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Clinical Study of Noni Extract in Men With Very Low Risk or Low Risk Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Noni extract
Sponsored by
University of Hawaii
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer

Eligibility Criteria

55 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Men with a diagnosis of very low risk (<5% risk of disease relapse after primary treatment, criteria; cT1c, Gleason <6, PSA < 10 ng/mL, fewer than 3 positive biopsy cores < 50% cancer in any core, PSA density < 0.15 ng/mL/g); low risk (10% risk of disease relapse after primary treatment, criteria; cT1-2a, Gleason <6, PSA < 10 ng/mL) prostate cancer
  2. Very low risk and low risk groups will be confirmed by Oncotype DX prostate cancer test and provided a Genomic Prostate Score (GPS)
  3. 55 years of age and older (>/= 55 years) at the time of informed consent
  4. No evidence of extraprostatic disease on 3T multiparametric pelvic MRI
  5. No baseline PT/PTT abnormalities, coagulopathies, or who are on any blood thinners.
  6. ECOG performance status 0-2
  7. Participants must have normal organ and marrow function as demonstrated by the following parameters being:

    • complete blood count (CBC) - no clinically significant findings
    • complete metabolic profile (CMP) - no clinically significant findings
  8. Willing to comply with proposed visit and treatment schedule
  9. Able to understand and willing to sign a written informed consent document

Exclusion Criteria:

  1. Prior history of treated prostate cancer
  2. Concomitant use of medications that are known CYP3A4 substrates
  3. Use of medications or supplements that are known to affect PSA within 30 days prior to informed consent, including toremifene citrate, finasteride, testosterone, dehydroepiandrosterone (DHEA) or other testosterone-like supplements. No dutasteride within 90 days prior to informed consent
  4. Consumption of any concomitant nutritional, herbal supplements, and antioxidants should be taken under the discretion of the investigator. The following foods/supplements are prohibited at least 7 days prior to initiation of and during study treatment:

    • St. John's wort or hyperforin (potent CYP3A4 enzyme inducer)
    • Grapefruit juice (potent cytochrome P450 CYP3A4 enzyme inhibitor)
  5. Use of any blood thinners.
  6. Consumption or use of any Noni or Noni-containing products
  7. History of renal or hepatic disease, including history of hepatitis B or C. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or any psychological, familial, sociological or other concomitant condition that would not allow adequate compliance with the study protocol
  8. Participation in any other investigational study or use of any other investigational agents within 30 days prior to study entry
  9. History of allergic reactions attributed to Noni or other compounds of similar chemical or biologic composition to Noni, or the inactive components present in Noni capsules.

Sites / Locations

  • University of Hawaii Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Noni 6,000 mg/day

Arm Description

Noni extract 6,000 mg/day (4 capsules with breakfast, 4 capsules with lunch and 4 capsules with dinner)

Outcomes

Primary Outcome Measures

Compare Genomic Prostate Score (GPS) in Prostatic Tumors
Exploring gene expression changes on Oncotype DX Genomic Prostate Score (GPS). The Oncotype DX assay is a clinically validated 17-gene genomic assay that provides a genomic prostate score (GPS; scale 0-100) measuring the heterogeneous nature of prostate tumors. A higher score means a higher risk of disease. Unfortunately, Genomic Health was unable to run the assay on 12-month prostate biopsy samples in which active cancer was not identified therefore we only have baseline data.
Number of Positive Cores Associated With Participants Disease Progression of Prostate Cancer
Measure tumor size at screening and compare after 12 months of study participation. Disease progression will be identified by either an increase in Gleason score, increase in positive cores, and/or an increase in tumor volume.

