Clinical trial NCT02648919: Clinical Study of Noni Extract in Men With Very Low Risk or Low Risk Prostate Cancer
Official title: Phase II Clinical Study of Noni Extract in Men With Very Low Risk or Low Risk Prostate Cancer
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: Prostate Cancer
Lead sponsor: University of Hawaii
Sponsor class: OTHER
Collaborators: name: University of Hawaii Cancer Research Center
First posted: 2016-01-07
Enrollment: 6
Sex: MALE
Minimum age (years): 55
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate the effects of Noni extract in men diagnosed with very low risk or low risk prostate cancer

Detailed description: Efficacy and safety of Noni extract will be assessed in an estimated sample size of 30 subjects. Efficacy will be measured by the induction of favorable gene expression changes on Oncotype Dx Prostate Cancer Test after 12 months of intervention with Noni extract (6,000 mg/day). Other efficacy endpoints include the incidence of tumor progression after 12 months of intervention with Noni extract and serum PSA doubling time. Safety measurements will include the incidence and severity of adverse events, effects on angiogenesis (CD34), cell proliferation (Ki-67), and apoptosis (TUNEL) in prostate tissue biopsy samples from Month 12

Eligibility criteria: Inclusion Criteria:

1. Men with a diagnosis of very low risk (\<5% risk of disease relapse after primary treatment, criteria; cT1c, Gleason \<6, PSA \< 10 ng/mL, fewer than 3 positive biopsy cores \< 50% cancer in any core, PSA density \< 0.15 ng/mL/g); low risk (10% risk of disease relapse after primary treatment, criteria; cT1-2a, Gleason \<6, PSA \< 10 ng/mL) prostate cancer
2. Very low risk and low risk groups will be confirmed by Oncotype DX prostate cancer test and provided a Genomic Prostate Score (GPS)
3. 55 years of age and older (\>/= 55 years) at the time of informed consent
4. No evidence of extraprostatic disease on 3T multiparametric pelvic MRI
5. No baseline PT/PTT abnormalities, coagulopathies, or who are on any blood thinners.
6. ECOG performance status 0-2
7. Participants must have normal organ and marrow function as demonstrated by the following parameters being:

   * complete blood count (CBC) - no clinically significant findings
   * complete metabolic profile (CMP) - no clinically significant findings
8. Willing to comply with proposed visit and treatment schedule
9. Able to understand and willing to sign a written informed consent document

Exclusion Criteria:

1. Prior history of treated prostate cancer
2. Concomitant use of medications that are known CYP3A4 substrates
3. Use of medications or supplements that are known to affect PSA within 30 days prior to informed consent, including toremifene citrate, finasteride, testosterone, dehydroepiandrosterone (DHEA) or other testosterone-like supplements. No dutasteride within 90 days prior to informed consent
4. Consumption of any concomitant nutritional, herbal supplements, and antioxidants should be taken under the discretion of the investigator. The following foods/supplements are prohibited at least 7 days prior to initiation of and during study treatment:

   * St. John's wort or hyperforin (potent CYP3A4 enzyme inducer)
   * Grapefruit juice (potent cytochrome P450 CYP3A4 enzyme inhibitor)
5. Use of any blood thinners.
6. Consumption or use of any Noni or Noni-containing products
7. History of renal or hepatic disease, including history of hepatitis B or C. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or any psychological, familial, sociological or other concomitant condition that would not allow adequate compliance with the study protocol
8. Participation in any other investigational study or use of any other investigational agents within 30 days prior to study entry
9. History of allergic reactions attributed to Noni or other compounds of similar chemical or biologic composition to Noni, or the inactive components present in Noni capsules.

Primary outcomes:
measure: Compare Genomic Prostate Score (GPS) in Prostatic Tumors
timeFrame: Change from screening and at 12 months or early termination
measure: Number of Positive Cores Associated With Participants Disease Progression of Prostate Cancer
timeFrame: Change from screening and at 12 months or early termination
Secondary outcomes:
measure: Effects of Noni Extract on Serum Prostate Specific Antigen (PSA) Levels
timeFrame: Baseline and 9 months
measure: Frequency of Adverse Events
timeFrame: Enrollment, 1, 3, 6, 9, and 12 months, and 7 days post treatment
measure: Explore the Molecular Pathways Contributing to the Activities Associated With Noni Extract in the Prostate Cancer (e.g. Cell Proliferation, and Apoptosis in Prostate Tissue Biopsy Samples) Via Immunohistochemistry (IHC) Staining.
timeFrame: Enrollment and 12 months or at early termination
measure: Explore the Molecular Pathways Contributing to the Activities Associated With Noni Extract in the Prostate Cancer (e.g., Angiogenesis) in Prostate Tissue Biopsy Samples) Via Immunohistochemistry (IHC) Staining.
timeFrame: Enrollment and 12 months or at early termination
Other outcomes:
Locations:
city: Honolulu
country: United States
facility: University of Hawaii Cancer Center
state: Hawaii
Study officials:
affiliation: Faculty
name: Jeffrey Huang, PharmD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Issell BF, Franke A, Fielding RM. Pharmacokinetic study of Noni fruit extract. J Diet Suppl. 2008;5(4):373-82. doi: 10.1080/19390210802519671.