search
Back to results

Treatment of Radiation and Cisplatin Induced Toxicities With Tempol

Primary Purpose

Mucositis, Nephrotoxicity, Ototoxicity

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Tempol
Placebo Solution
Sponsored by
Matrix Biomed, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mucositis focused on measuring cisplatin toxicity

Eligibility Criteria

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

Inclusion Criteria:

  1. Be ≥18 years of age with medically diagnosed squamous cell cancer of the head and neck (SCCHN);
  2. Be scheduled to receive radiotherapy or proton therapy administered with a curative intent;
  3. If female and of child bearing potential, be using an effective birth-control method with a history of reliability for the individual participant;
  4. If male and of child bearing potential, adequate methods of contraception must be employed including use of condoms with spermicide. No sperm donation for 90 days until after the conclusion of the study;
  5. Must be receiving cisplatin for chemotherapy;
  6. Be properly informed of the nature and risks of the clinical investigation, comply with all clinical investigation-related procedures, and sign an Informed Consent Form prior to entering the clinical investigation;
  7. Must have a score 2 or less on the ECOG performance status;
  8. Participant life expectancy ≥ 6 months; and
  9. Adequate baseline organ function (hematologic, liver, renal, nutritional and metabolic):

Haematology:

Absolute neutrophil count (ANC) ≥1.5 Hemoglobin ≥ 10 g/dL Platelets ≥ 100,000 per microliter of blood

Hepatic:

Total bilirubin ≤ 2 X (Upper limit normal) ULN Alanine amino transferase (ALT) and Aspartate aminotransferase (AST) ≤5 x ULN

Renal:

Serum creatinine ≤ ULN or, if > ULN calculated creatinine clearance (CrCl) ≥ 60 mL/min.

Nutritional and metabolic:

Urine Albumin < 3.0 mg/dl

Exclusion Criteria:

  1. Prior radiotherapy of the head and neck;
  2. Have a clinically significant infection defined as any acute viral, bacterial or fungal infection, which requires specific therapy. Anti-infectious therapy must have been completed within 14 days of starting study treatment;
  3. Be taking any non-approved therapy for oral mucositis, including β-carotene, tocopherol, laser irradiation, brushing the oral mucosa with silver-nitrate prophylactically, systemic TGF-β (transforming growth factor beta), or systemic KGF (keratinocyte growth factor) during or within 14 days of starting treatment;
  4. Be taking mugard;
  5. Be taking prostaglandins, pentoxifylline or leucovorin during or within 14 days of starting treatment;
  6. Be rinsing with allopurinol, hydrogen peroxide, sucralfate, or chlorhexidine mouthwashes during or within 14 days of starting treatment;
  7. Have had a recent, serious, non-malignant medical complication that, in the opinion of the investigator, makes the individual unsuitable for study participation;
  8. Have used an investigational drug within 28 days of the initiation of study treatment;
  9. Have a history of a positive blood test for HIV;
  10. At the time of screening, having a significant active medical illness which, in the opinion of the investigator, would preclude completion of the study;
  11. Participants with a treatment plan consisting of chemoradiation followed by further chemotherapy;
  12. Participants with body weight less than 35 kg, 77 lbs;
  13. Women who are pregnant or who are breastfeeding;
  14. Participants with known intolerance to platin drugs;
  15. History of insulin-dependent Diabetes Mellitus; and
  16. Participants with Hepatitis B/C.

Sites / Locations

  • UCSDRecruiting
  • Mercy Medical CenterRecruiting
  • UCSF Helen Diller Family Comprehensive Cancer Center
  • Central Coast Medical OncologyRecruiting
  • Mission Hope Health CenterRecruiting
  • Montefiore Medical Center-Einstein CampusRecruiting
  • Wake Forest University Health SciencesRecruiting
  • Seattle Cancer Care AllianceRecruiting
  • University of Washington Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Active 1000 mg Tempol Solution

Placebo Solution

Arm Description

Patients will take 1000 mg of Tempol a day for the duration of radiation treatment (6-8 weeks)

Patients will take placebo solution everyday for the duration of radiation treatment (6-8 weeks)

Outcomes

Primary Outcome Measures

Mucositis
To determine the efficacy of Tempol in reducing the incidence severe mucositis defined as grade 3 or 4 on the World Health Organization (WHO) scale. The incidence will measure the number of patients who experience grade 3 or 4 mucositis according to the World Health Organization (WHO) scale. A reduction in the number of patients who receive grade 3 or 4 mucositis over the course of the treatment is considered a positive change in incidence.

