ClinicalTrials.gg
TerminatedNCT03339622Updated Oct 9, 2019

Safety and Efficacy of Smoked Cannabis for Improving Quality of Life in Advanced Cancer Patients

A Phase 3 interventional study of PPP001 and placebo in Cancer and Chronic Pain Due to Malignancy (Finding), sponsored by Tetra Bio-Pharma. Terminated at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-10-09.

Sponsored by Tetra Bio-Pharma · Phase 3, Interventional, and Treatment

Why this study was terminated
Mycotoxin potential contamination of one lot of study drug

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Phase
Phase 3
Study type
Interventional
Enrollment
8
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Cancer causes pain in many of the patients that it affects. Physicians specialized in palliative care help advanced cancer patients to maintain as good pain control as possible through the use of medications such as opioids. Even with palliative care and optimal use of medications, many patients still suffer enormously as the cancer spreads. Because of this, some cancer patients also try or use cannabis in different ways to relieve their pain and improve the way they feel. However, there has not been much high-quality research done yet to prove whether or not cannabis products are truly useful to relieve severe cancer pain. This study is to test if advanced cancer patients who use inhaled medical cannabis (PPP001), in addition to palliative care management, will experience improvement in quality of life and relieve uncontrolled pain, providing safety conditions.

Read the detailed description

This is a 4-week randomized, double-blind, placebo-controlled, parallel group design trial to evaluate the safety and efficacy of inhaled PPP001 to improve quality of life (HRQoL) and reduce pain intensity, in patients with uncontrolled cancer pain and incurable malignancy.

Nine hundred forty six adult patients, male and female, with chronic cancer pain (at least 3 months in duration) and advanced disease, with an average weekly pain intensity score greater than 4 on a 11 points Numerical Rate Scale (NRS), will be prospectively recruited and invited to participate in this trial.

Informed consent will be obtained by a Research Assistant.

After baseline documentation with standardized scales, patients will be randomized to one of 2 parallel groups:

Group A: 4 weeks PPP001-kit three times daily; Group B: 4 weeks placebo-kit three times daily; The inhalation of PPP001 or placebo-kit will be allowed three times a day at 4-6 hour intervals. Rescue medication will also be allowed.

Patients will have a dose titration phase during the first week, followed by an additional 3-week period of treatment. The dose escalation will allow patients to adapt to the potential AEs of cannabis.

Patients will have follow-up after 1 week and 4 weeks of treatment. Once the patient has completed 4 weeks of inhaled PPP001 or placebo, it will be rolled into a long-term follow-up phase until drop-out or death. All patients, including the ones in the placebo group, will be allowed to receive the active treatment once the 4-weeks trial has finished, and continue it until death or drop-out.

02

Conditions studied

  • Cancer
  • Chronic Pain Due to Malignancy (Finding)

Keywords

  • uncontrollable cancer pain
  • incurable malignancy,
03

In context

Neoplasms

10,824 studies on the registry are indexed under Neoplasms; 2,325 are open to participants now.

This study's enrollment of 8 is below the median of 60 across 7,706 interventional studies indexed under Neoplasms.

Browse Neoplasms studies →

Lead sponsor

Tetra Bio-Pharma is the lead sponsor of 7 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Written
  2. Adult male and female patients at least 18 years of age
  3. Subject agreed to follow the protocol
  4. Advanced cancer for which there is no known curative therapy
  5. Patients experiencing pain ≥4 on NRS due to cancer related pain
  6. six weeks or longer
  7. PPI score less than or equal to 4 (survival more than 6 weeks)
  8. PPS greater than or equal 70%
  9. PaP Score Group A (30-day survival probability >70%)
  10. An (ECOG) performance status of 0, 1 or 2
  11. The patient has a clinical diagnosis of cancer related pain, which is not alleviated with their current optimized opioid treatment
  12. The patient is using no more than one type of breakthrough opioid analgesia
  13. Normal cognitive status according to MDAS and MiniCog
  14. Normal liver function (defined as 10-40 U/L and alanine aminotransferase 7-56 U/L)
  15. Normal renal function (defined as serum creatinine level \<133 µmol/L and Estimated (eGFR) greater than or equal to 60)
  16. The patient is able to perform deep inhalations and hold breath for at least 5 to 10 seconds. If there is any pulmonary disease diagnosed previously (obstructive and/or restrictive pathology), the patient must be able to perform a maximal inhalation of at least 12-15 ml/kg measured with an incentive spirometer, followed by a normal exhalation
  17. Ability to read and respond to questions in French or English.
  18. Previous or current use of opioid analgesics (at least 1 week)
  19. A female volunteer must meet one of the following criteria:

    If of - agrees to use one of the accepted regimens from at least 28 days prior to the first drug administration, during the study and for at least 60 days after the last dose. An acceptable method of contraception includes one of the following:

