Netupitant/Palonosetron Hydrochloride and Dexamethasone with or without Prochlorperazine or Olanzapine in Improving Chemotherapy-Induced Nausea and Vomiting in Patients with Breast Cancer
This randomized phase III trial studies how well netupitant/palonosetron hydrochloride and dexamethasone with or without prochlorperazine or olanzapine work in improving chemotherapy-induced nausea and vomiting in patients with breast cancer. Antiemetic drugs, such as prochlorperazine and olanzapine, may help lessen nausea and vomiting in patients with breast cancer treated with chemotherapy.
Eligibility
Inclusion Criterea
			
				- INCLUSION CRITERIA FOR PARTICIPATION IN THE CYCLE 1 PORTION OF THE STUDY
 
		 
		
			
				- Have a diagnosis of breast cancer and be chemotherapy naive; NOTE: prior methotrexate for non-cancerous conditions is allowed
 
		 
		
			
				- Be scheduled to receive a single-day chemotherapy regimen that contains doxorubicin and/or cyclophosphamide and/or carboplatin; Herceptin (trastuzumab) and other chemotherapy agents will be allowed with any of these regimens
 
		 
		
			
				- Be scheduled to receive an antiemetic regimen that does not contain Akynzeo
* For chemotherapy regimens with a high emetic risk, the antiemetic regimen must include an natural killer (NK)-1 antagonist receptor, a 5HT3 receptor antagonist and dexamethasone; other antiemetics, including additional dexamethasone and olanzapine, may also be included at cycle one
* For chemotherapy regimens with a moderate emetic risk, the antiemetic regimen must include a 5HT3 receptor antagonist and dexamethasone; other antiemetics, including additional dexamethasone and olanzapine, may also be included at cycle one
 
		 
		
			
				- Be able to read English; materials will not be provided in Spanish because validated translations of most of the study measures are not available in Spanish, and Spanish translating capacity is not available at all affiliate sites
 
		 
		
			
				- Have the ability to give written informed consent
 
		 
		
			
				- Be at least 18 years of age
 
		 
		
			
				- Be female
 
		 
		
			
				- Have Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
 
		 
		
			
				- NOTE: Because the National Comprehensive Cancer Network (NCCN) antiemetic guidelines state that olanzapine should be used with caution in elderly patients, patients 80 years of age or older must have approval from an oncologist or their designee to participate in this study
 
		 
		
			
				- NOTE: Because aprepitant can lower international normalized ratio (INR) levels if taken concurrently with warfarin, patients currently receiving warfarin must have approval from an oncologist or their designee to participate in this study.
 
		 
		
			
				- Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control, or abstinence) for the duration of the study and have a negative pregnancy test within 10 days prior to the initiation of chemotherapy; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately
 
		 
		
			
				- CYCLE II PORTION ONLY: Only participants with a nausea score >= 3 at least once on the 4-day home record from cycle 1 can be randomized for cycle 2
 
		 
		
			
				- CYCLE II PORTION ONLY: Participants must be scheduled to receive the same chemotherapy regimen as received at cycle 1
 
		 
		
			
				- CYCLE II PORTION ONLY: Because quinolone antibiotic therapy can increase the level or effect of olanzapine by altering drug metabolism and thereby potentially increase risk of side effects, patients currently receiving quinolone antibiotic therapy must have approval from an oncologist or their designee to participate in the cycle 2 portion of the study
 
		 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
	
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
			 
		
			
				
		- PARTICIPATION IN THE CYCLE I PORTION OF THE STUDY
 
		
		 
		
			
				
		- Have clinical evidence of current or impending bowel obstruction
 
		
		 
		
			
				
		- Have a known history of central nervous system disease (e.g., brain metastases or a seizure disorder)
 
		
		 
		
			
				
		- Have dementia
 
		
		 
		
			
				
		- Have uncontrolled diabetes mellitus or uncontrolled hyperglycemia
 
		
		 
		
			
				
		- Have severe hepatic impairment, severe renal impairment, or end-stage renal disease as determined by the treating physician
 
		
		 
		
			
				
		- Have had long-term treatment (> 5 days within the past 30 days) with an antipsychotic agent such as risperidone, quetiapine, clozapine, a phenothiazine, or a butyrophenone within 30 days before enrollment or plans for such treatment during the study period; Note: Participants could have received prochlorperazine and other phenothiazines as antiemetic therapy on a short term basis (i.e., =< 5 days)
 