Secondary Outcome Measures

Effects of Noni Extract on Serum Prostate Specific Antigen (PSA) Levels
Comparing the serum Prostate Specific Antigen (PSA) test levels for the duration of the trial in men diagnosed with very low risk or low risk prostate cancer. Measure the duration of time it takes for a subjects Prostate specific antigen level to double.
Frequency of Adverse Events
Tolerability of Noni extract in men diagnosed with very low risk or low risk prostate cancer as assessed by CTCAE v4.0
Explore the Molecular Pathways Contributing to the Activities Associated With Noni Extract in the Prostate Cancer (e.g. Cell Proliferation, and Apoptosis in Prostate Tissue Biopsy Samples) Via Immunohistochemistry (IHC) Staining.
Utilizing prostate tissue biopsy samples and serum blood plasma from participants prior to receiving noni extract and after the subject completes 12 months of receiving noni extract. Apoptosis was quantified based on caspase-3 immunostaining. Proliferation was quantified based on Ki-67 immunostaining.
Explore the Molecular Pathways Contributing to the Activities Associated With Noni Extract in the Prostate Cancer (e.g., Angiogenesis) in Prostate Tissue Biopsy Samples) Via Immunohistochemistry (IHC) Staining.
Utilizing prostate tissue biopsy samples and serum blood plasma from participants prior to receiving noni extract and after the subject completes 12 months of receiving noni extract. MVD, a surrogate for angiogenesis, was quantified based on CD-31 immunostaining.

Full Information

First Posted
December 30, 2015
Last Updated
October 27, 2021
Sponsor
University of Hawaii
Collaborators
University of Hawaii Cancer Research Center
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1. Study Identification

Unique Protocol Identification Number
NCT02648919
Brief Title
Clinical Study of Noni Extract in Men With Very Low Risk or Low Risk Prostate Cancer
Official Title
Phase II Clinical Study of Noni Extract in Men With Very Low Risk or Low Risk Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Terminated
Why Stopped
low accrual
Study Start Date
December 2015 (Actual)
Primary Completion Date
December 2018 (Actual)
Study Completion Date
December 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Hawaii
Collaborators
University of Hawaii Cancer Research Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the effects of Noni extract in men diagnosed with very low risk or low risk prostate cancer
Detailed Description
Efficacy and safety of Noni extract will be assessed in an estimated sample size of 30 subjects. Efficacy will be measured by the induction of favorable gene expression changes on Oncotype Dx Prostate Cancer Test after 12 months of intervention with Noni extract (6,000 mg/day). Other efficacy endpoints include the incidence of tumor progression after 12 months of intervention with Noni extract and serum PSA doubling time. Safety measurements will include the incidence and severity of adverse events, effects on angiogenesis (CD34), cell proliferation (Ki-67), and apoptosis (TUNEL) in prostate tissue biopsy samples from Month 12

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Noni 6,000 mg/day
Arm Type
Experimental
Arm Description
Noni extract 6,000 mg/day (4 capsules with breakfast, 4 capsules with lunch and 4 capsules with dinner)
Intervention Type
Drug
Intervention Name(s)
Noni extract
Other Intervention Name(s)
Healing Noni
Intervention Description
Intervention will be administered on an outpatient basis.Six bottles containing 60 capsules will be dispensed to all participants upon enrollment. Then 12 bottles (at 30-day visit) and 18 bottles (at 3, 6 and 9 month visits) will be dispensed to all participants.
Primary Outcome Measure Information:
Title
Compare Genomic Prostate Score (GPS) in Prostatic Tumors
Description
Exploring gene expression changes on Oncotype DX Genomic Prostate Score (GPS). The Oncotype DX assay is a clinically validated 17-gene genomic assay that provides a genomic prostate score (GPS; scale 0-100) measuring the heterogeneous nature of prostate tumors. A higher score means a higher risk of disease. Unfortunately, Genomic Health was unable to run the assay on 12-month prostate biopsy samples in which active cancer was not identified therefore we only have baseline data.
Time Frame
Change from screening and at 12 months or early termination
Title
Number of Positive Cores Associated With Participants Disease Progression of Prostate Cancer
Description
Measure tumor size at screening and compare after 12 months of study participation. Disease progression will be identified by either an increase in Gleason score, increase in positive cores, and/or an increase in tumor volume.
Time Frame
Change from screening and at 12 months or early termination
Secondary Outcome Measure Information:
Title
Effects of Noni Extract on Serum Prostate Specific Antigen (PSA) Levels
Description
Comparing the serum Prostate Specific Antigen (PSA) test levels for the duration of the trial in men diagnosed with very low risk or low risk prostate cancer. Measure the duration of time it takes for a subjects Prostate specific antigen level to double.
Time Frame
Baseline and 9 months
Title
Frequency of Adverse Events
Description
Tolerability of Noni extract in men diagnosed with very low risk or low risk prostate cancer as assessed by CTCAE v4.0
Time Frame
Enrollment, 1, 3, 6, 9, and 12 months, and 7 days post treatment
Title
Explore the Molecular Pathways Contributing to the Activities Associated With Noni Extract in the Prostate Cancer (e.g. Cell Proliferation, and Apoptosis in Prostate Tissue Biopsy Samples) Via Immunohistochemistry (IHC) Staining.
Description
Utilizing prostate tissue biopsy samples and serum blood plasma from participants prior to receiving noni extract and after the subject completes 12 months of receiving noni extract. Apoptosis was quantified based on caspase-3 immunostaining. Proliferation was quantified based on Ki-67 immunostaining.
Time Frame
Enrollment and 12 months or at early termination
Title
Explore the Molecular Pathways Contributing to the Activities Associated With Noni Extract in the Prostate Cancer (e.g., Angiogenesis) in Prostate Tissue Biopsy Samples) Via Immunohistochemistry (IHC) Staining.
Description
Utilizing prostate tissue biopsy samples and serum blood plasma from participants prior to receiving noni extract and after the subject completes 12 months of receiving noni extract. MVD, a surrogate for angiogenesis, was quantified based on CD-31 immunostaining.
Time Frame
Enrollment and 12 months or at early termination

