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Phase I Clinical Trial of Neem Leaf Extract for the Treatment of Chronic Lymphocytic Leukemia

Phase 1
18 Years
Not Enrolling
Refractory Chronic Lymphocytic Leukemia, Stage II Chronic Lymphocytic Leukemia, Stage III Chronic Lymphocytic Leukemia, Stage IV Chronic Lymphocytic Leukemia

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Trial Information

Phase I Clinical Trial of Neem Leaf Extract for the Treatment of Chronic Lymphocytic Leukemia

PRIMARY OBJECTIVES: I. To determine the lowest dose of neem leaf extract (NLE) with
antileukemic effect and acceptable toxicity in patients with chronic lymphocytic leukemia
(CLL). II. Establish the safety and toxicity of NLE in patients with CLL. SECONDARY
OBJECTIVES: I. Determine the efficacy of NLE in patients with CLL defined as overall
clinical response (CR + PR) by the IWCLL criterion. II. To develop a
pharmacokinetic/pharmacodynamic model relating neem leaf extract exposure to toxicity and
pharmacodynamic endpoints in CLL patients that will allow personalized dosing to target
optimal drug exposure. III. To conduct correlative studies. OUTLINE: This is a
dose-escalation study. Patients receive oral Azadirachta indica once daily on days 1-28.
Treatment repeats every 28 days for up to 8 courses in the absence of disease progression or
unacceptable toxicity. After completion of study treatment, patients are followed up every 3
months for 1 year.

Inclusion Criteria:

- Patients must have a definitive diagnosis of CLL as defined by the IWCLL criteria

- Patients may not have received any prior treatment for management of CLL; (no more
than 30 patients with treatment naive disease will be included in this study)

- Patients with advance stage disease (Rai Stage II-IV) may be included in this
clinical trial if they refuse to take standard chemotherapeutic regimens

- Patients with relapsed or relapsed/ resistant may be included in this clinical trial
if they refuse to take standard chemotherapeutic regimens

- Patients must understand and voluntarily sign an informed consent form

- Have an ECOG Performance Status of =< 2 at study entry

- Able to adhere to the study visit schedule and other protocol requirements

- Leukocytes >= 3,000/mcL

- Absolute neutrophil count >= 1,500/mcL

- Hemoglobin >= 10g/dl

- Platelets >= 50,000/mcl

- Total bilirubin within normal institutional limits

- AST (SGOT)/ ALT (SGPT) =< 2.5 X institutional ULN

- Patients of childbearing potential must agree to use acceptable contraceptive methods
(e.g., double barrier) during treatment

- Patient or legal representative must understand the investigational nature of this
study and sign an Independent Ethics Committee/Institutional Review Board approved
written informed consent form prior to receiving any study related procedure

Exclusion Criteria:

- Any serious medical condition, laboratory abnormality, or psychiatric illness that
would prevent the subject from signing the informed consent form

- Any condition, including the presence of laboratory abnormalities, which places the
subject at unacceptable risk if he/she were to participate in the study or confounds
the ability to interpret data from the study

- Trying to conceive, pregnant or breast feeding female patients

- Unwilling or unable to follow protocol requirements

- Any condition which in the Investigator's opinion deems the patient an unsuitable
candidate to receive study drug

- Patients who are consuming other herbals or non-traditional therapies (i.e. green tea
extracts and cumin) within the last 4 weeks(28 days) of initiating this clinical
study; note: patient must have stopped herbal or other non-traditional therapies for
CLL at least 28 days prior to initiating therapy on this study

- Patients with high-risk cytogenetic (del 17p, del 11q) determined by FISH analysis

- Prior organ transplant

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Lowest clinically active and tolerable dose

Outcome Time Frame:

After patients have completed at least 2 treatment courses

Safety Issue:


Principal Investigator

Asher Chanan-Khan

Investigator Role:

Principal Investigator

Investigator Affiliation:

Roswell Park Cancer Institute


United States: Institutional Review Board

Study ID:

I 169009



Start Date:

December 2010

Completion Date:

Related Keywords:

  • Refractory Chronic Lymphocytic Leukemia
  • Stage II Chronic Lymphocytic Leukemia
  • Stage III Chronic Lymphocytic Leukemia
  • Stage IV Chronic Lymphocytic Leukemia
  • Leukemia
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Leukemia, Lymphoid