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Trial registered on ANZCTR
Registration number
ACTRN12607000501448
Ethics application status
Approved
Date submitted
20/09/2007
Date registered
28/09/2007
Date last updated
27/03/2023
Date data sharing statement initially provided
27/03/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
A Randomised, double-blind placebo controlled study of subcutaneous ketamine in the management of cancer pain
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Scientific title
A Randomised, double-blind placebo controlled study of subcutaneous ketamine in the management of cancer pain
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Secondary ID [1]
251757
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001/07
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Universal Trial Number (UTN)
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Trial acronym
Ketamine for cancer pain
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pain from cancer or cancer treatment
2386
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Condition category
Condition code
Cancer
2490
2490
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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
phase III randomised, double blind, placebo controlled trial of ketamine 100mg to 300 mg then 500mg (if not responding) delivered by subcutaneous infusion over 24 hours for 5 days.
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Intervention code [1]
2110
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Treatment: Drugs
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Comparator / control treatment
Normal Saline 15 mls, over subcutaneous infusion over 24 hours for 5 days.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary outcome is the pain score on day 6.
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Assessment method [1]
3386
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Timepoint [1]
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Day 6
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Secondary outcome [1]
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Brief Pain Inventory average pain score at start days 1-6
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Assessment method [1]
5619
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Timepoint [1]
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Day 6
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Secondary outcome [2]
5659
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Performance Status at baseline and end of treatment
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Assessment method [2]
5659
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Timepoint [2]
5659
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Day 6
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Secondary outcome [3]
5660
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Opioid use, including number of breakthrough doses
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Assessment method [3]
5660
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Timepoint [3]
5660
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Day 6
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Secondary outcome [4]
5661
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Pain relief and quality of life
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Assessment method [4]
5661
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Timepoint [4]
5661
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Day 2
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Eligibility
Key inclusion criteria
•age >18 years
•pain related to cancer or its treatment
•moderate to severe pain
•patients with primarily nociceptive pain (Leeds Assessment of Neuropathic Symptoms and Signs score <12), or patients with predominantly neuropathic pain (Leeds Assessment of Neuropathic Symptoms and Signs score >12) treated appropriately
•stable backgound opioid dose
•stable co-analgesics during the study period
•patient is able to give fully informed written consent
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Minimum age
18
Years
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Maximum age
No limit
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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
Previous ketamine use Unstable pain, or undergoing active treatment to reduce pain (surgery, chemotherapy, radiotherapy) Medical history places patient at risk of known adverse reactions Pregnacny/ lactation Previous recreaional drug history Recent Monoamine oxidase inhibitors (non-reversible monoamine oxidase inhibitors are excluded for 4 weeks, reversible monoamine oxidase inhibitors are excluded for 2 days).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
At each centre, patients will be sequentially allocated a patient number.
All syringes will be prepared by the site clinical trial pharmacist according to the randomisation schedule, each syringe will be numbered according to the pre-determined randomisation code and labeled as ketamine/placebo 100, 300 or 500mg. All syringes will look identical in volume and colour to protect the blinding irrespective of the contents.
All new in-patients under the care or shared care of the palliative care team will be screened by the study nurse for their suitability to enter the study. The study nurse will ask the consultant in charge for permission to approach potentially eligible patients. This referral will be recorded within both the CRF and the patient clinical file.
Screening
If patients are suitable for entry and prepared to consent to the study, they will undergo baseline assessments and assessment of eligibility criteria and commence study the following morning. A screening log will be kept of all potentially eligible patients including the reasons for non entry.
At all times, from eligibility screening to completion of the study, all study staff are unaware of the treatment allocation. Allocation is concealed from the investigator at the time of the participant inclusion in the trial, the allocation is determined by contacting the site pharmacy.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Treatment for each patient will be allocated according to a block randomisation schedule held by the central registry in a 1:1 ratio. Block randomisation will ensure even allocation to each code. The central registry will supply strata tables to each site pharmacy.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
There is a dose modification schedule, and a resuce medication protocol for ketamine toxicity, opioid toxicity, and Psychomimetic toxicity.
