Anti-Nausea Medications for Preventing Kidney Damage

Not currently recruiting at 1 trial location
CO
MJ
Overseen ByMelanie Joy, PharmD, PhD
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: University of Colorado, Denver
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if anti-nausea medicines can prevent kidney damage in individuals treated with cisplatin, a common chemotherapy drug. Researchers seek to understand how these medications, along with individual genetic differences, influence cisplatin's effects on the kidneys. Participants will receive one of three anti-nausea drugs: Granisetron, Ondansetron (Zofran), or Palonosetron (Aloxi). This trial may be suitable for those undergoing cisplatin treatment who have not had kidney cancer or recent exposure to certain other treatments. As a Phase 3 trial, it represents the final step before FDA approval, offering an opportunity to contribute to research that could lead to new treatment options.

Do I need to stop my current medications for the trial?

The trial does not specify if you need to stop your current medications, but it requires no changes in chronic medications within 2 weeks before starting. This suggests you should maintain your current medication regimen without changes.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

In earlier studies, palonosetron has shown promise in reducing kidney damage caused by the chemotherapy drug cisplatin. One study found that patients who took palonosetron had a lower risk of kidney injury from cisplatin, suggesting it might help protect the kidneys.

Conversely, research suggests that ondansetron may increase the risk of kidney problems when used with cisplatin. Some animal studies showed that ondansetron might worsen kidney damage by affecting how the body handles cisplatin.

For granisetron, the evidence is less clear, but there is some concern. Studies have suggested that using drugs like granisetron could increase the risk of kidney damage with cisplatin.

Overall, palonosetron appears to be the safest option among these treatments based on current evidence. However, more research is needed to fully understand the risks and benefits of each medication.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments—granisetron, ondansetron, and palonosetron—because they could change the way we prevent kidney damage during chemotherapy with cisplatin. Unlike standard anti-nausea treatments, which primarily focus on reducing vomiting and queasiness, these drugs are being explored for their potential to minimize the toxic effects of cisplatin on the kidneys. Granisetron, ondansetron, and palonosetron are known for their ability to block serotonin receptors, which is a new angle in preventing kidney damage compared to current options. This innovative approach could lead to better outcomes for patients undergoing chemotherapy, making treatment both safer and more effective.

What evidence suggests that this trial's anti-nausea medications could be effective in preventing kidney damage?

This trial will compare the effects of different anti-nausea medications on kidney health in patients receiving cisplatin. Research has shown that palonosetron, one of the treatments in this trial, might protect kidneys from damage caused by cisplatin, a chemotherapy drug known for harming kidneys. Specifically, studies have found that palonosetron reduces cisplatin's harmful effects on the kidneys, possibly making it a safer option for those receiving this treatment. In contrast, ondansetron, another treatment option in this trial, increases the risk of kidney damage when used with cisplatin, as it causes more of the drug to accumulate in the kidneys. Granisetron, also being tested in this trial, controls nausea from chemotherapy, but evidence about its effects on kidney health is less clear. Overall, palonosetron seems to offer protective benefits, unlike ondansetron, which might increase kidney risk.23678

Who Is on the Research Team?

EJ

Edgar Jaimes, MD

Principal Investigator

Memorial Sloan Kettering Cancer Center

MJ

Melanie Joy, PharmD, PhD

Principal Investigator

University of Colorado, Denver

Are You a Good Fit for This Trial?

This trial is for adults aged 18-80 who are prescribed cisplatin for treatment and have healthy kidneys (eGFR > 60 ml/min^2) and liver. Participants should not be pregnant, breastfeeding, or have a history of heavy alcohol use. They must avoid grapefruit juice, alcohol, certain medications, and herbal supplements before the trial.

Inclusion Criteria

I am prescribed cisplatin at a dose higher than 25 mg/m^2.
No history of alcohol consumption of >14 drinks/week
Not pregnant or lactating
See 7 more

Exclusion Criteria

I have a severe stomach or bowel condition causing fluid loss.
I am not taking drugs like metformin or antivirals that affect drug transport in the body.
I have been diagnosed with kidney cancer.
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive cisplatin and are evaluated for kidney toxicity with antiemetic regimens

3 days
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Granisetron
  • Ondansetron
  • Palonosetron
Trial Overview The study tests if nausea drugs like Palonosetron, Granisetron, Ondansetron affect kidney damage from cisplatin therapy. It also examines how cisplatin levels in the body and genetic factors contribute to kidney injury risk.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Group I: PalonosetronExperimental Treatment1 Intervention
Group II: OndansetronExperimental Treatment1 Intervention
Group III: GranisetronExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials
1,842
Recruited
3,028,000+

