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A Open-label Prospective Cohort Trial of Curcumin Plus Tyrosine Kinase Inhibitors (TKI) for EGFR -Mutant Advanced NSCLC

Phase 1
Conditions
Lung Cancer
Interventions
Registration Number
NCT02321293
Lead Sponsor
Lady Davis Institute
Brief Summary

The purpose of this study is is to assess the safety and tolerability of curcumin in combination with EGFR-TKIs in selected patients with advanced non-resectable mutant EGFR NSCLC.

Detailed Description

This is a phase 1 open prospective cohort study to assess the safety and feasibility of using curcumin in conjunction with an EGFR-TKI in patients with advanced NSCLC. The investigators will use an enhanced bioavailable formulation of curcumin (CURCUViva TM at 80 mg/ 1 capsule per day) approved and licensed by Health Canada (NPN 80027414) that has been shown to have 2-3 times higher curcumin concentration in the blood as compared to previous clinical trials. As primary objective, the investigators will recruit 20 patients for a duration of 8 weeks to monitor adverse effects according to the the National Cancer Institute Common Terminology Criteria.Exploratory objectives would include assessing changes in health-related quality of life using the standardized FACT-L questionnaire and evaluating anti-inflammatory properties of curcumin by measuring CRP. If tolerable safety data is obtained, an expanded phase II trial will be designed.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Newly diagnosed or patients on treatment for histologically confirmed advanced EGFR-mutant NSCLC defined as unresectable stage 3A, stage 3B or stage 4.
  • The EGFR mutation analysis must be performed prior to enrolment into the trial (i.e., before a patient is consented). Any EGFR mutation-positive result must be documented and the analysis for the mutation will be performed using the JGH local testing methodology.
  • Receiving concurrent EGFR-TKI therapy.
  • Eastern Cooperative Oncology Group (ECOG) Performance Score 0-3
Exclusion Criteria
  • Symptomatic brain metastases.
  • Patients who are receiving any other investigational agents.
  • Patients using other non-vitamin or mineral regular natural health product, which includes Chinese Herbs.
  • Incapacity to understand and sign a written informed consent document in English/French.
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
1CurcuVIVA™CurcuVIVA™ (NPN 80027414) at a single dose of 80 mg PO daily without any dose escalation to be taken in conjunction with an EGFR-TKI therapy. CurcuVIVA™ is given in capsule forms. Unit strength of CurcuVIVA™ is equal to Turmeric Extract 25:1 348 mg (containing 80mg Longvida® Optimized Curcumin) Tyrosine Kinase Inhibitors: 1. Gefitinib is a targeted therapy, given in a capsule form once daily. The daily dose is 250 mg . 2. Erlotinib is a targeted therapy, given in a capsule form once daily. The daily dose is 150 mg . Study intervention is 8 weeks, following which the patients will continue taking their EGFR-TKI without curcumin until progression. The side effects of curcumin will be followed for another 8 weeks from the date of stopping curcumin.
1Tyrosine Kinase Inhibitor erlotinib (Tarceva)CurcuVIVA™ (NPN 80027414) at a single dose of 80 mg PO daily without any dose escalation to be taken in conjunction with an EGFR-TKI therapy. CurcuVIVA™ is given in capsule forms. Unit strength of CurcuVIVA™ is equal to Turmeric Extract 25:1 348 mg (containing 80mg Longvida® Optimized Curcumin) Tyrosine Kinase Inhibitors: 1. Gefitinib is a targeted therapy, given in a capsule form once daily. The daily dose is 250 mg . 2. Erlotinib is a targeted therapy, given in a capsule form once daily. The daily dose is 150 mg . Study intervention is 8 weeks, following which the patients will continue taking their EGFR-TKI without curcumin until progression. The side effects of curcumin will be followed for another 8 weeks from the date of stopping curcumin.
1Tyrosine Kinase Inhibitor gefitinib (Iressa)CurcuVIVA™ (NPN 80027414) at a single dose of 80 mg PO daily without any dose escalation to be taken in conjunction with an EGFR-TKI therapy. CurcuVIVA™ is given in capsule forms. Unit strength of CurcuVIVA™ is equal to Turmeric Extract 25:1 348 mg (containing 80mg Longvida® Optimized Curcumin) Tyrosine Kinase Inhibitors: 1. Gefitinib is a targeted therapy, given in a capsule form once daily. The daily dose is 250 mg . 2. Erlotinib is a targeted therapy, given in a capsule form once daily. The daily dose is 150 mg . Study intervention is 8 weeks, following which the patients will continue taking their EGFR-TKI without curcumin until progression. The side effects of curcumin will be followed for another 8 weeks from the date of stopping curcumin.
Primary Outcome Measures
NameTimeMethod
feasibility assessed by: Willingness of patients to participate= Number of enrolled/Number of approached patients,8 weeks

Feasibility will determine whether the use of curcumin is appropriate for further testing; and will be assessed by:

Willingness of patients to participate= Number of enrolled/Number of approached patients,

feasibility assessed by follow-up rate= number of actual study visits/ total number of study visits8 weeks

will by assessed by follow-up rate= number of actual study visits/ total number of study visits

feasibility Adherence/Compliance rate= Number of taken capsules/Total number of capsules8 weeks

Adherence/Compliance rate= Number of taken capsules/Total number of capsules

feasibility Questionnaires completion rate= Number of completed questionnaires/Total number of questionnaires8 weeks

Questionnaires completion rate= Number of completed questionnaires/Total number of questionnaires

safety number of side effects16 weeks

Safety will be assessed by number of side effects

Secondary Outcome Measures
NameTimeMethod
To evaluate and compare the changes in health-related quality of life before and after8 weeks

Patients' quality of life on curcumin treatment will be assessed by the FACT-L at the baseline, 4 weeks,8 weeks on concurrent curcumin and TKI and 8 weeks post-study. Clinically important difference in the score is considered 2 points.

To evaluate anti-inflammatory properties of Curcumin (assessed by measuring C-reactive protein)8 weeks

anti-inflammatory effects of curcumin will be assessed by measuring C-reactive protein tests will be performed at baseline, 2, 4, 8 and 16 weeks into study.

Trial Locations

Locations (1)

Peter Brojge Lung Cancer Center, Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

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