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Curcumin and Piperine in Reducing Inflammation for Ureteral Stent-Induced Symptoms in Patients With Cancer

Phase 1
Completed
Conditions
Malignant Neoplasm
Pain
Bladder Spasm
Urinary Urgency
Interventions
Other: Laboratory Biomarker Analysis
Dietary Supplement: Piperine Extract (Standardized)
Other: Quality-of-Life Assessment
Registration Number
NCT02598726
Lead Sponsor
Mayo Clinic
Brief Summary

This pilot phase I trial studies the side effects and best dose of curcumin when given together with piperine (piperine extract \[standardized\]) in reducing inflammation for ureteral stent-induced symptoms in patients with cancer. Curcumin is a spice similar to turmeric and works by decreasing the chemical moderators that produce inflammation in the body. Piperine is pepper and works by increasing the amount of curcumin available in the body when taken with curcumin. Giving curcumin together with piperine may reduce inflammation and discomfort from a ureteric stent in older patients with cancer.

Detailed Description

PRIMARY OBJECTIVES:

I. To conduct a dose-escalation study with curcumin and piperine to derive a safe, optimal biological dose of this combination in cancer patients.

SECONDARY OBJECTIVES:

I. To describe the grade 2+ toxicities associated with curcumin and piperine. II. To evaluate quality of life associated with this combination by means of the Mayo Modified Urinary Stent Symptom Questionnaire (USSQ).

TERTIARY OBJECTIVES:

I. To characterize the change in urinary prostaglandin E2 concentrations that occur at baseline and then after one week of curcumin + piperine.

OUTLINE: This is a dose-escalation study of curcumin.

Patients receive curcumin orally (PO) twice daily (BID) or thrice daily (TID) and piperine extract (standardized) PO on days 1-7 in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 1 month.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
9
Inclusion Criteria
  • Ureteral stent in place at study registration
  • Patient reports pain, spasms, or urgency symptoms after stent placement, which are thought to be unrelated to other causes as per the patient or healthcare provider or both (documentation in the medical record is unnecessary)
  • Ability to complete English language questionnaires by themselves or with assistance
  • After the week-long study treatment, participants must be willing to return to the enrolling institution for a follow-up visit
  • Willingness to provide mandatory 24 hour urine collection samples for research purposes
  • Able to swallow supplements
  • Patient must have either a history of cancer or active cancer
  • Registration >= 7 days after placement of a new stent or >= 3 days after a stent exchange
  • Willingness to refrain from grapefruit juice for 7 days prior to and for 7 days during the study
Exclusion Criteria
  • Receiving warfarin at registration
  • Active cholecystitis
  • Taking any of the following drugs at the time of study participation: epidermal growth factor receptor inhibitor, topoisomerase 1 inhibitor (camptothecin, irinotecan); buspirone, benzodiazepines, zolpidem, calcium channel blockers (such as felodipine, nifedipine, verapamil); digoxin or quinidine; codeine or fentanyl; phenytoin, propranolol, rifampin, or theophylline
  • History of alcohol abuse

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Supportive care (curcumin, piperine)CurcuminPatients receive curcumin PO BID or TID and piperine extract (standardized) PO on days 1-7 in the absence of disease progression or unacceptable toxicity.
Supportive care (curcumin, piperine)Laboratory Biomarker AnalysisPatients receive curcumin PO BID or TID and piperine extract (standardized) PO on days 1-7 in the absence of disease progression or unacceptable toxicity.
Supportive care (curcumin, piperine)Piperine Extract (Standardized)Patients receive curcumin PO BID or TID and piperine extract (standardized) PO on days 1-7 in the absence of disease progression or unacceptable toxicity.
Supportive care (curcumin, piperine)Quality-of-Life AssessmentPatients receive curcumin PO BID or TID and piperine extract (standardized) PO on days 1-7 in the absence of disease progression or unacceptable toxicity.
Primary Outcome Measures
NameTimeMethod
Maximum tolerated dose (MTD) of curcumin in combination with piperine7 days

The MTD of curcumin in combination with piperine is defined as the highest safely tolerated dose level where at most 1 out of 6 patients experience a dose limiting toxicity (DLT) with the next higher dose having at least 2 patients out of a maximum of 6 patients experiencing a DLT. DLT will be assessed using Common Terminology Criteria for Adverse Events version 4.0. Examined in an exploratory and hypothesis-generating fashion.

Incidence of adverse events, using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0Up to 1 month post-treatment

Examined in an exploratory and hypothesis-generating fashion. The number and severity of all adverse events (overall, by dose-level, and by tumor type) will be tabulated and summarized in this patient population. The grade 2+ adverse events will also be described and summarized in a similar fashion.

Optimal biologically active dose for curcumin in combination with piperine extract (standardized)7 days

Examined in an exploratory and hypothesis-generating fashion.

Secondary Outcome Measures
NameTimeMethod
Change in quality of life (QOL) by means of the USSQBaseline to 7 days

Reported descriptively. Graphical methods and descriptive statistics will be used to describe the QOL data at baseline and after treatment. Change in QOL from baseline will be assessed via the paired t-test or non-parametric equivalent (Wilcoxon Signed-Rank test). The questions from the USSQ will be summarized descriptively via frequency tables.

Trial Locations

Locations (1)

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

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