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Malignant TumorNCT04926545

XCHT for Irinotecan-Induced Gut Toxicities (Run-in Study)

A study testing Xiao Chai Hu Tang (XCHT), Raloxifene and FOLFIRI regimen in people with Malignant Tumor and Diarrhea, run by Guangzhou University of Traditional Chinese Medicine at 1 site in China.

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

Run-in safety study, to determine the safety of co-administration of irinotecan, raloxifene, and Xiao Chai Hu Tang (XCHT), and to optimize the blood collection time points for pharmacokinetic (PK) study for another randomized control trial. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Malignant Tumor, Diarrhea
What is being tested?
Xiao Chai Hu Tang (XCHT), Raloxifene and FOLFIRI regimen
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteChina
Study dates
16 Jul 2021to 20 Jul 2024
Phase
Interventional
Are there results?
None posted in the registry

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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Malignant tumor confirmed by histology or cytology;
  • Postmenopausal women, after bilateral oophorectomy; age > 60 years old, or age < 60 years old with menopause for more than 1 year;
  • Age ≥ 18 years old, ≤ 75 years old;
  • ECOG score of the patient ≤ 2 points;
  • Never been treated with irinotecan;
  • Plan to receive at least 3 rounds of FOLFIRI chemotherapy determined by physicians;
Show all 24Show fewer
  • Normal organ functions can meet the requirements for systemic chemotherapy:
  • Reserve functions of normal bone marrow: absolute neutrophil count (ANC) ≥ 1.5×109/L, PLT ≥ 100×109/L, hemoglobin ≥ 90 g/L;
  • Normal renal functions: serum creatinine ≤ 1.5 mg/dl (133 μmol/L) and/or creatinine clearance ≥ 60 ml/min;
  • Normal hepatic functions: total serum bilirubin level ≤ 1.5 times of the upper limit of normal value (ULN), serum aspartate aminotransferase (AST) \& alanine aminotransferase (ALT) ≤ 2.5 × ULN; If abnormal hepatic functions are caused by a potentially malignant tumor, and AST & ALT ≤ 5 × ULN;
  • Patient is willing to participate and cooperate to complete the questions in the case report form;
  • Patient can understand and sign the informed consent form, is well compliant, and can be followed up.
  • Cohort B: cancer patients who experienced irinotecan -induced diarrhea (grade >2)
  • Malignant tumor confirmed by histology or cytology;
  • Age ≥ 18 years old, ≤ 75 years old;
  • ECOG score of the patient ≤ 2 points;
  • Patients who have diarrhea worse than grade 2 due to irinotecan chemotherapy (the last dose of irinotecan is administered within 1 month);
  • Patients who plan to receive 3 rounds of FOLFIRI chemotherapy;
  • Normal organ functions can meet the requirements for systemic chemotherapy:
  • Reserve functions of normal bone marrow: absolute neutrophil count (ANC) ≥ 1.5×109/L, PLT ≥ 100×109/L, hemoglobin ≥ 90g/L;
  • Normal renal functions: serum creatinine ≤ 1.5mg/dl (133μmol/L) and/or creatinine clearance ≥ 60ml/min;
  • Normal hepatic functions: total serum bilirubin level ≤ 1.5 times of the upper limit of normal value (ULN), serum aspartate aminotransferase (AST) \& alanine aminotransferase (ALT) ≤ 2.5 × ULN; If abnormal hepatic functions are caused by a potentially malignant tumor, and AST & ALT ≤ 5 × ULN;
  • Patient is willing to participate and cooperate to complete the questions in the case report form;
  • Patients can understand and sign the informed consent form, is well compliant, and can be followed up.

Who cannot join

  • Patients with diagnosed depression, obsession or/and schizophrenia;
  • Patients with diagnosed inflammatory bowel diseases (including Crohn's disease, ulcerative colitis)
  • Patient with active tuberculosis and other uncontrolled infections;
  • Patient has previously received radiotherapy on the abdominal cavity and pelvic cavity;
  • Pregnant or lactating women;
  • Patient previously had or is now having thromboembolic (blood clotting) events.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Guangdong Provincial Hospital of Chinese Medicine

    Guangzhou, Guangdong, 510120

Other trials in China

About this study

Official title: Mechanistic and Pharmacokinetic Studies of Classical Chinese Formula Xiao Chai Hu Tang Against Irinotecan-Induced Gut Toxicities(Clinical Study Part:Run-in Safety Study)

Run-in safety study, to determine the safety of co-administration of irinotecan, raloxifene, and Xiao Chai Hu Tang (XCHT), and to optimize the blood collection time points for pharmacokinetic (PK) study for another randomized control trial.

