Clinical trial

A Phase 1 Study of d Limonene With Concurrent Radiation and Platinum Based Chemotherapy for Xerostomia Prevention in Locally Advanced Head and Neck Squamous Cell Carcinoma (HNSCC)

Name
IRB-51656
Description
This study explores the safety of d-limonene, a commercially-available dietary supplement (food) as a potential therapeutic for the severe dry mouth (xerostomia) experienced by patients with head and neck cancer as a side effect of their anti-cancer treatment.
Trial arms
Trial start
2021-02-15
Estimated PCD
2026-02-15
Trial end
2027-02-15
Status
Recruiting
Phase
Early phase I
Treatment
D-Limonene Gelcaps
Administered orally at 2 to 8 grams daily
Arms:
d-limonene -2gram, d-limonene -4gram, d-limonene -6gram, d-limonene -8gram, de-escalation dose d-limonene -2gram, de-escalation dose d-limonene -4gram, de-escalation dose d-limonene -6gram
Intensity modulated radiotherapy (IMRT)
Standard of Care -All patients will receive standard radiation treatment of 66 to 70 Gy given in 33 to 35 fractions (2 to 2.12 Gy/fractions) over 6.5 to 7 weeks.
Arms:
d-limonene -2gram, d-limonene -4gram, d-limonene -6gram, d-limonene -8gram, de-escalation dose d-limonene -2gram, de-escalation dose d-limonene -4gram, de-escalation dose d-limonene -6gram
Cisplatin
Standard of Care -Cisplatin as 100 mg/m2 IV
Arms:
d-limonene -2gram, d-limonene -4gram, d-limonene -6gram, d-limonene -8gram, de-escalation dose d-limonene -2gram, de-escalation dose d-limonene -4gram, de-escalation dose d-limonene -6gram
Xerostomia questionnaire
Xerostomia questionnaire consists of 4 items on dryness while eating/speaking and 4 on dryness at rest. Patients rate each symptom on an 11 point ordinal Likert scale from 0 to 10, with higher scores indicating greater xerostomia
Arms:
d-limonene -2gram, d-limonene -4gram, d-limonene -6gram, d-limonene -8gram, de-escalation dose d-limonene -2gram, de-escalation dose d-limonene -4gram, de-escalation dose d-limonene -6gram
Size
30
Primary endpoint
Dose limiting Toxicity
9 weeks
Eligibility criteria
Inclusion Criteria: * Histologically or cytologically confirmed diagnosis of advanced loco regional squamous cell carcinoma of the nasopharynx (AJCC v8 Stage II IV); oropharynx (AJCC v8 Stage I III for HPV+ cancer, excluding T1 2N0; AJCC v8 Stage III IV for Human papillomavirus (HPV) negative cancer); larynx (AJCC v8 Stage III to IV); or hypopharynx (AJCC v8 Stage III to IV), scheduled to undergo chemoradiation. Patients with squamous cell carcinoma of the head and neck from an unknown primary site with involved nodes (N1 to 3) also qualify. * Scheduled to received definitive RT with concurrent platinum based chemotherapy at Stanford * Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 to 1 * Must be able to swallow d limonene gelcaps at the time of enrollment. * Adequate hepatic function within 2 weeks prior to registration defined as follows: Bilirubin ≤ 2 mg/dL; aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \< 3 times the upper limit of normal * Adequate hematologic function within 2 weeks prior to registration defined as follows: * Absolute neutrophil count (ANC): ≥ 1,500/mm3 * Platelets: ≥ 100,000/mm3 * Hemoglobin: ≥ 8.0 g/dL (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dL is acceptable). * Adequate renal function defined as follows: Serum creatinine ≤ 1.5 mg/dL within 2 weeks prior to registration or creatinine clearance (CC) ≥ 50 mL/min within 2 weeks prior to registration determined by 24 hour collection or estimated by Cockcroft Gault formula: CCr male = \[(140 - age) x (wt in kg)\] \[(Serum Cr mg/dL) x (72)\] CCr female = 0.85 x (CrCl male) * Negative serum pregnancy test within 2 weeks prior to registration and agreement to use a birth control method during the entire duration of d limonene treatment for women of childbearing potential * Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: * History of allergic reactions attributed to citrus fruits * Pregnant or lactating
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE1'], 'designInfo': {'allocation': 'NON_RANDOMIZED', 'interventionModel': 'SEQUENTIAL', 'primaryPurpose': 'SUPPORTIVE_CARE', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 30, 'type': 'ESTIMATED'}}
Updated at
2024-02-21

1 organization

1 product

1 drug

1 indication

Product
D-Limonene
Indication
Dry Mouth