Secondary Outcome Measures

Mucositis
To determine the efficacy of Tempol in reducing the duration severe mucositis defined as grade 3 or 4 on the World Health Organization (WHO) scale. This duration will be measured by total number of days number a patient experiences grade 3 or 4 mucositis according to the World Health Organization (WHO) scale. A reduction in the total number of days a patient receives grade 3 or 4 mucositis over the course of the treatment is considered a positive change in duration.
Nephrotoxicity
Reduction in Serum Creatinine levels in active arm versus placebo arm.
Nephrotoxicity
Reduction in Blood Urea Nitrogen levels in active arm versus placebo arm.
Mucositis
To determine the efficacy of Tempol in reducing the time to onset of grades 1-4 mucositis on the World Health Organization (WHO) scale. This time to onset will measure the number of days after exposure to cisplatin before a patient experiences grade 1 through 4 mucositis according to the World Health Organization (WHO) scale. An increase in the total number of days before a patient receives grade 1 through 4 mucositis after cisplatin exposure is considered a positive change in time to onset.

Full Information

First Posted
March 8, 2018
Last Updated
February 2, 2022
Sponsor
Matrix Biomed, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT03480971
Brief Title
Treatment of Radiation and Cisplatin Induced Toxicities With Tempol
Official Title
A Double Blind, Placebo Controlled Dose Range Finding Study to Assess the Safety, Pharmacokinetics, and Efficacy of Tempol for the Reduction of Severe Mucositis in Head and Neck Cancer Patients Undergoing Combined Radio- and Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 13, 2019 (Actual)
Primary Completion Date
January 2023 (Anticipated)
Study Completion Date
April 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Matrix Biomed, Inc.

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 10 week trial to assess the ability of Tempol to prevent and/or reduce toxicities associated with cisplatin and radiation treatment in head and neck cancer patients. Over the course of the 10 week trial, mucositis, nephrotoxicity, and ototoxicity will be monitored and assessed.
Detailed Description
One hundred and twenty (120) participants with head and neck cancer are scheduled to undergo combined radio- and chemotherapy (n = 120). Nearly all (90% to 97%) participants receiving radiotherapy in the head and neck will develop some degree of mucositis. Of these participants treated with radiotherapy with or without chemotherapy, 34% to 43% will present severe mucositis. As a result, the participant's quality of life is affected, hospital admittance rates are higher, the use of total parenteral nutrition is increased and interruption of treatment is more frequent, all of which compromise tumor control. Mucositis causes 9% to 19% of chemotherapy and radiotherapy interruption. A common chemotherapeutic agent used in head and neck cancer is Cisplatin. Cisplatin (cis- diamminedichloroplatinum(II), CDDP) is an antineoplastic drug used in the treatment of many cancers including testicular cancer, ovarian cancer, bladder cancer, head and neck cancer, esophageal cancer, small and non-small cell lung cancer, breast cancer, cervical cancer, stomach cancer, prostate cancer, brain tumors, neuroblastoma, sarcomas, multiple myeloma, melanoma, mesothelioma, Hodgkin's lymphoma, non-Hodgkin's lymphoma, pancreatic cancer, and thyroid cancer. While toxicities include ototoxicity, gastrotoxicity, myelosuppression, and allergic reactions, the main dose-limiting side effect of cisplatin is nephrotoxicity followed by ototoxicity. Tempol is a piperidine nitroxide. Nitroxides are a class of stable free radical compounds that protects mammalian cells against numerous toxic agents. Tempol protects normal cells from radiation and cisplatin-induced damage; however, in cancerous or tumor cells, Tempol is reduced to its hydroxylamine form that does not and cannot protect the cells from radiation and cisplatin induced damage. This distinction is of particular importance in the setting of cancer treatment, in which both normal and tumor tissue is exposed to radiation and chemotherapy. Without using Tempol, both normal cells and cancer cells suffer from toxicity. Tempol is the only known compound to possess this functional duality. This compound has the potential to prevent many of the toxicities associated with cisplatin and radiation treatment including the prevention of mucositis, nephrotoxicity, and ototoxicity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mucositis, Nephrotoxicity, Ototoxicity
Keywords
cisplatin toxicity

