Modified MAC Diet and Gut Microbiota in CRC Patients
Primary Purpose
Colorectal Cancer, Gut Microbiota, Diet Intervention
Status
Unknown status
Phase
Not Applicable
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Modified MAC diet (3-weeks)
Sponsored by
About this trial
This is an interventional treatment trial for Colorectal Cancer focused on measuring Colorectal Cancer, Gut Microbiota, microbiota accessible carbohydrates
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed colorectal adenocarcinoma patients after curative surgery without post-operative chemotherapy (stage I and low-risk stage II)
- Male of female participants over the age of 19
- Eastern Cooperative Oncology Group (ECOG) performance score 0-2
- Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form and in this protocol
- Adequate hematologic and end-organ function
Exclusion Criteria:
- Patients with temporary/permanent stoma after surgery
- Diagnosed with locally advanced stage (more than high-risk stage II) colorectal cancer which require postoperative chemotherapy after surgery
- Diagnosed with metastatic stage IV colorectal cancer after surgery
- Uncontrolled diabetes (glycated hemoglobin A1c (HbA1c) > 8.0 g/dl)
- Active infection requiring antibiotics, antifungal or antiviral agents or received a course of antibiotics within 4 weeks prior to study treatments
- Known history of food allergy
- Known history of uncontrolled intercurrent illness including but not limited to: Infection/inflammation; severe liver dysfunction; bilateral interstitial lung disease; uncontrolled kidney disease; clinically significant (active) cardiovascular and pulmonary disease; hemorrhagic disease; inflammatory bowel disease, intestinal obstruction; Inability to swallow food; social and psychological problems etc.)
- Other medical and psychiatric conditions that would prohibit the understanding or rendering of informed consent which affect study compliance
Sites / Locations
- Korea University Anam Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Group 1
Group 2
Arm Description
Group 1: Modified MAC diet (first 3-weeks) followed by conventional diet (second 3-weeks)
Group 2: Conventional diet (first 3-weeks) followed by modified MAC diet (second 3-weeks)
Outcomes
Primary Outcome Measures
The change of gut microbiota diversity
a-diversity for interpersonal change and b-diversity for groups using 16s rRNA sequencing
Secondary Outcome Measures
The change of stool formation pattern
Daily check for stool pattern using Bristol Stool Score
The change of quality of life
3 times check for quality of life using EORTC QLQ-C30 plus QLQ-CR29 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 30 items for Common function and symptom plus 29 items specific for colorectal cancer, It is converted into a score range from 0-100, and the overall quality of life score is high, The higher the functional domain score and the lower the symptom domain score, the better the quality of life.)
The change of quality of life
3 times check for quality of life using EORTC QLQ-C30 plus QLQ-CR29
The change of gut microbiota metabolite
Analysis for gut microbiota producing short chain fatty acid
Full Information
NCT ID
NCT05039060
First Posted
August 10, 2021
Last Updated
August 31, 2021
Sponsor
Korea University Anam Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05039060
Brief Title
Modified MAC Diet and Gut Microbiota in CRC Patients
Official Title
A Modified Microbiota-Accessible Carbohydrates (MAC) Diet and Change of Gut Microbiota in Patients With Colorectal Cancer After Surgery: A Prospective, Open-label, Cross-over, Single Center Study
Study Type
Interventional
2. Study Status
Record Verification Date
August 2021
Overall Recruitment Status
Unknown status
Study Start Date
September 1, 2021 (Anticipated)
Primary Completion Date
November 30, 2022 (Anticipated)
Study Completion Date
February 28, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Korea University Anam Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
To explore the changes in the composition and diversity of intestinal microbiota during 3-weeks of modified MAC diet and conventional diet in stage I or low-risk stage II colorectal cancer (CRC) patients after surgery. Additionally, the investigator analyze the association of gut microbiota and stool formation pattern or quality of life according to dietary pattern. Therefore, the investigator identify the beneficial or harmful microbiota composition and diversity adapting modified MAC diet that related to cancer recurrence, which provide supporting evidence for future prospective trial.
Detailed Description
Colorectal cancer is the third most common cancer worldwide and a life-threatening disease that kills more than 500,000 people every year. It is known that, environmental factors such as diet and lifestyle play an important role in the development of colorectal cancer due to large differences in the incidence rate by region in addition to the genetic background associated with colorectal cancer. The physical activity, whole grains, dietary fiber, dairy products, and calcium supplement intake are factors that inhibit colorectal cancer, but red meat, processed meat, alcohol, and obesity act as risk factors inducing colorectal cancer. Therefore, it can be said that efforts to prevent cancer are important compared to other cancers.
A growing interest in the interaction of the gut microbiome with its host and its important role in health and disease is revealing that the interaction of the gut microbiome with humans plays an important role in the development of degenerative diseases, cancers and inflammatory diseases. According to recent studies, the risk of colorectal cancer is increased by the presence of specific gut microbiota, dysbiosis, and the interaction between diet and gut microbes. In other words, changes in diet affect the formation of the intestinal microbiota, and conversely, microorganisms mediate the generation of dietary factors that cause colorectal cancer.
In addition, microorganisms such as Fusobacterium nucleatum regulate autophagy and play a role in making it resistant to chemotherapy after colon cancer surgery, or whole grains in colorectal cancer patients with Fusobacterium nucleatum in tumor tissue. However, a cohort study has also reported that consuming a diet rich in dietary fiber helps to lower the incidence of colorectal cancer.
Diet and nutrients play a decisive role in the composition of the intestinal microflora involved in the regulation of inflammation and immune responses.
