Anticancer Activity of Nicotinamide on Lung Cancer

Il Yeong Park, Ph.D.

Status and phase: Unknown; Phase 3; Phase 2

Conditions: Non-Small-Cell Lung Carcinoma

Treatments: Drug: Nicotinamide

Study type: Interventional

Funder types: Other

Identifiers

NCT02416739

Amina-X-002

Details and patient eligibility

About

Nicotinamide is an inhibitor of human sirtuins (HDAC III), and is found to re-activate epigenetically silenced tumor suppressors, RUNX3 (runt-related gene 3) and others, in cancer cells. Nicotinamide was found to be effective in several animal cancer models including lung, bladder, liver, etc. The purpose of this study is to determine whether nicotinamide is also effective in the treatment of human lung cancer.

Full description

The standard therapy to the EGFR (epidermal growth factor receptor) mutation positive non-small-cell lung cancer patients who are not eligible to operation is to administer EGFR-TKIs (tyrosine kinase inhibitors, gefitinib or erlotinib). To determine the effectiveness of nicotinamide on lung cancer, nicotinamide or placebo tablet will be co-administered with gefitinib or erlotinib for two years until the event or censoring occurs. The stratified block randomization was designed with 3 covariates (EGFR mutation status, kind of EGFR-TKI, ECOG (Eastern Cooperative Oncology Group) performance status score variation). The size of lesions will be checked every other months by radiology. PD (progressive disease) will be assessed according to RECIST(Response Evaluation Criteria in Solid Tumors)1.1. After observing 36 events, an interim analysis of hazard ratio by Cox proportional hazard regression will be performed. The final analysis will be done by the same protocol after observation of 72 events. The significance level of the interim and final analysis were set to 0.0075 and 0.0209 respectively. Response rate, quality of life (measured by 10 questions at every visit), and overall survival will be analysed together. All other adverse reactions will be analysed and reported, if there.

Enrollment: 110 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Operation-impossible stage 4 non-small-cell lung carcinoma (NSCLC), or recurred terminal stage NSCLC after previous operation or radiation therapy
• EGFR mutated (exon 19 deletion or L858R mutation)
• Life expectation more than 3 months
• More than 1 measurable lesions by RECIST 1.1 which were not exposed to radiation previously
• ECOG (Eastern Cooperative Oncology Group ) performance status grade 0~2
• Who signed the informed consent form

Exclusion criteria

• Who had received chemotherapy or EGFR tyrosin kinase inhibitors previously, except whom had received operation at least 6 months ago and received supplementary chemotherapy
• Who has metastasized brain lesion that needs operation or radiation therapy
• Above grade 2, CTCAE (Common Toxicity Criteria for Adverse Effects) 4.0 criteria for blood, liver and kidney
• Who does Not agree to contraception
• Who has allergy to nicotinamide

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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110 participants in 2 patient groups, including a placebo group

Nicotinamide

Experimental group

Description:

Nicotinamide with EGFR-TKI: 1. gefitinib (250mg tab) or erlotinib (150mg tab) - per oral, once a day 2. nicotinamide (500mg tab) - per oral, twice a day, until the event or censoring occurs

Treatment:

Drug: Nicotinamide

Placebo

Placebo Comparator group

Description:

Placebo tablet with EGFR-TKI: 1. gefitinib (250mg tab) or erlotinib (150mg tab) - per oral, once a day 2. placebo tablet - per oral, twice a day, until the event or censoring occurs

Treatment:

Drug: Nicotinamide