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active 1000 mg Tempol Solution
Arm Type
Active Comparator
Arm Description
Patients will take 1000 mg of Tempol a day for the duration of radiation treatment (6-8 weeks)
Arm Title
Placebo Solution
Arm Type
Placebo Comparator
Arm Description
Patients will take placebo solution everyday for the duration of radiation treatment (6-8 weeks)
Intervention Type
Drug
Intervention Name(s)
Tempol
Other Intervention Name(s)
4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl
Intervention Description
Investigational product is Tempol (4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl) oral solution. Tempol solution is an orange-colored, aqueous solution containing 7% Tempol along with xanthan gum, xylitol, aspartame, acesulfame potassium, sodium saccharin, alcohol, peppermint and wintergreen oils.
Intervention Type
Drug
Intervention Name(s)
Placebo Solution
Intervention Description
The placebo contains the same excipients as the active product plus FD&C Yellow #6 for color matching.
Primary Outcome Measure Information:
Title
Mucositis
Description
To determine the efficacy of Tempol in reducing the incidence severe mucositis defined as grade 3 or 4 on the World Health Organization (WHO) scale. The incidence will measure the number of patients who experience grade 3 or 4 mucositis according to the World Health Organization (WHO) scale. A reduction in the number of patients who receive grade 3 or 4 mucositis over the course of the treatment is considered a positive change in incidence.
Time Frame
10 weeks
Secondary Outcome Measure Information:
Title
Mucositis
Description
To determine the efficacy of Tempol in reducing the duration severe mucositis defined as grade 3 or 4 on the World Health Organization (WHO) scale. This duration will be measured by total number of days number a patient experiences grade 3 or 4 mucositis according to the World Health Organization (WHO) scale. A reduction in the total number of days a patient receives grade 3 or 4 mucositis over the course of the treatment is considered a positive change in duration.
Time Frame
10 weeks
Title
Nephrotoxicity
Description
Reduction in Serum Creatinine levels in active arm versus placebo arm.
Time Frame
10 weeks
Title
Nephrotoxicity
Description
Reduction in Blood Urea Nitrogen levels in active arm versus placebo arm.
Time Frame
10 weeks
Title
Mucositis
Description
To determine the efficacy of Tempol in reducing the time to onset of grades 1-4 mucositis on the World Health Organization (WHO) scale. This time to onset will measure the number of days after exposure to cisplatin before a patient experiences grade 1 through 4 mucositis according to the World Health Organization (WHO) scale. An increase in the total number of days before a patient receives grade 1 through 4 mucositis after cisplatin exposure is considered a positive change in time to onset.
Time Frame
10 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be ≥18 years of age with medically diagnosed squamous cell cancer of the head and neck (SCCHN); Be scheduled to receive radiotherapy or proton therapy administered with a curative intent; If female and of child bearing potential, be using an effective birth-control method with a history of reliability for the individual participant; If male and of child bearing potential, adequate methods of contraception must be employed including use of condoms with spermicide. No sperm donation for 90 days until after the conclusion of the study; Must be receiving cisplatin for chemotherapy; Be properly informed of the nature and risks of the clinical investigation, comply with all clinical investigation-related procedures, and sign an Informed Consent Form prior to entering the clinical investigation; Must have a score 2 or less on the ECOG performance status; Participant life expectancy ≥ 6 months; and Adequate baseline organ function (hematologic, liver, renal, nutritional and metabolic): Haematology: Absolute neutrophil count (ANC) ≥1.5 Hemoglobin ≥ 10 g/dL Platelets ≥ 100,000 per microliter of blood Hepatic: Total bilirubin ≤ 2 X (Upper limit normal) ULN Alanine amino transferase (ALT) and Aspartate aminotransferase (AST) ≤5 x ULN Renal: Serum creatinine ≤ ULN or, if > ULN calculated creatinine clearance (CrCl) ≥ 60 mL/min. Nutritional and metabolic: Urine Albumin < 3.0 mg/dl Exclusion Criteria: Prior radiotherapy of the head and neck; Have a clinically significant infection defined as any acute viral, bacterial or fungal infection, which requires specific therapy. Anti-infectious therapy must have been completed within 14 days of starting study treatment; Be taking any non-approved therapy for oral mucositis, including β-carotene, tocopherol, laser irradiation, brushing the oral mucosa with silver-nitrate prophylactically, systemic TGF-β (transforming growth factor beta), or systemic KGF (keratinocyte growth factor) during or within 14 days of starting