Clinical trial targets worst side-effects of chemo
July 18, 2018
Clinical trial targets worst side-effects of breast cancer chemo
Breast Cancer Foundation NZ has committed $250,000 to a new clinical trial that will test the ability of a cheap, widely available drug to prevent two of chemotherapy’s most unpleasant side-effects: delayed nausea and vomiting.
The PantoCIN trial, led by medical oncologists Richard Isaacs and Navin Wewala from Palmerston North Hospital, will recruit 164 patients at up to nine hospitals around New Zealand. PantoCIN will be co-funded by Breast Cancer Trials Australia NZ, an international trials groups that has led many of the region’s largest clinical trials.
“Nausea is rated as the most distressing side effect and vomiting the third most distressing by patients receiving chemotherapy,” said Dr Isaacs, who specialises in breast cancer. “We’re pretty good at treating immediate reactions, but we know that delayed reactions, occurring from days two to five after chemo, can be underestimated by doctors and have a severe impact on a patient’s quality of life.
“We’re hoping the PantoCIN trial will provide an affordable, effective means of reducing these side effects, and we’re very grateful to Breast Cancer Foundation NZ for the funds that will help us put it to the test.”
Evangelia Henderson, chief executive at Breast Cancer Foundation NZ, said the chance to address such a widespread problem for patients made the investment an easy decision. “Between half and 80 percent of patients suffer these awful side-effects of chemo. If the trial achieves its primary target, which is a complete absence of delayed nausea and vomiting for many patients, we’ll be thrilled. At the very least, we’re hoping for a significant reduction.”
Patients enrolling in the trial will take either the trial drug, pantoprazole, or a placebo for their first chemo cycle, then will swap around for the second cycle. Pantoprazole is a type of medicine called a proton-pump inhibitor (PPI), designed to reduce gastric acid. It was chosen over similar products because of its mild side-effects and low likelihood of interaction with other medications, and its high bioavailability (the proportion of the drug that enters the bloodstream to have an active effect).
The current plan is for the trial, coordinated by Cancer Trials New Zealand, to run over two years in Northland, Auckland, Waikato, Tauranga, Palmerston North, Wellington, Nelson, Christchurch and Dunedin. Preparations are now underway to get the trial started as soon as possible.
“We don’t have a lot of multi-centre breast cancer clinical trials in New Zealand, so we see this as a great chance for our hospitals to build their experience in collaborating in this kind of venture,” said Evangelia Henderson.