Treatment of Radiation and Cisplatin Induced Toxicities with Tempol
A Double Blind, Placebo Controlled Dose Range Finding Study to Assess the Safety, Pharmacokinetics, and Efficacy of Tempol for the Reduction of Severe Mucositis in Head and Neck Cancer Patients Undergoing Combined Radio- and Chemotherapy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
One hundred and twenty (120) participants with head and neck cancer are scheduled to undergo combined radio- and chemotherapy (n = 120).
Nearly all (90% to 97%) participants receiving radiotherapy in the head and neck will develop some degree of mucositis. Of these participants treated with radiotherapy with or without chemotherapy, 34% to 43% will present severe mucositis. As a result, the participant's quality of life is affected, hospital admittance rates are higher, the use of total parenteral nutrition is increased and interruption of treatment is more frequent, all of which compromise tumor control. Mucositis causes 9% to 19% of chemotherapy and radiotherapy interruption.
A common chemotherapeutic agent used in head and neck cancer is Cisplatin. Cisplatin (cis- diamminedichloroplatinum(II), CDDP) is an antineoplastic drug used in the treatment of many cancers including testicular cancer, ovarian cancer, bladder cancer, head and neck cancer, esophageal cancer, small and non-small cell lung cancer, breast cancer, cervical cancer, stomach cancer, prostate cancer, brain tumors, neuroblastoma, sarcomas, multiple myeloma, melanoma, mesothelioma, Hodgkin's lymphoma, non-Hodgkin's lymphoma, pancreatic cancer, and thyroid cancer. While toxicities include ototoxicity, gastrotoxicity, myelosuppression, and allergic reactions, the main dose-limiting side effect of cisplatin is nephrotoxicity followed by ototoxicity.
Tempol is a piperidine nitroxide. Nitroxides are a class of stable free radical compounds that protects mammalian cells against numerous toxic agents. Tempol protects normal cells from radiation and cisplatin-induced damage; however, in cancerous or tumor cells, Tempol is reduced to its hydroxylamine form that does not and cannot protect the cells from radiation and cisplatin induced damage. This distinction is of particular importance in the setting of cancer treatment, in which both normal and tumor tissue is exposed to radiation and chemotherapy.
Without using Tempol, both normal cells and cancer cells suffer from toxicity. Tempol is the only known compound to possess this functional duality. This compound has the potential to prevent many of the toxicities associated with cisplatin and radiation treatment including the prevention of mucositis, nephrotoxicity, and ototoxicity.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Benji Crane
- Phone Number: 6264376506
- Email: bjcrane@matrixbiomed.com
Study Locations
-
-
California
-
La Jolla, California, United States, 92093
- Recruiting
- UCSD
-
Merced, California, United States, 95340
- Recruiting
- Mercy Medical Center
-
San Francisco, California, United States, 94158
- Active, not recruiting
- UCSF Helen Diller Family Comprehensive Cancer Center
-
Santa Maria, California, United States, 93454
- Recruiting
- Central Coast Medical Oncology
-
Santa Maria, California, United States, 93454
- Recruiting
- Mission Hope Health Center
-
-
New York
-
Bronx, New York, United States, 10461
- Recruiting
- Montefiore Medical Center-Einstein Campus
-
-
North Carolina
-
Winston-Salem, North Carolina, United States, 27157
- Recruiting
- Wake Forest University Health Sciences
-
-
Washington
-
Seattle, Washington, United States, 98195
- Recruiting
- University of Washington Medical Center
-
Seattle, Washington, United States, 98195
- Recruiting
- Seattle Cancer Care Alliance
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Be ≥18 years of age with medically diagnosed squamous cell cancer of the head and neck (SCCHN);
- Be scheduled to receive radiotherapy or proton therapy administered with a curative intent;
- If female and of child bearing potential, be using an effective birth-control method with a history of reliability for the individual participant;
- If male and of child bearing potential, adequate methods of contraception must be employed including use of condoms with spermicide. No sperm donation for 90 days until after the conclusion of the study;
- Must be receiving cisplatin for chemotherapy;
- Be properly informed of the nature and risks of the clinical investigation, comply with all clinical investigation-related procedures, and sign an Informed Consent Form prior to entering the clinical investigation;
- Must have a score 2 or less on the ECOG performance status;
- Participant life expectancy ≥ 6 months; and
- Adequate baseline organ function (hematologic, liver, renal, nutritional and metabolic):
Haematology:
Absolute neutrophil count (ANC) ≥1.5 Hemoglobin ≥ 10 g/dL Platelets ≥ 100,000 per microliter of blood
Hepatic:
Total bilirubin ≤ 2 X (Upper limit normal) ULN Alanine amino transferase (ALT) and Aspartate aminotransferase (AST) ≤5 x ULN
Renal:
Serum creatinine ≤ ULN or, if > ULN calculated creatinine clearance (CrCl) ≥ 60 mL/min.
