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A Trial of TBL12 Sea Cucumber Extract in Patients With Untreated Asymptomatic Myeloma

Primary Purpose

Myeloma

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
TBL12
Sponsored by
NYU Langone Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myeloma focused on measuring multiple myeloma, myeloma, asymptomatic myeloma, smoldering myeloma, Asymptomatic (smoldering) myeloma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of multiple myeloma based on standard criteria as follows:

Major Criteria

  • Plasmacytomas on tissue biopsy
  • Bone marrow plasmacytosis (> 30% plasma cells)
  • Monoclonal immunoglobulin (Ig) spike on serum electrophoresis (IgG > 3.5 g/dL or IgA > 2.0 g/dL); kappa or lambda light chain excretion > 1 g/day on 24 hour urine protein electrophoresis

Minor Criteria

  • Bone marrow plasmacytosis (10 to 30% plasma cells)
  • Monoclonal immunoglobulin present but of lesser magnitude than given under major criteria
  • Normal IgM < 50 mg/dL, IgA < 100 mg/dL, or IgG < 600 mg/dL

Any of the following sets of criteria will confirm the diagnosis of Multiple Myeloma:

  • Any two of the major criteria
  • Major criterion 1 plus minor criterion b, c
  • Major criterion 3 plus minor criterion a or c
  • Minor criteria a, b and c

    • Measurable disease, defined as a monoclonal immunoglobulin spike on serum electrophoresis of ≥ 1 g/dL and/or urine monoclonal immunoglobulin spike of ≥ 200 mg/24 hours.
    • Non-secretors must have measurable protein by Freelite or measurable disease such as plasmacytoma to be eligible.
    • Has asymptomatic disease, i.e., does not have hypercalcemia, renal insufficiency, anemia or bone lesions.
    • Karnofsky performance status ≥ 80 (See Appendix B)
    • Is infertile (i.e. surgically sterile or 12 months post-menopausal) or is practicing an adequate form of contraception, as judged by the investigator (i.e., birth control pills, double barrier method, abstinence, etc.)
    • Age 18 years or older
    • Has given voluntary written informed consent, prior to any study-related procedure not part of normal medical care, with the understanding that the patient may withdraw consent at any time without prejudice to future medical care.

Exclusion Criteria:

  • Prior treatment for myeloma (symptomatic or asymptomatic).
  • POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein (M-protein) and skin changes)
  • Plasma cell leukemia
  • Patients with a history of thyroid problems.
  • Receiving steroids > the equivalent of 10 mg prednisone daily for other medical conditions, e.g., asthma, systemic lupus erythematosis, rheumatoid arthritis
  • Infection not controlled by antibiotics
  • Human Immunodeficiency Virus (HIV) infection. Patients should provide consent for HIV testing according to the institution's standard practice
  • Known active hepatitis B or C
  • New York Hospital Association (NYHA) Class III or IV heart failure or EKG evidence of acute ischemic disease
  • Second malignancy requiring treatment in last 3 years
  • Other serious medical or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol
  • Positive pregnancy test in women of childbearing potential

Sites / Locations

  • New York University School of Medicine, Clinical Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sea cucumber extract

Arm Description

TBL12 is administered orally at a dose of 2 units (of 20 mL each) twice a day, in 4-week cycles, until disease progression or there is sign of disease progression.

Outcomes

Primary Outcome Measures

Duration of Response (All Treated Patients)
Response [complete response (CR), partial response (PR), and stable disease (SD)] was assessed after approximately 2 months, 6 months and then every 4 months, until progression of disease. Response and progression of disease evaluation is based on the criteria reported by Blade, et al. (1998).
Duration of Response (Excluding Patient Choice and Non-compliance)
Response [complete response (CR), partial response (PR), and stable disease (SD)] was assessed after approximately 2 months, 6 months and then every 4 months, until progression of disease. Response and progression of disease evaluation is based on the criteria reported by Blade, et al. (1998).

Secondary Outcome Measures

Percentage of Patients Who Have Responded to TBL12
Response to TBL12 is defined as SD or better after 2 cycles of TBL12. The evaluation of SD, PR, or CR is based on the report by Blade et al. (1998)

