Acetylamantadine Excretion by Cancer Patients

Urinary Excretion of Acetylamantadine by Cancer Patients

Several factors discourage the implementation of cancer screening to the population in general, which would result in earlier diagnosis and an expected improved survival. Concurrent in vivo and in vitro research has shown that drug acetylation activity is increased in cancer. Amantadine may be of value in detecting the presence of cancer. Accordingly, this study will examine how Amantadine is eliminated by the body in cancer patients. This is an important step in validating a cancer detection method that can be implemented economically for screening of large numbers of people.

Study Overview

• Status: Recruiting
• Conditions: Cancer
• Intervention / Treatment: Drug: Amantadine

Detailed Description

The study will involve the screening of volunteer patients with various types of cancer to provide a first indication of which types of cancer and at what stage of tumor burden acetylamantadine will be found in patients' plasma, saliva and urine samples. Volunteers will provide complete first morning urine collection prior to amantadine ingestion. The volunteers will then ingest a therapeutic dose of amantadine (200 mg: 2x100mg capsules), at least 2 hours before breakfast (nothing to eat or drink except water after midnight before the scheduled appointment), and their complete urine will be collected at 2 and 4 hours (plus or minus 1 hour) after amantadine ingestion. In addition, blood samples will be taken by venipuncture before and at 2 and 4 hours after drug ingestion. The patients will be asked to provide a saliva sample at the same time as the urine samples are taken after drug ingestion.

• Study Type: Observational
• Enrollment (Anticipated): 120

Contacts and Locations

• Study Contact: Name: Paramjit S Tappia, PhD; Phone Number: 204-258-1230; Email: ptappia@sbrc.ca
• Study Contact Backup: Name: Andrew Maksymiuk, MD; Phone Number: 204-787-1884; Email: amaksymiuk@cancercare.mb.ca

Study Locations

• Canada
  • Manitoba
    • Winnipeg, Manitoba, Canada, R2H 2A6
      • Recruiting
      • St. Boniface Hospital
      • Contact: Paramjit S Tappia, PhD; Phone Number: 204-258-1230; Email: ptappia@sbrc.ca
      • Contact: Andrew Maksymiuk, MD; Phone Number: 204-7871884; Email: amaksymiuk@cancercare.mb.ca

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 76 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients with newly diagnosed cancer

Description

Inclusion Criteria: newly diagnosed or untreated cancer (GI, lung, prostate and breast cancer)

-

Exclusion Criteria: Any previous adverse reaction to Amantadine

• currently pregnant or lactating

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Retrospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Amantadine; Lung cancer patients being prescribed chemotherapy	Drug: Amantadine; Amantadine is a drug that has been on the market for several years and is currently approved for the treatment of Parkinson's disease and for prevention against influenza A infection. Amantadine may be of value in detecting the presence of cancer.; Other Names: Systemic chemotherapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acetylated Amantadine levels in urine	Change in acetylamantadine excretion	2 and 4 hours after Amantadine ingestion

Collaborators and Investigators

• Sponsor: University of Manitoba
• Collaborators: St. Boniface Hospital; BioMark Technologies Inc.