treatment; Be taking mugard; Be taking prostaglandins, pentoxifylline or leucovorin during or within 14 days of starting treatment; Be rinsing with allopurinol, hydrogen peroxide, sucralfate, or chlorhexidine mouthwashes during or within 14 days of starting treatment; Have had a recent, serious, non-malignant medical complication that, in the opinion of the investigator, makes the individual unsuitable for study participation; Have used an investigational drug within 28 days of the initiation of study treatment; Have a history of a positive blood test for HIV; At the time of screening, having a significant active medical illness which, in the opinion of the investigator, would preclude completion of the study; Participants with a treatment plan consisting of chemoradiation followed by further chemotherapy; Participants with body weight less than 35 kg, 77 lbs; Women who are pregnant or who are breastfeeding; Participants with known intolerance to platin drugs; History of insulin-dependent Diabetes Mellitus; and Participants with Hepatitis B/C.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Benji Crane
Phone
6264376506
Email
bjcrane@matrixbiomed.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Benji Crane
Organizational Affiliation
Matrix Biomed, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
UCSD
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Individual Site Status
Recruiting
Facility Name
Mercy Medical Center
City
Merced
State/Province
California
ZIP/Postal Code
95340
Country
United States
Individual Site Status
Recruiting
Facility Name
UCSF Helen Diller Family Comprehensive Cancer Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94158
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Central Coast Medical Oncology
City
Santa Maria
State/Province
California
ZIP/Postal Code
93454
Country
United States
Individual Site Status
Recruiting
Facility Name
Mission Hope Health Center
City
Santa Maria
State/Province
California
ZIP/Postal Code
93454
Country
United States
Individual Site Status
Recruiting
Facility Name
Montefiore Medical Center-Einstein Campus
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States
Individual Site Status
Recruiting
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Individual Site Status
Recruiting
Facility Name
Seattle Cancer Care Alliance
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Washington Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
13680535
Citation
Arany I, Safirstein RL. Cisplatin nephrotoxicity. Semin Nephrol. 2003 Sep;23(5):460-4. doi: 10.1016/s0270-9295(03)00089-5.
Results Reference
background
PubMed Identifier
25271439
Citation
Ahmed LA, Shehata NI, Abdelkader NF, Khattab MM. Tempol, a superoxide dismutase mimetic agent, ameliorates cisplatin-induced nephrotoxicity through alleviation of mitochondrial dysfunction in mice. PLoS One. 2014 Oct 1;9(10):e108889. doi: 10.1371/journal.pone.0108889. eCollection 2014. Erratum In: PLoS One. 2014;9(12):e115983.
Results Reference
background
PubMed Identifier
16700732
Citation
Scully C, Sonis S, Diz PD. Oral mucositis. Oral Dis. 2006 May;12(3):229-41. doi: 10.1111/j.1601-0825.2006.01258.x.
Results Reference
background
PubMed Identifier
12783586
Citation
Hartmann JT, Lipp HP. Toxicity of platinum compounds. Expert Opin Pharmacother. 2003 Jun;4(6):889-901. doi: 10.1517/14656566.4.6.889.
Results Reference
background
PubMed Identifier
16020136
Citation
Sastry J, Kellie SJ. Severe neurotoxicity, ototoxicity and nephrotoxicity following high-dose cisplatin and amifostine. Pediatr Hematol Oncol. 2005 Jul-Aug;22(5):441-5. doi: 10.1080/08880010590964381.
Results Reference
background
PubMed Identifier
1850756
Citation
Samuni A, Winkelsberg D, Pinson A, Hahn SM, Mitchell JB, Russo A. Nitroxide stable radicals protect beating cardiomyocytes against oxidative damage. J Clin Invest. 1991 May;87(5):1526-30. doi: 10.1172/JCI115163.
Results Reference
background
PubMed Identifier
1649088
Citation
Samuni A, Mitchell JB, DeGraff W, Krishna CM, Samuni U, Russo A. Nitroxide SOD-mimics: modes of action. Free Radic Res Commun. 1991;12-13 Pt 1:187-94. doi: 10.3109/10715769109145785.
Results Reference
background
PubMed Identifier
2167262
Citation
Samuni A, Krishna CM, Mitchell JB, Collins CR, Russo A. Superoxide reaction with nitroxides. Free Radic Res Commun. 1990;9(3-6):241-9. doi: 10.3109/10715769009145682.
Results Reference
background
PubMed Identifier
22805306
Citation
Mitchell JB, Anver MR, Sowers AL, Rosenberg PS, Figueroa M, Thetford A, Krishna MC, Albert PS, Cook JA. The antioxidant tempol reduces carcinogenesis and enhances survival in mice when administered after nonlethal total body radiation. Cancer Res. 2012 Sep 15;72(18):4846-55. doi: 10.1158/0008-5472.CAN-12-1879. Epub 2012 Jul 17.
Results Reference
background

Learn more about this trial

Treatment of Radiation and Cisplatin Induced Toxicities With Tempol

We'll reach out to this number within 24 hrs