-modulating drugs have been under clinical investigation. A number of studies focused on the endocannabinoid system, which is involved amongst others in appetite-modulating, antiemetic, analgesic and anti-inflammatory processes.
As dronabinol is already used as magistral formulation, its beneficial effect has often been observed in these patients in the clinical routine, especially in patients with therapy-refractory nausea and emesis. Due to its broad efficacy it might be of benefit for patients suffering from malignancy. Thus, investigators want to evaluate the efficacy of dronabinol in the improvement of chemotherapy-induced and tumor-related symptoms in advanced pancreatic patients during systemic first-line chemotherapy. However, data on optimal dosage are conflicting yet.
In detail, investigators want to study whether dronabinol has a positive influence on quality of life and whether symptoms caused by the tumor or by the chemotherapy itself might be palliated by dronabinol. Beneficial and potential harmful side effects and the personal perception of advanced pancreatic cancer patients will be documented.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Dronabinol | Active comparator | Drug: Dronabinol in Oral Dosage FormBX-1 contains 25 mg dronabinol/ml (2.5% delta-9-trans-tetrahydrocannabinol = THC), oral solution; three applications per day from 2.5 mg (3 x 1 droplet) up to 30 mg (3 x 12 droplets) |
| Placebo | Placebo comparator | Drug: Placebo in Oral Dosage FormPlacebo: oral solution with cannabis flavor without active substance and otherwise identical to active comparator, three applications per day from 3 x 1 droplet up to 3 x 12 droplets |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Male and female subjects aged ≥18
- Patients with diagnosis of locally advanced, inoperable or metastatic pancreatic cancer, eligible for first-line chemotherapy with FOLFIRINOX or gemcitabine+Abraxane®
- According to investigator life expectancy of > 4 months at screening
- Female patients must either be post-menopausal or surgically sterilized or use a highly effective method of birth control (hormonal contraceptives, intra-uterine devices, or diaphragms with spermicide) for the duration of the study and/or must have a negative pregnancy test (female patients with childbearing potential only)
- Willing and able to provide written informed consent.
Key exclusion criteria (17 listed)
- Patients who are members of the staff of the trial center, staff of the sponsor or CRO, the investigator him/herself or close relatives of the investigator.
- Simultaneous participation in another interventional clinical trial, participation in another trial with less than 30 days or five half-lives of the IMP (whatever is longer) to screening, or previous participation in this trial.
- Ineligible for chemotherapy treatment with FOLFIRINOX or gemcitabine+Abraxane®
- Use of dronabinol or cannabis-based medicine with THC as constituent within 6 months before screening. A urine drug test will be performed during screening phase.
- Use of marihuana within the last 4 weeks and unwillingness to abstain for the duration of the study. A urine drug test will be performed during screening phase.
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 |
|---|---|---|
| Dronabinol in Oral Dosage FormAlso: BX-1Titration period for 4 weeks: titration according to tolerability from 2.5 mg (3 x 1 droplet) up to 30 mg (3 x 12 droplets) per day; dose increased by 2.5 mg (3 x 1 droplet) every other day Maintenance period for 12 weeks: individually tolerated maximum dose (up to 30 mg ≙ 3 x 12 droplets) at end of titration period will be continued for maintenance treatment Tapering period for 2 weeks: dose is decreased every other day by 5 mg (3 x 2 droplets) Safety follow-up: 4 weeks after end of treatment | Drug | Dronabinol |
| Placebo in Oral Dosage FormTitration period for 4 weeks: titration according to tolerability from 3 x 1 droplet up to 3 x 12 droplets per day; dose increased by 3 x 1 droplet every other day Maintenance period for 12 weeks: individually tolerated maximum dose (up to 3 x 12 droplets) at end of titration period will be continued for maintenance treatment Tapering period for 2 weeks: dose is decreased every other day by 3 x 2 droplets Safety follow-up: 4 weeks after end of treatment | Drug | Placebo |
Primary outcome
Standardized area under the curve of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score over the on-treatment period.
