Pulmonary Nodules
Conditions
Brief summary
The prevention and treatment of lung nodules involves many fields in preventive medicine and clinical medicine. A nodule is a growth or lump that may be malignant (cancer) or benign (not cancer). This study is aim to investigate the chemopreventive effect of limonene in inhibiting the occurrence/progression of ground glass pulmonary nodules. It is expected that limonene can be used as a safe and effective chemopreventive agent for preventing the development/progress of pulmonary nodules as well as expanding the indications of limonene.
Detailed description
Early prevention, early detection and early treatment of lung cancer can help reduce the incidence and improve the survival rate.Chemoprevention is known to have an important role in high-risk people because it has the potential to prevent or reverse the progression of lung cancer.Lung nodules are good targets for testing the efficacy of chemopreventive agents.So far，none of the chemopreventive agents have been shown to be effective. Limonene is widely found in the essential oils of traditional Chinese medicine tangerine peel, green peel and other plants. Its taste is sour, sweet and pungent. It has an aromatic odor effect. Limonene Capsule, a Chinese patent medicine, has been on the market, which is suitable for the treatment of cholecystitis, cholangitis, cholelithiasis, and postoperative biliary syndrome.Preliminary studies of the research group suggest that it has a potential anti-cancer effect. This randomized, double-blind, controlled trial studied limonene compared with placebo in treating high-risk patients with pure ground glass pulmonary nodules，so as to expand indications.
Interventions
DRUGLimonene capsule
Citrus foods rich in D-limonene were forbiden 2 days before taking the drug (washout period), which was maintained after taking the drug.Limonene capsules group and placebo group were used for treatment. The random number is generated by the central randomization system. All the recruiters were divided into placebo control group and limonene capsule administration group. The numbers will be assigned according to random numbers. In this study, qualified subjects were randomly assigned to the treatment group and the placebo control group at a ratio of 1:1. The drug was administered for 12 weeks, 3 times a day, 5 capsules each time.
Limonene capsules(Placebo)
Sponsors
Shanghai Chest Hospital
Shanghai Jiao Tong University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
45 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Non-smokers (those who have smoked less than 100 cigarettes in their lifetime, including those who have never smoked in their lifetime). * Subjects must have positive nodules detected by high-resolution CT（HRCT）: longest diameter \> 6 mm and \< 20 mm; pure ground glass nodule; according to the judgment of the clinician, follow-up can be performed, and surgical excision is not recommended for the time being; the nodules did not disappear or were not significantly reduced by more than 2 mm after six months follow-up; subjects should have at least one positive nodule when had multiple nodules. * ECOG performance status 0-1. * Those who accept and are willing to sign the informed consent.
Exclusion criteria
* Subjects with the history of autoimmune diseases and severe gastrointestinal diseases; * Subjects suffering from malignant tumor, severe heart disease, severe liver or kidney disease currently or within the past 5 years; * Within 6 weeks since prior herbal supplements, non-steroidal anti-inflammatory drugs, or antibiotics * Subjects who are allergic to limonene capsules or citrus foods; * Use of any other investigational agents at time of enrollment in the study during the three months preceding study enrollment * Pregnant or lactating females, or those who disagreeing with contraception; * Subjects who have a history of mental illness and cannot cooperate with this project; * HIV-positive subjects should be excluded. * Subjects whose organ and bone marrow function indexes exceeded the following range of normal value were excluded: 1. Leukocytes: 3.5-9.5 109/L; 2. Absolute neutrophil count: 1.8-6.3 109/L; 3. Platelets: 125-350 109/L; 4. Total bilirubin: 5.0-21.0 µmol /L; 5. AST (SGOT)/ALT (SGPT): 0.8-1.5; 6. Serum creatinine: 41-81 μmol/L; * Other situations where the researcher thinks it is inappropriate to participate in this research.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in the sum of longest diameters of target nodules (multiple nodules) between the drug group and the placebo group. | at baseline, three months and six months after administration | Difference in the sum of longest diameters of target nodules |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Plasma metabolomics | at baseline, three months and six months after administration | Analysis of plasma metabolomics |
| Proportion of circulating blood immune cells | at baseline, three months and six months after administration | Analysis of the proportion of circulating blood immune cells |
| Change in density of baseline non-target nodules between the two groups | at baseline, three months and six months after administration | Difference in density of baseline non-target nodules |
| Adverse events | at baseline, three months and six months after administration | Incidence of adverse events |
| Value of serum miRNA | at baseline, three months and six months after administration | Value of serum miRNA |
| Cytokine detection | at baseline, three months and six months after administration | Value of cytokine detection |
| Changes in the sum of longest diameters of baseline target nodules (multiple nodules) between the drug group and the placebo group | at baseline and twelve months after administration | Difference in the sum of longest diameters of target nodules |
| Change in diameters of baseline target nodules (single nodule) detected by CT between the two groups. | at baseline, three months and six months after administration | Difference in the longest diameters of baseline target nodules |
| Change in density of baseline target nodules between the two groups. | at baseline, three months and six months after administration | Difference in density of baseline target nodules |
| Change in the longest diameters size of baseline non-target nodules between the two groups | at baseline, three months and six months after administration | Difference in the longest diameters of baseline non-target nodules |
| Change in numbers of baseline non-target nodules between the two groups | at baseline, three months and six months after administration | Difference in numbers of baseline non-target nodules |
| Overall response rate of participants as measured by RECIST criteria between the two groups | at baseline, three months and six months after administration | Difference in the overall response rate of participants |
Countries
China
Contacts
Primary ContactZiyi Sheng, Master
Outcome results
None listed