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Curcumin in Preventing Gastric Cancer in Patients With Chronic Atrophic Gastritis or Gastric Intestinal Metaplasia

Primary Purpose

Chronic Atrophic Gastritis

Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Curcumin
Laboratory Biomarker Analysis
Placebo Administration
Quality-of-Life Assessment
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Chronic Atrophic Gastritis

Eligibility Criteria

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

Inclusion Criteria:

  • PRE-REGISTRATION INCLUSION CRITERIA
  • Ability to understand and the willingness to sign a written informed consent document
  • Willingness to undergo screening tests and procedures
  • Willingness to provide blood and tissue samples for safety/toxicity monitoring and biomarker analyses
  • Willingness to avoid the use of curcumin or any over-the-counter or prescription medications containing curcumin or curcuminoids
  • REGISTRATION/RANDOMIZATION INCLUSION CRITERIA
  • Histologically-confirmed chronic multifocal atrophic gastritis (MAG) and/or gastric intestinal metaplasia (GIM)
  • Helicobacter pylori negative, defined as negative stool antigen testing and negative histological examination
  • Eastern Cooperative Oncology Group (ECOG) performance status =< 1
  • Aspartate transaminase (AST), alanine transferase (ALT) within institutional limits of normal or judged to be not clinically significant by the investigator
  • Alkaline phosphatase within institutional limits of normal or judged to be not clinically significant by the investigator
  • Platelets within institutional limits of normal or judged to be not clinically significant by the investigator
  • Hemoglobin within institutional limits of normal or judged to be not clinically significant by the investigator
  • White blood cells (WBC) within institutional limits of normal or judged to be not clinically significant by the investigator
  • Blood urea nitrogen (BUN) within institutional limits of normal or judged to be not clinically significant by the investigator
  • Total bilirubin within institutional limits of normal or judged to be not clinically significant by the investigator
  • Creatinine within institutional limits of normal or judged to be not clinically significant by the investigator
  • Not pregnant or breast feeding; Note: The effects of Meriva on the developing human fetus at the recommended therapeutic dose are unknown; for this reason, individuals of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately

Exclusion Criteria:

  • PRE-REGISTRATION EXCLUSION CRITERIA
  • History of other malignancy =< 2 years prior to the registration/randomization evaluation, with the exception of basal cell or squamous cell skin cancer
  • History of colorectal cancer; exception: individuals with stage I or II colorectal cancer who have not received any chemotherapy
  • Known diagnosis of human immunodeficiency virus (HIV); Note: An HIV screening test does not have to be performed to evaluate this criterion
  • History of gastric surgery
  • Receiving any other investigational agents
  • Use of any anticoagulation medications, such as warfarin or Coumadin
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Pregnant or breast feeding; Note: Pregnant women are excluded from this study; because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with Meriva, breastfeeding should be discontinued if the mother is treated with Meriva
  • REGISTRATION/RANDOMIZATION EXCLUSION CRITERIA
  • Receiving any other investigational, anticoagulation, and/or chemotherapy agents
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to Meriva

Sites / Locations

  • Hospital Regional de Occidente
  • University of Puerto Rico

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arm I (curcumin)

Arm II (placebo)

Arm Description

Patients receive curcumin PO BID for 180 days in the absence of unacceptable toxicity.

Patients receive placebo PO BID for 180 days in the absence of unacceptable toxicity.

Outcomes

Primary Outcome Measures

Absolute change in IL-1beta cytokine levels in the gastric mucosa
Will be measured by Luminex assay. If the data are not normally distributed, the Wilcoxon Rank-Sum test will be used. The 95% confidence intervals will also be provided.

Secondary Outcome Measures

Incidence of adverse events
Will be graded by National Cancer Institute Common Terminology Criteria for Adverse Events version 4. The maximum grade for each type of adverse event will be recorded for each participant and frequency tables will be reviewed to determine the overall patterns. The number and severity of adverse events (overall and by intervention group) will be tabulated and summarized.
Change in histology gastric score
Will compare changes in histology gastric score for curcumin versus placebo.
Additional gastric mucosal cytokine/chemokine levels (IL-8, TNFalpha, and IP-10)
Will be quantified with Luminex assay. Changes in the concentrations (or categories) will be explored within and between the intervention arms. Fisher's exact tests, Wilcoxon rank sum tests, and two-sample t-tests will be used to assess differences between groups. McNemar's tests, Wilcoxon signed rank tests, and paired sample t-tests will be used to assess differences within each arm. Graphical methods (i.e. boxplots, scatter plots, etc.) will also be used to describe the data.
Gastric mucosal deoxyribonucleic acid (DNA) damage
Will be assessed by immunohistochemistry. Fisher's exact tests, Wilcoxon rank sum tests, and two-sample t-tests will be used to assess differences between groups. McNemar's tests, Wilcoxon signed rank tests, and paired sample t-tests will be used to assess differences within each arm. Graphical methods (i.e. boxplots, scatter plots, etc.) will also be used to describe the data.