Time frame: Prior to treatment start until end of 16 weeks maintenance treatment
The EORTC-QLQ-C30 is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials. The validated QLQ-C30 summary score is calculated as mean score of the 13 of the 15 EORTC QLQ-C30 scales (v3.0), based on 27 of 30 items (the Financial Impact scale and Quality of Life score are not included). A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems. A high score for a functional scale (physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning) represents a high / healthy level of functioning. Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
23 secondary outcomes
Standardized area under the curve of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score over the maintenance period
Time frame: After 4 weeks of treatment until week 16
Change of European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score from baseline to summary score over the maintenance period
Time frame: From treatment start until week 16
Symptom scales of European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
Time frame: At baseline and 2-weekly until end of treatment at week 18
Global quality of life of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
Time frame: At baseline and 2-weekly until end of treatment at week 18
Functional scales of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
Time frame: At baseline and 2-weekly until end of treatment at week 18
Mean change from baseline of the Glasgow Prognostic Score
Time frame: At baseline and at end of treatment at week 16
Amount of concomitant medication taken
Time frame: From baseline until end of treatment at week 18
Mean time to critical weight-loss (5%)
Time frame: From baseline until end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Lean body mass (LBM)
Time frame: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Total body water (TBW)
Time frame: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Fat mass (FM)
Time frame: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Body cell mass (BCM)
Time frame: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Extracellular mass (EM)
Time frame: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Phase angle (PA)
Time frame: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Resistance (Rz)
Time frame: At baseline and at end of treatment at week 16
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Reactance(Xc)
Time frame: At baseline and at end of treatment at week 16
Mean change from baseline of muscle strength
Time frame: At baseline and at end of treatment at week 16
Proportion of patients not adhering to individual baseline chemotherapy regimen
Time frame: From baseline until end of treatment at week 18
Chemotherapeutic dose intensity over the treatment period of 18 weeks
Time frame: From baseline until end of treatment at week 18
Frequency and severity of (serious) adverse events (S)AE
Time frame: From baseline until safety visit at week 22
Incidence of adverse drug reactions (ARs)
Time frame: From baseline until safety visit at week 22
Progression-free survival (PFS)
Time frame: From treatment start until the date of first documented progression or death from any cause assessed up to week 22
Overall survival (OS)
Time frame: From treatment start until death from any cause assessed up to week 22
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Apr 2025.
- Background: PubMed 28189366van Amerongen G, Kanhai K, Baakman AC, Heuberger J, Klaassen E, Beumer TL, Strijers RLM, Killestein J, van Gerven J, Cohen A, Groeneveld GJ. Effects on Spasticity and Neuropathic Pain of an Oral Formulation of Delta9-tetrahydrocannabinol in Patients WithProgressive Multiple Sclerosis. Clin Ther. 2018 Sep;40(9):1467-1482. doi: 10.1016/j.clinthera.2017.01.016. Epub 2017 Feb 9.
- Background: PubMed 27407130Davis MP. Cannabinoids for Symptom Management and Cancer Therapy: The Evidence. J Natl Compr Canc Netw. 2016 Jul;14(7):915-22. doi: 10.6004/jnccn.2016.0094.
- Background: PubMed 16849753Cannabis-In-Cachexia-Study-Group; Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T. Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol. 2006 Jul 20;24(21):3394-400. doi: 10.1200/JCO.2005.05.1847.
- Background: PubMed 28457056Turgeman I, Bar-Sela G. Cannabis Use in Palliative Oncology: A Review of the Evidence for Popular Indications. Isr Med Assoc J. 2017 Feb;19(2):85-88.
- Background: PubMed 11786587Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, Pundaleeka S, Kardinal CG, Fitch TR, Krook JE, Novotny PJ, Christensen B. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol. 2002 Jan 15;20(2):567-73. doi: 10.1200/JCO.2002.20.2.567.
- SponsorLink provided by the sponsor.
- Individual participant dataSharing planned: No
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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.
Felix Keil, Prof.MD principal investigator
Med. Dept. III, Hematolog and Oncology
11 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Dronabinol in Oral Dosage Form in people with Pancreatic Cancer Non-resectable and Chemotherapy-induced Nausea and Vomiting, run by Arbeitsgemeinschaft medikamentoese Tumortherapie at 11 sites in 2 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 6 inclusion and 17 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: finished, as of the sponsor's last update on 10 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 11 sites in Austria, Germany. 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. Some participants in this study may receive a placebo. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Standardized area under the curve of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score over the on-treatment period. (time frame: Prior to treatment start until end of 16 weeks maintenance treatment). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03984214, which also lists 5 linked publications.
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 10 Apr 2025.