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A Trial of Glutamine to Prevent Oxaliplatin Neurotoxicity and a Pharmacokinetic Analysis of Oxaliplatin

Primary Purpose

Colorectal Carcinoma, Neoplasms, Colorectal, Colorectal Cancer

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Glutamine
Sponsored by
AHS Cancer Control Alberta
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Colorectal Carcinoma focused on measuring glutamine, oxaliplatin, adverse effects

Eligibility Criteria

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

Study Population: The target population is patients with metastatic colorectal adenocarcinoma who are sufficiently robust to undergo at least 3 cycles of oxaliplatin based chemotherapy (mFOLFOX or XELOX) Sampling Method: Probability Sample.

Inclusion Criteria:

  • Patients must hvae metastatic colorectal cancer (stage IV)
  • Patients who have been treated with FOLFIRI regimen for metastatic setting may be eligible for this trial
  • Patients must be ≥ 18 years
  • Patients must have an Eastern Cooperative Oncology Group (EGOC) performance status 0 to 2.
  • Patients must have adequate renal function of creatinine < 1.5mg/dL and a creatinine clearance > 45mL/min; patients must have adequate hepatic function with a bilirubin < 1.5mg/dL and AST (normal range 0-14 U/L) and ALT (normal range 0-49 U/L); and patients must have adequate bone marrow function with absolute neutrophil count (ANC) ≥ 1,500/цL and platelets ≥ 100,000/цL and a hemoglobin ≥ 10g/d.
  • Patients must be willing and able to comply with the study protocol for the duration of the study.
  • Patients must give written informed consent prior to any study-specific screening procedures with the understanding that the patient may withdraw consent at any time without prejudice.
  • Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment. Women of childbearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation.
  • The investigator is requested to advise the patient how to achieve an adequate contraception
  • Life expectancy longer than 6 months

Exclusion Criteria:

  • Patients who have received oxaliplatin previously
  • Patients with previous of current diagnosis of peripheral sensory neuropathy
  • Patients who have tested positive for HIV
  • Patients with other significant medical, psychiatric disorders that, in the opinion of the investigator, will exclude the patient from the study for compliance or safety reasons.
  • Patients who cannot swallow
  • History of known allergy to oxaliplatin or other platinum compounds, to 5-FU, to LV, glutamine or to any ingredients in the formulations of the containers
  • Participation in another clinical trial with any investigational drug within 30 days prior to study screening.
  • Pernicious anemia or other megaloblastic anemia with vitamin B12 deficiency
  • Patients with concomitant treatment with drugs/ingredients reported to have a potential activity to prevent PSN
  • Patients who haven't successfully completed local therapy for previously treated CNS metastases and who haven't been discontinued with corticosteroid for > 4wks before starting chemotherapy. Patients with asymptomatic brain mets. who have no evidence of midline shift on CT/ MRI may be enrolled without initiation of local therapy for the CNS mets. Repeat scan must be preformed < 4wks to ensure no progression.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Dietary Supplement

    Dietary supplement

    Arm Description

    Arm A: At cycle 2, patients will be randomized to receive for 6 days- Glutamine 30g/day during cycle 2 and glutamine 40g/day during cycle 3

    Arm B: At cycle 2, patients will be randomized to receive for 6 days: Glutamine 40g/day at cycle 2 and glutamine 30g/day at cycle 3.

    Outcomes

    Primary Outcome Measures

    To evaluate potential pharmacokinetic interactions between oxaliplatin and glutamine at 30g and 40g in patients with metastatic colorectal cancer.

    Secondary Outcome Measures

    To evaluate effects of glutamine supplementation on neuropathy and diarrhea related to oxaliplatin, and on dose reductions and in patients with metastatic colorectal cancer.
    To compare the toxicity profile of glutamine and FOLFOX to historical data.

    Full Information

    First Posted
    July 2, 2010
    Last Updated
    February 23, 2016
    Sponsor
    AHS Cancer Control Alberta
    Collaborators
    Cross Cancer Institute
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01157039
    Brief Title
    A Trial of Glutamine to Prevent Oxaliplatin Neurotoxicity and a Pharmacokinetic Analysis of Oxaliplatin
    Official Title
    A Phase II Trial of Glutamin to Prevent Oxaliplatin Neurotoxicity and a Pharmacokinetic Analysis of Oxaliplatin.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2011
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    abandoned
    Study Start Date
    October 2011 (undefined)
    Primary Completion Date
    September 2012 (Anticipated)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    AHS Cancer Control Alberta
    Collaborators
    Cross Cancer Institute

