Tobacco Treatment Optimization and Preferences During Concurrent Cancer Treatment
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 126
- 试验地点
- 3
- 主要终点
- Proportion of participants that quit smoking.
研究概览
简要总结
Smoking cessation has been shown to improve the effectiveness and reduce the morbidity of tobacco-related cancer treatments. We will identify effective smoking cessation strategies for patients who are receiving treatment for tobacco-related cancer. In this trial, patients' preferences in smoking cessation therapy will be the principal determinant by providers in developing a three component regimen of pharmaceutical therapy, counseling, and nicotine replacement therapy. This study will identify this cohort's preferences for smoking cessation strategies. We will then examine the impact of utilizing patient preferences upon cessation efficacy by directly comparing cessation success in this study with our recently completed study of the same population using the same tobacco treatments which were randomly assigned.
详细描述
Background Cigarette smoking is associated with decreased survival and decreased efficacy of cancer therapy in those with smoking related malignancies. There is limited of study of smoking cessation for cancer patients being treated in regions with high tobacco use such as Kentucky. There is little study of cessation implementation in the community cancer treatment setting where the majority of cancer patients receive their cancer therapy. Most smokers have significant exposure to information and personal experience with tobacco treatments which, in some cases, leads to profound preferences. The effect of incorporating these patient preferences into tobacco treatment planning has not been studied or quantified.
Study Design Phase II therapeutic clinical trial.
Setting University of Kentucky Markey Cancer Center (MCC) and its affiliate research network of Community Cancer Centers (MCCRN)
Methods Ninety-three subjects will be selected. All subjects will be active smoking oncology patients with a diagnosis of smoking related malignancy who are beginning a new course of therapy. In conjunction with their treating clinician, all subjects will be counseled and then select one of 12 cessation strategies. This will include a choice of continuous pharmacologic agent (veranicline, bupropion or transdermal nicotine patch), counseling strategy (11 session high intensity motivational based counseling or single session low intensity counseling), and whether or not to use as needed nicotine (gum, lozenges or spray).
Data Analysis All subjects will be followed for six months. The primary endpoint will be a carbon monoxide monitoring confirmed negative seven-day point prevalence report of cessation at eight weeks. Data will then be analyzed and compared with a completed randomized clinical trial of the same treatment strategies in the same population of subjects where the cessation strategy was assigned (historical control). The proportion of subjects that have quit at week eight will be compared to the historical control proportion (namely, whether Ho:p=po vs Ha: p>po). This will be assessed using a z-score for a binomial proportion which will test whether the underlying proportion quitting at eight weeks (p) differs from the control proportion (po ranging from 0.215 to 0.26) estimated from our recently completed randomized trial of these same 12 cessation strategies.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •newly diagnosed or recurrent tobacco related malignancy
- •smoked at least 1 cigarette within 4 weeks of study enrollment
- •10-pack year history of cigarette smoking
- •smoked at least 1 cigarette within 1 month of cancer diagnosis
- •life expectancy greater than 1 year
排除标准
- •allergy to buproprion, varenicline and transdermal medicine
- •history of suicide attempt
- •hospitalized for psychiatric illness within past 2 years
- •history of active or uncontrolled eating disorder
- •uncontrolled epilepsy or seizure disorder
- •pregnant or lactating
- •within 3 months of myocardial infarction
- •unstable angina
- •uncontrolled hypertension
- •serious arrhythmia
- •history of taking varenicline or buproprion within one month of enrollment
- •concurrent enrollment in tobacco cessation therapy
研究组 & 干预措施
Group 1: Varenicline, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive varenicline, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Varenicline (Drug)
Group 1: Varenicline, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive varenicline, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: High-intensity counseling (Behavioral)
Group 1: Varenicline, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive varenicline, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Nicotine Replacement Products (Drug)
Group : Varenicline, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive varenicline and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Varenicline (Drug)
Group : Varenicline, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive varenicline and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: High-intensity counseling (Behavioral)
Group : Varenicline, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive varenicline and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: No nicotine replacement therapy (Other)
Group 3: Varenicline, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive varenicline, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Varenicline (Drug)
Group 3: Varenicline, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive varenicline, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Low-intensity counseling (Behavioral)
Group 3: Varenicline, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive varenicline, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Nicotine Replacement Products (Drug)
Group 4: Varenicline, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive varenicline and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Varenicline (Drug)
Group 4: Varenicline, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive varenicline and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Low-intensity counseling (Behavioral)
Group 4: Varenicline, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive varenicline and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: No nicotine replacement therapy (Other)
Group 5: Buproprion, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive Buproprion, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Bupropion (Drug)
Group 5: Buproprion, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive Buproprion, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: High-intensity counseling (Behavioral)
Group 5: Buproprion, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive Buproprion, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Nicotine Replacement Products (Drug)
Group 6: Buproprion, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive Buproprion and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Bupropion (Drug)
Group 6: Buproprion, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive Buproprion and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: High-intensity counseling (Behavioral)
Group 6: Buproprion, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive Buproprion and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: No nicotine replacement therapy (Other)
Group 7: Buproprion, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive Buproprion, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Bupropion (Drug)
Group 7: Buproprion, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive Buproprion, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Low-intensity counseling (Behavioral)
Group 7: Buproprion, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive Buproprion, counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Nicotine Replacement Products (Drug)
Group 8: Buproprion, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive Buproprion and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Bupropion (Drug)
Group 8: Buproprion, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive Buproprion and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Low-intensity counseling (Behavioral)
Group 8: Buproprion, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive Buproprion and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: No nicotine replacement therapy (Other)
Group 9: Nicotine, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch), counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Long-acting nicotine replacement therapy (Drug)
Group 9: Nicotine, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch), counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: High-intensity counseling (Behavioral)
Group 9: Nicotine, Intense Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch), counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Nicotine Replacement Products (Drug)
Group 10: Nicotine, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch) and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Long-acting nicotine replacement therapy (Drug)
Group 10: Nicotine, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch) and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: High-intensity counseling (Behavioral)
Group 10: Nicotine, Intense Counselling
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch) and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: No nicotine replacement therapy (Other)
Group 11: Nicotine, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch), counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Long-acting nicotine replacement therapy (Drug)
Group 11: Nicotine, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch), counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Low-intensity counseling (Behavioral)
Group 11: Nicotine, Minimal Counselling and NRT
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch), counseling, and nicotine replacement therapy (PRN NRT). Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Nicotine Replacement Products (Drug)
Group 12: Nicotine, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch) and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Long-acting nicotine replacement therapy (Drug)
Group 12: Nicotine, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch) and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: Low-intensity counseling (Behavioral)
Group 12: Nicotine, Minimal Counselling
Patients diagnosed with tobacco-related treatment will receive long acting nicotine replacement therapy (e.g. nicotine patch) and counseling. Dose and frequency will be based on patient preference, smoking history and other medical factors.
干预措施: No nicotine replacement therapy (Other)
结局指标
主要结局
Proportion of participants that quit smoking.
时间窗: at week 8
Proportion of participants that quit smoking at the 8 week assessment
Prevalence of cigarette use
时间窗: at week 8
Seven day point prevalence of cigarette use will be determined from participant reports and CO testing.
次要结局
- Prevalence of cigarette use(6 months)
- Preferred treatment(at baseline)
- Change in Cigarette Use(6 months)
- Drug Compliance(6 months)
- Counselling Compliance(6 months)
研究者
Joseph Valentino, MD
Professor
University of Kentucky