- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05379712
Nutritional Supplementation in Head and Neck Cancers
A Randomized Open Label Trial of Multimodal Oral Nutritional Supplementation Versus Standard Care, to Prevent / Attenuate Malnutrition in Patients With Cancers of the Head and Neck Receiving (Chemo)-Radiotherapy Treatment.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This will be an randomized, open label, parallel assignment study during cancer treatment (Baseline - Week 7 for Primary endpoint) comparing multimodal oral nutrition therapy versus standard care. Starting at Week 8, all patients receive the intervention arm until study ends at Week 14. Patients in the intervention arm continue the intervention, patients on the standard care arm cross over to the intervention (deferred nutrition intervention).
The primary objective is to assess a multimodal nutrition therapy with two Medical Foods (primary nutrition intervention+ adjuvant nutrition therapy) with features adapted for patients with cancers of the head and neck receiving chemo-radiotherapy treatment, to maintain oral dietary intake during treatment.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Vickie Baracos
- Phone Number: 780-432-8232
- Email: Vickie.Baracos@albertahealthservices.ca
Study Locations
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Alberta
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Edmonton, Alberta, Canada, T6G 1Z2
- Cross Cancer Institute
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Contact:
- Vickie Baracos
- Phone Number: 7804328232
- Email: Vickie.Baracos@albertahealthservices.ca
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients must have the ability to read, understand, and sign an informed consent and must be willing to comply with study treatment and follow-up.
- Male or female
- ≥18 years of age
- Histopathologically confirmed primary squamous cell carcinoma of the oral cavity and oropharynx, larynx or hypopharynx, who have agreed to receive radical intent radiotherapy as primary treatment or adjuvant treatment post-surgery, with or without platinum chemotherapy
- Capable of volitional oral nutritional intake at baseline.
- A diagnostic CT image taken with a maximum of 30 days before initiation of radical intent radiotherapy. If the CT scan history in the patient's clinical record does not include a study within this window, a baseline non-contrast enhanced CT abdomen will be conducted.
- An Eastern Cooperative Oncology Group Performance Status of ≤ 2
Exclusion Criteria:
- Fed by nasogastric tube, gastrostomy or total parenteral nutrition
- Cancer of the nasopharynx, thyroid or salivary gland
- Life expectancy <6 months.
- A known hypersensitivity / allergy to the investigational product or to any ingredient in their formulations (e.g. Milk/Lactose, Fish).
- Enrolment in any other clinical protocol or investigational study with an interventional agent or assessments that may interfere with study procedures.
- Patients with untreated brain metastases (patients with previously resected and/or radiated brain metastases without neurologic symptoms are permitted).
- Poorly controlled chronic illnesses or other inflammatory diseases (e.g. COPD, uncontrolled non-insulin dependent diabetes, rheumatoid arthritis).
- In the investigators' opinion, patients who have medical conditions that could interfere with nutrient metabolism or absorption (e.g., short bowel syndrome, Crohn's disease, etc.)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Multimodal Nutrition Therapy
To assess a multimodal nutrition therapy (primary nutrition intervention+ adjuvant nutrition therapy) with features adapted for patients with cancers of the head and neck receiving chemo-radiotherapy treatment, to maintain oral dietary intake during treatment. The regimen consists of 2 medical foods, each taken on an unrestricted basis (as and when preferred by each patient). Resource® Support Plus, a nutritionally complete Medical Food specifically for the dietary management of oncology patients with (risk of) malnutrition. BOOST® Soothe, a Medical Food formulated as a clear oral nutritional supplement for cancer patients with sensory alterations or oral discomfort due to cancer treatments, in particular chemo- and/or radiotherapy. |
Nestlé Resource Support Plus® is a high energy- and protein-density Medical Food enriched with omega 3 polyunsaturated fatty acids.
This is a nutritionally complete formula, in an easy to swallow, palatable, concentrated low volume, available in 2 flavours optimized for cancer patients undergoing chemotherapy and/or radiation in taste tests.
It provides in a 125 mL serving: 250 kcal, 11.5 g protein and 0.95g of omega-3 fatty acid (eicosapentaenoic acid, EPA).
|
No Intervention: Standard of Care
In this setting patients rely on oral dietary intake.
Ordinary, commercially available ingredients and food products are consumed.
