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Study of CoQ10 During One Cycle of Doxorubicin Treatment for Breast Cancer

Primary Purpose

Breast Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CoQ10
CoQ10 Placebo
Doxorubicin
Cyclophosphamide
Sponsored by
Columbia University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Breast Cancer focused on measuring Breast Cancer, Early Stage Breast Cancer, Complementary and Alternative Medicine, CAM

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of early stage breast cancer (stage I, II, or III);
  • Scheduled to receive at least four rounds of dose dense doxorubicin therapy in the neoadjuvant or adjuvant setting;
  • No other history of prior chemotherapy, radiation, or hormonal therapy in the previous 5 years;
  • For women receiving adjuvant therapy, single lumen implanted venous access device (i.e. single port) for unilateral cancer and double lumen implanted venous access device (i.e. double port) for bilateral breast cancer
  • Age 21 years or older;
  • ECOG performance status ≤ 2 (Karnofsky > 60%);
  • Normal organ and marrow function defined as: Leukocytes ≥ 3,000/uL, Absolute neutrophils count (ANC) ≥ 1,500/uL at baseline, Platelets ≥ 100,000/uL, Total bilirubin ≤ 1.5 X normal institutional limits, AST (SGOT)/ALT (SGPT) ≤ 2.5 X institutional ULN, Serum creatinine within normal institutional limits;
  • Left ventricular ejection fraction > 55%;
  • No history of CoQ10 supplement use within 30 days of initiating study drug;
  • No uncontrolled or significant co-morbid illness;
  • Not pregnant, not breastfeeding, and not planning on becoming pregnant during the course of the study;
  • Willingness to comply with all study intervention and follow-up procedures;
  • Ability to speak English or Spanish; and
  • Ability to provide informed consent.

Exclusion Criteria:

  • Inability to understand or an unwillingness to sign a written informed consent document;
  • Any significant toxic side effects related to first or second dose of doxorubicin/cyclophosphamide chemotherapy or biologic therapy that did not resolve to less than a CTCAE 3.0 grade 3 non-hematological toxicity;
  • Currently using any investigational agent;
  • Unstable or severe intercurrent medical condition that, in the opinion of the investigator, might interfere with the participant's ability to follow the protocol or achieve study objectives;
  • Psychological or sociological conditions, addictive disorders, or family problems that would preclude adherence with study drug or compliance with the protocol
  • Women who report pregnancy, are breast feeding, or have a positive pregnancy test;
  • Use of CoQ10 supplement use within 30 days of initiating study drug;
  • Use of over-the-counter nutritional vitamin greater than 5x RDA;
  • Fish allergy (due to fish-based softgel shell);
  • Currently taking FDA cardioprotective drugs, such as Zinecard (dexrazoxane);
  • History of chronic hepatitis B, hepatitis C, and HIV infection;
  • Problems swallowing oral medications due to prolonged emesis, mucositis, esophageal dysfunction, etc.; and,
  • Currently taking any form of antioxidant supplements while on study.
  • Use of warfarin.
  • Kosher (due to fish-based softgel shell)
  • Dietary restriction of tilapia (due to tilapia fish-based softgel shell)
  • Titanium Dioxide allergy (due to the opaque coloring used in the softgel).

Sites / Locations

  • Columbia University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Arm A Placebo

Arm B CoQ10

Arm Description

Patients will begin taking their study pills (CoQ10) on the morning of Cycle 2 Day 3 (11-15 days prior to Cycle 3), and will continue taking the study pills through the morning of their Cycle 3 infusion (Day 1 Cycle 3). Patients will then be crossed-over to the alternative condition. On the morning of Cycle 3 Day 3, patients will begin taking their study pills (CoQ10 placebo) and will continue taking the study pills through the morning of their Cycle 4 infusion (Day 1 Cycle 4). Infusion will be standard of care chemotherapy with doxorubicin and cyclophosphamide.