Full Information

First Posted
May 25, 2016
Last Updated
April 13, 2023
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT02782949
Brief Title
Curcumin in Preventing Gastric Cancer in Patients With Chronic Atrophic Gastritis or Gastric Intestinal Metaplasia
Official Title
Randomized, Double-Blind, Placebo-Controlled Trial of Meriva® (Curcuminoids) as a Candidate Chemoprevention Agent for Gastric Carcinogenesis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 4, 2017 (Actual)
Primary Completion Date
October 6, 2022 (Actual)
Study Completion Date
March 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
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
This randomized phase IIb trial studies how well curcumin works in preventing gastric cancer in patients with chronic atrophic gastritis and/or gastric intestinal metaplasia. Curcumin is an antioxidant compound found in plants that may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Detailed Description
PRIMARY OBJECTIVES: I. To compare the change in gastric mucosal interleukin 1beta (IL-1beta) cytokine level, quantified by Luminex assay technology, after a 6-month intervention in participants randomly assigned to the curcumin (Meriva [curcuminoids]) versus placebo arms. SECONDARY OBJECTIVES: I. To determine the safety and tolerability of Meriva versus placebo. II. To compare changes in Histology Gastric Score (HGS) from baseline to 6 months for Meriva versus placebo. III. To compare changes in additional gastric mucosal cytokine/chemokine levels (interleukin 8 [IL-8], tumor necrosis factor-alpha [TNFalpha], and inducible protein 10 [IP-10]; quantified by Luminex assay). IV. To compare changes in gastric mucosal deoxyribonucleic acid (DNA) damage as assessed by immunohistochemistry (IHC), of the biomarkers 8-hydroxy-2'-deoxyguanosine (8-OHdG) and phosphorylated subtype of histone H2A (H2AX). V. To explore associations between proinflammatory cytokine genotype status (IL-1beta, IL-8, and TNFalpha single nucleotide polymorphisms [SNPs]; characterized at baseline) and the above outcomes. OUTLINE: Patients are randomized into 1 of 2 arms. ARM 1: Patients receive curcumin orally (PO) twice daily (BID) for 180 days in the absence of unacceptable toxicity. ARM 2: Patients receive placebo PO BID for 180 days in the absence of unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days and 7 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Atrophic Gastritis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I (curcumin)
Arm Type
Experimental
Arm Description
Patients receive curcumin PO BID for 180 days in the absence of unacceptable toxicity.
Arm Title
Arm II (placebo)
Arm Type
Placebo Comparator
Arm Description
Patients receive placebo PO BID for 180 days in the absence of unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Curcumin
Other Intervention Name(s)
C.I. 75300, C.I. Natural Yellow 3, Diferuloylmethane, Turmeric Yellow
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
Placebo Administration
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
Quality-of-Life Assessment
Other Intervention Name(s)
Quality of Life Assessment
Intervention Description
Ancillary studies
Primary Outcome Measure Information:
Title
Absolute change in IL-1beta cytokine levels in the gastric mucosa
Description
Will be measured by Luminex assay. If the data are not normally distributed, the Wilcoxon Rank-Sum test will be used. The 95% confidence intervals will also be provided.
Time Frame
Baseline up to 6 months
Secondary Outcome Measure Information:
Title
Incidence of adverse events
Description
Will be graded by National Cancer Institute Common Terminology Criteria for Adverse Events version 4. The maximum grade for each type of adverse event will be recorded for each participant and frequency tables will be reviewed to determine the overall patterns. The number and severity of adverse events (overall and by intervention group) will be tabulated and summarized.
Time Frame
From time of first dose of curcumin up to 7 months
Title
Change in histology gastric score
Description
Will compare changes in histology gastric score for curcumin versus placebo.
Time Frame
Baseline up to 6 months
Title
Additional gastric mucosal cytokine/chemokine levels (IL-8, TNFalpha, and IP-10)
Description
Will be quantified with Luminex assay. Changes in the concentrations (or categories) will be explored within and between the intervention arms. Fisher's exact tests, Wilcoxon rank sum tests, and two-sample t-tests will be used to assess differences between groups. McNemar's tests, Wilcoxon signed rank tests, and paired sample t-tests will be used to assess differences within each arm. Graphical methods (i.e. boxplots, scatter plots, etc.) will also be used to describe the data.