Microbiota-Accessible Carbohydrates (MAC) refer to carbohydrates that the human intestine cannot digest, but that can be digested by intestinal microbes. It is not decomposed and not absorbed in the stomach or small intestine, and then broken down in the large intestine and then digested and metabolized by the intestinal microflora. During that process, short chain fatty acid (SCFA) is produced, which is known to increase beneficial intestinal bacteria and decrease inflammation around intestinal cells.
The composition of intestinal microbes changes due to intestinal preparation before colon cancer surgery, use of prophylactic antibiotics, and tissue changes in the intestine anastomosis, which may lead to enhanced toxicity, proliferation of pathogens, and reduction of beneficial intestinal bacteria. In addition, the presence of certain microorganisms may lead to complications such as anastomotic leakage or infection at the surgical site.
Thanks to the development of various genomic research techniques, there is a difference in the composition of intestinal microbes between colorectal cancer patients and healthy people, and the microbiome affects the development of adenoma or cancer as the number of beneficial bacteria decreases, the harmful bacteria changes in terms of age.
In this study, a modified MAC diet designed to adapt to a high-fiber diet after surgery and a patient-made diet for stage 1-2 colorectal cancer patients who do not receive chemotherapy after colon cancer surgery using the genomic analysis technique The purpose of this study is to explore the effect of diet on the composition of the intestinal microflora, and to analyze whether the different diet affects the pattern of defecation after colorectal cancer surgery, and the effect of these changes on the quality of life after colorectal cancer surgery.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer, Gut Microbiota, Diet Intervention
Keywords
Colorectal Cancer, Gut Microbiota, microbiota accessible carbohydrates
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Approximately 40 participants will be randomly assigned to following group (group 1 or group 2). The subjects will be consumed the modified MAC or conventional diet for first 3-weeks period then cross-over to second 3-weeks period.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
40 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Group 1
Arm Type
Active Comparator
Arm Description
Group 1: Modified MAC diet (first 3-weeks) followed by conventional diet (second 3-weeks)
Arm Title
Group 2
Arm Type
Placebo Comparator
Arm Description
Group 2: Conventional diet (first 3-weeks) followed by modified MAC diet (second 3-weeks)
Intervention Type
Dietary Supplement
Intervention Name(s)
Modified MAC diet (3-weeks)
Intervention Description
Modified MAC diet to adapt reduced energy intake and increased dietary fiber consumption with appropriate nutrients component
Dr.Kitchen Inc. directly provide home delivery service for the modified MAC diet including multigrain rice, meal kit, and snacks per day in a regular basis
Primary Outcome Measure Information:
Title
The change of gut microbiota diversity
Description
a-diversity for interpersonal change and b-diversity for groups using 16s rRNA sequencing
Time Frame
Stool sample collection for baseline, after the first 3-week diet, and then after second 3-week diet
Secondary Outcome Measure Information:
Title
The change of stool formation pattern
Description
Daily check for stool pattern using Bristol Stool Score
Time Frame
Up to 6 week (during study period)
Title
The change of quality of life
Description
3 times check for quality of life using EORTC QLQ-C30 plus QLQ-CR29 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 30 items for Common function and symptom plus 29 items specific for colorectal cancer, It is converted into a score range from 0-100, and the overall quality of life score is high, The higher the functional domain score and the lower the symptom domain score, the better the quality of life.)
Time Frame
Survey for baseline, after the first 3-week diet, and then after second 3-week diet
Title
The change of quality of life
Description
3 times check for quality of life using EORTC QLQ-C30 plus QLQ-CR29
Time Frame
Survey for baseline, after the first 3-week diet, and then after second 3-week diet
Title
The change of gut microbiota metabolite
Description
Analysis for gut microbiota producing short chain fatty acid
Time Frame
Stool sample collection for baseline, after the first 3-week diet, and then after second 3-week diet
10. Eligibility
Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed colorectal adenocarcinoma patients after curative surgery without post-operative chemotherapy (stage I and low-risk stage II)
Male of female participants over the age of 19
Eastern Cooperative Oncology Group (ECOG) performance score 0-2
Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form and in this protocol
Adequate hematologic and end-organ function
Exclusion Criteria:
Patients with temporary/permanent stoma after surgery
Diagnosed with locally advanced stage (more than high-risk stage II) colorectal cancer which require postoperative chemotherapy after surgery
Diagnosed with metastatic stage IV colorectal cancer after surgery
Uncontrolled diabetes (glycated hemoglobin A1c (HbA1c) > 8.0 g/dl)
Active infection requiring antibiotics, antifungal or antiviral agents or received a course of antibiotics within 4 weeks prior to study treatments
Known history of food allergy
Known history of uncontrolled intercurrent illness including but not limited to: Infection/inflammation; severe liver dysfunction; bilateral interstitial lung disease; uncontrolled kidney disease; clinically significant (active) cardiovascular and pulmonary disease; hemorrhagic disease; inflammatory bowel disease, intestinal obstruction; Inability to swallow food; social and psychological problems etc.)
Other medical and psychiatric conditions that would prohibit the understanding or rendering of informed consent which affect study compliance
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Soohyeon Lee, M.D., Ph.D.
Phone
02-920-5690
Email
soohyeon_lee@korea.ac.kr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Soohyeon Lee
Organizational Affiliation
Korea University Anam Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Korea University Anam Hospital
City
Seoul
ZIP/Postal Code
02841
Country
Korea, Republic of
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Soohyeon Lee, M.D., Ph.D.
Email
soohyeon_lee@korea.ac.kr
12. IPD Sharing Statement
Plan to Share IPD
No
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Modified MAC Diet and Gut Microbiota in CRC Patients
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