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| Name | Class |
|---|---|
| FLENI Instituto de Rehabilitación y Educación Terapéutica, BA, Argentina. | UNKNOWN |
| Bioanalytical Unit, Laboratorio Raffo S.A., BA, Argentina. | UNKNOWN |
| FLENI Multi-Specialty Research Center, BA, Argentina. |
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The purpose of this crossover, single-dose, bioequivalence study is to compare the rate and extent of absorption of Temozolomide after the administration of the study product (Dralitem®, Monte Verde S.A.) and the reference product (Temodal®, Schering Plough) in primary Central Nervous System patients.
Prospective, randomized, two-period, two treatment, two-way crossover bioequivalence study of two Temozolomide oral formulations (Dralitem vs. Temodal), in primary Central Nervous System tumor patients under fasting conditions. Open label to the patients and investigators and blind to the bioanalytical and clinical laboratories.
Study plan: days -21 to 0 (Recruitment period); days 1 to 5 (Treatment period); days 6 to 21 (Safety surveillance period). Sample size: 24 patients will be randomized. The patients will be administered Temozolomide 200 mg/m2 on the first two days (Dralitem) of the treatment cycle.
They will be admitted to the study clinical site on the evening of day 2. In the morning of day 3 they will be randomized into two groups of equal size. According to the assigned random number, each subject will receive a single oral dose of Temozolomide 200mg/m2 from either Monte Verde Sociedad Anónima (SA) product (Dralitem) or from Schering-Plough product (Temodal). The single dose of 200 mg/m2 will be reached with three different Temozolomide capsule strengths: 20, 100 and 250 mg. Drugs will be administered with 200-240 ml of water in semi-sitting upright position.
The following day (day 4) each subject will receive an oral dose of Temozolomide 200 mg/m2 of the product that did not receive the day before. On days 3 and 4 after drug administration, blood samples will be obtained for pharmacokinetic evaluation. The patient will be discharged from the clinical site on day 4 after completion of sampling for pharmacokinetic analysis. On day 5, all patients will receive Temozolomide 200 mg/m2 (Dralitem).
On days 3 and 4, samples of venous blood will be withdrawn from the forearm vein of each volunteer at the following time points: 0 (pre-dose) and 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours post-dose after each period administration. The washout period between the treatment arms was 10 hours, on days 3 and 4. Samples will be processed according to the validated method MANA (Método AnalÃtico) - PLB (Proyecto Laboratorio BioanalÃtico) 004 - TEM (Temozolomide) - 01/01. Measurement of plasma concentration of Temozolomide was performed using High Performance Liquid Chromatography (HPLC) followed by detection by tandem mass spectrometry (MS / MS).
The area under the curve (AUC) and the Cmax levels of the drug vs. time will be obtained for each subject. The resulting values of the logarithmic transformation of these parameters will be used for statistical comparisons (mixed effects ANOVA). The limits of the 90% confidence interval for the ratio of log transformed pharmacokinetic parameters will be calculated. Bioequivalence criteria: each calculated confidence interval should be within the acceptance range from 80.00 to 125.00.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Temodal | Active Comparator | Temozolomide (Schering-Plough) 200 mg/m2, single oral dose. |
|
| Dralitem | Experimental | Temozolomide (Monte Verde S.A.) 200 mg/m2, single oral dose |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Temozolomide | Drug |
|
| |
| Temozolomide |
| Measure | Description | Time Frame |
|---|---|---|
| Cmax | Rate of absorption of Temozolomide (Cmax) will be measured after the oral administration of the test product (Dralitem®, Monte Verde S.A.) or the reference product (Temodal®, Schering-Plough). | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
| AUC0-t | Extent of absorption of Temozolomide from time (0) to the last quantifiable concentration (t) will be measured after the oral administration of the test product (Dralitem®, Monte Verde S.A.) or the reference product (Temodal®, Schering-Plough) | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
