XCHT for Irinotecan-Induced Gut Toxicities (Run-in Study)
Malignant Tumor, Diarrhea
About this trial
This is an interventional basic science trial for Malignant Tumor focused on measuring Malignant tumor, Irinotecan, chemotherapy-induced diarrhea, Classical Chinese Formula, safety
Eligibility Criteria
Cohort A: Naïve (no irinotecan treatment before) postmenopausal female cancer patients.
Inclusion criteria:
- Malignant tumor confirmed by histology or cytology;
- Postmenopausal women, after bilateral oophorectomy; age > 60 years old, or age < 60 years old with menopause for more than 1 year;
- Age ≥ 18 years old, ≤ 75 years old;
- ECOG score of the patient ≤ 2 points;
- Never been treated with irinotecan;
- Plan to receive at least 3 rounds of FOLFIRI chemotherapy determined by physicians;
Normal organ functions can meet the requirements for systemic chemotherapy:
- Reserve functions of normal bone marrow: absolute neutrophil count (ANC) ≥ 1.5×109/L, PLT ≥ 100×109/L, hemoglobin ≥ 90 g/L;
- Normal renal functions: serum creatinine ≤ 1.5 mg/dl (133 μmol/L) and/or creatinine clearance ≥ 60 ml/min;
- Normal hepatic functions: total serum bilirubin level ≤ 1.5 times of the upper limit of normal value (ULN), serum aspartate aminotransferase (AST) & alanine aminotransferase (ALT) ≤ 2.5 × ULN; If abnormal hepatic functions are caused by a potentially malignant tumor, and AST & ALT ≤ 5 × ULN;
- Patient is willing to participate and cooperate to complete the questions in the case report form;
- Patient can understand and sign the informed consent form, is well compliant, and can be followed up.
Cohort B: cancer patients who experienced irinotecan -induced diarrhea (grade >2)
Inclusion criteria:
- Malignant tumor confirmed by histology or cytology;
- Age ≥ 18 years old, ≤ 75 years old;
- ECOG score of the patient ≤ 2 points;
- Patients who have diarrhea worse than grade 2 due to irinotecan chemotherapy (the last dose of irinotecan is administered within 1 month);
- Patients who plan to receive 3 rounds of FOLFIRI chemotherapy;
Normal organ functions can meet the requirements for systemic chemotherapy:
- Reserve functions of normal bone marrow: absolute neutrophil count (ANC) ≥ 1.5×109/L, PLT ≥ 100×109/L, hemoglobin ≥ 90g/L;
- Normal renal functions: serum creatinine ≤ 1.5mg/dl (133μmol/L) and/or creatinine clearance ≥ 60ml/min;
- Normal hepatic functions: total serum bilirubin level ≤ 1.5 times of the upper limit of normal value (ULN), serum aspartate aminotransferase (AST) & alanine aminotransferase (ALT) ≤ 2.5 × ULN; If abnormal hepatic functions are caused by a potentially malignant tumor, and AST & ALT ≤ 5 × ULN;
- Patient is willing to participate and cooperate to complete the questions in the case report form;
- Patients can understand and sign the informed consent form, is well compliant, and can be followed up.
Exclusion Criteria:
- Patients with diagnosed depression, obsession or/and schizophrenia;
- Patients with diagnosed inflammatory bowel diseases (including Crohn's disease, ulcerative colitis)
- Patient with active tuberculosis and other uncontrolled infections;
- Patient has previously received radiotherapy on the abdominal cavity and pelvic cavity;
- Pregnant or lactating women;
- Patient previously had or is now having thromboembolic (blood clotting) events.
Sites / Locations
- Guangdong Provincial Hospital of Chinese MedicineRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Irinotecan naive cohort
Irinotecan used cohort
This cohort will enroll 6 postmenopausal female patients who have never received irinotecan treatment before. Patients in irinotecan naive cohort will receive 3 cycles of FOLFIRI chemotherapy, during which 4 rounds of pharmacokinetic studies will be conducted. Round 0 (before chemotherapy): pharmacokinetic testing (raloxifene 60mg as probe) before XCHT administration, then XCHT for 4 days with pharmacokinetic testing (raloxifene 60mg as probe) on the 4th day of XCHT administration. Round 1(1st cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (without raloxifene) on day 4. Round 2 (2nd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 3. Round 3 (3rd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 3.
This cohort will recruit 18 patients who were treated with irinotecan previously and have at least one diarrhea episode with a severity of more than grade 2. Patients in irinotecan used cohort will receive 3 cycles of FOLFIRI chemotherapy, during which 3 rounds of pharmacokinetic studies will be conducted. Round 1(1st cycle of chemotherapy): FOLFIRI, with pharmacokinetic testing (raloxifene 60mg as probe) on the first day of chemotherapy. Round 2 (2nd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 4. Round 3 (3rd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 3.