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Trial registered on ANZCTR
Registration number
ACTRN12617001118392
Ethics application status
Approved
Date submitted
11/07/2017
Date registered
31/07/2017
Date last updated
8/05/2019
Date data sharing statement initially provided
8/05/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Treatment of ectopic pregnancies of participants with vinorelbine tablets.
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Scientific title
Safety and efficacy of oral vinorelbine in treatment of ectopic pregnancies
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Secondary ID [1]
292391
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
VINO trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
ECTOPIC PREGNANCY
304009
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Condition category
Condition code
Reproductive Health and Childbirth
303340
303340
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0
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Other reproductive health and childbirth disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Given the promising in vitro and in vivo data, coupled with vinorelbine’s established safety and tolerability profiles in the treatment of human oncology patients, we now wish to progress this concept to the clinic. We hope to recruit 20 participants with stable ectopic pregnancies and treat them each with 2 doses of 60mg/m² of oral vinoralbine, spaced one week apart, instead of methotrexate. The primary aims of this study are to assess the safety, toxicity and tolerability profiles of vinorelbine when administered exclusively to a cohort of women with stable ectopic pregnancies.
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Intervention code [1]
298589
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Treatment: Drugs
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Comparator / control treatment
No control group in this study
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
302728
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The primary objective of this study is to assess the safety, toxicity and tolerability of administering vinorelbine to patients with ectopic pregnancies with blood tests.
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Assessment method [1]
302728
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Timepoint [1]
302728
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The end (resolution) of the ectopic pregnancy – either when serum hCG levels return to less than 5; or when the pregnancy is surgically excised. Participants will have FBC, U&Es, LFTs and hCG done on day 0, day 4 and day 7 to test for neutropaenia and any derangement in liver enzymes.
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Secondary outcome [1]
336837
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Length of time from treatment initiation to resolution of ectopic pregnancy by review of medical records.
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Assessment method [1]
336837
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Timepoint [1]
336837
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The end (resolution) of the ectopic pregnancy – either when serum hCG levels return to less than 5; or when the pregnancy is surgically excised,t
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Secondary outcome [2]
337420
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Failure of medical management . Clinical signs and symptoms of a ruptured ectopic.
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Assessment method [2]
337420
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Timepoint [2]
337420
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Within 30 days post documented resolution of ectopic pregnancy
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Eligibility
Key inclusion criteria
• Aged 18-50 years old
• English speaking
• Able to provide informed consent to participate
• A diagnosis of a tubal ectopic pregnancy on transvaginal ultrasound
• A stable ectopic pregnancy (no evidence of bleeding or rupture)
• A pre-treatment serum Human Chorionic Gonadotrophin (hCG) level of 1,000 – 3,000 IU/L
• Adnexal mass less than or equal to 3.0 cm, with no fetal cardiac activity
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Unable to provide informed consent to participate
• A multiple pregnancy
• Contraindication(s) to vinorelbine or to medical management of ectopic pregnancy
• Immunodeficiency disorder(s)
• A current malignancy
• Received chemotherapy or radiation therapy in the previous five years
• Concomitant disease which could significantly impair gastric absorption (Inflammatory bowel disease, coeliac, etc.)
