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Phase II Trial of Polyphenon E in Former Smokers With Abnormal Sputa


Phase 2
45 Years
74 Years
Not Enrolling
Both
Lung Cancer, Tobacco Use Disorder

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Trial Information

Phase II Trial of Polyphenon E in Former Smokers With Abnormal Sputa


OBJECTIVES:

- Evaluate the efficacy and safety of defined green tea catechin extract (polyphenon E)
in former smokers with abnormal sputum score using stringent, newly developed response
criteria of combined nuclear morphometry and malignancy-associated changes as the
primary surrogate endpoint.

- Evaluate if polyphenon E can modulate other surrogate endpoint biomarkers of aberrant
methylation, cell cycle regulation, apoptosis, oncogene/tumor suppressor gene
expression, as well as phase I and II enzyme regulation.

- Establish a library of in-vivo confocal micro-endoscopy and optical coherent tomography
images of the bronchial epithelium with corresponding histopathology, nuclear
morphometry, and other biomarker information to assess the potential of confocal
micro-endoscopy as a non-biopsy method to assess the effect of chemoprevention agents.

OUTLINE: This is an open label, part 1 study followed by a randomized, double-blind, part 2
study.

- Part 1 (completed March 22, 2006): Patients receive oral defined green tea catechin
extract twice daily in months 1 and 2 and inhaled budesonide twice daily in month 2.

Patients undergo autofluorescence bronchoscopy with biopsies, oral and bronchial brushing,
and bronchoalveolar lavage at the end of months 1 and 2.

- Part 2: Patients are stratified by gender and randomized to 1 of 2 treatment arms.

- Arm I: Patients receive oral defined green tea catechin extract twice daily for 6
months.

- Arm II: Patients receive oral placebo twice daily for 6 months. Patients who have
progressive or stable disease at 6 months may receive open-label defined green tea
catechin extract.

Patients undergo autofluorescence bronchoscopy with biopsies, oral and bronchial brushing,
and bronchoalveolar lavage at the end of months 6 and 12.

Blood samples are collected periodically for biomarker studies. After completion of study
therapy, patients are followed periodically for 6 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Current smokers who have smoked at least 30 pack-years (e.g., 1 pack per day for 30
years or more) (part 1; completed March 22, 2006)

- Former smokers who have smoked at least 30 pack-years (part 2)

- A former smoker is defined as one who has stopped smoking for one or more years

- Abnormal sputum score ≥ 0.25 by computer-assisted image analysis

- Exhaled carbon monoxide level < 5 ppm (part 2 )

- Willing to take defined green tea catechin extract/placebo twice a day regularly

- No evidence of overt lung cancer

- No carcinoma in situ or invasive cancer on bronchoscopy or abnormal spiral chest
CT suspicious of lung cancer

PATIENT CHARACTERISTICS:

Inclusion criteria:

- ECOG performance status 0-1

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- Creatinine normal

- Bilirubin normal

- AST and ALT normal

- Alkaline phosphatase normal

Exclusion criteria:

- Chronic active hepatitis/liver cirrhosis

- Severe heart disease (e.g., unstable angina, chronic congestive heart failure, use of
antiarrhythmic agents)

- Ongoing gastric ulcer

- Acute bronchitis or pneumonia within one month

- Known reaction to lidocaine, albuterol sulfate, midazolam hydrochloride, and/or
alfentanil hydrochloride

- Known allergy to green tea and/or corn starch, gelatin, or other nonmedicinal
ingredients

- Any medical condition, such as acute or chronic respiratory failure or bleeding
disorder that, in the opinion of the investigator, could jeopardize the patient's
safety during participation in the study

- Unwilling to have a bronchoscopy

- Unwilling to have a spiral chest CT

PRIOR CONCURRENT THERAPY:

- No more than 5 cups of tea a week

- No concurrent anticoagulant treatment such as warfarin or heparin

- No use of other natural health products containing green tea compounds

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Outcome Measure:

Changes in oncogene/tumor suppression gene expression (part 1; completed March 22, 2006)

Outcome Time Frame:

36 months

Safety Issue:

No

Principal Investigator

Stephen Lam, MD

Investigator Role:

Study Chair

Investigator Affiliation:

British Columbia Cancer Agency

Authority:

United States: Food and Drug Administration

Study ID:

CDR0000578191

NCT ID:

NCT00573885

Start Date:

January 2008

Completion Date:

December 2008

Related Keywords:

  • Lung Cancer
  • Tobacco Use Disorder
  • non-small cell lung cancer
  • small cell lung cancer
  • tobacco use disorder
  • Lung Neoplasms
  • Tobacco Use Disorder

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