| AUC0-∞ | Extent of absorption of Temozolomide from time (0) to infinity (∞) will be measured after oral administration of the test product (Dralitem®, Monte Verde S.A.) or the reference product (Temodal®, Schering-Plough). | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs and SAEs will be collected from the start of study treatment and until two weeks post last dose. If AEs or SAEs extend in time and are not resolved before the end of the 2-week follow up period, this period shall last until the event/s are resolved. | Up to two weeks post last dose |
| Measure | Description | Time Frame |
|---|---|---|
| Kel | Rate at which Temozolomide is removed from the body. | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
| T1/2 | Time required for Temozolomide plasma concentration to decrease by 50% |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alejandro D Muggeri, Physician | FLENI Instituto ClÃnico-Quirúrgico de Diagnóstico y Tratamiento | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| FLENI Instituto de Rehabilitación y Educación Terapéutica | Belen de Escobar | Buenos Aires | B1625XAS | Argentina | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28756607 | Derived | Muggeri A, Vago M, Perez S, Rubio M, Gonzalez C, Magarinos C, Rosenberg M, Costa F, Perez-Lloret S. A Randomized, Open-Label, Two-Way Crossover, Single-Dose Bioequivalence Study of Temozolomide 200 mg/m2 (Dralitem(R) vs. Temodal(R) Capsules) in Patients with Primary Tumors of the Central Nervous System Under Fasting Conditions. Drugs R D. 2017 Sep;17(3):427-434. doi: 10.1007/s40268-017-0199-3. |
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Of the initial sample size of 24 patients, 19 were effectively screened during a period from October 2012 and October 2013; 3 patients did not meet inclusion criteria and 16 were randomized to the two intervention arms.
This study enrolled patients with primary tumours of the Central Nervous System (CNS) excluding patients with primary CNS lymphoma, from FLENI Clinical-Surgical Diagnosis and Treatment Institute, Buenos Aires, Argentina. The last patient completed in October 2013.
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| ID | Title | Description |
|---|---|---|
| FG000 | Temodal, Then Dralitem | During days 1 and 2, all patients received a single oral dose of 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®). On day 3 patients received 200 mg/m2 of Temozolomide from Schering-Plough (Temodal®) as a single oral dose. After a washout period of 10 hours, they then received 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®). On day 5 all patients received Temozolomide 200 mg/m2 from Monte Verde S.A. (Dralitem®).All patients were under fasting conditions two hours before and after each drug administration. |
| FG001 | Dralitem, Then Temodal | During days 1 and 2, all patients received a single oral dose of 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®). On day 3 patients received 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®) as a single oral dose. After a washout period of 10 hours, they then received 200 mg/m2 of Temozolomide from Schering-Plough (Temodal®). On day 5 all patients received Temozolomide 200 mg/m2 from Monte Verde S.A.(Dralitem®). All patients were under fasting conditions two hours before and after each drug administration. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Intervention (Day 3) |
| ||||||||||||||||
| Washout (10 Hours) |
| ||||||||||||||||
| Second Intervention (Day 4) |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Temodal, Then Dralitem | During days 1 and 2, all patients received a single oral dose of 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®). On day 3 patients received 200 mg/m2 of Temozolomide from Schering-Plough (Temodal®) as a single oral dose. After a washout period of 10 hours, they then received 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®). On day 5 all patients received Temozolomide 200 mg/m2 from Monte Verde S.A. (Dralitem®).All patients were under fasting conditions two hours before and after each drug administration. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Cmax | Rate of absorption of Temozolomide (Cmax) will be measured after the oral administration of the test product (Dralitem®, Monte Verde S.A.) or the reference product (Temodal®, Schering-Plough). | All those subjects who completed the study and were compliant with all the protocol procedures were considered evaluable for statistical pharmacokinetic analysis. Those who received at least one dose of the products under study but did not comply with the study procedures were included in the safety analysis only. | Posted | Mean | Standard Deviation | mcg/mL | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
|
Eighteen days for each arm (Safety Surveillance Period).