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/11/2007
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Actual
28/03/2008
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Date of last participant enrolment
Anticipated
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Actual
2/02/2011
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Date of last data collection
Anticipated
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Actual
7/02/2011
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Sample size
Target
150
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Accrual to date
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Final
150
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Recruitment in Australia
Recruitment state(s)
NSW,VIC,QLD,SA,WA
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Commonwealth Department of Health and Ageing
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Address [1]
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Canberra
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Flinders University
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Address
Flinders Drive
Bedford Park, SA 5042
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Country
Australia
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Secondary sponsor category [1]
2382
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Government body
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Name [1]
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Department of Health and Ageing
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Address [1]
2382
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Canberra
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Country [1]
2382
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
4556
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Repatriation General Hospital
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Ethics committee address [1]
4556
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Daws Road Daw Park SA 5041
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Ethics committee country [1]
4556
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Australia
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Date submitted for ethics approval [1]
4556
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27/09/2007
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Approval date [1]
4556
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30/01/2008
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Ethics approval number [1]
4556
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EC00191
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Ethics committee name [2]
4573
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Hope Healthcare
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Ethics committee address [2]
4573
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Braeside Hospital Locked Bag 82 Wetherill Park, NSW 2164
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Ethics committee country [2]
4573
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Australia
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Date submitted for ethics approval [2]
4573
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27/09/2007
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Approval date [2]
4573
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07/12/2007
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Ethics approval number [2]
4573
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EC00425
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Ethics committee name [3]
5259
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Flinders Clinical Research Ethics Committee
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Ethics committee address [3]
5259
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Flinders Medical Centre Bedford Park, SA 5042
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Ethics committee country [3]
5259
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Australia
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Date submitted for ethics approval [3]
5259
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23/10/2007
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Approval date [3]
5259
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27/03/2008
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Ethics approval number [3]
5259
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EC00188
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Ethics committee name [4]
5260
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South Western Sydney Area Health Service Human Research Ethics Committee
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Ethics committee address [4]
5260
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Research Development Office Level 8, Building 14 Royal Prince Alfred Hospital Missendon Road Camberdown, NSW, 2050
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Ethics committee country [4]
5260
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Australia
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Date submitted for ethics approval [4]
5260
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12/11/2007
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Approval date [4]
5260
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25/03/2008
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Ethics approval number [4]
5260
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EC00136
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Ethics committee name [5]
5261
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Mater Health Services Human Research Ethics Committee
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Ethics committee address [5]
5261
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Raymond Tce South Brisbane, QLD, 4101
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Ethics committee country [5]
5261
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Australia
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Date submitted for ethics approval [5]
5261
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15/11/2007
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Approval date [5]
5261
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26/02/2008
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Ethics approval number [5]
5261
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EC00332
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Ethics committee name [6]
5262
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Peter MacCallum Cancer Centre Ethics Committee
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Ethics committee address [6]
5262
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Peter MacCallum Cancer Centre St Marys Place East Melbourne Vic 3002
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Ethics committee country [6]
5262
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Australia
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Date submitted for ethics approval [6]
5262
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19/11/2007
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Approval date [6]
5262
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01/04/2008
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Ethics approval number [6]
5262
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EC00235
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Ethics committee name [7]
258958
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Alfred Hospital Ethics Committee
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Ethics committee address [7]
258958
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Alfred Hospital, Commercial Road, Melbourne Victoria, 3004
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Ethics committee country [7]
258958
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Australia
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Date submitted for ethics approval [7]
258958
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16/11/2009
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Approval date [7]
258958
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01/02/2010
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Ethics approval number [7]
258958
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EC00315
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Ethics committee name [8]
258959
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St John of God Health Care Ethics Committee
