评估口服阿瑞匹坦联合昂丹司琼在乳腺癌抗体偶联药物治疗中应用的真实世界研究

注册号:

Registration number:

ChiCTR2500109080 

最近更新日期:

Date of Last Refreshed on:

2025-09-11 10:45:20 

注册时间:

Date of Registration:

2025-09-11 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

评估口服阿瑞匹坦联合昂丹司琼在乳腺癌抗体偶联药物治疗中应用的真实世界研究

Public title:

A real-world study on the application of oral aprepitant combined with ondansetron in the treatment of breast cancer antibody-drug conjugates

注册题目简写:

English Acronym:

研究课题的正式科学名称:

评估口服阿瑞匹坦联合昂丹司琼在乳腺癌抗体偶联药物治疗中应用的真实世界研究

Scientific title:

A real-world study on the application of oral aprepitant combined with ondansetron in the treatment of breast cancer antibody-drug conjugates

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

蒋雷 

研究负责人:

蒋雷 

Applicant:

Jiang Lei 

Study leader:

Jiang Lei 

申请注册联系人电话:

Applicant telephone:

+86 138 8912 8372

研究负责人电话:

Study leader's
telephone:

+86 138 8912 8372

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

lovelongmao@163.com

研究负责人电子邮件:

Study leader's E-mail:

lovelongmao@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

沈阳市大东区小河沿路44号

研究负责人通讯地址:

沈阳市大东区小河沿路44号

Applicant address:

No. 44 Xiaoheyan Road, Shenyang, Liaoning, China.

Study leader's address:

No. 44 Xiaoheyan Road, Shenyang, Liaoning, China.

申请注册联系人邮政编码:

Applicant postcode:

110042

研究负责人邮政编码:

Study leader's postcode:

110042

申请人所在单位:

辽宁省肿瘤医院

Applicant's institution:

Liaoning Cancer Hospital and Institute

研究负责人所在单位:

辽宁省肿瘤医院

Affiliation of the Leader:

Liaoning Cancer Hospital and Institute

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

KY20250825

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

辽宁省肿瘤医院伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Liaoning Provincial Cancer Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025-08-20 00:00:00

伦理委员会联系人:

李爽

Contact Name of the ethic committee:

Li Shuang

伦理委员会联系地址:

沈阳市大东区小河沿路44号

Contact Address of the ethic committee:

No. 44 Xiaoheyan Road, Shenyang, Liaoning, China.

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 24 8191 6632

伦理委员会联系人邮箱:

Contact email of the ethic committee:

szlyy315@163.com

研究实施负责(组长)单位:

辽宁省肿瘤医院

Primary sponsor:

Liaoning Cancer Hospital and Institute

研究实施负责(组长)单位地址:

辽宁省沈阳市大东区小河沿路44号

Primary sponsor's address:

No. 44 Xiaoheyan Road, Shenyang, Liaoning, China.

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

辽宁省

市(区县):

Country:

China

Province:

LiaoNing

City:

单位(医院):

辽宁省肿瘤医院

具体地址:

沈阳市大东区小河沿路44号

Institution
hospital:

Liaoning Cancer Hospital and Institute

Address:

No. 44 Xiaoheyan Road, Shenyang, Liaoning, China.

经费或物资来源:

中国医药事业卫生发展基金会

Source(s) of funding:

China Medical and Health Development Foundation

研究疾病:

乳腺癌  

Target disease:

breast cancer

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

连续入组 

Study design:

Sequential 

研究目的:

抗体药物偶联物(ADC)通过将单克隆抗体与细胞毒性药物结合,靶向肿瘤细胞并精准递送药物,实现了高效的抗肿瘤效应,目前在乳腺癌治疗临床实践中应用日益广泛,针对其不良反应的有效管理是改善患者生活质量和避免不良反应而导致停药的关键。而ADC药物相关呕吐的管理的规范和指南信息有限,更多的信息来自临床实验,缺乏真实世界研究。在2024年ASCO年会上,汇总了7项I-III期临床试验中1449例患者接受德曲妥珠单抗治疗的数据显示,大多数恶心和呕吐事件在治疗前3周内报告,大多数为NCI CTCAE 1级或2级。而ERICA研究评估了奥氮平在预防首次接受德曲妥珠单抗治疗的患者出现恶心/呕吐的有效性,显示奥氮平5mg连续使用6天与5-HT3RA和DEX联合使用,可能是减少接受ADC治疗患者延迟和持续性恶心/呕吐的有效选择。而目前包括NK1受体拮抗剂的三联方案(DEX + 5-HT3+NK1)是化疗导致高度致吐风险化疗方案的推荐方案。对于接受中度致吐风险化疗方案治疗的患者指南则推荐二联方案或三联方案。为确保患者从ADC药物治疗中最大程度获益,必须充分控制其不良反应。而恶心和呕吐在ADC药物临床试验中十分常见,并严重影响患者的生活质量和治疗依从性,最终导致临床获益的降低。因此我们开展本项真实世界的研究,从治疗开始进行预防性止吐治疗,并充分评估每例患者的恶心呕吐的完全缓解率。以及治疗期间急性恶心/呕吐及预期性恶心/呕吐的发生率,以期给予抗体偶联药物恶心呕吐不良反应控制方面的更多数据支持和选择。  

