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Stage I Bladder CancerPhase 2NCT00666562

Green Tea Extract in Treating Patients With Nonmetastatic Bladder Cancer

A Phase 2 study testing Defined Green Tea Catechin Extract, Laboratory Biomarker Analysis and Pharmacological Study in people with Stage I Bladder Cancer and Stage II Bladder Cancer, run by National Cancer Institute (NCI) at 6 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Green tea extract contains ingredients that may slow the growth of certain cancers. It is not yet known whether green tea extract is more effective than a placebo when given before surgery in treating patients with bladder. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Defined Green Tea Catechin Extract, Laboratory Biomarker Analysis and Pharmacological Study
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
31 participants
Where
6 sitesUnited States
Study dates
2 Jul 2008to 9 Jun 2017
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Criteria:

  • Diagnosis of bladder cancer
  • Bladder tumor discovered on cystoscopy within the past 60 days
  • Invasive or non-invasive tumor
  • Primary tumor may represent either an initial diagnosis or recurrent disease of any clinical stage
  • No metastatic disease
  • Must be an eligible candidate for a partial cystectomy, radical cystectomy, or trans-urethral resection of bladder tumor (TURBT)
  • Has not undergone any treatment for superficial or invasive bladder cancer since the diagnostic cystoscopy
  • TURBT or radical cystectomy is the planned curative surgical treatment
  • ECOG performance status (PS) 0-1 OR Karnofsky PS 70-100%
  • More than 30 days since any prior intravesical therapy or adjuvant chemotherapy
  • More than 30 days since prior bladder surgery
  • Biopsies are not considered surgeries
  • No prior pelvic radiotherapy
  • No concurrent systemic chemotherapy for any other cancer, except nonmelanoma skin cancer
  • No concurrent NSAIDs (e.g., ibuprofen, naproxen, or cyclooxygenase-2 inhibitors) except =< 81 mg aspirin per day
  • Concurrent acetaminophen (Tylenol) or prescription opioids combined with acetaminophen (i.e., Percocet, Darvocet, Vicodin, Tylenol #3) allowed for pain
  • No other concurrent investigational agents
  • White Blood Cell (WBC) >= 3,000/mm^3
  • Platelet count >= 100,000/mm^3
  • Hemoglobin >= 10 g/dL
  • Alkaline phosphatase =< upper limit of normal (ULN)
  • Bilirubin =< ULN
  • Asparate Aminotransferase (AST) and Alanine Transaminase (ALT) =< ULN
  • Sodium 135-144 mmol/L (inclusive)
  • Potassium 3.2-4.8 mmol/L (inclusive)
  • Chloride 85-114 mmol/L (inclusive)
  • Bicarbonate >11 mEQ/dL
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Willing to avoid green tea beverages and green tea-containing products during study participation
  • No evidence of other cancers, except nonmelanoma skin cancer
  • No history of allergic reactions attributed to tea or to any of the compounds of similar chemical or biologic composition to Polyphenon E or any of the inactive ingredients in Polyphenon E capsules
  • No uncontrolled intercurrent illness including, but not limited to, any of the following: Ongoing or active infection, Symptomatic congestive heart failure, Unstable angina pectoris, Cardiac arrhythmia, Psychiatric illness/social situations that would limit study compliance
  • More than 24 hours since prior and no concurrent consumption of any other green tea supplements or more than 2 cups (16 oz) of green tea either through dietary sources or through nutritional supplementation
  • Topical cosmetics (i.e., lotions, shampoos, makeup) that contain green tea are allowed
  • Creatinine normal
  • Not pregnant or nursing

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

United States6 sites
  • University of Alabama at Birmingham Cancer Center

    Birmingham, Alabama, 35233

  • Lahey Hospital and Medical Center

    Burlington, Massachusetts, 01805

  • University of Wisconsin Hospital and Clinics

    Madison, Wisconsin, 53792

  • Minneapolis Veterans Medical Center

    Minneapolis, Minnesota, 55417

  • University of Rochester

    Rochester, New York, 14642

  • Urology San Antonio Research PA

    San Antonio, Texas, 78229

Other trials in United States

About this study

Official title: A Phase II Randomized, Placebo-Controlled Trial of Polyphenon E to Evaluate Bladder Tissue Levels of EGCG

Green tea extract contains ingredients that may slow the growth of certain cancers. It is not yet known whether green tea extract is more effective than a placebo when given before surgery in treating patients with bladder. This randomized phase II trial is studying green tea extract to see how well it works compared to a placebo when given before surgery in treating patients with nonmetastatic bladder cancer.

