Chemotherapy Effect Clinical Trial
Official title:
Can Fasting Decrease the Side Effects of Chemotherapy?
This is a prospective randomized crossover trial. Patients will be randomized to the FMD or regular diet during three rounds of chemotherapy. After the third round, patients will cross over to the opposite arm. The primary hypothesis is that there will be fewer cases of Grade 2-4 nausea when patients are in the FMD sequence. The primary objective is to assess differences in toxicities in patients undergoing chemotherapy with a combination of taxol/carboplatin when using a fasting mimicking diet when compared to normal diet before and after treatment.
Randomization and blinding:
Subjects will be allocated to sequence 1 (normal diet first, FMD second) or sequence 2 (FMD
first, normal diet second) using a computer generated randomization scheme. There will be no
blinding
Intervention:
Over the course of three rounds of chemotherapy, patients in the FMD will consume a diet that
consists of 10 cal/kg/day and includes 50% fat, 40% carbohydrates, and no more than 10%
protein. The diet includes nuts, olives, vegetable broth, broccoli/cauliflower, white
rice/puffed rice cake, onion, tea/coffee, almond milk. The diet prohibits meat products,
dairy, alcohol, sugar, and artificial sweeteners. Patients will be instructed to drink 2 cups
of water each morning, take their usual medications and limit exercise to walking.
The table below provides the schedule of fasting during the cycle of chemotherapy
(Time during chemotherapy cycle, Diet)
- 2 days prior to chemotherapy, Fasting mimicking diet
- 1 day prior to chemotherapy, Fasting mimicking diet
- Day of chemotherapy, Full fasting(water only)
- 1 day after chemotherapy, Fasting mimicking diet
- 2 days after chemotherapy, Fasting mimicking diet
Prior to each chemotherapy cycle and coincident FMD arm, weight, and laboratory testing will
be conducted and patients will be asked to keep track of side effects as per usual care for
patients undergoing chemotherapy. Patients will be asked to keep a food log and record the
quality of their sleep as part of the study.
There will be no restrictions for use of usual standard medications, including anti-nausea
medication. This is generally Zofran oral, q8 hours PRN. Anti-nausea medication usage will be
recorded in the study database. Although it is expected to be consistent throughout the diet
and control periods for each subject, dosage and frequency will be recorded throughout the
study, and it will be noted if anti-nausea medication is effective during the control period
for each subject.
Endpoint evaluation:
Severity of AEs will be assessed using the National Cancer Institute (NCI) Common Terminology
Criteria for Adverse Events (CTCAE) Version 5.0 for toxicity and adverse event reporting. A
copy of the CTCAE Version 3.0 can be downloaded from
https://www.eortc.be/services/doc/ctc/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf.
AEs not corresponding to the CTCAE term will be assessed according to their impact on the
subject's ability to perform daily activities as follows:
Mild (grade 1) - the AE does not interfere in a significant manner with the subject's normal
functioning level. It may be an annoyance.
- Moderate (grade 2) - the AE produces some impairment of functioning, but is not
hazardous to health. It is uncomfortable or an embarrassment.
- Severe (grade 3) - the AE produces significant impairment of functioning or
incapacitation and is a definite hazard to the subject's health.
- Life threatening (grade 4) - Life threatening or disabling.
- Fatal (grade 5) Causes death of the participant.
Estimated study duration:
Patient participation is approximately 16 weeks.
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