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men with a diagnosis of very low risk (<5% risk of disease relapse after primary treatment, criteria; cT1c, Gleason <6, PSA < 10 ng/mL, fewer than 3 positive biopsy cores < 50% cancer in any core, PSA density < 0.15 ng/mL/g); low risk (10% risk of disease relapse after primary treatment, criteria; cT1-2a, Gleason <6, PSA < 10 ng/mL) prostate cancer Very low risk and low risk groups will be confirmed by Oncotype DX prostate cancer test and provided a Genomic Prostate Score (GPS) 55 years of age and older (>/= 55 years) at the time of informed consent No evidence of extraprostatic disease on 3T multiparametric pelvic MRI No baseline PT/PTT abnormalities, coagulopathies, or who are on any blood thinners. ECOG performance status 0-2 Participants must have normal organ and marrow function as demonstrated by the following parameters being: complete blood count (CBC) - no clinically significant findings complete metabolic profile (CMP) - no clinically significant findings Willing to comply with proposed visit and treatment schedule Able to understand and willing to sign a written informed consent document Exclusion Criteria: Prior history of treated prostate cancer Concomitant use of medications that are known CYP3A4 substrates Use of medications or supplements that are known to affect PSA within 30 days prior to informed consent, including toremifene citrate, finasteride, testosterone, dehydroepiandrosterone (DHEA) or other testosterone-like supplements. No dutasteride within 90 days prior to informed consent Consumption of any concomitant nutritional, herbal supplements, and antioxidants should be taken under the discretion of the investigator. The following foods/supplements are prohibited at least 7 days prior to initiation of and during study treatment: St. John's wort or hyperforin (potent CYP3A4 enzyme inducer) Grapefruit juice (potent cytochrome P450 CYP3A4 enzyme inhibitor) Use of any blood thinners. Consumption or use of any Noni or Noni-containing products History of renal or hepatic disease, including history of hepatitis B or C. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or any psychological, familial, sociological or other concomitant condition that would not allow adequate compliance with the study protocol Participation in any other investigational study or use of any other investigational agents within 30 days prior to study entry History of allergic reactions attributed to Noni or other compounds of similar chemical or biologic composition to Noni, or the inactive components present in Noni capsules.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey Huang, PharmD
Organizational Affiliation
Faculty
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Hawaii Cancer Center
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96734
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
22436097
Citation
Issell BF, Franke A, Fielding RM. Pharmacokinetic study of Noni fruit extract. J Diet Suppl. 2008;5(4):373-82. doi: 10.1080/19390210802519671.
Results Reference
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Clinical Study of Noni Extract in Men With Very Low Risk or Low Risk Prostate Cancer

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