Full Information

First Posted
February 14, 2011
Last Updated
February 11, 2015
Sponsor
NYU Langone Health
Collaborators
Unicorn Pacific Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01302366
Brief Title
A Trial of TBL12 Sea Cucumber Extract in Patients With Untreated Asymptomatic Myeloma
Official Title
A Phase II Trial of TBL12 Sea Cucumber Extract in Patients With Untreated Asymptomatic Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2015
Overall Recruitment Status
Terminated
Why Stopped
due to lack of funding
Study Start Date
February 2011 (undefined)
Primary Completion Date
December 2013 (Actual)
Study Completion Date
December 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NYU Langone Health
Collaborators
Unicorn Pacific Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study proposes to determine the clinical activity of this agent in patients with asymptomatic multiple myeloma. It is believed that TBL12 will help delay the onset of active multiple myeloma, with very few-if any- side effects.
Detailed Description
Multiple myeloma is a cancer that evolves from a state known as Monoclonal Gammopathy of Undetermined Significance (MGUS), defined by parameters of M spike and bone marrow. After evolution to myeloma, patients may be asymptomatic, that is, without any endorgan disease of hypercalcemia, renal insufficiency, anemia or bone lesions. In asymptomatic myeloma (ASxM), there is no standard therapy. Thalidomide has been tried in patients with ASxM but with significant toxicity. The patients with ASxM are evaluable in terms of paraprotein measurements. TBL12 sea cucumber extract has been shown to have a number of antitumor properties preclinically, including antiangiogenesis and direct tumor cytotoxicity. TBL12 has been used by a number of patients as a food supplement without any toxicity detected. The investigators thus propose to determine the clinical activity of this agent in patients with ASxM. Patients will be given TBL12 at the dose of 2 units of 20 mL each twice per day daily until disease progression and the effects on the paraprotein noted. Clinical effects seen will be correlated with any in vitro changes in angiogenesis in patient bone marrow samples. The results of this trial may form the basis for the use of this nontoxic agent in patients with the prodrome of or with other early cancers.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myeloma
Keywords
multiple myeloma, myeloma, asymptomatic myeloma, smoldering myeloma, Asymptomatic (smoldering) myeloma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sea cucumber extract
Arm Type
Experimental
Arm Description
TBL12 is administered orally at a dose of 2 units (of 20 mL each) twice a day, in 4-week cycles, until disease progression or there is sign of disease progression.
Intervention Type
Drug
Intervention Name(s)
TBL12
Primary Outcome Measure Information:
Title
Duration of Response (All Treated Patients)
Description
Response [complete response (CR), partial response (PR), and stable disease (SD)] was assessed after approximately 2 months, 6 months and then every 4 months, until progression of disease. Response and progression of disease evaluation is based on the criteria reported by Blade, et al. (1998).
Time Frame
up to 3 years
Title
Duration of Response (Excluding Patient Choice and Non-compliance)
Description
Response [complete response (CR), partial response (PR), and stable disease (SD)] was assessed after approximately 2 months, 6 months and then every 4 months, until progression of disease. Response and progression of disease evaluation is based on the criteria reported by Blade, et al. (1998).
Time Frame
up to 3 years
Secondary Outcome Measure Information:
Title
Percentage of Patients Who Have Responded to TBL12
Description
Response to TBL12 is defined as SD or better after 2 cycles of TBL12. The evaluation of SD, PR, or CR is based on the report by Blade et al. (1998)
Time Frame
2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of multiple myeloma based on standard criteria as follows: Major Criteria Plasmacytomas on tissue biopsy Bone marrow plasmacytosis (> 30% plasma cells) Monoclonal immunoglobulin (Ig) spike on serum electrophoresis (IgG > 3.5 g/dL or IgA > 2.0 g/dL); kappa or lambda light chain excretion > 1 g/day on 24 hour urine protein electrophoresis Minor Criteria Bone marrow plasmacytosis (10 to 30% plasma cells) Monoclonal immunoglobulin present but of lesser magnitude than given under major criteria Normal IgM < 50 mg/dL, IgA < 100 mg/dL, or IgG < 600 mg/dL Any of the following sets of criteria will confirm the diagnosis of Multiple Myeloma: Any two of the major criteria Major criterion 1 plus minor criterion b, c Major criterion 3 plus minor criterion a or c Minor criteria a, b and c Measurable disease, defined as a monoclonal immunoglobulin spike on serum electrophoresis of ≥ 1 g/dL and/or urine monoclonal immunoglobulin spike of ≥ 200 mg/24 hours. Non-secretors must have measurable protein by Freelite or measurable disease such as plasmacytoma to be eligible. Has asymptomatic disease, i.e., does not have hypercalcemia, renal insufficiency, anemia or bone lesions. Karnofsky performance status ≥ 80 (See Appendix B) Is infertile (i.e. surgically sterile or 12 months post-menopausal) or is practicing an adequate form of contraception, as judged by the investigator (i.e., birth control pills, double barrier method, abstinence, etc.) Age 18 years or older Has given voluntary written informed consent, prior to any study-related procedure not part of normal medical care, with the understanding that the patient may withdraw consent at any time without prejudice to future medical care. Exclusion Criteria: Prior treatment for myeloma (symptomatic or asymptomatic). POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein (M-protein) and skin changes) Plasma cell leukemia Patients with a history of thyroid problems. Receiving steroids > the equivalent of 10 mg prednisone daily for other medical conditions, e.g., asthma, systemic lupus erythematosis, rheumatoid arthritis Infection not controlled by antibiotics Human Immunodeficiency Virus (HIV) infection. Patients should provide consent for HIV testing according to the institution's standard practice Known active hepatitis B or C New York Hospital Association (NYHA) Class III or IV heart failure or EKG evidence of acute ischemic disease Second malignancy requiring treatment in last 3 years Other serious medical or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol Positive pregnancy test in women of childbearing potential
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Amitabha Mazumder, MD
Organizational Affiliation
NYU School of Medicine, Clinical Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
New York University School of Medicine, Clinical Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
9753033
Citation
Blade J, Samson D, Reece D, Apperley J, Bjorkstrand B, Gahrton G, Gertz M, Giralt S, Jagannath S, Vesole D. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol. 1998 Sep;102(5):1115-23. doi: 10.1046/j.1365-2141.1998.00930.x. No abstract available.
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A Trial of TBL12 Sea Cucumber Extract in Patients With Untreated Asymptomatic Myeloma

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