Read the detailed description

There will be two cohorts with a total of 24 patients in this study. Cohort A will enroll 6 naïve postmenopausal female patients who have never received irinotecan treatment before. Patients in this group will have 4 rounds of studies following different protocol to determine (1) the impact of XCHT on raloxifene PK (Round 0, co-administration of XCHT and raloxifene); (2) the impact of XCHT on irinotecan PK (Round 1, co-administration of XCHT and standard FOLFIRI); (3) the safety of co- administration of XCHT, raloxifene, and FOLFIRI and evaluation of raloxifene as a probe for XCHT treatment to prevent irinotecan-induced severe delayed-onset diarrhea (Round 2 and 3, co-administration of XCHT, raloxifene, and standard FOLFIRI). The reason to recruit postmenopausal women is that these patients usually take raloxifene to prevent osteoporosis and the risk of raloxifene is expected to be limited.

Cohort B will recruit 18 patients who were treated with irinotecan previously and have at least one diarrhea episode with a severity of ≥grade 2. The reason we propose to recruit patients who had diarrhea induced by irinotecan is that these patients are supposed to be sensitive to irinotecan so that we can determine the PK changes and safety. Patients in this group will have 3 rounds of FOLFIRI chemotherapy to determine (1) the impact of FOLFIRI on raloxifene PK (Round 1, co-administration of FOLFIRI with raloxifene); (2) the complete PK profile of SN-38, SN-38G, raloxifene, raloxifene-glucuronide, and XCHT components (Round 2, co- administration of FOLFIRI with XCHT and raloxifene); and (3) the safety of co-administration of XCHT, raloxifene, and FOLFIRI in sensitive patients and evaluation of raloxifene as a probe for XCHT treatment to prevent irinotecan-induced diarrhea (Round 3, co-administration of XCHT, raloxifene and standard FOLFIRI).

Being tested
Xiao Chai Hu Tang (XCHT), Raloxifene, FOLFIRI regimen
Keywords
Malignant tumor, Irinotecan, chemotherapy-induced diarrhea, Classical Chinese Formula, safety
Medical subject headings
Neoplasms, Diarrhea

What participants receive

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

  • Xiao Chai Hu Tang (XCHT)Drug

    Also called Xiao Chai Hu Tang granules from Nin Jiom Medicine Manufactory (Hong Kong) Ltd.

    XCHT 9g, po qd, 3 days before each cycle of chemotherapy for 5 days, except the 1st cycle of chemotherapy for irinotecan used cohort patients.

    Additional XCHT, 9g qd will be orally administrated for 4 days during the Round 0 study for irinotecan naive cohort patients.

  • RaloxifeneOther

    Also called Evista from Eli Lilly

    Raloxifene 60mg po, used as probe for pharmacokinetic testing. For irinotecan naive cohort patients, raloxifene 60mg will be orally administrated on Day 1 and Day 5 (4th day of XCHT administration) during round 0 study, Day 3 (the day before chemotherapy) during round 2 and round 3 study. For irinotecan used cohort patients, raloxifene 60mg will be orally administrated on Day 1 (irinotecan using day) during round 1 study, Day 4 (irinotecan using day) during round 2 study, and Day 3 (the day before chemotherapy) during round 3 study.

  • FOLFIRI regimenDrug

    Also called Irinotecan Hydrochloride from Pfizer+Folinic acid+5-fluorouracil (5-FU)

    Patients will receive 3 cycles of FOLFIRI regimen for chemotherapy. Irinotecan intravenous (IV) infusion (180 mg/m2) through a drip into the bloodstream over 90 minutes. Folinic acid (400 mg/m2) IV infusion through a drip into the bloodstream over 2 hours. 5-fluorouracil (5-FU) IV bolus (400 mg/m2) into the bloodstream over 5 minutes, followed by 5-FU (2400 mg/m2) continuous IV infusion through a drip or pump into the bloodstream for 46-48 hours.

