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Study of Genistein in Pediatric Oncology Patients (UVA-Gen001) (UVA-Gen001)

Primary Purpose

Lymphoma, Childhood Lymphoma, Solid Tumor

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Genistein
Placebo
Sponsored by
University of Virginia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Lymphoma focused on measuring Genistein, Soy, Chemotherapy side-effects, Pediatric Cancer, Isoflavone

Eligibility Criteria

1 Year - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Newly diagnosed solid tumor or lymphoma with histological verification
  2. Age 1 - 21 years at time of diagnosis
  3. Karnofsky/Lanksy performance score of ≥ 50
  4. Able to tolerate enteral medication administration
  5. Planned chemotherapeutic regimen for a patient must meet all of the following criteria:

    • A known myelosuppressive regimen which includes at least two of the following agents: actinomycin, carboplatin, cisplatin, cyclophosphamide, daunorubicin, doxorubicin, etoposide, ifosfamide, topotecan
    • At least four consecutive cycles
    • Cycle length is either 14 or 21 days
    • Regimen must either alternate myelosuppressive chemotherapeutic agents in an X-Y-X-Y format, such that the same chemotherapy is given every other cycle (e.g. vincristine/doxorubicin/cyclophosphamide │ ifosfamide/etoposide), or repeat the same chemotherapeutic agents each cycle in an X-X-X-X format (e.g. repeated cycles of cisplatin/etoposide/bleomycin). Courses eligible for this trial may occur at any time during treatment provided that they are consecutive and follow the one of the described patterns. Non-myelosuppressive anti-neoplastic treatments will not be considered for the purposes of determining eligibility. Questions regarding whether or not a patient's chemotherapy plan meets inclusion criteria will be decided by the Study Chair.
  6. Informed consent or parental permission and assent obtained prior to trial-related activities
  7. Able and willing to comply with all study related procedures
  8. Women of childbearing potential must agree to use adequate contraception 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 treating physician immediately

Exclusion Criteria

  1. Known allergy to soy or any soy-based food or supplement
  2. Unable or unwilling to discontinue consuming prohibited soy-based food or supplements while participating in this study
  3. Pre-existing neutropenia or neutrophil qualitative or quantitative disorder
  4. Pre-existing cytopenia or bone marrow failure syndrome
  5. History of gastric or duodenal ulcers or hyperacidity syndromes
  6. History of Human Immunodeficiency Virus (HIV)
  7. Has an active infection requiring systemic therapy
  8. Planned treatment does not include myelosuppressive chemotherapy
  9. Enrolled on a therapeutic or supportive care clinical trial within the last 30 days
  10. Current acute or chronic leukemia diagnosis
  11. Requires medication dosing via an enteral feeding tube that terminates in the duodenum or jejunum. (Enteral feeding tubes that terminate in the stomach are acceptable for study medication delivery.)
  12. Pregnant or breastfeeding woman
  13. Incarceration
  14. Secondary malignancy, i.e. the cancer for which the patient is presently or will be receiving treatment may not be a malignancy related to prior cancer therapy
  15. Any condition which might be worsened by estrogen, such as breast cancer, uterine cancer, ovarian cancer, endometriosis or uterine fibroids
  16. Any condition, in the investigator's opinion, that would compromise patient safety or study outcomes
  17. Anyone who, in the investigator's discretion, would be unwilling or unable to comply with study procedures

Sites / Locations

  • University of Virginia

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm A: Genistein followed by Placebo

Arm B: Placebo followed by Genistein

Arm Description

Genistein daily throughout chemotherapy cycles 1 and 2, and placebo daily during chemotherapy cycles 3 and 4

Placebo daily throughout chemotherapy cycles 1 and 2, and genistein daily during chemotherapy cycles 3 and 4

Outcomes

Primary Outcome Measures

Time to neutrophil count recovery following myelosuppressive chemotherapy

Secondary Outcome Measures

Serum marker levels of inflammation during cycles of chemotherapy
Number of days that participants experience adverse events that are commonly caused by chemotherapy treatment
Number of participants who experience adverse events that are commonly caused by chemotherapy treatment
Number of times per participant that adverse events that are commonly caused by chemotherapy treatment occur
Severity of adverse events that are commonly caused by chemotherapy treatment
Number of days that participants are hospitalized or have prolonged hospitalization due to an adverse event
Number of days that planned cancer treatment is delayed due to an adverse event
Percent that planned cancer treatment doses are reduced due to an adverse event
Number of days that antimicrobial treatment is administered
Number of participants who are administered granulocyte-colony stimulating factor (G-CSF)
Number of times per participant that granulocyte-colony stimulating factor (G-CSF) is administered
Number of participants who are administered a blood product
Number of times per participant that a blood product is administered
Number of times that a blood product is administered for anemia, decreased platelets, abnormal bleeding, or the subject's best interest

