Minocycline Hydrochloride in Reducing Chemotherapy Induced Depression and Anxiety in Patients With Stage I-III Breast Cancer
Randomized Placebo Controlled Study of Minocycline for Amelioration of Chemotherapy Induced Affective Disorders
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate anxiety and depression in women with stages I-III breast cancer during the first 8 weeks of doxorubicin-based adjuvant therapy randomized to receive either minocycline (minocycline hydrochloride) or placebo.
II. To evaluate markers of neuro-inflammation as assessed by blood based inflammatory cytokines and C11-choline positron emission tomography (PET) in women with stages I-III breast cancer during the first 8 weeks of doxorubicin-based adjuvant therapy randomized to receive either minocycline or placebo.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Beginning 1 week prior to chemotherapy, patients receive minocycline hydrochloride orally (PO) twice daily (BID) for 9 weeks.
ARM II: Beginning 1 week prior to chemotherapy, patients receive placebo PO BID for 9 weeks.
After completion of study treatment, patients are followed up for 6 months.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Ohio
-
Columbus, Ohio, United States, 43210
- Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Women diagnosed with breast cancer stages I-III initiating first line adjuvant or neoadjuvant doxorubicin hydrochloride (DOX) chemotherapy
- Postmenopausal defined as amenorrhea > 12 months or follicle stimulating hormone (FSH) and estradiol in institutional postmenopausal range
- Ability to understand English and read and write at the 8th grade level and give a written informed consent document
- For additional cohort, women with breast cancer stages I-III who currently on or within 18 months of completing first line adjuvant or neoadjuvant DOX chemotherapy or other chemotherapy for breast cancer.
Exclusion Criteria:
- Rheumatoid arthritis and other types of autoimmune and inflammatory joint disease, with the exception of osteoarthritis and fibromyalgia
- Concurrent other malignancy or metastatic malignancy of any kind
- Reported diagnosis of major depression or anxiety disorder prior to breast cancer (BC) diagnosis
- Currently prescribed psychotropic medications including anti-depressants
- Known bleeding disorders
- History of diabetes mellitus, heart disease or stroke
- Current use of warfarin or other anticoagulants
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, hypertension, or psychiatric illness/social situation that would limit compliance with study requirements
- Pregnant or nursing women
- Concurrent use of daily full dose aspirin (>= 325 mg/day), nonsteroidal anti-inflammatory drugs (NSAIDs) or NSAID-containing products or steroids; one month washout period is required prior to randomization
- Unable to give informed consent
- Tetracycline allergy
- Any contraindication to magnetic resonance imaging (MRI)/PET examination including but not limited to ferromagnetic metal in the body, pacemaker, or severe claustrophobia; (however, this portion is optional and if patient is otherwise eligible, can enroll in study without participating in imaging study)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm I (minocycline hydrochloride)
Beginning 1 week prior to chemotherapy, patients receive minocycline hydrochloride orally PO BID for 9 weeks.
Laboratory biomarker analysis will also be obtained weekly on protocol.
Questionnaire administration weekly.
|
100 mg bid given by mouth for 9 weeks
Other Names:
Correlative blood levels for cortisol, high sensitivity c-reactive protein (hs-CRP) and inflammatory factors including but not limited to IL-6, TNF-α, IL-1β, and MCP-1 will also be obtained weekly on protocol.
Other Names:
The CES-D and STAI will be administrated weekly.
Other Names:
|
|
Placebo Comparator: Arm II (placebo)
Beginning 1 week prior to chemotherapy, patients receive placebo PO BID for 9 weeks.
Laboratory biomarker analysis will also be obtained weekly on protocol.
Questionnaire administration weekly.
|
Correlative blood levels for cortisol, high sensitivity c-reactive protein (hs-CRP) and inflammatory factors including but not limited to IL-6, TNF-α, IL-1β, and MCP-1 will also be obtained weekly on protocol.
