Efficacy and Safety of Dronabinol in the Improvement of Chemotherapy-induced and Tumor-related Symptoms in Advanced Pancreatic Cancer

Last updated: April 9, 2025
Sponsor: Arbeitsgemeinschaft medikamentoese Tumortherapie
Overall Status: Completed

Phase

3

Condition

Effects Of Chemotherapy

Colic

Vomiting

Treatment

Placebo in Oral Dosage Form

Dronabinol in Oral Dosage Form

Clinical Study ID

NCT03984214
AGMT_DISCOVER
  • Ages > 18
  • All Genders

Study 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 titration up to the maximum tolerated dose.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Male and female subjects aged ≥18

  • Patients with diagnosis of locally advanced, inoperable or metastatic pancreaticcancer, eligible for first-line chemotherapy with FOLFIRINOX orgemcitabine+Abraxane®

  • According to investigator life expectancy of > 4 months at screening

  • Female patients must either be post-menopausal or surgically sterilized or use ahighly effective method of birth control (hormonal contraceptives, intra-uterinedevices, or diaphragms with spermicide) for the duration of the study and/or musthave 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 thenormal medical practice.

Exclusion

Exclusion Criteria:

  • Patients who are members of the staff of the trial center, staff of the sponsor orCRO, the investigator him/herself or close relatives of the investigator.

  • Simultaneous participation in another interventional clinical trial, participationin another trial with less than 30 days or five half-lives of the IMP (whatever islonger) 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 monthsbefore screening. A urine drug test will be performed during screening phase.

  • Use of marihuana within the last 4 weeks and unwillingness to abstain for theduration of the study. A urine drug test will be performed during screening phase.

  • Currently receiving chemotherapy or anticipated use of chemotherapy due to anycondition not related to locally advanced or metastatic pancreatic cancer

  • History of or existing cardiac diseases or pathological findings (e.g. chronicinsufficiency NYHA III/IV, severe arrhythmia, unstable angina pectoris, myocardialinfarction within the past 6 months, significant QT-prolongation etc.), which in theopinion of the investigator might interfere with the safety or tolerability of thestudy treatment. An ECG has to be done to exclude pathological findings and must notbe older than 3 months before screening or if none is available, has to be performedduring the screening phase and assessed prior to randomization

  • Clinically relevant, severe pulmonary diseases, uncontrolled hypertension, or poorlycontrolled 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, narcoticsor drug abuse

  • Pregnancy or breast feeding

  • Known allergy to cannabinoids and other constituents of the investigationalmedicinal product

  • Intake of prohibited concomitant medication

  • Any other substantial medical condition that in the opinion of the investigatorcould create undue risk to the subject or could affect adherence with the trialprotocol

  • Legal incapacity, limited legal capacity or any other condition which makes thesubject unable to understand the subject information and informed consent form (ICF)

  • Patients unable or unwilling to waive driving motor vehicles or using machinesespecially during titration period

  • Unable or unwilling to comply with the protocol regulations

Study Design

Total Participants: 109
Treatment Group(s): 2
Primary Treatment: Placebo in Oral Dosage Form
Phase: 3
Study Start date:
December 16, 2019
Estimated Completion Date:
September 25, 2024

Study 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.

Connect with a study center

  • Klinikum Wels-Grieskirchen GmbH, Abteilung für Innere Medizin IV

    Wels, Oberösterreich 4600
    Austria

    Site Not Available

  • KABEG-Klinikum Klagenfurt am Woerthersee, Abteilung f. Anaesthesie u. Intensivmedizin

    Klagenfurt, 9020
    Austria

    Site Not Available

  • LKH Hochsteiermark - Leoben, Abt. f. Innere Medizin, Haemato-Onkologie

    Leoben, 8700
    Austria

    Active - Recruiting

  • LKH Hochsteiermark - Standort Leoben Abteilung für Innere Medizin und Hämatologie und internistische Onkologie

    Leoben, 8700
    Austria

    Site Not Available

  • IIIrd Medical Department, Private Medical University Hospital Salzburg

    Salzburg, 5020
    Austria

    Site Not Available

  • Krankenhaus d. Barmherzigen Brüder, Abt. f. Innere Medizin

    St. Veit an der Glan, 9300
    Austria

    Site Not Available

  • Pyhrn-Eisenwurzen Klinikum Steyr, Interne Medizin II

    Steyr, A-4400
    Austria

    Site Not Available

  • Hanusch Krankenhaus der Wiener Gebietskrankenkasse

    Vienna, 1140
    Austria

    Site Not Available

  • Medizinische Univ. Wien, Univ.Klinik f. Innere Medizin I, Onkologie

    Vienna, 1090
    Austria

    Site Not Available

  • KH Zams, Innere Medizin, Internistische Onkologie u. Haematologie

    Zams, 6511
    Austria

    Site Not Available

  • Universitätsmedizin Göttingen Abt. f. Gastroenterologie, gastrointestinale Onkologie u. Endokrinologie

    Göttingen, 37075
    Germany

    Site Not Available

  • München Klinik Neuperlach

    München, 81737
    Germany

    Site Not Available

  • Marienhospital Onkologie, Hämatologie, Palliativmedizin

    Stuttgart, 07199
    Germany

    Site Not Available

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