- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01139281
The Protective Effect of Ginkgo Biloba Extract on Cisplatin-induced Ototoxicity in Humans
June 7, 2010 updated by: University of Brasilia
The Protective Effect of Ginkgo Biloba Extract on Cisplatin-Induced Ototoxicity in Humans Beings Evaluated by Distortion Product Otoacoustic Emissions
The proposal of this study was to evaluate in human beings, using distortion product otoacoustic emission (DPOAE) test, the action of ginkgo biloba extract (GBE761)as a possible ear protective against cisplatin (CDDP) induced hearing loss.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
The ototoxicity is an alteration caused by drugs that compromises the auditory and vestibular functions.
The cisplatin (CDDP) is a potent antineoplastic agent used for the treatment of cancer in both adults and children although it has several side effects.
Current opinion is that cisplatin ototoxicity occurs due to alterations in the antioxidant system of the outer hair cells (OHC) of the cochlea.
The distortion-product otoacoustic emissions (DPOAE) has been showed to be a sensitive test for diagnosis of OHC injury and has been used for monitoring treatment with ototoxic drugs.
Because of their antioxidant properties, the ginkgo biloba extract (GBE761) was evaluated in human beings as a possible ear protective against cisplatin induced hearing loss, using DPOAE test.
Study Type
Interventional
Enrollment (Actual)
15
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
DF
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Brasília, DF, Brazil, 70000-000
- Hospital de Base do Distrito Federal (HBDF)
-
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Over the age of eighteen
- Patients that will begin treatment with cisplatin
- No prior treatment with cisplatin
Exclusion Criteria:
- Individuals with middle ear, cochlear or retrocochlear disease
- Presence of changes in pure tone audiometry and/or distortion-product otoacoustic emissions
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Study Group
The Study Group(SG) received Ginkgo biloba extract(GBE761)(240mg/day)plus cisplatin(CDDP)
|
The subjects were randomized and allocated in two groups: Control Group(CG) and Study Group(SG).
the study group received GBE761(120mg twice a day) plus cisplatin and was guided to ingest GBE761 just before initial cisplatin dosage.
The maximum cumulative cisplatin dosage was 300mg/m².
They were followed up for ninety days.
Comparisons were made between baseline distortion-product otoacoustic emissions measurements and those DPOAE records after maximum cumulative cisplatin dosage.
Other Names:
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PLACEBO_COMPARATOR: Control Group(CG)
The Control Group received Placebo plus CDDP
|
The subjects were randomized and allocated in two groups: control group and study group.
The control group received placebo plus cisplatin and was guided to ingest Placebo just before initial cisplatin dosage.
The maximum cumulative cisplatin dosage was 300mg/m².
They were followed up for ninety days.
Comparisons were made between baseline distortion-product otoacoustic emissions measurements and those DPOAE records after maximum cumulative cisplatin dosage.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
the effect of GBE761 as a possible protector against cisplatin (CDDP) induced hearing loss was evaluated through the DPOAE. Comparisons were made between baseline measurements and those records after maximum cumulative CDDP dosage.
Time Frame: the patients were followed about ninety days
|
The protective effect of GBE761 on CDDP induced ototoxicity in human beings was evaluated with DPOAE mean amplitudes and signal-to-noise ratio (SNR) values at in the frequencies ranging from 1 to 8KHz in the study and control groups, between before and after cumulative CDDP injections, in order to evaluate the significant differences in DPOAE results, and so to differentiate hearing status ( normal hearing or hearing loss) while the subjects were taking GBE or placebo.
|
the patients were followed about ninety days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Mirela A Dias, University of Brasilia
- Study Chair: Carlos CP Oliveira, University of Brasilia
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Biro K, Noszek L, Prekopp P, Nagyivanyi K, Geczi L, Gaudi I, Bodrogi I. Characteristics and risk factors of cisplatin-induced ototoxicity in testicular cancer patients detected by distortion product otoacoustic emission. Oncology. 2006;70(3):177-84. doi: 10.1159/000093776. Epub 2006 Jun 2.