Full Information

First Posted
October 27, 2015
Last Updated
February 8, 2022
Sponsor
University of Virginia
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1. Study Identification

Unique Protocol Identification Number
NCT02624388
Brief Title
Study of Genistein in Pediatric Oncology Patients (UVA-Gen001)
Acronym
UVA-Gen001
Official Title
A Randomized, Placebo-Controlled Pilot Study of Genistein Supplementation in Pediatric Cancer Patients Receiving Myelosuppressive Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Terminated
Why Stopped
Poor enrollment
Study Start Date
August 2016 (undefined)
Primary Completion Date
September 2021 (Actual)
Study Completion Date
September 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Virginia

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Toxicities related to pediatric cancer treatment can lead to significant illness, organ damage, treatment delays, increased health care cost, and decrease in quality of life. Such toxicities are largely due to tissue damage sustained by chemotherapy, and strategies designed to limit such cellular damage to normal tissues may reduce therapy-related morbidity and mortality. In addition to their in vitro and in vivo anti-cancer effects, naturally occurring soy isoflavones have anti-inflammatory and anti-oxidant properties, and have been shown to reduce side effects of therapy in adult oncology clinical trials. This study will examine the effect of genistein, the major isoflavone component in soybeans and the most extensively studied of the soy isoflavones, on short-term side effects of myelosuppressive chemotherapy in pediatric cancer patients. Subjects will be randomized to receive either: a) 30 mg genistein daily throughout chemotherapy Cycles 1 and 2 and placebo during chemotherapy Cycles 3 and 4; or b) placebo daily during chemotherapy Cycles 1 and 2 and 30 mg genistein daily during chemotherapy Cycles 3 and 4. Investigators hypothesize that subjects will have fewer short-term therapy-related side effects during cycles of chemotherapy given in conjunction with genistein supplementation than cycles given with placebo.
Detailed Description
This is a multi-center, randomized, double blind, placebo-controlled crossover study to evaluate the effect of soy isoflavones on the short term untoward effects of myelosuppressive chemotherapy used to treat pediatric cancers. Newly diagnosed cancer patients aged 1-21 years will be registered to the study and informed consent will be obtained prior to any study-related procedures. Stratification will be based on length of chemotherapy cycles, between 14 day and 21 day cycles. Within strata registered subjects will be randomized 1:1 to one of two schedules: Arm A: Subjects will receive genistein daily throughout chemotherapy cycles 1 and 2, and placebo during chemotherapy cycles 3 and 4 Arm B: Subjects will receive placebo daily throughout chemotherapy cycles 1 and 2, and genistein during chemotherapy cycles 3 and 4 Subjects will be assessed for safety and efficacy during each cycle with clinical labs, cytokine panels, and physical exams. Drug compliance will be monitored by use of a patient diary as well as monitoring of serum genistein levels. Adverse events will be monitored starting on Cycle 1 Day 1 through 30 days following the last day of protocol therapy (genistein/placebo).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma, Childhood Lymphoma, Solid Tumor, Childhood Solid Tumor, Neuroblastoma, Ewing Sarcoma, Hodgkin Lymphoma, Non-Hodgkin Lymphoma, Rhabdomyosarcoma, Soft Tissue Sarcoma, Medulloblastoma, Germ Cell Tumor, Wilms Tumor, Brain Neoplasms, Medulloblastoma, Childhood, Neuroectodermal Tumors, Primitive
Keywords
Genistein, Soy, Chemotherapy side-effects, Pediatric Cancer, Isoflavone