Patients will begin taking their study pills (CoQ10 placebo) on the morning of Cycle 2 Day 3 (11-15 days prior to Cycle 3), and will continue taking the study pills through the morning of their Cycle 3 infusion (Day 1 Cycle 3). Patients will then be crossed-over to the alternative condition. On the morning of Cycle 3 Day 3, patients will begin taking their study pills (CoQ10) and will continue taking the study pills through the morning of their Cycle 4 infusion (Day 1 Cycle 4). Infusion will be standard of care chemotherapy with doxorubicin and cyclophosphamide.

Outcomes

Primary Outcome Measures

Maximum tolerated dose of CoQ10 that does not alter the pharmacokinetics of doxorubicin
To test increasing doses on different groups of people until the highest dose with acceptable side effects is found.

Secondary Outcome Measures

Full Information

First Posted
September 11, 2009
Last Updated
October 13, 2022
Sponsor
Columbia University
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1. Study Identification

Unique Protocol Identification Number
NCT00976131
Brief Title
Study of CoQ10 During One Cycle of Doxorubicin Treatment for Breast Cancer
Official Title
Phase I Randomized, Placebo-Controlled, Cross-Over, Dose-Finding Pharmacokinetic Study of CoQ10 During One Cycle of Doxorubicin Treatment for Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Completed
Study Start Date
September 2009 (Actual)
Primary Completion Date
September 30, 2012 (Actual)
Study Completion Date
January 20, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Columbia University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study hopes to examine the effects of Coenzyme Q10 on doxorubicin (Adriamycin) metabolism during breast cancer treatment.
Detailed Description
Doxorubicin is a lifesaving breast cancer treatment. However, approximately 3-20% of women who receive doxorubicin treatment experience some damage to their heart muscle. Coenzyme Q10 is a fat soluble antioxidant dietary supplement that may protect against this heart damage during doxorubicin treatment. It is unknown how Coenzyme Q10 may interact with doxorubicin. This study will assess the effects of Coenzyme Q10 on doxorubicin metabolism. This is a phase I randomized, placebo-controlled, cross-over pharmacokinetic and dose-finding study to assess the safety of CoQ10 during doxorubicin treatment for breast cancer. Safety will be assessed by measuring 1) intra-patient differences in doxorubicin and its active metabolites, with and without CoQ10, and 2) adverse events. The investigator hypothesizes that CoQ10 administration during doxorubicin treatment is safe and will not affect doxorubicin active metabolites. Using three dose levels of CoQ10, the maximum tolerated dose (MTD) will be determined by assessing change in doxorubicin concentration (area under the curve (AUC), change in peak concentration levels (Cmax)), and adverse events.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
Breast Cancer, Early Stage Breast Cancer, Complementary and Alternative Medicine, CAM

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A Placebo
Arm Type
Placebo Comparator
Arm Description
Patients will begin taking their study pills (CoQ10) on the morning of Cycle 2 Day 3 (11-15 days prior to Cycle 3), and will continue taking the study pills through the morning of their Cycle 3 infusion (Day 1 Cycle 3). Patients will then be crossed-over to the alternative condition. On the morning of Cycle 3 Day 3, patients will begin taking their study pills (CoQ10 placebo) and will continue taking the study pills through the morning of their Cycle 4 infusion (Day 1 Cycle 4). Infusion will be standard of care chemotherapy with doxorubicin and cyclophosphamide.
Arm Title
Arm B CoQ10
Arm Type
Experimental
Arm Description
Patients will begin taking their study pills (CoQ10 placebo) on the morning of Cycle 2 Day 3 (11-15 days prior to Cycle 3), and will continue taking the study pills through the morning of their Cycle 3 infusion (Day 1 Cycle 3). Patients will then be crossed-over to the alternative condition. On the morning of Cycle 3 Day 3, patients will begin taking their study pills (CoQ10) and will continue taking the study pills through the morning of their Cycle 4 infusion (Day 1 Cycle 4). Infusion will be standard of care chemotherapy with doxorubicin and cyclophosphamide.
Intervention Type
Drug
Intervention Name(s)
CoQ10
Other Intervention Name(s)
Coenzyme Q10
Intervention Description
Capsules taken daily for two weeks prior to Cycle 3 chemotherapy infusion OR Capsules taken daily for two weeks prior to Cycle 4 infusion. Dose Level 1: 300mg/d CoQ10 (2 capsules) Dose Level 2: 600mg/d CoQ10 (4 capsules) Dose Level 3: 1200mg/d CoQ10 (8 capsules)
Intervention Type
Other
Intervention Name(s)
CoQ10 Placebo
Other Intervention Name(s)
Coenzyme Q10 Placebo
Intervention Description
Capsules taken daily for two weeks prior to Cycle 3 chemotherapy infusion OR Capsules taken daily for two weeks prior to Cycle 4 infusion. Dose Level 1: 300mg/d placebo (2 capsules) Dose Level 2: 600mg/d placebo (4 capsules) Dose Level 3: 1200mg/d placebo (8 capsules)
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Other Intervention Name(s)
Doxil
Intervention Description
Standard of care chemotherapy medication used to treat cancer.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
Cytoxan
Intervention Description
Standard of care chemotherapy medication used to treat cancer.
Primary Outcome Measure Information:
Title
Maximum tolerated dose of CoQ10 that does not alter the pharmacokinetics of doxorubicin
Description
To test increasing doses on different groups of people until the highest dose with acceptable side effects is found.
Time Frame
At the end of Cycle 4 Day 2 (each cycle is 21 days)

