Muscadine Grape Extract for the Improvement of Fatigue in Older Cancer Survivors
This early phase I trial evaluates how well muscadine grape extract improves fatigue in older patients with a history of cancer who are experiencing fatigue. Muscadine grape extract is a natural, nutritional supplement with anti-inflammatory, antioxidant and potential chemopreventive (preventing or delaying the development of cancer) activities that may reduce fatigue.
Inclusion Criteria
- Self reported history of cancer diagnosed > 12 months prior to enrollment excluding non-melanoma skin cancer with no evidence of disease at enrollment
- Eligible solid tumor cancer types include stage 1-3 breast, lung, head and neck, colorectal, anal, prostate, melanoma, bladder/ureteral, esophageal, gastric, pancreatic, kidney, liver/biliary, uterine, cervical, ovarian, sarcoma. (superficial disease and in situ disease only is excluded)
- Eligible hematologic malignancies include lymphoma any subtype any stage in remission, multiple myeloma in remission, leukemia any subtype in remission
- Eligible prior cancer treatment modalities include surgery, radiation, chemotherapy, hormonal therapies, immunotherapy, biologic therapies
- All anti-cancer therapy completed > 12 months prior to enrollment
- Age 65 years and older
- Presence of self-reported fatigue defined by a response of “somewhat, quite a bit or very much” to the screening question “During the past seven days, did you feel fatigued: Not at all, a little bit, somewhat, quite a bit, very much?”
- Ability to walk without requiring assistance from another individual (use of cane or walker acceptable)
- Leukocytes >= 3,000/mcL
- Absolute neutrophil count >= 1,500/mcL
- Platelets >= 100,000/mcL
- Total bilirubin within normal institutional limits
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< x 2.5 x institutional upper limit of normal
- Creatinine clearance >= 30 mL/min
- Ability to understand and the willingness to sign an Institutional Review Board (IRB)-approved informed consent document (either directly or via a legally authorized representative)
Exclusion Criteria
- Active malignancy or on-going cancer treatment including oral anti-estrogen therapy, immunotherapy, biologic therapy
- Men receiving androgen deprivation therapy
- Use of Coumadin or Warfarin
- Symptomatic congestive heart failure
- Lung disease requiring oxygen
- End stage renal disease requiring dialysis
- Inability to swallow capsules
- Chronic nausea or diarrhea defined by a frequency of >= once per week
- Hemoglobin < 10 g/dl
- Diagnosis of dementia
- 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 requirements
- Known untreated hypothyroidism
- Allergy to muscadine grapes or muscadine grape preparations
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT04495751.
PRIMARY OBJECTIVE:
I. To evaluate whether administration of muscadine grape extract (MGE) supplementation (4 tablets twice daily, approximately 1320 mg total phenolics) decreases Patient Reported Outcomes Measurement and Information System (PROMIS) Fatigue score from baseline to 12 weeks compared to placebo.
SECONDARY OBJECTIVES:
I. To evaluate whether administration of MGE supplementation (4 tablets twice daily) causes changes in physical function (Pepper Assessment Tool for Disability [PAT-D], Short Physical Performance Battery), physical fitness (6-minute walk), physical activity (Minnesota Leisure Questionnaire), and sedentary behavior (Sedentary Behavior Questionnaire) from baseline to 12 weeks compared to placebo.
II. To compare changes in health related quality of life (PROMIS Global Health) at 12 weeks in participants randomized to MGE group versus (vs.) placebo.
III. To compare changes in the Fried frailty index at 12 weeks in participants randomized to MGE vs. placebo.
EXPLORATORY OBJECTIVES:
I. To explore whether MGE administration alters 8-hydroxy-2 deoxyguanosine, peripheral blood mitochondrial function, interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, C-reactive protein, hepatocyte growth factor from baseline to 12 weeks compared to the placebo arm.
II. To explore whether MGE administration alters the microbiome from baseline to 12 weeks compared to the placebo arm.
III. To explore whether 8-hydroxy-2 deoxyguanosine, peripheral blood mitochondrial function, IL-6, TNF-alpha, C-reactive protein, hepatocyte growth factor and the microbiome may mediate changes in self-reported fatigue and physical function, fitness and activity from baseline to 12 weeks.
IV. To explore whether MGE administration causes changes in cognitive speed (Digital Symbol Substitution Test) from baseline to 12 weeks compared to placebo.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive muscadine grape extract orally (PO) twice daily (BID) for 12 weeks in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive placebo PO BID for 12 weeks in the absence of disease progression or unacceptable toxicity.
After completion of study, patients are followed up for 30 days after the last dose of the study drug.
Trial PhasePhase O
Trial Typesupportive care
Lead OrganizationWake Forest University Health Sciences
Principal InvestigatorHeidi Diana Klepin
- Primary IDWFBCCC 98320
- Secondary IDsNCI-2020-08090, IRB00067614
- ClinicalTrials.gov IDNCT04495751