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Pharmacokinetic (PK) Analysis of Antitumor B in Patients With Oral Cancer

Primary Purpose

Squamous Cell Carcinoma of the Oral Cavity

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Antitumor B
Sponsored by
Medical College of Wisconsin
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Squamous Cell Carcinoma of the Oral Cavity focused on measuring Anti-tumor B, ACAPHA, Pharmacokinetics

Eligibility Criteria

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

Inclusion Criteria:

  • Clinical diagnosis of oral cavity squamous cell cancer.
  • Patient can start study agent administration but histological confirmation of squamous cell cancer (SCC) of the oral cavity (or histologic variants of SCC) by the pathologist must happen within 7 days of registration in order to continue study agent administration.
  • Clinical stage II-IVA (as defined by the American Joint Committee on Cancer, 8th Edition) and amenable to surgical resection
  • New diagnosis of oral SCC, new second primary, or recurrent oral SCC following a minimum remission of 6 months following previous definite surgery
  • History and physical examination by an otolaryngologist and medical oncologist within 14 calendar days of study registration
  • Study agent administration should start within 7 days of registration
  • Patient must receive administration of study agent for a minimum of 7 days
  • Zubrod Score/Eastern Cooperative Oncology Group (ECOG) Performance status < 2.
  • Age ≥ 18 years.
  • Complete Blood Count (CBC)/differential obtained within 14 calendar days prior to registration, with adequate bone marrow function defined as follows:

    • Absolute neutrophil count (ANC) ≥ 1,500 cells/mm^3;
    • Platelets ≥ 100,000 cells/mm^3;
    • Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dl is acceptable.);
  • Adequate renal and hepatic function within 14 calendar days prior to registration, defined as follows:

    o Serum creatinine < 1.5 mg/dl or creatinine clearance (CCr) ≥ 50 ml/min within 14 calendar days prior to registration, determined by 24-hour collection or estimated by Cockcroft-Gault formula: CCr male = [(140 - age) x (wt in kg)] [(Serum Cr mg/dl) x (72)] CCr female = 0.85 x (CrCl male)

  • Total bilirubin < 2 x the institutional upper limit of normal (ULN) within 14 calendar days prior to registration
  • aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≤ 3 x the institutional ULN within 14 calendar days prior to registration
  • Magnesium, calcium, glucose, potassium, and sodium within 14 calendar days prior to registration, with the following required parameters:

    • Magnesium: > 0.9 mg/dl or < 3 mg/dl;
    • Calcium: > 7 mg/dl or < 12.5 mg/dl;
    • Glucose: > 40 mg/dl or < 250 mg/dl;
    • Potassium: > 3 mmol/L or < 6 mmol/L;
    • Sodium: > 130 mmol/L or < 155 mmol/L.
  • Female patients must meet one of the following:

    • Postmenopausal for at least one year before the screening visit, or
    • Surgically sterile (e.g., undergone a hysterectomy or bilateral oophorectomy), or
    • If subject is of childbearing potential (defined as not satisfying either of the above two criteria), agree to practice two acceptable methods of contraception (combination methods requires use of two of the following: diaphragm with spermicide, cervical cap with spermicide, contraceptive sponge, male or female condom, hormonal contraceptive) from the time of signing of the informed consent form through 90 days after the last dose of study agent, AND
    • Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [e.g., calendar, ovulation, symptothermal, postovulation methods] and withdrawal are not acceptable contraception methods.)
  • Male patients, even if surgically sterilized (e.g., status post vasectomy), must agree to one of the following:

    • Practice effective barrier contraception during the entire study period and through 60 calendar days after the last dose of study agent, OR
    • Must also adhere to the guidelines of any study-specific pregnancy prevention program, if applicable, OR
    • Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [e.g., calendar, ovulation, symptothermal, post ovulation methods] and withdrawal are not acceptable methods of contraception.)
  • Patients must be deemed able to comply with the study plan.
  • Gastric tube study agent administration is permissible.
  • Patients must provide study-specific informed consent prior to study entry.

Exclusion Criteria:

  • History of active liver disease
  • Pregnant or lactating women are ineligible due to unforeseeable risks to embryo or fetus.
  • Concurrent use of any medicinal botanical, natural, or other herbal compound/s that the study PI believes could potentially impact the results/objectives of this study
  • Planned subtotal or debulking surgery, as determined by enrolling physician determination, is not permissible.
  • Prior systemic chemotherapy for oral SCC; note that prior chemotherapy for a different cancer is allowable.
  • Prior radiotherapy for oral SCC is permissible if disease free for 1 year since prior oral cancer treatment and free of significant late radiation effects.
  • Severe active comorbidity such as uncontrolled cardiac disease, infection, severe Chronic Obstructive Pulmonary Disease (COPD).