    • Abstinence from heterosexual intercourse
    • Systemic contraceptives (birth control pills, injectable/implant/insertable hormonal birth control products, transdermal patch)
    • Intrauterine device (with or without hormones)
    • Condom with spermicide or condom with intravaginally applied spermicide If of non-childbearing potential - should be surgically sterile (i.e. has undergone complete hysterectomy, bilateral oophorectomy, or tubal ligation) or in a menopausal state (at least one year without menses)
  20. A male volunteer with sexual partners who are pregnant, possibly pregnant, or who could become pregnant must meet the following criteria:

    • Participant is unable to procreate, defined as surgically sterile (i.e. has undergone a vasectomy within the last 6 months)
    • Participant agrees to use one of the accepted contraceptive regimens from first drug administration until 3 months after the last drug administration. An acceptable method of contraception includes one of the following:

A. Abstinence from heterosexual intercourse. B. Condom with spermicide or condom with intravaginally applied spermicide

Exclusion criteria

Exclusion Criteria:

  1. Pain due to other causes different than cancer related pain
  2. Previous serious adverse event or to cannabis or cannabinoids
  3. Inability to understand and comply with the instructions of the study
  4. Presence of significant cardiac disease (history of unstable ischemic heart disease, heart failure, severe and uncontrolled hypertension) that, in the opinion of the investigator, would put the patient at risk of a arrhythmia or myocardial infarction
  5. Current substance use disorder according to the Fifth Edition (DSM 5)
  6. Life-time history of dependence on cannabis or diagnosis of cannabis use disorder (CUD) according to the DSM 5
  7. Life-time history of DSM 5 schizophrenia, bipolar disorder, or previous psychosis with or intolerance to cannabinoids
  8. Current or history of suicidal ideation according to the Columbia-Suicide Severity Rating Scale (C-SSRS) approved by FDA in 2012 for assessment of suicidal ideation and behaviour
  9. Pregnant, breast-feeding or female patients of and male patients whose partner is of child-bearing potential, unless willing to ensure that they or their partner use effective , for example, oral contraception, double barrier, intra-uterine device, during the study and for three months thereafter (however, a male condom should not be used in conjunction with a female condom as this may not prove effective)
  10. Hepatic impairment ( more than three times normal) or renal function impairment (serum creatinine level >133 µmol/L, Estimated (eGFR) \<60)
  11. Cognitive impairment according to MDAS and MiniCog
  12. Patient has any planned clinical interventions that would affect their pain (e.g., chemotherapy or radiation therapy where, in the clinical judgment of the investigator, these would be expected to affect pain)
  13. Cancer treatments that may interfere with stability of treatment (epidural, radiotherapy, chemotherapy, hormonal therapy)
  14. Epilepsy
  15. The patient is currently using or has used cannabinoid based medications within 30 days of study entry and is unwilling to abstain for the duration of the study
  16. Positive urine drug screen for cannabinoids and other potential abuse substances (e.g. alcohol, cocaine, amphetamines and methamphetamines, hallucinogens, unprescribed opioids and ketamine, etc.)
  17. Participation in another clinical trial within 30 days of enrolment in our trial
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
8 participants (actual)

Study arms

  • Experimental
    smoked cannabis (PPP001)

    280 mg dried cannabis pellet -(9% THC / 2% CBD per pellet)

    Combination Product: PPP001

  • Placebo comparator
    THC free placebo

    280 mg dried extracted cannabis pellet (0% THC / 0.6% CBD per pellet)

    Combination Product: placebo

Interventions

  • Combination productPPP001

    1 pellet smoked three times a day with titanium pipe (280 mg dried cannabis pellet - 9% THC / 2% CBD per pellet)

    Also known as: titanium pipe

  • Combination productplacebo

    1 pellet smoked three times a day with titanium pipe (280 mg dried cannabis pellet - 0% THC / 0.6% CBD per pellet)

    Also known as: titanium pipe

06

What researchers measure

Primary outcomes

  1. improve Health Related Quality of Life (HRQoL) of patients with uncontrolled cancer pain and incurable malignancy

    Does the daily use of PPP001-kit improve European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 15 Palliative (EORTC-QLQ-C15-PAL). Scale range is 1 to 4; 1 (Not at All) being the worst rating to the maximal rating of 4 (Very Much).

    Time frame: Change from Baseline in HRQoL at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months.

Secondary outcomes

  1. Does the daily use of PPP001-kit improve uncontrolled cancer pain

    Changes in pain as measured by the Brief Pain Inventory-Short Form (BPI-SF) scale. Scale range is 0 to 10; 0 (No pain) being the best rating to the maximal rating of 10 (Pain as bad as you can imagine).

    Time frame: Change from Baseline in BPI-SF at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months

  2. Does the daily use of PPP001-kit improve symptom burden

    Changes in symptom burden as measured by the revised Edmonton Symptom Assessment System version with Constipation and Sleep was added to assess improvement in symptom burden (ESAS-r-CS). Scale range is 0 to 10; 0 (No symptom) being the best rating to the maximal rating of 10 (Worst possible score for symptom).