Study groups in NCT04926545
Study groupRoleWhat they receive
Irinotecan naive cohortExperimentalThis cohort will enroll 6 postmenopausal female patients who have never received irinotecan treatment before. Patients in irinotecan naive cohort will receive 3 cycles of FOLFIRI chemotherapy, during which 4 rounds of pharmacokinetic studies will be conducted. Round 0 (before chemotherapy): pharmacokinetic testing (raloxifene 60mg as probe) before XCHT administration, then XCHT for 4 days with pharmacokinetic testing (raloxifene 60mg as probe) on the 4th day of XCHT administration. Round 1(1st cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (without raloxifene) on day 4. Round 2 (2nd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 3. Round 3 (3rd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 3.
Receives: Drug: Xiao Chai Hu Tang (XCHT); Other: Raloxifene; Drug: FOLFIRI regimen
Irinotecan used cohortExperimentalThis cohort will recruit 18 patients who were treated with irinotecan previously and have at least one diarrhea episode with a severity of more than grade 2. Patients in irinotecan used cohort will receive 3 cycles of FOLFIRI chemotherapy, during which 3 rounds of pharmacokinetic studies will be conducted. Round 1(1st cycle of chemotherapy): FOLFIRI, with pharmacokinetic testing (raloxifene 60mg as probe) on the first day of chemotherapy. Round 2 (2nd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 4. Round 3 (3rd cycle of chemotherapy): XCHT for 5 days and FOLFIRI on day 4, with pharmacokinetic testing (raloxifene 60mg as probe) on day 3.
Receives: Drug: Xiao Chai Hu Tang (XCHT); Other: Raloxifene; Drug: FOLFIRI regimen

What is being measured

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

  1. Average trajectory of irinotecan, raloxifene, XCHT and their metabolites (14 compounds)

    Plasma concentration for each compounds will be tested at 8 points for each Round.

    Measured: The blood samples (2.0 ml) will be collected at 8 points for each Round (hour 0, hour 0.5, hour 1, hour 2, hour 4, hour 6, hour 8, and hour 24 after raloxifene administration)

Secondary outcomes (4)
  1. incidences of grade ≥3 diarrhea

    The diarrhea severity will be evaluated following standard criteria in NCI-CTC AE 5.0

    Measured: Through study completion, an average of 2 months

  2. occult blood test for stool

    occult blood test for stool, reported as negative, weak positive, and positive.

    Measured: Through study completion, an average of 2 months

  3. incidence of other chemo-related adverse effects

    Other adverse reactions will be evaluated following standard criteria in NCI-CTC AE 5.0

    Measured: Through study completion, an average of 2 months.

  4. incidence of diarrhea (grade ≥2)

    The diarrhea severity will be evaluated following standard criteria in NCI-CTC AE 5.0 Grade 2 is defined as Stool is increased by 4-6 times each day relative to baseline; discharge from stoma moderately increased.

    Measured: Through study completion, an average of 2 months.

Timeline

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

  1. First posted15 Jun 2021
  2. Study start16 Jul 2021
  3. Primary completion20 Jul 2024
  4. Study completion20 Jul 2024

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 N/A
Primary purpose
Basic science
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04926545
Sponsor's protocol ID
2021KT1005
Other IDs
81961128028
Status last verified
Apr 2024
First submitted
30 May 2021
Last updated
30 Jul 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Xiao Chai Hu Tang (XCHT), Raloxifene and FOLFIRI regimen in people with Malignant Tumor and Diarrhea, run by Guangzhou University of Traditional Chinese Medicine at 1 site in China.

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

Who may be eligible to take part?

The sponsor lists 24 inclusion and 6 exclusion criteria. 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 30 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Average trajectory of irinotecan, raloxifene, XCHT and their metabolites (14 compounds) (time frame: The blood samples (2.0 ml) will be collected at 8 points for each Round (hour 0, hour 0.5, hour 1, hour 2, hour 4, hour 6, hour 8, and hour 24 after raloxifene administration)). 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 30 Jul 2024.

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