Read the detailed description

PRIMARY OBJECTIVES I. To compare the levels of epigallocatechin-3-gallate (EGCG) in nonmalignant bladder tissue from patients with bladder cancer treated with oral polyphenon E 800 mg EGCG or polyphenon E 1200 mg EGCG once daily for 14-28 days.

SECONDARY OBJECTIVES:

  1. To compare the levels of EGCG in nonmalignant versus malignant bladder tissue samples from these patients.

II. To examine the dose-response modulation of surrogate intermediate endpoint biomarkers (e.g., Proliferating Cell Nuclear Antigen [PCNA], Matrix Metallopeptidase 2 [MMP2], clusterin, Vascular endothelial Growth Factor [VEGF], p27, and ODC) in malignant and nonmalignant samples of bladder tissue from these patients after administration of polyphenon E.

III. To correlate EGCG levels in samples of serum, urine, and tissue from these patients.

IV. To examine the levels of other catechins (i.e., epicatechin, epicatechin gallate, and epigallocatechin) found in polyphenon E in samples of serum, urine, and tissue from these patients.

  1. To compare the metabolism of EGCG by Catechol-O-Methyltransferase (COMT) and Uridinediphosphate-Glucuronosyltransferase (UGT) in relation to pharmacogenetic polymorphisms in COMT and UGT in samples of serum, urine, and tissue from these patients.

VI. To examine the changes in serum Insulin Growth Factor 1 (IGF-1) and IGFBP-3 levels after administration of polyphenon E in these patients.

OUTLINE:

This is a multicenter study. Patients are stratified according to tumor site and disease invasiveness (invasive vs noninvasive). Patients are randomized to 1 of 3 treatment arms.

Arm I: Patients receive six oral placebo capsules once daily for 14-28 days in the absence of unacceptable toxicity.

Arm II: Patients receive four oral polyphenon E capsules and two oral placebo capsules once daily for 14-28 days in the absence of unacceptable toxicity.

Arm III: Patients receive six oral polyphenon E capsules once daily for 14-28 days in the absence of unacceptable toxicity.

After completion of study treatment, patients undergo trans-urethral resection of bladder tumor or cystectomy.

Blood, urine, and tissue samples are obtained at baseline and at the end of study treatment for correlative laboratory studies. Samples are evaluated for pharmacokinetics of polyphenon E using high performance liquid chromatography. Levels of epigallocatechin-3-gallate [EGCG] and other catechins found in polyphenon E are assessed for correlation in serum, urine, and tissue. Intermediate endpoint biomarkers are evaluated for dose-response modulation in serum (i.e., IGF-1 and IGFBP-3) via ELISA and in bladder tissue obtained at the time of bladder surgery (i.e., PCNA, MMP2, clusterin, VEGF, p27, and ODS) via IHC. Patients at the University of Wisconsin undergo additional biopsy of bladder tissue for matrix-assisted laser desorption quadrupole time-of-flight (O-MALDI-qTOF) analysis of EGCG pharmacokinetics. Tissue samples are examined for intracellular concentration and distribution of EGCG. Genotyping studies for pyrosequencing of UGT and COMT polymorphisms are also performed.

Being tested
Defined Green Tea Catechin Extract, Laboratory Biomarker Analysis, Pharmacological Study, Placebo, Therapeutic Conventional Surgery
Medical subject headings
Urinary Bladder Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Defined Green Tea Catechin ExtractDietary supplement

