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| Name | Class |
|---|---|
| Dartmouth College | OTHER |
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Conjugated Linoleic Acid (CLA) is obtained in the human diet by consumption of foods containing ruminant fat. Milk and dairy products have shown the highest amounts of CLA. Clarinol (CLA), is considered a natural supplement and is not regulated by the Food and Drug Administration (FDA). CLA is known to inhibit proliferation of human breast cancer cells and tumors in rodent breast cancer models and reduced Spot 14 (THRSP, S14) and Fatty Acid Synthase (FASN) gene expression in breast cancer cells and tht the two major CLA isomers used in nutritional supplements (C9, t11 and t10, c12) were equipotent in reducing breast cancer cell growth. This study looks at the hypothesis that S14 expression is decreased by CLA and will characterize the major pharmacodynamic (PD) effects of CLA in newly diagnosed Breast cancer patients on Tumor tissue lipogenic pathway. FASN, S14 and Lipoprotein Lipase (LPL), Ki67 and apoptotic index expression will be assessed by quantitative immunohistochemistry (IHC) in initial breast cancer biopsies and compared to that in resected breast tumor tissue after the study subject has been taking CLA for ten to twenty-eight days. Tissue from adjacent breast adipocytes will also be analyzed to determine whether adipose tissue effects can serve as a surrogate marker for those in tumor tissue. A sample of the original biopsy will be compared to the tumor resection sample to determine the levels of CLA in the breast cancer cells.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CLA | Experimental | open-label, single-institution proof of principle study of oral CLA in patients with newly diagnosed adenocarcinoma of the breast. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conjugated Linoleic Acid (CLA) | Drug | Conjugated linoleic acid (CLA, Clarinolâ„¢) oral soft gel capsules will be administered in an open-labeled, manner to all subjects enrolled in the study. Subjects will be treated with 7.5 grams of oral CLA daily, taken in divided dose, twice daily between 8 am and 12 noon and between 8 pm and 12 midnight. CLA will be taken for a minimum of ten days prior to surgical resection of their breast malignancy. In the event that the subject's surgical resection date is delayed, subjects may take CLA for up to 28 days. The last dose of CLA prior to the surgical resection will be taken at 12 midnight or as close as possible to that time and the patient will record the time of the last dosing. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Spot 14 Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry and Staining Intensities Scored at 0, 1, or 2 | To determine whether ≥ 10 days of CLA consumption suppresses Spot 14 expression in breast cancer tissue in vivo. The staining intensities scoring system used is: no immuostaining (0), weak staining (1), and strong staining (2). The scoring system used objectively and quantitatively assesses the expression of Spot 14, fatty acid synthase, and lipoprotein lipase using the image processing and analysis software Image-Pro Plus™ (MediaCybernetics). | Up to 28 days |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With FASN Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry and Staining Intensities Scored at 0, 1, or 2 | To determine whether ≥ 10 days of CLA consumption suppresses FASN expression in breast cancer tissue in vivo. The staining intensities scoring system used is: no immuostaining (0), weak staining (1), and strong staining (2). The scoring system used objectively and quantitatively assesses the expression of Spot 14, fatty acid synthase, and lipoprotein lipase using the image processing and analysis software Image-Pro Plus™ (MediaCybernetics). |
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Inclusion Criteria:
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Burton L Eisenberg, MD | Norris Cotton Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dartmouth Hitchcock Medical Center, Norris Cotton Cancer Center | Lebanon | New Hampshire | 03756 | United States |
Participants must have been able to take the study drug for a minimum of 10 days prior to tumor resection. For some potential participants the surgery date was scheduled earlier than 10 days and the study drug was not dispensed.
Women with invasive breast cancer were recruited from the Breast Oncology Clinic at the Norris Cotton Cancer Center at the Geisel School of Medicine at Dartmouth from June 2009 to March 2011. All patients gave written informed consent before entry into the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Conjugated Linoleic Acid | Women with histologically proven invasive non-metastatic breast cancer. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Pre-CLA treatment and up to 2 years Post-CLA treatment |
| Number of Participants With LPL Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry and Staining Intensities Scored at 0, 1, or 2 | To determine whether ≥ 10 days of CLA consumption suppresses LPL expression in brest cancer tissue in vivo. The staining intensities scoring system used is: no immuostaining (0), weak staining (1), and strong staining (2). The scoring system used objectively and quantitatively assesses the expression of Spot 14, fatty acid synthase, and lipoprotein lipase using the image processing and analysis software Image-Pro Plus™ (MediaCybernetics). | Pre-CLA treatment and up to 2 years Post-CLA treatment |
| Number of Participants With Ki67 Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry | To determine whether ≥ 10 days of CLA consumption impacts the status of tumor proliferation by calculating the percentage of cells expressing Ki67. | Pre-CLA treatment and up to 2 years Post-CLA treatment |
| Assess Tumor Cell Apoptosis by Immunostaining for Cleaved Caspase 3 Pre and Post CLA | To determine whether ≥ 10 days of CLA consumption impacts the status of tumor cell apoptosis by measuring the presence of immunostaining for cleaved caspase 3. | Pre-CLA treatment and up to 2 years Post-CLA treatment |
| Number of Participants With Measurable Concentration of the Circulating Plasma Free CLA Isomers c9,t11 and t10,c12 Matched to Spot 14 Expression. | Pre-CLA treatment and up to 2 years Post-CLA treatment |
| Number of Participants With Measurable Concentration of the Circulating Plasma Free CLA Isomers c9t11 and t10c12 Matched to Ki-67 Expression | Pre-CLA treatment and up to 2 years Post-CLA treatment |
| Safety of Short Term Treatment With 7.5 Gram CLA Per Day. | 2 months |
| COMPLETED |
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| NOT COMPLETED |
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24 women completed study treatments. Not all tumors yeiled data for secondary endpoints.