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Ethics committee address [8]
258959
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Level 3 St John of God House, 177-179 Cambridge Street, WEMBLEY WA 6014
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Ethics committee country [8]
258959
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Australia
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Date submitted for ethics approval [8]
258959
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06/08/2009
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Approval date [8]
258959
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19/03/2010
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Ethics approval number [8]
258959
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EC00286
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Ethics committee name [9]
258960
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Hollywood Private Hospital Research Ethics Committee
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Ethics committee address [9]
258960
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Hollywood Private Hospital Ethics Committee Locked Bag 2002 NEDLANDS WA 6009
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Ethics committee country [9]
258960
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Australia
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Date submitted for ethics approval [9]
258960
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12/11/2007
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Approval date [9]
258960
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07/11/2008
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Ethics approval number [9]
258960
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EC00266
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Ethics committee name [10]
258961
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St Vincent's Hospital (Melbourne) HREC D
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Ethics committee address [10]
258961
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Research Governance Unit PO Box 2900 FITZROY VIC 3065
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Ethics committee country [10]
258961
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Australia
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Date submitted for ethics approval [10]
258961
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30/04/2009
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Approval date [10]
258961
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22/09/2009
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Ethics approval number [10]
258961
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EC00344
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Summary
Brief summary
This study looks at the effectiveness of the pain-killing drug ketamine in people with widespread cancer who are receiving palliative care and have difficult cancer pain that does not respond well to opioid drugs. Who is it for? You can join this study if you have widespread cancer and are receiving palliative care, and have difficult cancer pain that does not respond well to opioid (morphine-like) drugs. Trial details Participants will be divided into two groups. One group will receive five days of treatment with increasing doses of ketamine given under the skin (sub-cutaneously), and the other will receive a non-active compound (placebo) also given under the skin. Blood samples will be collected. The study will assess pain control, quality of life, side effects from ketamine, and reduction in the need for usual pain medicines. The study nurses and the doctors and nurses in the ward will monitor all participants closely for any unexpected problems and to ensure that pain is managed appropriately. Ketamine may be helpful for pain related to cancer, especially pain resulting from nerve damage. However studies to date are incomplete and evidence is needed to support continued clinical use. It is hoped that after this study, if ketamine is proven safe and effective in difficult cancer pain, it will become more easily available for Australian cancer patients.
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Trial website
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Trial related presentations / publications
Janet Hardy , Stephen Quinn, Belinda Fazekas, John Plummer, Simon Eckermann, Meera Agar, Odette Spruyt, Debra Rowett and David C. Currow. Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Toxicity of Subcutaneous Ketamine in the Management of Cancer Pain. J Clin Oncol. 2012 Oct 10;30(29):3611-7.
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Public notes
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Contacts
Principal investigator
Name
28062
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Prof Janet Hardy
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Address
28062
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Mater Health Services
Raymond Terrace
South Brisbane
QLD, 4101
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Country
28062
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Australia
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Phone
28062
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+61 7 31632775
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Fax
28062
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Email
28062
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[email protected]
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Contact person for public queries
Name
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Prof Janet Hardy
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Address
11219
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Director Of Palliative Care
Mater Health Services
Raymond Terrace
South Brisbane
QLD 4101
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Country
11219
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Australia
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Phone
11219
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07 3163 2775/8074/8545
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Fax
11219
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07 3163 8856
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Email
11219
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[email protected]
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Contact person for scientific queries
Name
2147
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Prof Janet Hardy
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Address
2147
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Director Of Palliative Care
Mater Health Services
Raymond Terrace
South Brisbane
QLD 4101
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Country
2147
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Australia
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Phone
2147
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07 3840 2775/8074/8545
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Fax
2147
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07 3840 8856
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Email
2147
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Primary and secondary outcome IPD
Data Dictionary
Protocol
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When will data be available (start and end dates)?
01/06/2023 to 01/06/2027
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Available to whom?
Researchers undertaking secondary research
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Available for what types of analyses?
Those analyses described in approved proposals only
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How or where can data be obtained?
Anyone who wishes to access the data should submit a proposal to
[email protected]
. If approved, data requestors will need to sign a data access agreement. After that,the ITCC Data Center will transfer the requested data and other documents to data requestors.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
18706
Study protocol
[email protected]
18707
Clinical study report
[email protected]
18708
Ethical approval
[email protected]
18709
Informed consent form
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
CYP2B6*6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: Impact on adverse effects.
2015
https://dx.doi.org/10.1111/bcp.12614
N.B. These documents automatically identified may not have been verified by the study sponsor.
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