The standard of care includes weekly consultation with specialist oncology Registered Dietitian.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in mean cumulative energy intake
Time Frame: Up to 14 weeks
|
Energy intake is calculated from a one-day diet record in which the patient lists the identity and quantity of all foods and beverages consumed in the designated 24 hour time period at the end of each week (Baseline - Week 14).
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Up to 14 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in mean cumulative protein take
Time Frame: Up to 14 Weeks
|
Energy intake is calculated from a one-day diet record in which the patient lists the identity and quantity of all foods and beverages consumed in the designated 24 hour time period at the end of each week (Baseline - Week 14)
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Up to 14 Weeks
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Change in body weight (kg)
Time Frame: Baseline-Week 14
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Change in weight (kg) from the previous week.
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Baseline-Week 14
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Change in Nutritional blood biomarkers
Time Frame: Baseline measures will be compared to levels at weeks 7 and 14
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A sample of blood will be collected for albumin, absolute neutrophil count, lymphocyte count, C-reactive protein, standard complete blood count-differential White Blood cell count and to measure serum CRP and albumin
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Baseline measures will be compared to levels at weeks 7 and 14
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Head and Neck Symptom Checklist
Time Frame: Up to 14 weeks
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A survey tool for HNC patient self-assessment of the presence and degree of interference with eating, over the past 3 days, of 17 symptoms known to impact dietary intake.
Scores range from 34 to 170 pts, where higher scores reflect a greater presence and interference with eating.
Completed at weeks 0, 4, 7, 11, 14
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Up to 14 weeks
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Taste and smell survey
Time Frame: Up to 14 weeks
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A survey tool for patient self-assessment of the presence, characterization and severity of taste and smell alterations.
This tool yields a 'chemosensory complaint score' of up to 16 (greatest severity of taste and smell alterations).
Completed at weeks 0, 4, 7, 11, 14.
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Up to 14 weeks
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Medication use for pain
Time Frame: Up to 14 weeks
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Use of pain medication will be captured weekly by a one- day pain medication log.
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Up to 14 weeks
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Percent oral intake from oral nutritional supplements
Time Frame: Up to 14 weeks
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The volume (mL) of study products consumed will be determined from the weekly one-day diet record.
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Up to 14 weeks
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Product Sensory Assessment questionnaire
Time Frame: Up to 14 weeks
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A product evaluation form for the Medical Nutrition products will be used to evaluate product overall sensory assessment, including acceptance and perception of characteristic product attributes that influence overall sensory acceptance.
Medical Nutrition sensory acceptance will be evaluated by "overall liking" on the 9-point hedonic scale (1= dislike extremely; 9 = like extremely).
Completed at weeks 0, 2, 4, 6, 8, 10, 12, 14.
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Up to 14 weeks
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Functional Assessment of Anorexia-Cachexia Treatment (FAACT) 5 Question Anorexia/Cachexia subscale (AC/S)
Time Frame: Up to 14 weeks
|
The FAACT is a validated Quality of Life Scale to capture patient experience of cancer related cachexia - anorexia.
Completed at weeks 0, 4, 7,11, 14
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Up to 14 weeks
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Cumulative energy intake (kcal/kg BW)
Time Frame: Up to 14 weeks
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Energy intake is calculated from a one-day diet record in which the patient lists the identity and quantity of all foods and beverages consumed in the designated 24 hour time period at the end of each week (Baseline - Week 14)
|
Up to 14 weeks
|
Cumulative protein take (g pro/kg BW)
Time Frame: Up to 14 weeks
|
Protein intake is calculated from a one-day diet record in which the patient lists the identity and quantity of all foods and beverages consumed in the designated 24 hour time period at the end of each week (Baseline - Week 14)
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Up to 14 weeks
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Change in computed-tomography (CT) defined skeletal muscle and fat mass)
Time Frame: Within 30 days prior to start of treatment, Week 14
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Imaging for body composition (muscle, fat)
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Within 30 days prior to start of treatment, Week 14
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Tertiary hospital admission
Time Frame: Up to 14 weeks
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Review of patient medical records for instances of hospitalization with date(s) of admission falling between baseline and week 14 of study.
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Up to 14 weeks
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Vickie Baracos, Cross Cancer Institute, Alberta Health Services
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IIT-0024
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
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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