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A: Genistein followed by Placebo
Arm Type
Experimental
Arm Description
Genistein daily throughout chemotherapy cycles 1 and 2, and placebo daily during chemotherapy cycles 3 and 4
Arm Title
Arm B: Placebo followed by Genistein
Arm Type
Experimental
Arm Description
Placebo daily throughout chemotherapy cycles 1 and 2, and genistein daily during chemotherapy cycles 3 and 4
Intervention Type
Drug
Intervention Name(s)
Genistein
Other Intervention Name(s)
5, 7-dihydroxy-3-(4-hydroxyphenyl)-4H-1-benzopyran-4-one, i-cool tablets containing 30 mg geniVida™
Intervention Description
Estrogen-like compound (isoflavone) derived from soybeans
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Pill that contains no medicine
Primary Outcome Measure Information:
Title
Time to neutrophil count recovery following myelosuppressive chemotherapy
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Secondary Outcome Measure Information:
Title
Serum marker levels of inflammation during cycles of chemotherapy
Time Frame
Once before treatment starts and then four more times while the study drug is being taken, an 8 - 16 week period if there are no chemotherapy delays
Title
Number of days that participants experience adverse events that are commonly caused by chemotherapy treatment
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of participants who experience adverse events that are commonly caused by chemotherapy treatment
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of times per participant that adverse events that are commonly caused by chemotherapy treatment occur
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Severity of adverse events that are commonly caused by chemotherapy treatment
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of days that participants are hospitalized or have prolonged hospitalization due to an adverse event
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of days that planned cancer treatment is delayed due to an adverse event
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Percent that planned cancer treatment doses are reduced due to an adverse event
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of days that antimicrobial treatment is administered
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of participants who are administered granulocyte-colony stimulating factor (G-CSF)
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of times per participant that granulocyte-colony stimulating factor (G-CSF) is administered
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of participants who are administered a blood product
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of times per participant that a blood product is administered
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays
Title
Number of times that a blood product is administered for anemia, decreased platelets, abnormal bleeding, or the subject's best interest
Time Frame
From the first date study drug is taken until the last date that study drug is taken, about 8 - 12 weeks if there are no chemotherapy delays

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Newly diagnosed solid tumor or lymphoma with histological verification Age 1 - 21 years at time of diagnosis Karnofsky/Lanksy performance score of ≥ 50 Able to tolerate enteral medication administration Planned chemotherapeutic regimen for a patient must meet all of the following criteria: A known myelosuppressive regimen which includes at least two of the following agents: actinomycin, carboplatin, cisplatin, cyclophosphamide, daunorubicin, doxorubicin, etoposide, ifosfamide, topotecan At least four consecutive cycles Cycle length is either 14 or 21 days Regimen must either alternate myelosuppressive chemotherapeutic agents in an X-Y-X-Y format, such that the same chemotherapy is given every other cycle (e.g. vincristine/doxorubicin/cyclophosphamide │ ifosfamide/etoposide), or repeat the same chemotherapeutic agents each cycle in an X-X-X-X format (e.g. repeated cycles of cisplatin/etoposide/bleomycin). Courses eligible for this trial may occur at any time during treatment provided that they are consecutive and follow the one of the described patterns. Non-myelosuppressive anti-neoplastic treatments will not be considered for the purposes of determining eligibility. Questions regarding whether or not a patient's chemotherapy plan meets inclusion criteria will be decided by the Study Chair. Informed consent or parental permission and assent obtained prior to trial-related activities Able and willing to comply with all study related procedures Women of childbearing potential must agree to use adequate contraception 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 treating physician immediately Exclusion Criteria Known allergy to soy or any soy-based food or supplement Unable or unwilling to discontinue consuming prohibited soy-based food or supplements while participating in this study Pre-existing neutropenia or neutrophil qualitative or quantitative disorder Pre-existing cytopenia or bone marrow failure syndrome History of gastric or duodenal ulcers or hyperacidity syndromes History of Human Immunodeficiency Virus (HIV) Has an active infection requiring systemic therapy Planned treatment does not include myelosuppressive chemotherapy Enrolled on a therapeutic or supportive care clinical trial within the last 30 days Current acute or chronic leukemia diagnosis Requires medication dosing via an enteral feeding tube that terminates in the duodenum or jejunum. (Enteral feeding tubes that terminate in the stomach are acceptable for study medication delivery.) Pregnant or breastfeeding woman Incarceration Secondary malignancy, i.e. the cancer for which the patient is presently or will be receiving treatment may not be a malignancy related to prior cancer therapy Any condition which might be worsened by estrogen, such as breast cancer, uterine cancer, ovarian cancer, endometriosis or uterine fibroids Any condition, in the investigator's opinion, that would compromise patient safety or study outcomes Anyone who, in the investigator's discretion, would be unwilling or unable to comply with study procedures
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William C. Petersen, Jr., M.D.
Organizational Affiliation
University of Virginia
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States

12. IPD Sharing Statement

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Study of Genistein in Pediatric Oncology Patients (UVA-Gen001)

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