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The investigators hypothesize that glutamine significantly reduces the incidence and severity of peripheral neuropathy in patients receiving oxaliplatin for metastatic colorectal cancer, decreases the need for dose reduction of oxaliplatin, and it does not impair oxaliplatin efficacy or pharmacokinetics.
    Detailed Description
    This is a phase II , open-label, non randomized study of oral glutamine administration to evaluate oxaliplatin pharmacokinetics, and to prevent oxaliplatin neurotoxicity in patients with metastatic colorectal cancer.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Colorectal Carcinoma, Neoplasms, Colorectal, Colorectal Cancer, Colorectal Tumors, Metastasis
    Keywords
    glutamine, oxaliplatin, adverse effects

    7. Study Design

    Primary Purpose
    Supportive Care
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Dietary Supplement
    Arm Type
    Experimental
    Arm Description
    Arm A: At cycle 2, patients will be randomized to receive for 6 days- Glutamine 30g/day during cycle 2 and glutamine 40g/day during cycle 3
    Arm Title
    Dietary supplement
    Arm Type
    Experimental
    Arm Description
    Arm B: At cycle 2, patients will be randomized to receive for 6 days: Glutamine 40g/day at cycle 2 and glutamine 30g/day at cycle 3.
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Glutamine
    Other Intervention Name(s)
    L-glutamine
    Intervention Description
    Glutamine- During the first cycle of oxaliplatin based combination therapy (mFOLFOX 6 or XELOX) no patient will receive glutamine. At cycle 2, patients will be randomized to receive for 6 days either : Glutamine 30g/day during cycle 2 and glutamine 40g/day during cycle 3 (ARM A) or glutamine 40g/day at cycle 2 and glutamine 30g/day at cycle 3 (Arm B).
    Primary Outcome Measure Information:
    Title
    To evaluate potential pharmacokinetic interactions between oxaliplatin and glutamine at 30g and 40g in patients with metastatic colorectal cancer.
    Time Frame
    Post cycle 2 and cycle 3
    Secondary Outcome Measure Information:
    Title
    To evaluate effects of glutamine supplementation on neuropathy and diarrhea related to oxaliplatin, and on dose reductions and in patients with metastatic colorectal cancer.
    Time Frame
    Post cycle 2 to 30-day follow-up visit
    Title
    To compare the toxicity profile of glutamine and FOLFOX to historical data.
    Time Frame
    Post cycle 2 to 30-day follow-up visit.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Study Population: The target population is patients with metastatic colorectal adenocarcinoma who are sufficiently robust to undergo at least 3 cycles of oxaliplatin based chemotherapy (mFOLFOX or XELOX) Sampling Method: Probability Sample. Inclusion Criteria: Patients must hvae metastatic colorectal cancer (stage IV) Patients who have been treated with FOLFIRI regimen for metastatic setting may be eligible for this trial Patients must be ≥ 18 years Patients must have an Eastern Cooperative Oncology Group (EGOC) performance status 0 to 2. Patients must have adequate renal function of creatinine < 1.5mg/dL and a creatinine clearance > 45mL/min; patients must have adequate hepatic function with a bilirubin < 1.5mg/dL and AST (normal range 0-14 U/L) and ALT (normal range 0-49 U/L); and patients must have adequate bone marrow function with absolute neutrophil count (ANC) ≥ 1,500/цL and platelets ≥ 100,000/цL and a hemoglobin ≥ 10g/d. Patients must be willing and able to comply with the study protocol for the duration of the study. Patients must give written informed consent prior to any study-specific screening procedures with the understanding that the patient may withdraw consent at any time without prejudice. Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment. Women of childbearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation. The investigator is requested to advise the patient how to achieve an adequate contraception Life expectancy longer than 6 months Exclusion Criteria: Patients who have received oxaliplatin previously Patients with previous of current diagnosis of peripheral sensory neuropathy Patients who have tested positive for HIV Patients with other significant medical, psychiatric disorders that, in the opinion of the investigator, will exclude the patient from the study for compliance or safety reasons. Patients who cannot swallow History of known allergy to oxaliplatin or other platinum compounds, to 5-FU, to LV, glutamine or to any ingredients in the formulations of the containers Participation in another clinical trial with any investigational drug within 30 days prior to study screening. Pernicious anemia or other megaloblastic anemia with vitamin B12 deficiency Patients with concomitant treatment with drugs/ingredients reported to have a potential activity to prevent PSN Patients who haven't successfully completed local therapy for previously treated CNS metastases and who haven't been discontinued with corticosteroid for > 4wks before starting chemotherapy. Patients with asymptomatic brain mets. who have no evidence of midline shift on CT/ MRI may be enrolled without initiation of local therapy for the CNS mets. Repeat scan must be preformed < 4wks to ensure no progression.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Michael Sawyer, MD
    Organizational Affiliation
    Alberta Health services
    Official's Role
    Study Chair

    12. IPD Sharing Statement

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    A Trial of Glutamine to Prevent Oxaliplatin Neurotoxicity and a Pharmacokinetic Analysis of Oxaliplatin

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