Time Frame
Baseline up to 6 months
Title
Gastric mucosal deoxyribonucleic acid (DNA) damage
Description
Will be assessed by immunohistochemistry. Fisher's exact tests, Wilcoxon rank sum tests, and two-sample t-tests will be used to assess differences between groups. McNemar's tests, Wilcoxon signed rank tests, and paired sample t-tests will be used to assess differences within each arm. Graphical methods (i.e. boxplots, scatter plots, etc.) will also be used to describe the data.
Time Frame
Baseline up to 6 months
Other Pre-specified Outcome Measures:
Title
Proinflammatory cytokine genotype status (IL-1beta, IL-8, and TNFalpha single nucleotide polymorphisms)
Description
Will be examined in relation to the outcomes above to further characterize the at-risk population and generate hypotheses for future studies.
Time Frame
At baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: PRE-REGISTRATION INCLUSION CRITERIA Ability to understand and the willingness to sign a written informed consent document Willingness to undergo screening tests and procedures Willingness to provide blood and tissue samples for safety/toxicity monitoring and biomarker analyses Willingness to avoid the use of curcumin or any over-the-counter or prescription medications containing curcumin or curcuminoids REGISTRATION/RANDOMIZATION INCLUSION CRITERIA Histologically-confirmed chronic multifocal atrophic gastritis (MAG) and/or gastric intestinal metaplasia (GIM) Helicobacter pylori negative, defined as negative stool antigen testing and negative histological examination Eastern Cooperative Oncology Group (ECOG) performance status =< 1 Aspartate transaminase (AST), alanine transferase (ALT) within institutional limits of normal or judged to be not clinically significant by the investigator Alkaline phosphatase within institutional limits of normal or judged to be not clinically significant by the investigator Platelets within institutional limits of normal or judged to be not clinically significant by the investigator Hemoglobin within institutional limits of normal or judged to be not clinically significant by the investigator White blood cells (WBC) within institutional limits of normal or judged to be not clinically significant by the investigator Blood urea nitrogen (BUN) within institutional limits of normal or judged to be not clinically significant by the investigator Total bilirubin within institutional limits of normal or judged to be not clinically significant by the investigator Creatinine within institutional limits of normal or judged to be not clinically significant by the investigator Not pregnant or breast feeding; Note: The effects of Meriva on the developing human fetus at the recommended therapeutic dose are unknown; for this reason, individuals of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately Exclusion Criteria: PRE-REGISTRATION EXCLUSION CRITERIA History of other malignancy =< 2 years prior to the registration/randomization evaluation, with the exception of basal cell or squamous cell skin cancer History of colorectal cancer; exception: individuals with stage I or II colorectal cancer who have not received any chemotherapy Known diagnosis of human immunodeficiency virus (HIV); Note: An HIV screening test does not have to be performed to evaluate this criterion History of gastric surgery Receiving any other investigational agents Use of any anticoagulation medications, such as warfarin or Coumadin Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Pregnant or breast feeding; Note: Pregnant women are excluded from this study; because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with Meriva, breastfeeding should be discontinued if the mother is treated with Meriva REGISTRATION/RANDOMIZATION EXCLUSION CRITERIA Receiving any other investigational, anticoagulation, and/or chemotherapy agents History of allergic reactions attributed to compounds of similar chemical or biologic composition to Meriva
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marcia R Cruz-Correa
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Regional de Occidente
City
Santa Rosa De Copan
ZIP/Postal Code
41101
Country
Honduras
Facility Name
University of Puerto Rico
City
San Juan
ZIP/Postal Code
00936
Country
Puerto Rico

12. IPD Sharing Statement

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Curcumin in Preventing Gastric Cancer in Patients With Chronic Atrophic Gastritis or Gastric Intestinal Metaplasia

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