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of early stage breast cancer (stage I, II, or III); Scheduled to receive at least four rounds of dose dense doxorubicin therapy in the neoadjuvant or adjuvant setting; No other history of prior chemotherapy, radiation, or hormonal therapy in the previous 5 years; For women receiving adjuvant therapy, single lumen implanted venous access device (i.e. single port) for unilateral cancer and double lumen implanted venous access device (i.e. double port) for bilateral breast cancer Age 21 years or older; ECOG performance status ≤ 2 (Karnofsky > 60%); Normal organ and marrow function defined as: Leukocytes ≥ 3,000/uL, Absolute neutrophils count (ANC) ≥ 1,500/uL at baseline, Platelets ≥ 100,000/uL, Total bilirubin ≤ 1.5 X normal institutional limits, AST (SGOT)/ALT (SGPT) ≤ 2.5 X institutional ULN, Serum creatinine within normal institutional limits; Left ventricular ejection fraction > 55%; No history of CoQ10 supplement use within 30 days of initiating study drug; No uncontrolled or significant co-morbid illness; Not pregnant, not breastfeeding, and not planning on becoming pregnant during the course of the study; Willingness to comply with all study intervention and follow-up procedures; Ability to speak English or Spanish; and Ability to provide informed consent. Exclusion Criteria: Inability to understand or an unwillingness to sign a written informed consent document; Any significant toxic side effects related to first or second dose of doxorubicin/cyclophosphamide chemotherapy or biologic therapy that did not resolve to less than a CTCAE 3.0 grade 3 non-hematological toxicity; Currently using any investigational agent; Unstable or severe intercurrent medical condition that, in the opinion of the investigator, might interfere with the participant's ability to follow the protocol or achieve study objectives; Psychological or sociological conditions, addictive disorders, or family problems that would preclude adherence with study drug or compliance with the protocol Women who report pregnancy, are breast feeding, or have a positive pregnancy test; Use of CoQ10 supplement use within 30 days of initiating study drug; Use of over-the-counter nutritional vitamin greater than 5x RDA; Fish allergy (due to fish-based softgel shell); Currently taking FDA cardioprotective drugs, such as Zinecard (dexrazoxane); History of chronic hepatitis B, hepatitis C, and HIV infection; Problems swallowing oral medications due to prolonged emesis, mucositis, esophageal dysfunction, etc.; and, Currently taking any form of antioxidant supplements while on study. Use of warfarin. Kosher (due to fish-based softgel shell) Dietary restriction of tilapia (due to tilapia fish-based softgel shell) Titanium Dioxide allergy (due to the opaque coloring used in the softgel).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heather Greenlee, ND, PhD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Study of CoQ10 During One Cycle of Doxorubicin Treatment for Breast Cancer

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