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Cognitive Behavioral Therapy With or Without Armodafinil in Treating Cancer Survivors With Insomnia and Fatigue After Chemotherapy

Abramson Cancer Center at Penn Medicine logo

Abramson Cancer Center at Penn Medicine

Status and phase

Completed
Phase 2

Conditions

Unspecified Adult Solid Tumor, Protocol Specific

Treatments

Procedure: Sleep Disorder Therapy
Procedure: Fatigue assessment and management
Drug: Armodafinil
Other: Placebo
Procedure: Management of Therapy
Procedure: Quality of Life assessment
Procedure: cognitive assessment
Other: Questionnaire Administration
Procedure: Fatifue assessment and management
Procedure: Quality-of-Life Assessment
Procedure: Quality of Life Assessment
Procedure: Sleep disorder therapy
Procedure: Management of therapy and complications
Procedure: Cognitive Assessment
Procedure: Fatigue Assessment and Management
Procedure: Quality-of-life assessment

Study type

Interventional

Funder types

Other

Identifiers

NCT01019187
UPCC 19108

Details and patient eligibility

About

RATIONALE: Sleep disorder counseling may reduce fatigue and insomnia as well as improve the well-being and quality of life of cancer survivors. Armodafinil may help relieve insomnia and fatigue in patients with cancer after chemotherapy. PURPOSE: This randomized phase II trial is studying how well cognitive behavioral therapy with or without armodafinil works in treating cancer survivors with insomnia and fatigue after chemotherapy.

Full description

Detailed DescriptionOBJECTIVES:

I. To determine if one or more of the intervention strategies (i.e., CBT-I, armodafinil, or both), when compared to a placebo only group, reduce insomnia in cancer patients following the conclusion of chemotherapy and/or radiation therapy.

II. To determine if one or more of the intervention strategies (i.e, CBT-I, armodafinil, or both), when compared to a placebo only group, reduce fatigue in cancer patients following the conclusion of chemotherapy and/or radiation therapy.

III. To determine if one or more of the intervention strategies (i.e., CBT-I, armodafinil, or both), when compared to a placebo only group, improve QOL in cancer patients following the conclusion of chemotherapy and/or radiation therapy.

OUTLINE: Patients are randomized to 1 of 4 treatment arms (cognitive behavioral therapy, armodafinil, both, or neither).

After completion of study treatment, patients are followed for 30 days.

Enrollment

226 estimated patients

Sex

All

Ages

21 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Have a diagnosis of cancer
  • Be able to understand written and spoken English
  • Be able to swallow medication
  • Have preferred sleep phase between 7:30 pm and 11:00 am
  • Be willing to discontinue any medications /OTCs/Herbals for sleep for the 11-week study period
  • Be presumed to be in a state of cancer remission; use of tamoxifen, an aromatase inhibitor, and/or Herceptin is permitted
  • Self-report problems with insomnia for at least three months and that the insomnia began or got worse with the onset of cancer or treatment
  • At least one month must have passed since completion of chemotherapy and/or radiation treatment
  • Report insomnia on the SDS-CL at a frequency of at least 3 days a week

Exclusion criteria

  • Have ever taken modafinil or armodafinil had CBT-I therapy (CBT-I therapy for the sake of this protocol will be defined as any cognitive behavioral-based treatment for insomnia that includes a sleep restriction component)
  • Have an unstable medical or psychiatric illness (Axis I- current or within the last 5 years)
  • Have a history of seizures or severe headaches, or uncontrolled cardiac disease or hypertension
  • Be presently taking an anticoagulant or a corticosteroid
  • Have taken amphetamines (e.g., methylphenidate, pemoline [Cylert] or similar psycho stimulants) within the past 30 days
  • Be currently pregnant or nursing
  • Have a history of substance abuse, or meet criteria for current alcohol abuse or dependence as assessed by a CAGE test score >= 2 or an Alcohol Use Disorders Identification Test (AUDIT) score >= 13
  • Have surgery planned within the study period
  • Have ever been diagnosed with sleep apnea or have sleep apnea as indicated by endorsing either question 11 (I wake up choking or gasping for air) or question 12 (My bed partner has noticed that I seem to stop breathing) on the Sleep Disorders Symptom Check at the "Often" or "Frequently" level
  • Have serious RLS/PLMs indicated by endorsing two or more items associated with RLS/PLMs on the Sleep Disorders Symptom Check at the "Frequently" level

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Factorial Assignment

Masking

Double Blind

226 participants in 4 patient groups, including a placebo group

Arm I
Placebo Comparator group
Description:
Patients receive oral placebo twice daily for 47 days.
Treatment:
Other: Questionnaire Administration
Procedure: Fatigue Assessment and Management
Procedure: Quality-of-Life Assessment
Procedure: Fatigue Assessment and Management
Other: Placebo
Other: Placebo
Other: Questionnaire Administration
Other: Questionnaire Administration
Other: Questionnaire Administration
Arm II
Experimental group
Description:
Patients receive oral armodafinil twice daily for 47 days.
Treatment:
Other: Questionnaire Administration
Procedure: Quality-of-life assessment
Procedure: Fatigue Assessment and Management
Drug: Armodafinil
Drug: Armodafinil
Procedure: Fatigue Assessment and Management
Procedure: Management of Therapy
Other: Questionnaire Administration
Other: Questionnaire Administration
Other: Questionnaire Administration
Procedure: Sleep Disorder Therapy
Arm III
Experimental group
Description:
Patients receive oral placebo twice daily for 47 days. Patients undergo cognitive behavioral therapy for insomnia comprising sleep restriction therapy, stimulus control instruction, sleep hygiene guidelines, and a session of cognitive therapy for 7 weeks.
Treatment:
Other: Questionnaire Administration
Procedure: Management of therapy and complications
Procedure: Sleep disorder therapy
Procedure: Fatigue assessment and management
Procedure: Sleep disorder therapy
Procedure: cognitive assessment
Procedure: Quality of Life assessment
Other: Placebo
Other: Placebo
Other: Questionnaire Administration
Other: Questionnaire Administration
Other: Questionnaire Administration
Arm IV
Experimental group
Description:
Patients receive oral armodafinil twice daily for 47 days. Patients undergo cognitive behavioral therapy for insomnia as in Arm III for 7 weeks.
Treatment:
Other: Questionnaire Administration
Drug: Armodafinil
Procedure: Sleep disorder therapy
Procedure: Quality of Life Assessment
Drug: Armodafinil
Procedure: Fatifue assessment and management
Procedure: Sleep disorder therapy
Other: Questionnaire Administration
Other: Questionnaire Administration
Other: Questionnaire Administration
Procedure: Cognitive Assessment

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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