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Trial registered on ANZCTR
Registration number
ACTRN12613000058774
Ethics application status
Approved
Date submitted
7/12/2012
Date registered
16/01/2013
Date last updated
16/01/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Mitotane Therapeutic Drug Monitoring Study: Assessing Mitotane Pharmacodynamics in Adrenocortical Cancer in Children and Adults
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Scientific title
Mitotane Pharmacodynamics in Adrenocortical Cancer in Children and Adults
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Secondary ID [1]
281630
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None
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Universal Trial Number (UTN)
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Trial acronym
Mitotane TDM Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Adrenocortical cancer
287916
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Condition category
Condition code
Cancer
288292
288292
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0
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Other cancer types
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Mitotane dose adjustment based on plasma level of mitotane and metabolites, to achieve ideal mitotane plasma level (14-20 mg/L) as quickly as possible, and minimise adverse impact of overdosing. (Mitotane is administered orally daily in single or divided doses, starting at 1 or 2 g/day,and the dose required is highly variable and unpredictable). Treatment duration is at the discretion of the treating clinician.
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Intervention code [1]
286163
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Treatment: Drugs
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Comparator / control treatment
none
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To determine the relationship between plasma mitotane and metabolite levels and toxicity (as assessed clinically), and confirm the published relationship with response.
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Assessment method [1]
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Timepoint [1]
288468
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Continually from start until end of treatment period
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Secondary outcome [1]
300251
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To identify factors that account for variability in mitotane kinetics.
- we will correlate mitotane and metabolite pharmacokinetic (PK) parameters with phenotypic factors, including age, gender and body mass index. We anticipate that age, gender and body mass index will partly correlate with PK.
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Assessment method [1]
300251
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Timepoint [1]
300251
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Continually from start until end of treatment period
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Secondary outcome [2]
300252
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Assess the role of mitotane metabolites in contribution to toxicity, by correlating plasma levels with clinical assessments
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Assessment method [2]
300252
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Timepoint [2]
300252
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Continually from start until end of treatment period
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Secondary outcome [3]
300253
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To provide a precise mitotane therapeutic drug monitoring process that rapidly achieves trough levels in the range 14-20mg/L, by frequent, informed dose escalation.
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Assessment method [3]
300253
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Timepoint [3]
300253
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Continually from start until end of treatment period
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Secondary outcome [4]
300684
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To achieve Ideal plasma level as soon as possible (preferably within 4 weeks) after starting mitotane, and maintained without exceeding the ideal range
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Assessment method [4]
300684
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Timepoint [4]
300684
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Continually from start until end of treatment period
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Eligibility
Key inclusion criteria
1. Adrenocortical carcinoma, any stage.
2. Treating physician is of the opinion that Mitotane therapy is indicated for the patient
3. Normal haematological parameters
4. Normal liver function
5. Adequate renal function
6. Eastern Co-operative Oncology Group (ECOG) performance status 0-2 .
7. No other significant medical illness.
8. Geographically accessible and physically capable of completing study investigations as required.
9. Informed consent for study investigations.
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Minimum age
0
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
none
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
eligible subjects will be invited
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Pharmacokinetics / pharmacodynamics
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Statistical methods / analysis
Simple statistical tests (chi square, Pearson correlation, etc) will be used to determine the relationship between mitotane and metabolite levels and toxicity, and confirm the published relationship with response.
To identify factors that account for variability in mitotane kinetics, mitotane and metabolite pharmacokinetic parameters will be correlated with phenotypic factors, including age, gender and body mass index. A PD model for toxicity will be derived using independent variables of dose, plasma level and patient characteristics. WinNonLin, Statistica or similar non-linear modeling software will be used.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/01/2013
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Hunter Medical Research Institute
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Address [1]
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Locked bag 1000
New Lambton 2305
NSW
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Country [1]
286438
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Australia
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Primary sponsor type
Hospital
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Name
Calvary Mater Newcastle
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Address
Edith St
Waratah, 2298
NSW
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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none
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Address [1]
285224
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Country [1]
285224
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288514
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HNE Health HREC
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Ethics committee address [1]
288514
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Locked Bag 1 New Lambton, 2305 NSW
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Ethics committee country [1]
288514
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Australia
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Date submitted for ethics approval [1]
288514
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Approval date [1]
288514
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Ethics approval number [1]
288514
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Summary
Brief summary
Mitotane is the only systemic treatment available for advanced adrenocortical cancer and is toxic, with variable pharmacokinetics (variable drug metabolism between patients). This study aims to achieve ideal plasma levels of the drug quickly by adjustment of the dose based on plasma level, and maintain the plasma level within the ideal range by regular blood level monitoring and dose adjustment. We also aim to study factors that contribute to variability between patients in their metabolism of the drug, and confirm a relationship between drug level and anticancer effect. As a consequence of this study we aim to provide a high quality therapeutic drug monitoring service for clinicians and patients with this disease in Australia.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Stephen Ackland
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Address
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Medical Oncology
Calvary Mater Newcastle Hospital,
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Hunter Cancer Research Alliance
Locked Bag 7
Hunter Region Mail Centre, 2310
NSW
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Country
36446
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Australia
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Phone
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+61249211146
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Fax
36446
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Email
36446
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[email protected]
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Contact person for public queries
Name
36447
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Stephen Ackland
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Address
36447
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Medical Oncology
Calvary Mater Newcastle Hospital,
and
Hunter Cancer Research Alliance
Locked Bag 7
Hunter Region Mail Centre, 2310
NSW
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Country
36447
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Australia
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Phone
36447
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+61249211146
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Fax
36447
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Email
36447
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[email protected]
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Contact person for scientific queries
Name
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Madhu Garg
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Address
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Medical Oncology
Calvary Mater Newcastle Hospital,
and
Hunter Cancer Research Alliance
Locked Bag 7
Hunter Region Mail Centre, 2310
NSW
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Country
36448
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Australia
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Phone
36448
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+61249211150
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Fax
36448
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Email
36448
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF