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Baseline levels of PAR-4 secreted by normal cells are generally inadequate to cause massive apoptosis in cancer cells and drugs that bolster the secretion of PAR-4 would constitute an important therapeutic advance.The apoptosis sensitizing features of hydroxychloroquine enhance the anti-tumor effects of a broad range of cancer therapeutics. The investigators hypothesize that hydroxychloroquine will induce at least 2-fold increase in systemic (plasma) PAR-4 levels compared to pre-treatment plasma levels in patients with resectable solid tumors.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Initial: Hydroxychloroquine 400mg HCQ | Experimental | These initial 3 patients received 200mg hydroxychloroquine (HCQ) twice daily (400mg/day total) for 14 days prior to surgery. |
|
| Secondary: Hydroxychloroquine 800mg HCQ | Experimental | Based on data analysis from the initial patients, these patients received 400mg hydroxychloroquine (HCQ) twice daily (800mg/day total) for 14 days prior to surgery. |
|
| Tertiary: Hydroxychloroquine 400mg HCQ | Experimental | Based on data from the primary and secondary groups, patients received 200mg hydroxychloroquine (HCQ) twice daily (400mg/day total) for 14 days prior to surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hydroxychloroquine, 200mg twice dailiy | Drug | Hydroxychloroquine, 200mg twice daily (400mg/day total) was given to subjects for up to 14 days prior to surgery. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Patients With Elevated Par-4 Levels | Number of patients with 2-fold change in Par-4 levels from baseline to day 14 | Baseline and day 14 |
| Optimal Biologic Dose of Hydroxychloroquine | Dose (mg twice daily) wherein 70% of patients exhibit a 2-fold increase in Par-4 levels with a dose-limiting toxicity of no more than 30%. | Day 14 |
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Inclusion Criteria:
Patients must have a histologically confirmed solid tumor that is planned for surgical resection.
Age ≥18 years.
ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A).
Patients must be able to ingest oral medications.
Patients must have normal organ and marrow function as defined below:
Patients must be able to undergo surgical resection of their tumor as determined by the treating surgeon.
Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation.
Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Peng Wang, MD, PhD | Lucille P. Markey Cancer Center at University of Kentucky | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Kentucky, Markey Cancer Center | Lexington | Kentucky | 40536 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30603055 | Result | Wang P, Burikhanov R, Jayswal R, Weiss HL, Arnold SM, Villano JL, Rangnekar VM. Neoadjuvant administration of hydroxychloroquine in a phase 1 clinical trial induced plasma Par-4 levels and apoptosis in diverse tumors. Genes Cancer. 2018 May;9(5-6):190-197. doi: 10.18632/genesandcancer.181. |
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10 patients enrolled in this dose escalation study. In Period 1, three patients were assigned to receive 200mg HCQ twice daily. Based on toxicity and PAR-4 levels, in Period 2 the next four patients received 400mg HCQ twice daily. Following additional analysis, in Period 3 the final three patients received 200mg HCQ twice daily.
This study was initiated July 2015 at the University of Kentucky and enrolled 10 adult patients with early stage solid malignancies.
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| ID | Title | Description |
|---|---|---|
| FG000 | Initial: Hydroxychloroquine 400mg HCQ | These patients received 200mg hydroxychloroquine (HCQ) twice daily (400mg/day total) for 14 days prior to surgery. |
| FG001 | Secondary: Hydroxychloroquine 800mg HCQ | These patients received 400mg hydroxychloroquine (HCQ) twice daily (800mg/day total) for 14 days prior to surgery. |
| FG002 | Tertiary: Hydroxychloroquine 400mg HCQ | Based on data from primary and secondary groups, these patients received 200mg hydroxychloroquine (HCQ) twice daily (400mg/day total) for 14 days prior to surgery. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Dose (200mg HCQ Twice Daily) |
| |||||||||||||
| Second Dose (400mg HCQ Twice Daily) |
| |||||||||||||
| Third Dose(200mg HCQ Twice Daily) |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Initial: Hydroxychloroquine 400mg HCQ | Hydroxychloroquine 14 days Hydroxychloroquine: Hydroxychloroquine (200mg twice per day; 400mg total) was given to subjects for up to 14 days prior to surgery. |
| BG001 | Secondary: Hydroxychloroquine 800mg HCQ |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | One patient was unanalyzable |
| 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 | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Patients With Elevated Par-4 Levels | Number of patients with 2-fold change in Par-4 levels from baseline to day 14 | Posted | Count of Participants | Participants | Baseline and day 14 |
|
14 days
Patients were queried about adverse events during study visits.
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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 | Initial: Hydroxychloroquine 400mg HCQ | Hydroxychloroquine 14 days Hydroxychloroquine: Hydroxychloroquine (200mg twice daily; 400mg total) was given to subjects for up to 14 days prior to surgery. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Peng Wang | University of Kentucky | (859) 257-4488 | p.wang@uky.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 20, 2016 | Mar 4, 2019 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Dec 19, 2017 | Mar 4, 2019 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D006886 | Hydroxychloroquine |
| ID | Term |
|---|---|
| D002738 | Chloroquine |
| D000634 | Aminoquinolines |
| D011804 | Quinolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
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| Hydroxychloroquine, 400mg twice daily | Drug | Hydroxychloroquine, 400mg twice daily (800mg/day total) was given to subjects for up to 14 days prior to surgery. |
|
| NOT COMPLETED |
|
|
| NOT COMPLETED |
|
Hydroxychloroquine 14 days Hydroxychloroquine: Hydroxychloroquine (400mg twice per day; 800mg total) was given to subjects for up to 14 days prior to surgery. |
| BG002 | Tertiary: Hydroxychloroquine 400mg HCQ | Hydroxychloroquine 14 days Hydroxychloroquine: Hydroxychloroquine (200mg twice per day; 400mg total) was given to subjects for up to 14 days prior to surgery. |
| BG003 | Total | Total of all reporting groups |
| Count of Participants |
| Participants |
|
| Sex: Female, Male | One patient was unanalyzable | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | One patient was unanalyzable | Count of Participants | Participants |
|
| Race (NIH/OMB) | one patient unanalyzable | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG002 | Tertiary: Hydroxychloroquine 400mg HCQ | Based on data from the primary and secondary groups, patients received 200mg hydroxychloroquine (HCQ) twice daily (400mg/day total) for 14 days prior to surgery. Hydroxychloroquine, 200mg twice dailiy: Hydroxychloroquine, 200mg twice daily (400mg/day total) was given to subjects for up to 14 days prior to surgery. |
|
|
| Primary | Optimal Biologic Dose of Hydroxychloroquine | Dose (mg twice daily) wherein 70% of patients exhibit a 2-fold increase in Par-4 levels with a dose-limiting toxicity of no more than 30%. | All patients | Posted | Number | mg twice daily | Day 14 |
|
|
|
| 1 |
| 3 |
| 0 |
| 3 |
| 1 |
| 3 |
| EG001 | Secondary: Hydroxychloroquine 800mg HCQ | Hydroxychloroquine 14 days Hydroxychloroquine: Hydroxychloroquine (400mg twice daily; 800mg total) was given to subjects for up to 14 days prior to surgery. | 0 | 4 | 0 | 4 | 2 | 4 |
| EG002 | Tertiary: Hydroxychloroquine 400mg HCQ | Hydroxychloroquine 14 days Hydroxychloroquine: Hydroxychloroquine (200mg twice daily, 400mg total) was given to subjects for up to 14 days prior to surgery. | 1 | 3 | 0 | 3 | 1 | 3 |
| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
|
| Abdominal Pain | General disorders | Systematic Assessment |
|
| Floaters | Eye disorders | Systematic Assessment |
|
| Anorexia | General disorders | Systematic Assessment |
|
| Blurred Vision | Eye disorders | Systematic Assessment |
|
| Urinary Tract Infection | Renal and urinary disorders | Systematic Assessment |
|
| Chest Pain | Cardiac disorders | Systematic Assessment |
|
| Thromboembolism | Vascular disorders | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | Systematic Assessment |
|
| Headache | Nervous system disorders | Systematic Assessment |
|
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| D000072471 |
| Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |