Ovarian Cancer
Conditions
Keywords
dose escalation, ArtemiCoffee, Artemisia annua, ART-Coffee, herbal
Brief summary
This is a phase I dose-escalation study of Artemisia annua (Aa) in patients with advanced ovarian cancer who have completed front-line chemotherapy with carboplatin and paclitaxel. The primary objective of this study is to determine the recommended phase II dose (RP2D) of Artemisia annua.
Detailed description
This is a phase I dose-escalation study of Artemisia annua (Aa) decaffeinated coffee in patients with advanced ovarian cancer who have completed front-line chemotherapy with carboplatin and paclitaxel. The primary objective of this study is to determine the recommended phase II dose (RP2D) of Aa decaf coffee pods. Sequential cohorts of three patients per cohort will have escalating doses of Aa, starting with one cup per day (450mg) and with a maximum of 4 cups per day (1800mg). After identifying the RP2D, the study will evaluate an expansion cohort of 6 patients for further tolerability and secondary endpoints. The secondary endpoints include: 1) Efficacy as measured by time to tumor progression or recurrence; 2) the ability of Aa decaf coffee to influence downstream biomarkers of the NRF2/KEAP1 signaling pathway; and 3) plasma concentrations of artemisinin and dihydroartemisinin.
Interventions
DRUGArtemisia annua 450mg
Artemisia annua will be self-administered via a preparation of decaffeinated coffee.
DRUGArtemisia annua 900mg
Artemisia annua will be self-administered via a preparation of decaffeinated coffee.
DRUGArtemisia annua 1350mg
Artemisia annua will be self-administered via a preparation of decaffeinated coffee.
DRUGArtemisia annua 1800mg
Artemisia annua will be self-administered via a preparation of decaffeinated coffee.
DRUGArtemisia annua - recommended phase II dose
Artemisia annua will be self-administered via a preparation of decaffeinated coffee. The dose for this cohort will be based on analysis of previous cohorts.
Sponsors
ArtemiLife
Frederick R. Ueland, M.D.
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Able to understand and willing to sign a written informed consent document. * Age ≥ 18 years. * Patients diagnosed with Stage II-IV ovarian cancer who have completed initial first-line therapy with carboplatin and paclitaxel and achieved a complete response. * Creatinine clearance ≥ 60 mL/min * Total bilirubin ≤ 1.5 x ULN, and AST and ALT ≤ 3.0 x ULN * GOG Performance Status ≤ 2.
Exclusion criteria
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study visits, in the opinion of the treating physician. * Pregnant women are excluded from this study. * Concurrent use of strong inducers of CYP2A6, including phenobarbital and rifampin * Women with active gastric ulcers are excluded from this study. * Patients who are receiving concurrent maintenance therapy with a PARP inhibitor for a known hereditary recombinant deficiency (HRD) mutation. Bevacizumab maintenance therapy is allowed. * Concurrent use of nevirapine, ritonavir and strong UGT inhibitors or inducers.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recommended Phase II Dose | 150 days | This study will determine the recommended phase II dose of Artemisia annua decaffeinated coffee. Once the dose escalation is finished or 12 patients are evaluated for the dose-limiting toxicity (DLT), the final recommended phase II dose will be determined by isotonic regression to pool the DLT information across all dose levels. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression Free Survival | 150 days | Median progression free survival will be calculated for all groups. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in NQ01 expression. | Up to 150 days (baseline and post-treatment) | Change in cell-free (cfRNA) levels of NQ01 (NAD(P)H:quinone oxidoreductase 1) will be measured at baseline and post-treatment. |
| Change in HO-1 expression. | Up to 150 days (baseline and post-treatment) | Change in cell-free (cfRNA) levels of HO1 (heme oxygenase 1) will be measured at baseline and post-treatment. |
| Change in plasma concentration of artemisinin. | Up to 150 days (baseline and post-treatment) | The change in plasma concentration of artemisinin will be measured pre- and post-study. |
| Change in CD99 expression. | Up to 150 days (baseline and post-treatment) | Change in cell-free (cfRNA) levels of CD99 (ATP-binding cassette sub-family F member 2) will be measured at baseline and post-treatment. |
| Change in ABCF2 expression. | Up to 150 days (baseline and post-treatment) | Change in cell-free (cfRNA) levels of HO1 (ATP-binding cassette sub-family F member 2) will be measured at baseline and post-treatment. |
| Change in plasma concentration of dihydroartemisinin. | Up to 150 days (baseline and post-treatment) | The change in plasma concentration of dihydroartemisinin will be measured pre- and post-study. |
Countries
United States
Outcome results
None listed