- Blakley BW, Myers SF. Patterns of hearing loss resulting from cis-platinum therapy. Otolaryngol Head Neck Surg. 1993 Sep;109(3 Pt 1):385-91. doi: 10.1177/019459989310900302.
- Bridi R, Crossetti FP, Steffen VM, Henriques AT. The antioxidant activity of standardized extract of Ginkgo biloba (EGb 761) in rats. Phytother Res. 2001 Aug;15(5):449-51. doi: 10.1002/ptr.814.
- Christen Y, Maixent JM. What is Ginkgo biloba extract EGb 761? An overview--from molecular biology to clinical medicine. Cell Mol Biol (Noisy-le-grand). 2002 Sep;48(6):601-11.
- Dhooge I, Dhooge C, Geukens S, De Clerck B, De Vel E, Vinck BM. Distortion product otoacoustic emissions: an objective technique for the screening of hearing loss in children treated with platin derivatives. Int J Audiol. 2006 Jun;45(6):337-43. doi: 10.1080/14992020600582117.
- Gardner CD, Zehnder JL, Rigby AJ, Nicholus JR, Farquhar JW. Effect of Ginkgo biloba (EGb 761) and aspirin on platelet aggregation and platelet function analysis among older adults at risk of cardiovascular disease: a randomized clinical trial. Blood Coagul Fibrinolysis. 2007 Dec;18(8):787-93. doi: 10.1097/MBC.0b013e3282f102b1.
- Gorga MP, Neely ST, Ohlrich B, Hoover B, Redner J, Peters J. From laboratory to clinic: a large scale study of distortion product otoacoustic emissions in ears with normal hearing and ears with hearing loss. Ear Hear. 1997 Dec;18(6):440-55. doi: 10.1097/00003446-199712000-00003.
- Gorga MP, Stover L, Neely ST, Montoya D. The use of cumulative distributions to determine critical values and levels of confidence for clinical distortion product otoacoustic emission measurements. J Acoust Soc Am. 1996 Aug;100(2 Pt 1):968-77. doi: 10.1121/1.416208.
- Hatzopoulos S, Di Stefano M, Campbell KC, Falgione D, Ricci D, Rosignoli M, Finesso M, Albertin A, Previati M, Capitani S, Martini A. Cisplatin ototoxicity in the Sprague Dawley rat evaluated by distortion product otoacoustic emissions. Audiology. 2001 Sep-Oct;40(5):253-64.
- Hibatallah J, Carduner C, Poelman MC. In-vivo and in-vitro assessment of the free-radical-scavenger activity of Ginkgo flavone glycosides at high concentration. J Pharm Pharmacol. 1999 Dec;51(12):1435-40. doi: 10.1211/0022357991777083.
- Huang T, Cheng AG, Stupak H, Liu W, Kim A, Staecker H, Lefebvre PP, Malgrange B, Kopke R, Moonen G, Van De Water TR. Oxidative stress-induced apoptosis of cochlear sensory cells: otoprotective strategies. Int J Dev Neurosci. 2000 Apr-Jun;18(2-3):259-70. doi: 10.1016/s0736-5748(99)00094-5.
- Rybak LP, Husain K, Morris C, Whitworth C, Somani S. Effect of protective agents against cisplatin ototoxicity. Am J Otol. 2000 Jul;21(4):513-20.
- Kaltenbach JA, Church MW, Blakley BW, McCaslin DL, Burgio DL. Comparison of five agents in protecting the cochlea against the ototoxic effects of cisplatin in the hamster. Otolaryngol Head Neck Surg. 1997 Nov;117(5):493-500. doi: 10.1016/S0194-59989770020-2.
- Kobuchi H, Droy-Lefaix MT, Christen Y, Packer L. Ginkgo biloba extract (EGb 761): inhibitory effect on nitric oxide production in the macrophage cell line RAW 264.7. Biochem Pharmacol. 1997 Mar 21;53(6):897-903. doi: 10.1016/s0006-2952(96)00873-8.