Safety population included all subjects who received at least one dose of intervention.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Temodal | Temozolomide (Schering-Plough) 200 mg/m2, single oral dose. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Itchy Rash | Skin and subcutaneous tissue disorders | MedDRA (10.1) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Alejandro Muggeri (Principal Investigator) | FLENI- mrc (FLENI Multi-specialty Research Center) | 54-11-5777 3200 | 2020 | alemuggeri@hotmail.com.ar |
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| ID | Term |
|---|---|
| D001932 | Brain Neoplasms |
| ID | Term |
|---|---|
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D000077204 | Temozolomide |
| ID | Term |
|---|---|
| D003606 | Dacarbazine |
| D014226 | Triazenes |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
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| Drug |
|
|
| 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
| FLENI Instituto ClÃnico-Quirúrgico de Diagnóstico y Tratamiento |
| Ciudad Autónoma de Buenos Aires |
| Buenos Aires |
| C1428AQK |
| Argentina |
| NOT COMPLETED |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| BG001 | Dralitem, Then Temodal | During days 1 and 2, all patients received a single oral dose of 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®). On day 3 patients received 200 mg/m2 of Temozolomide from Monte Verde S.A. (Dralitem®) as a single oral dose. After a washout period of 10 hours, they then received 200 mg/m2 of Temozolomide from Schering-Plough (Temodal®). On day 5 all patients received Temozolomide 200 mg/m2 from Monte Verde S.A.(Dralitem®). All patients were under fasting conditions two hours before and after each drug administration. |
| BG002 | Total | Total of all reporting groups |
| Years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Height | Mean | Standard Deviation | cm |
|
| Weight, Continuous | Mean | Standard Deviation | kg |
|
| Body Surface, Continuous | Mean | Standard Deviation | m^2 |
|
| Body Mass Index | Mean | Standard Deviation | kg/m^2 |
|
| Dralitem |
Temozolomide (Monte Verde S.A.) 200 mg/m2, single oral dose Temozolomide |
|
|
|
| Secondary | Number of Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs and SAEs will be collected from the start of study treatment and until two weeks post last dose. If AEs or SAEs extend in time and are not resolved before the end of the 2-week follow up period, this period shall last until the event/s are resolved. | Not Posted | Up to two weeks post last dose |
| Other Pre-specified | Kel | Rate at which Temozolomide is removed from the body. | Posted | Mean | Standard Deviation | 1/h | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
|
|
|
| Other Pre-specified | T1/2 | Time required for Temozolomide plasma concentration to decrease by 50% | Posted | Mean | Standard Deviation | hours | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
|
|
|
| Primary | AUC0-t | Extent of absorption of Temozolomide from time (0) to the last quantifiable concentration (t) will be measured after the oral administration of the test product (Dralitem®, Monte Verde S.A.) or the reference product (Temodal®, Schering-Plough) | All those subjects who completed the study and were compliant with all the protocol procedures were considered evaluable for statistical pharmacokinetic analysis. Those who received at least one dose of the products under study but did not comply with the study procedures were included in the safety analysis only. | Posted | Mean | Standard Deviation | mcg*h/mL | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
|
|
|
|
| Primary | AUC0-∞ | Extent of absorption of Temozolomide from time (0) to infinity (∞) will be measured after oral administration of the test product (Dralitem®, Monte Verde S.A.) or the reference product (Temodal®, Schering-Plough). | All those subjects who completed the study and were compliant with all the protocol procedures were considered evaluable for statistical pharmacokinetic analysis. Those who received at least one dose of the products under study but did not comply with the study procedures were included in the safety analysis only. | Posted | Mean | Standard Deviation | mcg*h/mL | 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0, 2.5, 3.0, 4.0, 6.0, 8.0, 10.0 hours on Days 3 and 4 |
|
|
|
|
| 0 |
| 16 |
| 5 |
| 16 |
| EG001 | Dralitem | Temozolomide (Monte Verde S.A.) 200 mg/m2, single oral dose. | 0 | 16 | 4 | 16 |
| Vomiting | Gastrointestinal disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Gastritis | Gastrointestinal disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Hyporexia | Metabolism and nutrition disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Leg Edema | Vascular disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Weakness | Nervous system disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Loss of taste | Nervous system disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Adynamia | Nervous system disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Abdominal Pain | Gastrointestinal disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Heartburn | Gastrointestinal disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Expressive aphasia | Nervous system disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Fever syndrome | General disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Proctorrhagia | Gastrointestinal disorders | MedDRA (10.1) | Non-systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (10.1) | Non-systematic Assessment |
|
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| D001927 |
| Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D001393 |
| Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |