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Randomized Study of Beet Root in Locally Advanced Squamous Cell Cancer of the Head and Neck

Primary Purpose

Mucositis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Beetroot
Placebo
Sponsored by
David Travis Thomas
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mucositis focused on measuring Mucositis, Beetroot, Head and neck cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must have histologically squamous cell carcinoma of the head and neck and be planned for definitive radiation and chemotherapy.
  • Patients must have not received prior radiotherapy or chemotherapy for the current head and neck cancer. Patients may have a history of prior malignancy, but must be able to tolerate full dose radiation and chemotherapy for the current head and neck cancer, as determined by the treating oncologist.
  • Age ≥18 years.
  • ECOG performance status ≤2
  • Life expectancy of greater than 3 months
  • Patients must have normal organ and marrow function as defined below:

    • leukocytes ≥3,000/mcL
    • absolute neutrophil count ≥1,500/mcL
    • platelets ≥100,000/mcL
    • total bilirubin ≤ 1.5 times ULN (upper limit of normal)
    • ALT and AST ≤ 2.5 times the ULN
    • Creatinine ≤ 1.5 times ULN OR
    • Measured creatinine clearance > 60 mL/min
    • Able to swallow thin liquids or have a feeding tube for delivery of nutrition.
  • No uncontrolled illness including, but not limited to, any of the following:

    • Ongoing or active serious infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Uncontrolled cardiac arrhythmia
    • Uncontrolled hypertension
    • Psychiatric illness or social situation that would preclude compliance with study
  • No other concurrent investigational or anticancer therapies or agents.
  • Women of childbearing 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.
  • Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of beet root administration.
  • Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Active infection > CTCAE Grade 2, that is considered clinically serious by the treating physician.
  • Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study dietary supplement.
  • Patients who are receiving any other investigational agents.
  • Pregnant women are excluded from this study because chemo-radiation has the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with chemoradiation, breastfeeding should be discontinued.
  • HIV-positive patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with beet root.
  • Subjects with a history of calcium oxalate nephrolithiasis.
  • Subjects with a significant history of malabsorption (e.g. celiac sprue, short bowel syndrome, or other, as determined by the treating physician).

Sites / Locations

  • University of Kentucky

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Beetroot

Placebo

Arm Description

Beetroot 10 grams concentrated organic beetroot crystals

Placebo

Outcomes

Primary Outcome Measures

Adherence to Treatment
Number of patients completing radiotherapy and three cycles of chemotherapy with no delay
Endurance
Biodex endurance peak torque (Nm)

Secondary Outcome Measures

Body Composition (Lean Body Mass)
Grams of lean body mass
Muscle Strength
Peak force (Nm) from one-legged maximum voluntary contraction (MVC) using the Biodex isokinetic machine.

Full Information

First Posted
January 23, 2014
Last Updated
July 26, 2019
Sponsor
David Travis Thomas
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1. Study Identification

Unique Protocol Identification Number
NCT02058849
Brief Title
Randomized Study of Beet Root in Locally Advanced Squamous Cell Cancer of the Head and Neck
Official Title
Randomized Phase II Study of Concentrated Beet Root in Participants Being Treated for Locally Advanced Unresectable, Previously Untreated Squamous Cell Cancer of the Head and Neck
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
December 2014 (Actual)
Primary Completion Date
April 1, 2018 (Actual)
Study Completion Date
May 1, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
David Travis Thomas

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
The objective of the current proposal is to determine if concentrated beet root could improve medical treatment compliance as defined by completion of radiotherapy and 3 cycles of chemoradiation without dose reduction, preserve fat-free mass, and strength while reducing mucositis. The investigators central hypothesis is that dietary nitrate supplementation in head and neck cancer patients receiving aggressive medical care will improve compliance with medical treatment by attenuating the loss of muscle mass and strength and reducing symptoms (mucositis) associated with treatment compared to patients receiving standard care with placebo.
Detailed Description
This is a parallel 2-arm, 1:1 pilot randomized, placebo controlled supplementation study designed to examine improvements in chemoradiation compliance, body composition, strength/endurance, quality of life, nutrition status, and mucositis symptoms by supplementing beetroot juice over a period of 12 weeks. The Investigators plan to recruit 50 individuals with squamous cell carcinoma of the head and neck who are planning to undergo chemoradiation/intensity-modulated radiation therapy (IMRT). All subjects will be over 18 years of age. Eastern Cooperative Oncology Group (ECOG) performance status should be less than or equal to 2, which is necessary to ensure the patient can adequately participate in the supplementation and planned test procedures. All eligible participants will have a life expectancy greater than or equal to 3 months and normal organ and marrow function at the time of enrollment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mucositis
Keywords
Mucositis, Beetroot, Head and neck cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Beetroot
Arm Type
Experimental
Arm Description
Beetroot 10 grams concentrated organic beetroot crystals
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Beetroot
Other Intervention Name(s)
BEETELITE™ NeO Shot
Intervention Description
10g Beetroot powder mixed with 4-8 oz.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Adherence to Treatment
Description
Number of patients completing radiotherapy and three cycles of chemotherapy with no delay
Time Frame
Up to 6 weeks
Title
Endurance
Description
Biodex endurance peak torque (Nm)
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Secondary Outcome Measure Information:
Title
Body Composition (Lean Body Mass)
Description
Grams of lean body mass
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Title
Muscle Strength
Description
Peak force (Nm) from one-legged maximum voluntary contraction (MVC) using the Biodex isokinetic machine.
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Other Pre-specified Outcome Measures:
Title
Handgrip Strength
Description
Peak force (kg) measured using a handgrip dynamometer
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Title
Handgrip Strength at 30 Seconds
Description
Handgrip strength (kg) at 30 seconds measured using a handgrip dynamometer
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Title
Body Fat
Description
Grams of body fat
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Title
Bone Mineral Content
Description
Bone mineral content (grams).
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Title
Bone Mineral Density
Description
Bone mineral density (grams per centimeter squared)
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Title
Fat Free Mass
Description
Kilograms of fat free mass
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).
Title
Total Body Mass
Description
Kilograms of body mass
Time Frame
Baseline (1-2 weeks pre-IMRT), Midpoint (7-8 weeks following IMRT initiation), Endpoint (4-6 weeks following Midpoint).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically squamous cell carcinoma of the head and neck and be planned for definitive radiation and chemotherapy. Patients must have not received prior radiotherapy or chemotherapy for the current head and neck cancer. Patients may have a history of prior malignancy, but must be able to tolerate full dose radiation and chemotherapy for the current head and neck cancer, as determined by the treating oncologist. Age ≥18 years. ECOG performance status ≤2 Life expectancy of greater than 3 months Patients must have normal organ and marrow function as defined below: leukocytes ≥3,000/mcL absolute neutrophil count ≥1,500/mcL platelets ≥100,000/mcL total bilirubin ≤ 1.5 times ULN (upper limit of normal) ALT and AST ≤ 2.5 times the ULN Creatinine ≤ 1.5 times ULN OR Measured creatinine clearance > 60 mL/min Able to swallow thin liquids or have a feeding tube for delivery of nutrition. No uncontrolled illness including, but not limited to, any of the following: Ongoing or active serious infection Symptomatic congestive heart failure Unstable angina pectoris Uncontrolled cardiac arrhythmia Uncontrolled hypertension Psychiatric illness or social situation that would preclude compliance with study No other concurrent investigational or anticancer therapies or agents. Women of childbearing 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. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of beet root administration. Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Active infection > CTCAE Grade 2, that is considered clinically serious by the treating physician. Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study dietary supplement. Patients who are receiving any other investigational agents. Pregnant women are excluded from this study because chemo-radiation has the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with chemoradiation, breastfeeding should be discontinued. HIV-positive patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with beet root. Subjects with a history of calcium oxalate nephrolithiasis. Subjects with a significant history of malabsorption (e.g. celiac sprue, short bowel syndrome, or other, as determined by the treating physician).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Travis Thomas, PH.D., RD
Organizational Affiliation
University of Kentucky
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Kentucky
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Randomized Study of Beet Root in Locally Advanced Squamous Cell Cancer of the Head and Neck

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