- Meyerhoff WL, Maale GE, Yellin W, Roland PS. Audiologic threshold monitoring of patients receiving ototoxic drugs. Preliminary report. Ann Otol Rhinol Laryngol. 1989 Dec;98(12 Pt 1):950-4. doi: 10.1177/000348948909801206.
- Palomar Garcia V, Abdulghani Martinez F, Bodet Agusti E, Andreu Mencia L, Palomar Asenjo V. Drug-induced otoxicity: current status. Acta Otolaryngol. 2001 Jul;121(5):569-72. doi: 10.1080/00016480121545.
- Campbell K. Ototoxicity: understanding oxidative mechanisms. J Am Acad Audiol. 2003 Apr;14(3):121-3. doi: 10.3766/jaaa.14.3.2. No abstract available.
- Campbell KC, Durrant J. Audiologic monitoring for ototoxicity. Otolaryngol Clin North Am. 1993 Oct;26(5):903-14.
- Diamond BJ, Shiflett SC, Feiwel N, Matheis RJ, Noskin O, Richards JA, Schoenberger NE. Ginkgo biloba extract: mechanisms and clinical indications. Arch Phys Med Rehabil. 2000 May;81(5):668-78. doi: 10.1016/s0003-9993(00)90052-2.
- Franklin DJ, McCoy MJ, Martin GK, Lonsbury-Martin BL. Test/retest reliability of distortion-product and transiently evoked otoacoustic emissions. Ear Hear. 1992 Dec;13(6):417-29. doi: 10.1097/00003446-199212000-00008.
- Bonfils P, Avan P. Distortion-product otoacoustic emissions. Values for clinical use. Arch Otolaryngol Head Neck Surg. 1992 Oct;118(10):1069-76. doi: 10.1001/archotol.1992.01880100061014.
- Kemp DT, Ryan S, Bray P. A guide to the effective use of otoacoustic emissions. Ear Hear. 1990 Apr;11(2):93-105. doi: 10.1097/00003446-199004000-00004.
- Kimberley BP. Applications of distortion-product emissions to an otological practice. Laryngoscope. 1999 Dec;109(12):1908-18. doi: 10.1097/00005537-199912000-00003.
- Knight KR, Kraemer DF, Winter C, Neuwelt EA. Early changes in auditory function as a result of platinum chemotherapy: use of extended high-frequency audiometry and evoked distortion product otoacoustic emissions. J Clin Oncol. 2007 Apr 1;25(10):1190-5. doi: 10.1200/JCO.2006.07.9723.
- Komune S, Asakuma S, Snow JB Jr. Pathophysiology of the ototoxicity of cis-diamminedichloroplatinum. Otolaryngol Head Neck Surg. 1981 Mar-Apr;89(2):275-82. doi: 10.1177/019459988108900226.
- Kushner BH, Budnick A, Kramer K, Modak S, Cheung NK. Ototoxicity from high-dose use of platinum compounds in patients with neuroblastoma. Cancer. 2006 Jul 15;107(2):417-22. doi: 10.1002/cncr.22004.
- Laurell G, Bagger-Sjoback D. Dose-dependent inner ear changes after i.v. administration of cisplatin. J Otolaryngol. 1991 Jun;20(3):158-67.
- Le Bars PL, Kastelan J. Efficacy and safety of a Ginkgo biloba extract. Public Health Nutr. 2000 Dec;3(4A):495-9. doi: 10.1017/s1368980000000574.
- Lonsbury-Martin BL, Whitehead ML, Martin GK. Clinical applications of otoacoustic emissions. J Speech Hear Res. 1991 Oct;34(5):964-81. doi: 10.1044/jshr.3405.964.
- Mahadevan S, Park Y. Multifaceted therapeutic benefits of Ginkgo biloba L.: chemistry, efficacy, safety, and uses. J Food Sci. 2008 Jan;73(1):R14-9. doi: 10.1111/j.1750-3841.2007.00597.x.