Nutritional and metabolic:
Urine Albumin < 3.0 mg/dl
Exclusion Criteria:
- Prior radiotherapy of the head and neck;
- Have a clinically significant infection defined as any acute viral, bacterial or fungal infection, which requires specific therapy. Anti-infectious therapy must have been completed within 14 days of starting study treatment;
- Be taking any non-approved therapy for oral mucositis, including β-carotene, tocopherol, laser irradiation, brushing the oral mucosa with silver-nitrate prophylactically, systemic TGF-β (transforming growth factor beta), or systemic KGF (keratinocyte growth factor) during or within 14 days of starting treatment;
- Be taking mugard;
- Be taking prostaglandins, pentoxifylline or leucovorin during or within 14 days of starting treatment;
- Be rinsing with allopurinol, hydrogen peroxide, sucralfate, or chlorhexidine mouthwashes during or within 14 days of starting treatment;
- Have had a recent, serious, non-malignant medical complication that, in the opinion of the investigator, makes the individual unsuitable for study participation;
- Have used an investigational drug within 28 days of the initiation of study treatment;
- Have a history of a positive blood test for HIV;
- At the time of screening, having a significant active medical illness which, in the opinion of the investigator, would preclude completion of the study;
- Participants with a treatment plan consisting of chemoradiation followed by further chemotherapy;
- Participants with body weight less than 35 kg, 77 lbs;
- Women who are pregnant or who are breastfeeding;
- Participants with known intolerance to platin drugs;
- History of insulin-dependent Diabetes Mellitus; and
- Participants with Hepatitis B/C.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Active 1000 mg Tempol Solution
Patients will take 1000 mg of Tempol a day for the duration of radiation treatment (6-8 weeks)
|
Investigational product is Tempol (4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl) oral solution.
Tempol solution is an orange-colored, aqueous solution containing 7% Tempol along with xanthan gum, xylitol, aspartame, acesulfame potassium, sodium saccharin, alcohol, peppermint and wintergreen oils.
Other Names:
|
|
Placebo Comparator: Placebo Solution
Patients will take placebo solution everyday for the duration of radiation treatment (6-8 weeks)
|
The placebo contains the same excipients as the active product plus FD&C Yellow #6 for color matching.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mucositis
Time Frame: 10 weeks
|
To determine the efficacy of Tempol in reducing the incidence severe mucositis defined as grade 3 or 4 on the World Health Organization (WHO) scale. The incidence will measure the number of patients who experience grade 3 or 4 mucositis according to the World Health Organization (WHO) scale. A reduction in the number of patients who receive grade 3 or 4 mucositis over the course of the treatment is considered a positive change in incidence. |
10 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mucositis
Time Frame: 10 weeks
|
To determine the efficacy of Tempol in reducing the duration severe mucositis defined as grade 3 or 4 on the World Health Organization (WHO) scale. This duration will be measured by total number of days number a patient experiences grade 3 or 4 mucositis according to the World Health Organization (WHO) scale. A reduction in the total number of days a patient receives grade 3 or 4 mucositis over the course of the treatment is considered a positive change in duration. |
10 weeks
|
|
Nephrotoxicity
Time Frame: 10 weeks
|
Reduction in Serum Creatinine levels in active arm versus placebo arm.
|
10 weeks
|
|
Nephrotoxicity
Time Frame: 10 weeks
|
Reduction in Blood Urea Nitrogen levels in active arm versus placebo arm.
|
10 weeks
|
|
Mucositis
Time Frame: 10 weeks
|
To determine the efficacy of Tempol in reducing the time to onset of grades 1-4 mucositis on the World Health Organization (WHO) scale. This time to onset will measure the number of days after exposure to cisplatin before a patient experiences grade 1 through 4 mucositis according to the World Health Organization (WHO) scale. An increase in the total number of days before a patient receives grade 1 through 4 mucositis after cisplatin exposure is considered a positive change in time to onset. |
10 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Benji Crane, Matrix Biomed, Inc.
Publications and helpful links
General Publications
- Arany I, Safirstein RL. Cisplatin nephrotoxicity. Semin Nephrol. 2003 Sep;23(5):460-4. doi: 10.1016/s0270-9295(03)00089-5.