    Also called Polyphenon E, Polyphenon E TM

    Given orally

  • Laboratory Biomarker AnalysisOther

    Correlative studies

  • Pharmacological StudyOther

    Correlative studies

  • PlaceboDrug

    Also called placebo therapy, PLCB, sham therapy

    Given orally

  • Therapeutic Conventional SurgeryProcedure or surgery

    Undergo surgery

Study groups in NCT00666562
Study groupRoleWhat they receive
Arm I (placebo)Placebo comparatorPatients receive six oral placebo capsules once daily for 14-28 days.
Receives: Other: Laboratory Biomarker Analysis; Other: Pharmacological Study; Drug: Placebo
Arm II (polyphenon E, placebo)ExperimentalPatients receive four oral polyphenon E capsules and two oral placebo capsules once daily for 14-28 days in the absence of unacceptable toxicity.
Receives: Dietary Supplement: Defined Green Tea Catechin Extract; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study; Drug: Placebo
Arm III (polyphenon E, trans-urethral resection or cystectomy)ExperimentalPatients receive six oral polyphenon E capsules once daily for 14-28 days in the absence of unacceptable toxicity. After completion of study treatment, patients undergo trans-urethral resection of bladder tumor or cystectomy.
Receives: Dietary Supplement: Defined Green Tea Catechin Extract; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study; Procedure: Therapeutic Conventional Surgery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Epigallocatechin Gallate (EGCG) Levels in Nonmalignant Bladder Tissue (e.g., Normal-appearing Urothelium, Inflammatory Lesions in the Bladder, Sessile Noninvasive Bladder Tumors, and Papillary Noninvasive Bladder Tumors)

    Comparison of nonmalignant bladder tissue levels of EGCG between the placebo group and the EGCG groups combined using student t-test.

    Measured: up to 28 days

Secondary outcomes (12)
  1. Levels of EGCG in Malignant Bladder Tissue

    Measured: up to 28 days

  2. Levels of Surrogate Intermediate Endpoint Biomarkers in Malignant and Nonmalignant Bladder Tissue Assessed by Immunohistochemistry

    Measured: up to 28 days

  3. Serum Insulin Growth Factor-1 (IGF-1) Levels Assessed by ELISA

    Measured: Baseline and up to day 28

  4. Levels of Other Catechins (Epicatechin Gallate, Epicatechin, and Epigallocatechin) Found in Polyphenon E Tumor Tissue Samples

    Measured: up to 28 days

  5. Absolute Change for Baseline From EGCG in Serum Samples

    The difference between the amount at the end of study (up to 28 days) from baseline.

    Measured: Baseline and up to 28 days

  6. Metabolism of EGCG in Serum and Urine in Relation to Pharmacogenetic Polymorphisms in Catechol-O-Methyltransferase (COMT)

    Measured: At Baseline

  7. Serum IGFBP-3 Levels Assessed by ELISA

    Measured: Baseline and up to 28 days

  8. Levels of Other Catechins (Epicatechin Gallate, Epicatechin, and Epigallocatechin) Found in Polyphenon E Normal Tissue Samples

    Measured: up to 28 days

  9. Absolute Change From Baseline of Other Catechins (Epicatechin Gallate, Epicatechin, and Epigallocatechin) Found in Polyphenon E in Urine Samples

    The difference between the amount at the end of study (up to 28 days) from baseline.

    Measured: Baseline and up to 28 days

  10. Absolute Change From Baseline of Other Catechins (Epicatechin Gallate, Epicatechin, and Epigallocatechin) Found in Polyphenon E Plasma Samples

    The difference between the amount at the end of study (up to 28 days) from baseline.

    Measured: Baseline and up to 28 days

  11. Absolute Change for Baseline of EGCG in Urine Samples

    The difference between the amount at the end of study (up to 28 days) from baseline.

    Measured: Baseline and up to 28 days

  12. Metabolism of EGCG in Serum and Urine in Relation to Pharmacogenetic Polymorphisms in Uridinediphosphate- Glucuronosyltransferase (UGT)

    Measured: At Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Apr 2008 (estimated)
  2. Study start2 Jul 2008
  3. Primary completion26 Apr 2012
  4. Study completion9 Jun 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00666562
Sponsor's protocol ID
NCI-2009-00906
Other IDs
NCI-2009-00906, CO06810, CDR0000594276, H-2007-0250, UWI06-8-01, UWI06-8-01, N01CN35153, P30CA014520
Status last verified
Oct 2017
First submitted
24 Apr 2008
Last updated
17 Nov 2017

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Defined Green Tea Catechin Extract, Laboratory Biomarker Analysis and Pharmacological Study in people with Stage I Bladder Cancer and Stage II Bladder Cancer, run by National Cancer Institute (NCI) at 6 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Mar 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Epigallocatechin Gallate (EGCG) Levels in Nonmalignant Bladder Tissue (e.g., Normal-appearing Urothelium, Inflammatory Lesions in the Bladder, Sessile Noninvasive Bladder Tumors, and Papillary Noninvasive Bladder Tumors) (time frame: up to 28 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Nov 2017.

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