    Time frame: Change from Baseline in ESAS-r-CS at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months

  3. Does the daily use of PPP001-kit improve functional status

    Changes in Palliative Performance Scale (PPSv2) version 2. Scale range is a left to right and downward scale for participant to find the best description of their palliative performance. Worst being 0% score representing Dead to PPS 100% representing Full ability to interact and function.

    Time frame: Change from Baseline in PPSv2 at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months

  4. Does the daily use of PPP001-kit improve the QoL of family caregivers

    Changes in Caregivers Quality of Life Index- Cancer (CQOLC). Scale range is 0 to 4; 0 meaning Not at All affected and 4 meaning Very Much affected.

    Time frame: Change from Baseline in CQOLC at Weeks 1 and 4

  5. Changes in validated Udvalg for klinische Undersøgelser (UKU) Side Effects Rating Scale, Self-rating version for Patients (UKU-SERS-Pat)

    Changes in validated Udvalg for klinische Undersøgelser (UKU) Side Effects Rating Scale, Self-rating version for Patients (UKU-SERS-Pat). Scale range is 0 to 3 for rating the degree of severity and a second scale for the investigator that assigns a casual relationship of improbable, possible or probable.

    Time frame: Change versus placebo for safety and tolerability at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months.

  6. Does the daily use of PPP001-kit improve cognition

    Changes in validated Mini-Cog. Scale range is numerical and rates the ability to recall words and ability to draw a clock showing numbers from 1 to 12 and then drawing the given time.

    Time frame: Change versus placebo for Mini-Cog at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months

  7. Does the daily use of PPP001-kit influence pharmacodynamics

    Changes in a 100-mm VAS of good drug effect, and a VAS for the items "high," "relaxed," "stressed," and "happy" (0 = not at all, 10 = extremely)

    Time frame: Change versus placebo for 100-mm VAS at Weeks 1 and 4

  8. Does the daily use of PPP001-kit influence the use of concurrent medications

    Changes in concurrent medications will be measured using the Medication Quantification Scale (MQS) version III. The MQS version III is a method of quantifying different pain drug regimens by evaluating the use of 22 distinct drug classes (e.g., nonsteroidal anti-inflammatory drugs \[NSAIDs\], antidepressants, benzodiazepines, opiates). A single value is calculated based on a patient's pain medication profile, taking into account dosages, and the types of pain medications prescribed.

    Time frame: Change from Baseline in MQS version III at Weeks 1 and 4.

  9. Does the daily use of PPP001-kit improve quality of life

    Changes in validated European Quality of Life-5 Dimensions (EQ-5D). First scale range provides 5 statements that describe the participants health TODAY; it includes 5 different health assessments. The second scale is 0 to 100 and requires that the participant places a mark on the scale showing how good or bad they feel TODAY; 0 meaning The worst health they can imagine; 100 meaning the best health they can imagine.

    Time frame: Change from Baseline in EQ-5D at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months

  10. Does the daily use of PPP001-kit improve uncontrolled cancer pain

    Changes in pain as measured by the Numerical Rating Scale (NRS). The NRS is a measure of the average weekly pain intensity score greater than on a 0 to 10 points scale where 0 is No Pain and 10 is the worst pain.

    Time frame: Change from Baseline in NRS at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months

  11. Does the daily use of PPP001-kit improve mood and illness-understanding

    Changes in validated Memorial Delirium Assessment Scale (MDAS). Scale range is 0 to 3; 0 meaning None and 3 meaning Severe.

    Time frame: Change versus placebo for MDAS at Weeks 1 and 4. Change from baseline at 12-weeks follow-up and every 6-weeks after week 12 follow-up until the date of death from any cause or assessed up to 12 months

  12. Does the daily use of PPP001-kit influence the use of the need for rescue medication

    Rescue medication will be based on the calculation of 10% of the total morphine equivalent daily dose (MEDD). The reduction or increase in the total MEDD will be recorded after starting treatment with PPP001.

    Time frame: Change from Baseline in rescue medication reported as an MEDD at Weeks 1 and 4.

07

Study locations

1 site
  • Sante Cannabis
    Montréal, Quebec H2L 3K9, Canada
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Mar 2018 to primary completion in Dec 2018, 8 months.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 17, 2017
First posted
Nov 13, 2017
StartActual
Mar 29, 2018
Primary completionActual
Dec 17, 2018
CompletionActual
Feb 8, 2019
Last update
Oct 9, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Oct 9, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03339622
Lead sponsor
Tetra Bio-Pharma
Responsible party
Sponsor
First posted
Nov 13, 2017
Start date
Mar 29, 2018
Primary completion
Dec 17, 2018
Completion
Feb 8, 2019
Last update
Oct 9, 2019

Study contacts

Antonio Vigano, MD, MSc
principal investigator · McGill University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Oct 2019. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: PPP001

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