Other Names:
The CES-D and STAI will be administrated weekly.
Other Names:
Placebo given by mouth for 9 weeks
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Changes in Center for Epidemiological Studies Depression Scale (CES-D) Scores
Time Frame: Baseline to 9 weeks
|
CES-D scale a short self-reported scaled designed to measure depressive symptomology in the general population.
At baseline, depressive symptom severity will be assessed using the CES-D instrument.
Evaluation of the patients assessment if suicidal ideation is reported at baseline.
A value of 0, 1, 2, or 3 is assigned to a response depending upon positively or negatively.
The subject will be withdrawn from the administrated serially every cycle starts on protocol during clinic visits (Patients will self-administer forms given out by research coordinator).The internal consistency for the STAI is .95;
higher scores indicate greater anxiety.41
The internal consistency for the CES-D is approximately .85 among BC patients,42 and an important benefit of using this scale in medical studies is that it is relatively unaffected by physical symptoms.
Total scores range from 0-60 with higher scores reflecting greater depressive symptoms.
The 95% confidence intervals of the depression change from b
|
Baseline to 9 weeks
|
|
Changes in the State Trait Anxiety Index (STAI) Scores
Time Frame: Baseline to 9 weeks
|
The mean changes over time in State Trait Anxiety Index (STAI) scores from baseline to the end of study for the two study groups.
The influences of covariate, such as disease stage and depression drug usage, will be considered in the mixed models as exploratory analyses.
The range of possible scores for form Y of the STAI varies from a minimum score of 20 to a maximum score of 80. STAI scores are commonly classified as "no or low anxiety" (20-37), "moderate anxiety" (38-44), and "high anxiety" (45-80).The 95% confidence intervals of the change in the primary outcome measures from baseline to the end of study and the differences between the treatment and placebo groups will be estimated based on the models.
|
Baseline to 9 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Changes in Hamilton Anxiety Rating Scale Scores
Time Frame: Baseline to 9 weeks
|
The 95% confidence intervals of the anxiety change from baseline to the end of study and the difference between the treatment and placebo groups.
The influences of covariate, such as disease stage and depression drug usage, will be considered in the mixed models as exploratory analyses.
In addition, change overtime of all outcomes for each individual will be plotted to visually explore any patterns and to generate hypothesis to be tested in future studies.
|
Baseline to 9 weeks
|
|
Changes in Hamilton Rating Scale for Depression Scores
Time Frame: Baseline to 9 weeks
|
The 95% confidence intervals of the depression change from baseline to the end of study and the difference between the treatment and placebo groups.
The influences of covariate, such as disease stage and depression drug usage, will be considered in the mixed models as exploratory analyses.
In addition, change overtime of all outcomes for each individual will be plotted to visually explore any patterns and to generate hypothesis to be tested in future studies.
|
Baseline to 9 weeks
|
|
Changes in Inflammatory Blood Markers
Time Frame: Baseline to 6 months
|
Scatter plots will be used to explore the pair-wise correlation among the changes of CES-D and STAI scores, blood biomarkers changes, and PET/MRI measures.
A statistical model will be used to explore whether the blood based biomarkers and PET/MRI measures can be used to predict the changes in CES-D and STAI scores, which then could be used as potential surrogate markers in future studies.
|
Baseline to 6 months
|
|
Changes in the PET/MRI Measures
Time Frame: Baseline to 6 months
|
Scatter plots will be used to explore the pair-wise correlation among the changes of CES-D and STAI scores, blood biomarkers changes, and PET/MRI measures.
A statistical model will be used to explore whether the blood based biomarkers and PET/MRI measures can be used to predict the changes in CES-D and STAI scores, which then could be used as potential surrogate markers in future studies.
|
Baseline to 6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Bhuvaneswari Ramaswamy, MD, Ohio State University Comprehensive Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- OSU-13165
- NCI-2014-00851 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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