ClinicalTrials.Veeva

Menu

Tobacco Treatment Optimization and Preferences During Concurrent Cancer Treatment (TTOP)

J

Joseph Valentino, MD

Status and phase

Completed
Phase 2

Conditions

Cancer, Treatment-Related
Smoking Cessation

Treatments

Drug: Bupropion
Behavioral: High-intensity counseling
Other: No nicotine replacement therapy
Drug: Nicotine Replacement Products
Drug: Long-acting nicotine replacement therapy
Drug: Varenicline
Behavioral: Low-intensity counseling

Study type

Interventional

Funder types

Other

Identifiers

NCT04634071
MCC-20-MULTI-34

Details and patient eligibility

About

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.

Full description

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.

Revised Enrollment Number: Effective with Amendment 2, Expand targeted enrollment from 96 to 126 due to higher than expected drop-out/censoring rate in order to evaluate the primary endpoint

Enrollment

126 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • 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

Exclusion criteria

  • 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

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

126 participants in 12 patient groups

Group 1: Varenicline, Intense Counselling and NRT
Experimental group
Description:
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.
Treatment:
Drug: Varenicline
Drug: Nicotine Replacement Products
Behavioral: High-intensity counseling
Group : Varenicline, Intense Counselling
Experimental group
Description:
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.
Treatment:
Drug: Varenicline
Other: No nicotine replacement therapy
Behavioral: High-intensity counseling
Group 3: Varenicline, Minimal Counselling and NRT
Experimental group
Description:
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.
Treatment:
Behavioral: Low-intensity counseling
Drug: Varenicline
Drug: Nicotine Replacement Products
Group 4: Varenicline, Minimal Counselling
Experimental group
Description:
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.
Treatment:
Behavioral: Low-intensity counseling
Drug: Varenicline
Other: No nicotine replacement therapy
Group 5: Buproprion, Intense Counselling and NRT
Experimental group
Description:
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.
Treatment:
Drug: Nicotine Replacement Products
Behavioral: High-intensity counseling
Drug: Bupropion
Group 6: Buproprion, Intense Counselling
Experimental group
Description:
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.
Treatment:
Other: No nicotine replacement therapy
Behavioral: High-intensity counseling
Drug: Bupropion
Group 7: Buproprion, Minimal Counselling and NRT
Experimental group
Description:
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.
Treatment:
Behavioral: Low-intensity counseling
Drug: Nicotine Replacement Products
Drug: Bupropion
Group 8: Buproprion, Minimal Counselling
Experimental group
Description:
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.
Treatment:
Behavioral: Low-intensity counseling
Other: No nicotine replacement therapy
Drug: Bupropion
Group 9: Nicotine, Intense Counselling and NRT
Experimental group
Description:
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.
Treatment:
Drug: Long-acting nicotine replacement therapy
Drug: Nicotine Replacement Products
Behavioral: High-intensity counseling
Group 10: Nicotine, Intense Counselling
Experimental group
Description:
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.
Treatment:
Drug: Long-acting nicotine replacement therapy
Other: No nicotine replacement therapy
Behavioral: High-intensity counseling
Group 11: Nicotine, Minimal Counselling and NRT
Experimental group
Description:
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.
Treatment:
Behavioral: Low-intensity counseling
Drug: Long-acting nicotine replacement therapy
Drug: Nicotine Replacement Products
Group 12: Nicotine, Minimal Counselling
Experimental group
Description:
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.
Treatment:
Behavioral: Low-intensity counseling
Drug: Long-acting nicotine replacement therapy
Other: No nicotine replacement therapy

Trial contacts and locations

3

Loading...

Central trial contact

Joseph Valentino, MD

Data sourced from clinicaltrials.gov

Clinical trials

Find clinical trialsTrials by location
© Copyright 2026 Veeva Systems