- Maitra I, Marcocci L, Droy-Lefaix MT, Packer L. Peroxyl radical scavenging activity of Ginkgo biloba extract EGb 761. Biochem Pharmacol. 1995 May 26;49(11):1649-55. doi: 10.1016/0006-2952(95)00089-i.
- Marcocci L, Packer L, Droy-Lefaix MT, Sekaki A, Gardes-Albert M. Antioxidant action of Ginkgo biloba extract EGb 761. Methods Enzymol. 1994;234:462-75. doi: 10.1016/0076-6879(94)34117-6. No abstract available.
- McKenna DJ, Jones K, Hughes K. Efficacy, safety, and use of ginkgo biloba in clinical and preclinical applications. Altern Ther Health Med. 2001 Sep-Oct;7(5):70-86, 88-90.
- Ohlms LA, Lonsbury-Martin BL, Martin GK. The clinical application of acoustic distortion products. Otolaryngol Head Neck Surg. 1990 Jul;103(1):52-9. doi: 10.1177/019459989010300108.
- Ozturan O, Jerger J, Lew H, Lynch GR. Monitoring of cisplatin ototoxicity by distortion-product otoacoustic emissions. Auris Nasus Larynx. 1996;23:147-51. doi: 10.1016/s0385-8146(96)80023-x.
- Pincemail J, Dupuis M, Nasr C, Hans P, Haag-Berrurier M, Anton R, Deby C. Superoxide anion scavenging effect and superoxide dismutase activity of Ginkgo biloba extract. Experientia. 1989 Aug 15;45(8):708-12. doi: 10.1007/BF01974564.
- Probst R, Hauser R. Distortion product otoacoustic emissions in normal and hearing-impaired ears. Am J Otolaryngol. 1990 Jul-Aug;11(4):236-43. doi: 10.1016/0196-0709(90)90083-8.
- Ravi R, Somani SM, Rybak LP. Mechanism of cisplatin ototoxicity: antioxidant system. Pharmacol Toxicol. 1995 Jun;76(6):386-94. doi: 10.1111/j.1600-0773.1995.tb00167.x.
- Rademaker-Lakhai JM, Crul M, Zuur L, Baas P, Beijnen JH, Simis YJ, van Zandwijk N, Schellens JH. Relationship between cisplatin administration and the development of ototoxicity. J Clin Oncol. 2006 Feb 20;24(6):918-24. doi: 10.1200/JCO.2006.10.077.
- Ress BD, Sridhar KS, Balkany TJ, Waxman GM, Stagner BB, Lonsbury-Martin BL. Effects of cis-platinum chemotherapy on otoacoustic emissions: the development of an objective screening protocol. Third place--Resident Clinical Science Award 1998. Otolaryngol Head Neck Surg. 1999 Dec;121(6):693-701. doi: 10.1053/hn.1999.v121.a101567.
- Rybak LP, Kelly T. Ototoxicity: bioprotective mechanisms. Curr Opin Otolaryngol Head Neck Surg. 2003 Oct;11(5):328-33. doi: 10.1097/00020840-200310000-00004.
- Rybak LP. Mechanisms of cisplatin ototoxicity and progress in otoprotection. Curr Opin Otolaryngol Head Neck Surg. 2007 Oct;15(5):364-9. doi: 10.1097/MOO.0b013e3282eee452.
- Rybak LP, Whitworth CA, Mukherjea D, Ramkumar V. Mechanisms of cisplatin-induced ototoxicity and prevention. Hear Res. 2007 Apr;226(1-2):157-67. doi: 10.1016/j.heares.2006.09.015. Epub 2006 Nov 17.
- Rybak LP, Whitworth C, Somani S. Application of antioxidants and other agents to prevent cisplatin ototoxicity. Laryngoscope. 1999 Nov;109(11):1740-4. doi: 10.1097/00005537-199911000-00003.