Publications and helpful links

General Publications

• Young RC. Cancer statistics, 2002: progress or cause for concern? CA Cancer J Clin. 2002 Jan-Feb;52(1):6-7. doi: 10.3322/canjclin.52.1.6. No abstract available.
• Smith RA, Cokkinides V, von Eschenbach AC, Levin B, Cohen C, Runowicz CD, Sener S, Saslow D, Eyre HJ; American Cancer Society. American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2002 Jan-Feb;52(1):8-22. doi: 10.3322/canjclin.52.1.8.
• Bras AP, Hoff HR, Aoki FY, Sitar DS. Amantadine acetylation may be effected by acetyltransferases other than NAT1 or NAT2. Can J Physiol Pharmacol. 1998 Jul-Aug;76(7-8):701-6. doi: 10.1139/cjpp-76-7-8-701.
• Bras AP, Janne J, Porter CW, Sitar DS. Spermidine/spermine n(1)-acetyltransferase catalyzes amantadine acetylation. Drug Metab Dispos. 2001 May;29(5):676-80.
• Matsui I, Wiegand L, Pegg AE. Properties of spermidine N-acetyltransferase from livers of rats treated with carbon tetrachloride and its role in the conversion of spermidine into putrescine. J Biol Chem. 1981 Mar 10;256(5):2454-9. No abstract available.
• Pegg AE, Seely JE, Poso H, della Ragione F, Zagon IA. Polyamine biosynthesis and interconversion in rodent tissues. Fed Proc. 1982 Dec;41(14):3065-72.
• Seiler N. Functions of polyamine acetylation. Can J Physiol Pharmacol. 1987 Oct;65(10):2024-35. doi: 10.1139/y87-317.
• Bettuzzi S, Davalli P, Astancolle S, Carani C, Madeo B, Tampieri A, Corti A. Tumor progression is accompanied by significant changes in the levels of expression of polyamine metabolism regulatory genes and clusterin (sulfated glycoprotein 2) in human prostate cancer specimens. Cancer Res. 2000 Jan 1;60(1):28-34. Erratum In: Cancer Res 2000 Mar 1;60(5):1472. Saverio, B [corrected to Bettuzzi, S]; Pierpaola, D [corrected to Davalli, P]; Serenella, A [corrected to Astancolle, S]; ,C [corrected to Carani, C]; Bruno, M [corrected to Madeo, B]; Auro, T [corrected to Tampieri, A]; Arnaldo, C [corrected to Corti, A].
• Russell DH. Increased polyamine concentrations in the urine of human cancer patients. Nat New Biol. 1971 Sep 29;233(39):144-5. doi: 10.1038/newbio233144a0. No abstract available.
• Suh JW, Lee SH, Chung BC, Park J. Urinary polyamine evaluation for effective diagnosis of various cancers. J Chromatogr B Biomed Sci Appl. 1997 Jan 24;688(2):179-86. doi: 10.1016/s0378-4347(96)00266-6.
• Takenoshita S, Matsuzaki S, Nakano G, Kimura H, Hoshi H, Shoda H, Nakamura T. Selective elevation of the N1-acetylspermidine level in human colorectal adenocarcinomas. Cancer Res. 1984 Feb;44(2):845-7.
• Kingsnorth AN, Wallace HM. Elevation of monoacetylated polyamines in human breast cancers. Eur J Cancer Clin Oncol. 1985 Sep;21(9):1057-62. doi: 10.1016/0277-5379(85)90291-3.
• Pine MJ, Huben RP, Pegg AE. Production of N1-acetyl spermidine by renal cell tumors. J Urol. 1989 Mar;141(3):651-5. doi: 10.1016/s0022-5347(17)40925-6.
• Sessa A, Perin A. Increased synthesis of N1-acetylspermidine in hepatic preneoplastic nodules and hepatomas. Cancer Lett. 1991 Feb;56(2):159-63. doi: 10.1016/0304-3835(91)90091-u.
• Dilman VM, Anisimov VN, Kolosov AI, Bulovskaya LN. On the relationship between the activity of acetylation, growth of experimental tumors and efficacy of their suppression by hydrazine sulphate. Oncology. 1976;33(5-6):219-21. doi: 10.1159/000225149.
• Bulovskaya LN, Krupkin RG, Bochina TA, Shipkova AA, Pavlova MV. Acetylator phenotype in patients with breast cancer. Oncology. 1978;35(4):185-8. doi: 10.1159/000225282.
• Chekharina YeA, Bulovskaya LN, Pavlova MV, Krupkin RG. Activity of N-acetyltransferase in patients with malignant lymphomas. Neoplasma. 1978;25(4):471-5.
• Geylan YS, Dizbay S, Guray T. Arylamine N-acetyltransferase activities in human breast cancer tissues. Neoplasma. 2001;48(2):108-11.
• Estrada-Rodgers L, Levy GN, Weber WW. Characterization of a hormone response element in the mouse N-acetyltransferase 2 (Nat2*) promoter. Gene Expr. 1998;7(1):13-24.
• Olsen H, Morland J. Ethanol-induced increase in drug acetylation in man and isolated rat liver cells. Br Med J. 1978 Nov 4;2(6147):1260-2. doi: 10.1136/bmj.2.6147.1260.
• Olsen H, Morland J. Ethanol-induced increase in procainamide acetylation in man. Br J Clin Pharmacol. 1982 Feb;13(2):203-8. doi: 10.1111/j.1365-2125.1982.tb01357.x.
• LESTER D. THE ACETYLATION OF ISONIAZID IN ALCOHOLICS. Q J Stud Alcohol. 1964 Sep;25:541-3. No abstract available.
• Thomas BH, Solomonraj G. Drug interactions with isoniazid metabolism in rats. J Pharm Sci. 1977 Sep;66(9):1322-6. doi: 10.1002/jps.2600660930.
• Obayashi M, Matsui-Yuasa I, Kitano A, Kobayashi K, Otani S. Posttranslational regulation of spermidine/spermine N1-acetyltransferase with stress. Biochim Biophys Acta. 1992 May 7;1131(1):41-6. doi: 10.1016/0167-4781(92)90096-i.
• Perin A, Sessa A. Polyamine acetylation in rat liver following long-term ethanol ingestion. Biochim Biophys Acta. 1993 Feb 13;1156(2):113-6. doi: 10.1016/0304-4165(93)90124-q.
• Aoki FY, Sitar DS. Clinical pharmacokinetics of amantadine hydrochloride. Clin Pharmacokinet. 1988 Jan;14(1):35-51. doi: 10.2165/00003088-198814010-00003.
• Gaudry SE, Sitar DS, Smyth DD, McKenzie JK, Aoki FY. Gender and age as factors in the inhibition of renal clearance of amantadine by quinine and quinidine. Clin Pharmacol Ther. 1993 Jul;54(1):23-7. doi: 10.1038/clpt.1993.104.
• Hyvonen T, Keinanen TA, Khomutov AR, Khomutov RM, Eloranta TO. Monitoring of the uptake and metabolism of aminooxy analogues of polyamines in cultured cells by high-performance liquid chromatography. J Chromatogr. 1992 Feb 7;574(1):17-21. doi: 10.1016/0378-4347(92)80093-6.
• Lou G, Zhang M, Minuk GY. Effects of acute ethanol exposure on polyamine and gamma-aminobutyric acid metabolism in the regenerating liver. Alcohol. 1999 Nov;19(3):219-27. doi: 10.1016/s0741-8329(99)00050-6.

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2013
• Primary Completion (Anticipated): December 1, 2021
• Study Completion (Anticipated): December 1, 2021

Study Registration Dates

• First Submitted: October 27, 2014
• First Submitted That Met QC Criteria: October 27, 2014
• First Posted (Estimate): October 29, 2014

Study Record Updates

• Last Update Posted (Actual): March 17, 2021
• Last Update Submitted That Met QC Criteria: March 15, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Peripheral Nervous System Agents; Antiviral Agents; Analgesics; Sensory System Agents; Analgesics, Non-Narcotic; Dopamine Agents; Antiparkinson Agents; Anti-Dyskinesia Agents; Amantadine
• Other Study ID Numbers: B2012:063