- Ahmed LA, Shehata NI, Abdelkader NF, Khattab MM. Tempol, a superoxide dismutase mimetic agent, ameliorates cisplatin-induced nephrotoxicity through alleviation of mitochondrial dysfunction in mice. PLoS One. 2014 Oct 1;9(10):e108889. doi: 10.1371/journal.pone.0108889. eCollection 2014. Erratum In: PLoS One. 2014;9(12):e115983.
- Scully C, Sonis S, Diz PD. Oral mucositis. Oral Dis. 2006 May;12(3):229-41. doi: 10.1111/j.1601-0825.2006.01258.x.
- Hartmann JT, Lipp HP. Toxicity of platinum compounds. Expert Opin Pharmacother. 2003 Jun;4(6):889-901. doi: 10.1517/14656566.4.6.889.
- Sastry J, Kellie SJ. Severe neurotoxicity, ototoxicity and nephrotoxicity following high-dose cisplatin and amifostine. Pediatr Hematol Oncol. 2005 Jul-Aug;22(5):441-5. doi: 10.1080/08880010590964381.
- Samuni A, Winkelsberg D, Pinson A, Hahn SM, Mitchell JB, Russo A. Nitroxide stable radicals protect beating cardiomyocytes against oxidative damage. J Clin Invest. 1991 May;87(5):1526-30. doi: 10.1172/JCI115163.
- Samuni A, Mitchell JB, DeGraff W, Krishna CM, Samuni U, Russo A. Nitroxide SOD-mimics: modes of action. Free Radic Res Commun. 1991;12-13 Pt 1:187-94. doi: 10.3109/10715769109145785.
- Samuni A, Krishna CM, Mitchell JB, Collins CR, Russo A. Superoxide reaction with nitroxides. Free Radic Res Commun. 1990;9(3-6):241-9. doi: 10.3109/10715769009145682.
- Mitchell JB, Anver MR, Sowers AL, Rosenberg PS, Figueroa M, Thetford A, Krishna MC, Albert PS, Cook JA. The antioxidant tempol reduces carcinogenesis and enhances survival in mice when administered after nonlethal total body radiation. Cancer Res. 2012 Sep 15;72(18):4846-55. doi: 10.1158/0008-5472.CAN-12-1879. Epub 2012 Jul 17.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Mouth Diseases
- Stomatognathic Diseases
- Wounds and Injuries
- Pathologic Processes
- Digestive System Diseases
- Gastrointestinal Diseases
- Chemically-Induced Disorders
- Gastroenteritis
- Otorhinolaryngologic Diseases
- Ear Diseases
- Drug-Related Side Effects and Adverse Reactions
- Radiation Injuries
- Ototoxicity
- Mucositis
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antioxidants
- Protective Agents
- Protein Synthesis Inhibitors
- Neuroprotective Agents
- Radiation-Protective Agents
- TEMPO
- Tempol
Other Study ID Numbers
Other Study ID Numbers
- MBI-04-04
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
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Mucositis
-
NCT05322421CompletedOral Mucositis (Ulcerative) Due to Radiation | Radiation-Induced Mucositis | Radiation Mucositis
-
NCT06031012Completed
-
NCT07400328RecruitingStomatitis | Hematopoietic Stem Cell Transplantation | Oral Mucositis | Gastrointestinal Mucositis
-
NCT06381635RecruitingRadiation Mucositis
-
NCT06708702WithdrawnOral Mucositis | Oral Mucositis (Ulcerative) Due to Radiation | Oral Mucositis (Ulcerative) Due to Antineoplastic Therapy | Oral Mucositis Due to Radiation
-
NCT04596410Recruiting
-
NCT03577535Completed
-
NCT07073092Not yet recruitingOral Mucositis Due to Chemotherapy
-
NCT06711315CompletedMucositis Oral | Childhood Oncology
-
NCT02508389CompletedRadiation Induced Oral Mucositis
Clinical Trials on Tempol
-
NCT04337099Available
-
NCT04887311Not yet recruitingAtaxia Telangiectasia | Ataxia Telangiectasia Louis-Bar | Ataxia Telangiectasia in Children
-
NCT04876755Not yet recruitingProstate Cancer Recurrent | Biochemical Recurrent Prostate Cancer
-
NCT04874506Not yet recruitingGlioblastoma | Glioblastoma Multiforme
-
NCT00801086Unknown
-
NCT04729595Terminated
-
NCT05491928AvailableMetastatic Cancer
-
NCT03242590Completed
-
NCT03680404CompletedCardiovascular Diseases | Cardiovascular Risk Factor | Vasoconstriction
-
NCT03680638CompletedCardiovascular Diseases | Vasodilation | Cardiovascular Risk Factor