• History of surgical resection of the stomach/small bowel
• Breastfeeding
• Hepatic impairment, renal impairment, or haematological toxicity
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Statistical analysis for this study will be performed using GraphPad Prism 6 (GraphPad Software, La Jolla, CA). Given the study design and objectives of this particular trial:
• There is no comparison arm, so clinical variables and the clinical course will be presented as descriptive statistics
• There is no power calculation to perform
• Continuous variables will be statistically analysed using a t-test (parametric) or a Mann-Whitney test (non-parametric), as appropriate
• Categorical variables will be statistically analysed using a chi-squared test or Fisher’s exact test, as appropriate
• Biochemical pathology results will be assessed as continuous variables
• A p value of <0.05 will be considered statistically significant.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/02/2018
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Actual
9/08/2018
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Date of last participant enrolment
Anticipated
4/02/2020
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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
20
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Accrual to date
10
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Final
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Recruitment outside Australia
Country [1]
9047
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New Zealand
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State/province [1]
9047
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Auckland
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Funding & Sponsors
Funding source category [1]
296946
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Hospital
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Name [1]
296946
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Prathima Chowdary
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Address [1]
296946
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North Shore Hospital,
124 Shakespeare Road,
Takapuna,
Auckland 0620, NZ
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Country [1]
296946
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New Zealand
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Primary sponsor type
Hospital
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Name
North Shore Hospital
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Address
North Shore Hospital,
124 Shakespeare Road,
Takapuna,
Auckland 0620, NZ
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Country
New Zealand
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Secondary sponsor category [1]
295950
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None
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Name [1]
295950
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Address [1]
295950
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Country [1]
295950
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298151
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Health and Disability Ethics Committee
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Ethics committee address [1]
298151
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
298151
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New Zealand
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Date submitted for ethics approval [1]
298151
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03/08/2017
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Approval date [1]
298151
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02/02/2018
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Ethics approval number [1]
298151
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Summary
Brief summary
Ectopic pregnancies are pregnancies that occur outside of the womb, with the vast majority located in the Fallopian tube (the tube which carries a fertilised egg to the womb). They are potentially life threatening as they can erode maternal blood vessels and cause fatal internal bleeding. They are relatively common, representing around 2% of pregnancies. If an ectopic pregnancy is identified early and is small in size, a drug called methotrexate can be administered via injection. However, only a small number of ectopic pregnancies (~25%) are identified early enough to be suitable for this medication. Additionally, methotrexate is unsuccessful in treating ectopic pregnancies in up to 30% of cases. This means that the majority of ectopic pregnancies are ultimately removed surgically. This exposes many affected women to both surgical and anaesthetic risks; is complex (requiring doctors with specialist surgical skills); and can involve the removal of the woman’s Fallopian tube. As fertility preservation is an important concern in this area of medicine, the development of a new medical therapy with a higher success rate than methotrexate would be a major advance in the clinical care of women who have ectopic pregnancies. Excitingly, we have discovered in pre-clinical laboratory studies that vinorelbine, an orally available chemotherapeutic medication, may be appropriate for use as an alternative to methotrexate in the medical treatment of ectopic pregnancies. Specifically, we have found in our laboratory studies that vinorelbine is 1,000 to 10,000 times more effective than methotrexate at killing placental cells, is more effective than methotrexate in an animal model ectopic pregnancy, does not cause cell death of donated human Fallopian tubes and does not impact upon subsequent breeding in mice (after a four week washout period). Together, these findings indicate that vinorelbine may not impede future fertility, and that may be an efficacious treatment for ectopic pregnancy. Given these promising pre-clinical results, we hope to progress this concept and eventually translate these laboratory findings into clinical care. We propose to begin this process with a proof-of-concept, early phase clinical trial. We will recruit 20 women with stable ectopic pregnancies and treat the participants with two doses of 60mg/m² of oral vinorelbine, spaced one week apart. We will assess the safety, toxicity and tolerability of vinorelbine therapy in these women, as well as monitoring the effectiveness of vinorelbine in killing placental cells and resolving ectopic pregnancies. If successful, we will gain sufficient evidence to progress our investigations of vinorelbine as a treatment for ectopic pregnancies to a large-scale, randomized clinical trial. We hope that it may form the basis for an efficient and safe future medical treatment option for this group of women who do not wish to undergo surgery or have their tube removed.
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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
76150
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Dr Prathima Chowdary
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Address
76150
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Waitemata District Health Board
North Shore Hospital
Auckland 0620, NZ
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Country
76150
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New Zealand
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Phone
76150
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+6494868900
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Fax
76150
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Email
76150
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[email protected]
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Contact person for public queries
Name
76151
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Prathima Chowdary
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Address
76151
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Waitemata District Health Board
North Shore Hospital
Auckland 0620, NZ
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Country
76151
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New Zealand
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Phone
76151
0
+6494868900
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Fax
76151
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Email
76151
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[email protected]
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Contact person for scientific queries
Name
76152
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Prathima Chowdary
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Address
76152
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Waitemata District Health Board
North Shore Hospital
Auckland 0620, NZ
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Country
76152
0
New Zealand
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Phone
76152
0
+6494868900
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Fax
76152
0
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Email
76152
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
1983
Informed consent form
373273-(Uploaded-02-05-2019-18-54-36)-Study-related document.doc
1984
Ethical approval
373273-(Uploaded-02-05-2019-18-55-54)-Study-related document.pdf
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