Sites / Locations

  • Froedtert Hospital and the Medical College of Wisconsin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Antitumor B

Arm Description

ATB will be administered on an outpatient basis.

Outcomes

Primary Outcome Measures

Area Under the Curve (AUC) for Matrine in Saliva
The total systemic exposure to matrine as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted matrine concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Area Under the Curve for Matrine in Plasma
The total systemic exposure to matrine as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted matrine concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Maximum Concentration (Cmax) of Matrine in Saliva
This measure is the maximum concentration observed. The results will be reported in ng/ml.
Maximum Concentration of Matrine in Plasma
This measure is the maximum concentration observed. The results will be reported in ng/ml.
Area Under the Curve (AUC) for Maackiain in Saliva
The total systemic exposure to maackiain as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted maackiain concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Area Under the Curve (AUC) for Maackiain in Plasma
The total systemic exposure to maackiain as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted maackiain concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Maximum Concentration of Maackiain in Saliva
This measure is the maximum concentration observed. The results will be reported in ng/ml.
Maximum Concentration of Maackiain in Plasma
This measure is the maximum concentration observed. The results will be reported in ng/ml.

Secondary Outcome Measures

Full Information

First Posted
March 1, 2018
Last Updated
May 10, 2023
Sponsor
Medical College of Wisconsin
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT03459729
Brief Title
Pharmacokinetic (PK) Analysis of Antitumor B in Patients With Oral Cancer
Official Title
PK Analysis of Antitumor B in Patients With Oral Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 24, 2021 (Actual)
Primary Completion Date
February 15, 2022 (Actual)
Study Completion Date
February 15, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Medical College of Wisconsin
Collaborators
National Cancer Institute (NCI)

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
A Window of Opportunity Clinical Trial. This study design permits examination of effects of an oral agent on cancer patients during the "window" between diagnosis of their cancer and their definitive cancer surgery. Similar to a phase 0 study, the trial design permits examination of the biologic effects of an agent; in this study pharmacokinetic properties will be examined.
Detailed Description
Study Intervention Description: Study participants will take the natural botanical compound ATB during a short window (7 to 28 days). Participants will provide blood samples, and saliva samples during Anti-tumor B (ATB) administration and a portion of the initial tumor biopsy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Squamous Cell Carcinoma of the Oral Cavity
Keywords
Anti-tumor B, ACAPHA, Pharmacokinetics