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| ID | Title | Description |
|---|---|---|
| BG000 | Single Arm Study | Women with histologically proven invasive non-metastatic breast cancer. |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||
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| Age, Categorical | Count of Participants | Participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Number of Participants With Spot 14 Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry and Staining Intensities Scored at 0, 1, or 2 | To determine whether ≥ 10 days of CLA consumption suppresses Spot 14 expression in breast cancer tissue in vivo. The staining intensities scoring system used is: no immuostaining (0), weak staining (1), and strong staining (2). The scoring system used objectively and quantitatively assesses the expression of Spot 14, fatty acid synthase, and lipoprotein lipase using the image processing and analysis software Image-Pro Plus™ (MediaCybernetics). | Posted | Number | participants | Up to 28 days |
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| Secondary | Number of Participants With FASN Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry and Staining Intensities Scored at 0, 1, or 2 | To determine whether ≥ 10 days of CLA consumption suppresses FASN expression in breast cancer tissue in vivo. The staining intensities scoring system used is: no immuostaining (0), weak staining (1), and strong staining (2). The scoring system used objectively and quantitatively assesses the expression of Spot 14, fatty acid synthase, and lipoprotein lipase using the image processing and analysis software Image-Pro Plus™ (MediaCybernetics). | Posted | Number | participants | Pre-CLA treatment and up to 2 years Post-CLA treatment |
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| Secondary | Number of Participants With LPL Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry and Staining Intensities Scored at 0, 1, or 2 | To determine whether ≥ 10 days of CLA consumption suppresses LPL expression in brest cancer tissue in vivo. The staining intensities scoring system used is: no immuostaining (0), weak staining (1), and strong staining (2). The scoring system used objectively and quantitatively assesses the expression of Spot 14, fatty acid synthase, and lipoprotein lipase using the image processing and analysis software Image-Pro Plus™ (MediaCybernetics). | Posted | Number | participants | Pre-CLA treatment and up to 2 years Post-CLA treatment |
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| Secondary | Number of Participants With Ki67 Expression Pre and Post CLA as Assessed by Quantitative Immunohistochemistry | To determine whether ≥ 10 days of CLA consumption impacts the status of tumor proliferation by calculating the percentage of cells expressing Ki67. | Posted | Count of Participants | Participants | Pre-CLA treatment and up to 2 years Post-CLA treatment |
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| Secondary | Assess Tumor Cell Apoptosis by Immunostaining for Cleaved Caspase 3 Pre and Post CLA | To determine whether ≥ 10 days of CLA consumption impacts the status of tumor cell apoptosis by measuring the presence of immunostaining for cleaved caspase 3. | Posted | Mean | Standard Deviation | stained cells/field | Pre-CLA treatment and up to 2 years Post-CLA treatment |
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| Secondary | Number of Participants With Measurable Concentration of the Circulating Plasma Free CLA Isomers c9,t11 and t10,c12 Matched to Spot 14 Expression. | Posted | Count of Participants | Participants | Pre-CLA treatment and up to 2 years Post-CLA treatment |
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| Secondary | Number of Participants With Measurable Concentration of the Circulating Plasma Free CLA Isomers c9t11 and t10c12 Matched to Ki-67 Expression | Posted | Count of Participants | Participants | Pre-CLA treatment and up to 2 years Post-CLA treatment |
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| Secondary | Safety of Short Term Treatment With 7.5 Gram CLA Per Day. | Reported toxicities deemed | Posted | Number | participants | 2 months |
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3 months
maximum allowed time frames include 4 weeks for screening, 28 days for study drug,and 4 weeks of follow up.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Subjects Taking 1 or More Doses of CLA | Women with histologically proven invasive, non metastatic breast cancer who received at least one day of CLA. | 0 | 24 | 14 | 24 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| abdominal pain | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| alopecia | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Anorexia | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
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| anxiety | Psychiatric disorders | CTCAE (3.0) | Non-systematic Assessment |
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| constipation | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Edema - limbs | Blood and lymphatic system disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Fatigue | General disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Headache | Nervous system disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Heartburn | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
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| insomnia | General disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Nausea | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Palpitations | Cardiac disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Peripheral Neuropathy | Nervous system disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Seroma | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
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| Elevated WBC | Blood and lymphatic system disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Skin Infection | Infections and infestations | CTCAE (3.0) | Non-systematic Assessment |
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| Ulceration | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Burton Eisenberg, MD, Deputy Director, Norris Cotton Cancer Center | Norris Cotton Cancer Center | 603-653-3613 | Burton.L.Eisenberg@Dartmouth.edu |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| D044243 | Linoleic Acids, Conjugated |
| ID | Term |
|---|---|
| D008041 | Linoleic Acids |
| D043371 | Fatty Acids, Omega-6 |
| D005231 | Fatty Acids, Unsaturated |
| D005227 | Fatty Acids |
| D008055 | Lipids |
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| Spot 14 Expression Grade 2 |
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