National Institute of General Medical Sciences (NIGMS)

Collaborator

Trials
315
Recruited
251,000+

Memorial Sloan Kettering Cancer Center

Collaborator

Trials
1,998
Recruited
602,000+

Rutgers University

Collaborator

Trials
127
Recruited
2,814,000+

Published Research Related to This Trial

In a study of 1,085 chemotherapy-naive patients, a single oral dose of granisetron (2 mg) provided equivalent antiemetic control compared to intravenous ondansetron (32 mg) during the first 48 hours after chemotherapy.
Both medications were well tolerated, but ondansetron was associated with a higher incidence of dizziness and abnormal vision, suggesting that granisetron may be a safer option for some patients.
Comparison of single-dose oral granisetron versus intravenous ondansetron in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy: a multicenter, double-blind, randomized parallel study.Perez, EA., Hesketh, P., Sandbach, J., et al.[2022]
In a study of 97 pediatric outpatients, a dose of 40 micrograms.kg-1 of granisetron significantly reduced the incidence and frequency of postoperative nausea and vomiting (PONV) compared to a placebo and a lower dose of 10 micrograms.kg-1.
While effective, administering the higher dose of granisetron to prevent PONV in high-risk patients would incur an additional cost of approximately $99 to $101 per patient, indicating a trade-off between efficacy and financial impact.
The dose-response relation and cost-effectiveness of granisetron for the prophylaxis of pediatric postoperative emesis.Cieslak, GD., Watcha, MF., Phillips, MB., et al.[2019]
In a study involving 987 chemotherapy-naive patients receiving cisplatin, single doses of granisetron (10 or 40 micrograms/kg) were found to be as effective as three doses of ondansetron (0.15 mg/kg) in preventing chemotherapy-induced nausea and vomiting.
All treatment regimens were well-tolerated, indicating that both granisetron and ondansetron are safe options for managing emesis in patients undergoing chemotherapy.
Comparative clinical trial of granisetron and ondansetron in the prophylaxis of cisplatin-induced emesis. The Granisetron Study Group.Navari, R., Gandara, D., Hesketh, P., et al.[2017]

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/33982438/
Effects of 5-HT ₃ receptor antagonists on cisplatin-induced ...The aim of this study was to investigate the effects of 5-HT 3 receptor antagonists in a mouse model of cisplatin-induced kidney injury.
Evaluation of Cisplatin-Induced Acute Kidney Injury in ...Nephrotoxicity is a well-known side effect of cisplatin, accounting for up to 30% of kidney injury in hospitalized patients with cancer. The emetogenic nature ...
Journal of the American Society of NephrologyCisplatin is a platinum-based chemotherapeutic drug that causes acute kidney injury (AKI), as assessed by serum creatinine (SCr) in over 30% of patients.
Cisplatin-Induced Renal Failure Measured by Glomerular ...Conclusions: Cisplatin significantly affects renal function, as evidenced by a decrease in GFR measured with DTPA. The findings underscore the importance of the ...
(PDF) Evaluation of Cisplatin-Induced Acute Kidney Injury ...Cisplatin is highly emetogenic and resulting volume depletion can contribute to acute kidney injury (AKI). Anti-emetic drugs such as 5-hydroxytryptamine type 3 ...
Effects of 5‐HT₃ receptor antagonists on cisplatin‐ ...The results suggest that the concomitant use of first‐generation 5‐HT₃ receptor antagonists may be a risk factor for cisplatin‐induced renal damage. However, ...
A Pharmacokinetic/Toxicodynamic Model of Cisplatin ...Cisplatin is a platinum-based chemotherapeutic that causes acute kidney injury in over 30% of patients. The aim of this study was to develop ...
Nephrotoxicity Evaluation in Outpatients Treated with ...Study evaluates cisplatin-induced nephrotoxicity in outpatients receiving chemotherapy. Renal parameters and electrolyte levels should be monitored before ...
Unbiased ResultsWe believe in providing patients with all the options.
Your Data Stays Your DataWe only share your information with the clinical trials you're trying to access.
Verified Trials OnlyAll of our trials are run by licensed doctors, researchers, and healthcare companies.
Terms of Service·Privacy Policy·Cookies·Security