- Rybak LP, Ramkumar V. Ototoxicity. Kidney Int. 2007 Oct;72(8):931-5. doi: 10.1038/sj.ki.5002434. Epub 2007 Jul 25.
- Rybak LP, Whitworth CA. Ototoxicity: therapeutic opportunities. Drug Discov Today. 2005 Oct 1;10(19):1313-21. doi: 10.1016/S1359-6446(05)03552-X.
- Sie KC, Norton SJ. Changes in otoacoustic emissions and auditory brain stem response after cis-platinum exposure in gerbils. Otolaryngol Head Neck Surg. 1997 Jun;116(6 Pt 1):585-92. doi: 10.1016/S0194-59989770232-8.
- Singh B, Kaur P, Gopichand, Singh RD, Ahuja PS. Biology and chemistry of Ginkgo biloba. Fitoterapia. 2008 Sep;79(6):401-18. doi: 10.1016/j.fitote.2008.05.007. Epub 2008 Jun 27.
- Stavroulaki P, Apostolopoulos N, Segas J, Tsakanikos M, Adamopoulos G. Evoked otoacoustic emissions--an approach for monitoring cisplatin induced ototoxicity in children. Int J Pediatr Otorhinolaryngol. 2001 May 31;59(1):47-57. doi: 10.1016/s0165-5876(01)00455-4.
- Stover L, Gorga MP, Neely ST, Montoya D. Toward optimizing the clinical utility of distortion product otoacoustic emission measurements. J Acoust Soc Am. 1996 Aug;100(2 Pt 1):956-67. doi: 10.1121/1.416207.
- Toral-Martinon R, Shkurovich-Bialik P, Collado-Corona MA, Mora-Magana I, Goldgrub-Listopad S, Shkurovich-Zaslavsky M. Distortion product otoacoustic emissions test is useful in children undergoing cisplatin treatment. Arch Med Res. 2003 May-Jun;34(3):205-8. doi: 10.1016/S0188-4409(03)00022-5.
- Vermorken JB, Kapteijn TS, Hart AA, Pinedo HM. Ototoxicity of cis-diamminedichloroplatinum (II): influence of dose, schedule and mode of administration. Eur J Cancer Clin Oncol. 1983 Jan;19(1):53-8. doi: 10.1016/0277-5379(83)90398-x.
- Zorowka PG, Schmitt HJ, Gutjahr P. Evoked otoacoustic emissions and pure tone threshold audiometry in patients receiving cisplatinum therapy. Int J Pediatr Otorhinolaryngol. 1993 Jan;25(1-3):73-80. doi: 10.1016/0165-5876(93)90011-q.
- Sockalingam R, Freeman S, Cherny TL, Sohmer H. Effect of high-dose cisplatin on auditory brainstem responses and otoacoustic emissions in laboratory animals. Am J Otol. 2000 Jul;21(4):521-7.
- Fukaya H, Kanno H. [Experimental studies of the protective effect of ginkgo biloba extract (GBE) on cisplatin-induced toxicity in rats]. Nihon Jibiinkoka Gakkai Kaiho. 1999 Jul;102(7):907-17. doi: 10.3950/jibiinkoka.102.907. Japanese.
- Huang X, Whitworth CA, Rybak LP. Ginkgo biloba extract (EGb 761) protects against cisplatin-induced ototoxicity in rats. Otol Neurotol. 2007 Sep;28(6):828-33. doi: 10.1097/mao.0b013e3180430163.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
June 1, 2007
Primary Completion (ACTUAL)
June 1, 2008
Study Completion (ACTUAL)
June 1, 2008
Study Registration Dates
First Submitted
June 1, 2010
First Submitted That Met QC Criteria
June 7, 2010
First Posted (ESTIMATE)
June 8, 2010
Study Record Updates
Last Update Posted (ESTIMATE)
June 8, 2010
Last Update Submitted That Met QC Criteria
June 7, 2010
Last Verified
May 1, 2010
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- CEPSESDF-024-07
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.
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