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Antitumor B
Arm Type
Experimental
Arm Description
ATB will be administered on an outpatient basis.
Intervention Type
Drug
Intervention Name(s)
Antitumor B
Other Intervention Name(s)
Zeng Sheng Ping, ATB, ACAPHA
Intervention Description
Study participants will take the natural botanical compound ATB during a short window (seven to 28 days). It will be administered at a dose of 1200 mg three times per day (roughly spaced every 8 hours).
Primary Outcome Measure Information:
Title
Area Under the Curve (AUC) for Matrine in Saliva
Description
The total systemic exposure to matrine as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted matrine concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Time Frame
Day 1
Title
Area Under the Curve for Matrine in Plasma
Description
The total systemic exposure to matrine as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted matrine concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Time Frame
Day 1
Title
Maximum Concentration (Cmax) of Matrine in Saliva
Description
This measure is the maximum concentration observed. The results will be reported in ng/ml.
Time Frame
Day 1
Title
Maximum Concentration of Matrine in Plasma
Description
This measure is the maximum concentration observed. The results will be reported in ng/ml.
Time Frame
Day 1
Title
Area Under the Curve (AUC) for Maackiain in Saliva
Description
The total systemic exposure to maackiain as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted maackiain concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Time Frame
Day 1
Title
Area Under the Curve (AUC) for Maackiain in Plasma
Description
The total systemic exposure to maackiain as represented by the AUC will be calculated as the area bounded by the x-axis and the line drawn as straight segments through the plotted maackiain concentrations at the time points: predose (0 minutes), 30 minutes, 60 minutes, 120 minutes, 180 minutes, 240 minutes, 360 minutes, 480 minutes, and 1,440 minutes. The results will be reported in (ng x hour)/ml.
Time Frame
Day 1
Title
Maximum Concentration of Maackiain in Saliva
Description
This measure is the maximum concentration observed. The results will be reported in ng/ml.
Time Frame
Day 1
Title
Maximum Concentration of Maackiain in Plasma
Description
This measure is the maximum concentration observed. The results will be reported in ng/ml.
Time Frame
Day 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Clinical diagnosis of oral cavity squamous cell cancer. Patient can start study agent administration but histological confirmation of squamous cell cancer (SCC) of the oral cavity (or histologic variants of SCC) by the pathologist must happen within 7 days of registration in order to continue study agent administration. Clinical stage II-IVA (as defined by the American Joint Committee on Cancer, 8th Edition [see Amin, 2017]) and amenable to surgical resection New diagnosis of oral SCC, new second primary, or recurrent oral SCC following a minimum remission of 6 months following previous definite surgery History and physical examination by an otolaryngologist and medical oncologist within 14 calendar days of study registration Study agent administration should start within 7 days of registration Patient must receive administration of study agent for a minimum of 7 days Zubrod Score/Eastern Cooperative Oncology Group (ECOG) Performance status < 2. Age ≥ 18 years. Complete Blood Count (CBC)/differential obtained within 14 calendar days prior to registration, with adequate bone marrow function defined as follows: Absolute neutrophil count (ANC) ≥ 1,500 cells/mm^3; Platelets ≥ 100,000 cells/mm^3; Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dl is acceptable.); Adequate renal and hepatic function within 14 calendar days prior to registration, defined as follows: o Serum creatinine < 1.5 mg/dl or creatinine clearance (CCr) ≥ 50 ml/min within 14 calendar days prior to registration, determined by 24-hour collection or estimated by Cockcroft-Gault formula: CCr male = [(140 - age) x (wt in kg)] [(Serum Cr mg/dl) x (72)] CCr female = 0.85 x (CrCl male) Total bilirubin < 2 x the institutional upper limit of normal (ULN) within 14 calendar days prior to registration Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≤ 3 x the institutional ULN within 14 calendar days prior to registration Magnesium, calcium, glucose, potassium, and sodium within 14 calendar days prior to registration, with the following required parameters: Magnesium: > 0.9 mg/dl or < 3 mg/dl; Calcium: > 7 mg/dl or < 12.5 mg/dl; Glucose: > 40 mg/dl or < 250 mg/dl; Potassium: > 3 mmol/L or < 6 mmol/L; Sodium: > 130 mmol/L or < 155 mmol/L. Female patients must meet one of the following: Postmenopausal for at least one year before the screening visit, or Surgically sterile (e.g., undergone a hysterectomy or bilateral oophorectomy), or If the subject is of childbearing potential (defined as not satisfying either of the above two criteria), agree to practice two acceptable methods of contraception (combination methods requires use of two of the following: diaphragm with spermicide, cervical cap with spermicide, contraceptive sponge, male or female condom, hormonal contraceptive) from the time of signing of the informed consent form through 90 days after the last dose of study agent, AND Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [e.g., calendar, ovulation, symptothermal, postovulation methods] and withdrawal are not acceptable contraception methods.) Male patients, even if surgically sterilized (e.g., status post vasectomy), must agree to one of the following: Practice effective barrier contraception during the entire study period and through 60 calendar days after the last dose of study agent, OR Must also adhere to the guidelines of any study-specific pregnancy prevention program, if applicable, OR Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [e.g., calendar, ovulation, symptothermal, post ovulation methods] and withdrawal are not acceptable methods of contraception.) Patients must be deemed able to comply with the study plan. Gastric tube study agent administration is permissible. Patients must provide study-specific informed consent prior to study entry. Exclusion Criteria: History of active liver disease Pregnant or lactating women are ineligible due to unforeseeable risks to embryo or fetus. Concurrent use of any medicinal botanical, natural, or other herbal compound/s that the study PI believes could potentially impact the results/objectives of this study Planned subtotal or debulking surgery, as determined by enrolling physician determination, is not permissible. Prior systemic chemotherapy for oral SCC; note that prior chemotherapy for a different cancer is allowable. Prior radiotherapy for oral SCC is permissible if disease free for 1 year since prior oral cancer treatment and free of significant late radiation effects. Severe active comorbidity such as uncontrolled cardiac disease, infection, severe Chronic Obstructive Pulmonary Disease (COPD).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stuart Wong, MD
Organizational Affiliation
Medical College of Wisconsin
Official's Role
Principal Investigator
Facility Information:
Facility Name
Froedtert Hospital and the Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28094848
Citation
Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, Meyer L, Gress DM, Byrd DR, Winchester DP. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017 Mar;67(2):93-99. doi: 10.3322/caac.21388. Epub 2017 Jan 17.
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Pharmacokinetic (PK) Analysis of Antitumor B in Patients With Oral Cancer

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