Objectives of Study:

Antibody-drug conjugates (ADCs) have achieved highly efficient anti-tumor effects by combining monoclonal antibodies with cytotoxic drugs, targeting tumor cells and precisely delivering drugs. They are increasingly widely used in the clinical practice of breast cancer treatment. Effective management of their adverse reactions is crucial for improving patients' quality of life and avoiding treatment discontinuation due to adverse reactions. However, there is limited information on the management of ADC-related vomiting in guidelines and norms, with more data coming from clinical trials rather than real-world studies. At the 2024 ASCO Annual Meeting, data from 1,449 patients treated with trastuzumab deruxtecan in 7 phase I-III clinical trials were summarized, showing that most nausea and vomiting events were reported within the first three weeks of treatment, and most were NCI CTCAE grade 1 or 2. The ERICA study evaluated the effectiveness of olanzapine in preventing nausea/vomiting in patients receiving trastuzumab deruxtecan for the first time, indicating that continuous use of 5 mg olanzapine for 6 days in combination with 5-HT3RA and DEX might be an effective option for reducing delayed and persistent nausea/vomiting in ADC-treated patients. Currently, the triple combination of DEX + 5-HT3 + NK1 receptor antagonists is recommended for highly emetogenic chemotherapy regimens, while dual or triple combinations are recommended for moderately emetogenic regimens. To ensure patients maximize the benefits of ADC treatment, adverse reactions must be fully controlled. Nausea and vomiting are very common in ADC clinical trials and significantly affect patients' quality of life and treatment compliance, ultimately reducing clinical benefits. Therefore, we conducted this real-world study to provide more data support and options for the control of nausea and vomiting adverse reactions associated with antibody-drug conjugates. Prophylactic antiemetic treatment was initiated at the start of treatment, and the complete response rate of nausea and vomiting in each patient was fully evaluated, as well as the incidence of acute and anticipatory nausea/vomiting during treatment.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1. 怀孕期或哺乳期女性; 2. 严重的肝肾功能及心功能异常患者; 3. 化疗前24h出现过呕吐的患者; 4. 对NK-1 RA和/或其辅料过敏患者; 5. 其他非肿瘤因素所致的恶心、呕吐,正在服用其他致吐性药物或酒精中毒患者;

Exclusion criteria:

1. Pregnant or lactating women; 2. Patients with severe liver, kidney and cardiac function abnormalities; 3. Patients who have experienced vomiting within 24 hours before chemotherapy; 4. Patients allergic to NK-1 RA and/or its excipients; 5. Patients with nausea and vomiting caused by non-tumor factors, who are currently taking other emetogenic drugs or are suffering from alcohol poisoning;

研究实施时间:

Study execute time:

From 2025-09-10 00:00:00 To 2026-10-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-09-11 00:00:00 To 2026-10-01 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

100

Group:

Experimental group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

辽宁 

市(区县):

沈阳 

Country:

China

Province:

Liaoning

City:

ShenYang

单位(医院):

辽宁省肿瘤医院 

单位级别:

三甲 

Institution
hospital:

Liaoning Cancer Hospital and Institute

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

治疗过程中(0-120小时),完全缓解(未出现呕吐且未接受补救治疗)的受试者比例

指标类型:

主要指标

Outcome:

During the treatment period (0 - 120 hours), the proportion of subjects who achieved complete remission (without vomiting and without receiving rescue treatment)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

急性期(0-24小时)和延迟期(25-120小时)内,完全缓解的受试者比例

指标类型:

次要指标

Outcome:

The proportion of subjects achieving complete remission during the acute phase (0 - 24 hours) and the delayed phase (25 - 120 hours);

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

治疗过程中,既往接受放疗患者的完全控制(无呕吐、无补救治疗和无轻微恶心 (VAS<25mm)) 的受试者比例;

指标类型:

次要指标

Outcome:

During the treatment process, the proportion of patients who had previously received radiotherapy and achieved complete control (without vomiting, without rescue treatment, and without mild nausea (VAS < 25mm)) among the subjects;

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

不同期限内,发生不同等级恶心/呕吐的患者比例

指标类型:

次要指标

Outcome:

The proportion of patients experiencing different levels of nausea/vomiting within different time periods

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

接受补救治疗的受试者比例

指标类型:

次要指标

Outcome:

The proportion of subjects who received remedial treatment

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

至治疗失败(根据首次呕吐发作时间或补救 治疗时间,以先发生为准)的时间

指标类型:

次要指标

Outcome:

Up to the time of treatment failure (based on the time of the first vomiting episode or the time of the remedial treatment, whichever occurs first)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

治疗前后FLIE 评分的变化

指标类型:

次要指标

Outcome:

The changes in FLIE scores before and after treatment

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

治疗前后医院焦虑和抑郁量表 (HAD) 评分变化

指标类型:

次要指标

Outcome:

Changes in the Hospital Anxiety and Depression Scale (HAD) scores before and after treatment

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

none

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

无/none

Randomization Procedure (please state who generates the random number sequence and by what method):

none

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

研究结束后6个月,经研究者同意后可邮箱获取;

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

After 6 months of the conclusion of the study, it can be obtained via email with the consent of the researcher.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-09-11 10:44:53