		
		 
		
			
				
		- Have a known cardiac arrhythmia, uncontrolled congestive heart failure, or acute myocardial infarction within the previous 6 months
 
		
		 
		
			
				
		- Be taking benzodiazepines regularly (> 5 days within the past 30 days); pro re nata (PRN) use (=< 5 days) for the short-term relief of the symptoms of anxiety, anxiety associated with depressive symptoms, or as a rescue medication for breakthrough CINV is allowed
 
		
		 
		
			
				
		- Be taking anticholinergic medications
 
		
		 
		
			
				
		- Be receiving quinolone antibiotic therapy
 
		
		 
		
			
				
		- Be taking amifostine (Ethiofos)
 
		
		 
		
			
				
		- Have a known hypersensitivity to olanzapine or to phenothiazines
 
		
		 
		
			
				
		- CYCLE II PORTION ONLY: Must not have received Akynzeo at cycle 1
 
		
		 
		
			
				
		- CYCLE II PORTION ONLY: Must still meet all the exclusion criteria for cycle 1
 
		
		 
		
	
Participating Clinics
	
		
		North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
		
	 
		
		Radiation Oncology Centers of Nevada Southeast
		
	 
		
		Kingman Regional Medical Center
		
	 
		
		Hope Cancer Care of Nevada
		
	 
		
		Comprehensive Cancer Centers of Nevada-Southeast Henderson
		
	 
		
		Las Vegas Cancer Center-Henderson
		
	 
		
		GenesisCare USA - Henderson
		
	 
		
		GenesisCare USA - Las Vegas
		
	 
		
		HealthCare Partners Medical Group Oncology/Hematology-Tenaya
		
	 
		
		Comprehensive Cancer Centers of Nevada - Henderson
		
	 
		
		Carson Tahoe Regional Medical Center
		
	 
		
		Comprehensive Cancer Centers of Nevada - Northwest
		
	 
		
		Radiation Oncology Centers of Nevada Central
		
	 
		
		Cancer Therapy and Integrative Medicine
		
	 
		
		Radiation Oncology Associates
		
	 
		
		Comprehensive Cancer Centers of Nevada
		
	 
		
		Alliance for Childhood Diseases/Cure 4 the Kids Foundation
		
	 
		
		Cancer and Blood Specialists-Henderson
		
	 
		
		Comprehensive Cancer Centers of Nevada - Central Valley
		
	 
		
		HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
		
	 
		
		University Medical Center of Southern Nevada
		
	 
		
		Saint Mary's Regional Medical Center
		
	 
		
		Renown Regional Medical Center
		
	 
		
		OptumCare Cancer Care at MountainView
		
	 
		
		Sunrise Hospital and Medical Center
		
	 
		
		OptumCare Cancer Care at Charleston
		
	 
		
		Comprehensive Cancer Centers of Nevada-Horizon Ridge
		
	 
		
		
		
		Hope Cancer Care of Nevada-Pahrump
		
	 
		
		OptumCare Cancer Care at Seven Hills
		
	 
		
		Comprehensive Cancer Centers of Nevada - Town Center
		
	 
		
		
		Lake Huron Medical Center
		
	 
		
		Las Vegas Cancer Center-Medical Center
		
	 
		
		GenesisCare USA - Fort Apache
		
	 
		
		GenesisCare USA - Vegas Tenaya
		
	 
		
		Cancer and Blood Specialists-Shadow
		
	 
		
		OptumCare Cancer Care at Fort Apache
		
	 
		
		HealthCare Partners Medical Group Oncology/Hematology-San Martin
		
	 
		
		HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
		
	 
		
		Comprehensive Cancer Centers of Nevada-Summerlin
		
	 
		
		Cancer and Blood Specialists-Tenaya
		
	 
		
		
		Summerlin Hospital Medical Center
		
	 
		
		
		Las Vegas Urology - Green Valley
		
	 
		
		Urology Specialists of Nevada - Central
		
	 
		
		Urology Specialists of Nevada - Southwest
		
	 
		
		Las Vegas Urology - Pecos
		
	 
		
		Urology Specialists of Nevada - Green Valley
		
	 
		
		Las Vegas Urology - Pebble
		
	 
		
		Urology Specialists of Nevada - Northwest
		
	 
		
		Las Vegas Prostate Cancer Center
		
	 
		
		Las Vegas Urology - Sunset
		
	 
		
		Las Vegas Urology - Cathedral Rock