A Study Evaluating Bacillus Cereus in the Prevention of Afatinib-associated Diarrhea

Diarrhea Clinical Trial

Official title:

A Single-arm, Single-institutional, Phase II Study Evaluating the Efficacy and Safety of Bacillus Cereus (Changfukang®) in the Prevention of Afatinib-associated Diarrhea in NSCLC Patients

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT03486587
• Other study ID #: 2017-FXY-137
• Status: Terminated
• Phase: Phase 2
• Start date: April 15, 2018
• Est. completion date: December 31, 2020

Study information

• Verified date: September 2021
• Source: Sun Yat-sen University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Afatinib is an irreversible ErbB-family blocker with approved clinical activity in non-small-cell lung cancer (NSCLC) with EGFR mutations. It has received regulatory approval for use as a treatment for patients with lung adenocarcinoma whose tumors harbour activating EGFR mutations within exons 18-21 of the EGFR receptor, or patients with lung squamous cell carcinoma whose disease progress after platinum-based doublet chemotherapy. However, diarrhea is the most commonly reported adverse events associated with afatinib treatment (> 90%). Although these events are generally mild to moderate in severity, diarrhea adversely affects the tolerability of cancer treatment, and in severe cases diarrhea has the potential to affect the efficacy of treatment due to poor compliance, or treatment interruption, or dosage reduction. Currently, no prophylactic measure was demonstrated efficaciously. Bacillus cereus is an aerobic spore-forming bacterium that is commonly found in soil. The efficacy of Bacillus cereus in the management of afatinib treatment-associated diarrhoea has not been extensively evaluated in clinical studies. This is a single-arm, single-institutional, phase II study evaluating the efficacy and safety of Bacillus cereus (Changfukang®) in the prevention of afatinib-associated diarrhea in NSCLC patients.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 12
• Est. completion date: December 31, 2020
• Est. primary completion date: August 31, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• Histologically confirmed locally advanced or metastastic non-small-cell lung cancer
• Suitable for the treatment of afatinib assessed by investigator
• Age >=18 years old
• Eastern Cooperative Oncology Group (ECOG) performance status 0-2
• Life expectancy of at least 12 weeks
• Able to swallow and retain oral medications
• Women of childbearing potential must agree and commit to the use of a highly effective non-hormonal method of contraception, ie, intrauterine device, bilateral tubal ligation, vasectomized partner, or abstinence (only when it is the preferred lifestyle of the patient), from the time of informed consent until 28 days after the last dose of the investigational products. Men and their female partners of childbearing potential must agree and commit to use a highly effective method of contraception (ie, any of the above methods or hormonal contraception associated with inhibition of ovulation) while on treatment and for 3 months after last dose of investigational products
• Provide written, informed consent to participate in the study and follow the study procedures
• Patient has adequate bone marrow as defined by the following laboratory values:
• White blood cell = 3.0 × 109/L
• Absolute neutrophil count = 1.5 × 109/L
• Platelets = 75 × 109/L
• Patient has adequate organ function as defined by the following laboratory values:
• In absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) should be below 2.5 × ULN. If the patient has liver metastases, ALT and AST should be < 5 × ULN
• Total serum bilirubin < ULN; or total bilirubin = 3.0 × ULN with direct bilirubin within normal range of the central laboratory in patients with well documented
• Gilbert's Syndrome
• Serum creatinine = 1.5 × ULN

Exclusion Criteria:

• Previous treatment with EGFR-TKI or anti-EGFR antibody
• History of gastrointestinal disease with diarrhea as the primary symptom in the last three months.
• Another malignancy within 3 years prior to randomization, with the exception of adequately treated in-situ carcinoma of the cervix, uteri, basal or squamous cell carcinoma or non-melanomatous skin cancer
• Diagnosed as having CNS metastases, except those whose CNS disease were stable and dehydration treatment were unrequired within 4 weeks prior to the first dose of afatinib
• Any severe and / or uncontrolled medical conditions

Related Conditions & MeSH terms

• Diarrhea
• Treatment Side Effects

Intervention

Drug:
• Bacillus Cereus tablets
Bacillus Cereus tablets was taken two tablets three times a day.

Locations

Country	Name	City	State
China	Sun Yat-sen University Cancer Center	Guangzhou	Guangdong

Sponsors (1)

Lead Sponsor	Collaborator
Sun Yat-sen University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Overall Response Rate	Overall response rate as measured in accordance with the Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1	Up to 4 weeks
Other	Clinical Benefit Response	Clinical benefit response as measured in accordance with the Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1	Up to 4 weeks
Other	Progression-free Survival	Progression-free Survival as measured in accordance with the Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1	Up to 4 weeks
Primary	Diarrhoea rate of all grades	Proportion of subjects experiencing diarrhoea of all grades, as defined by the National Cancer Institute common terminology criteria for adverse events (NCI CTCAE) version 4.03, recorded as AEs in the Electronic case report form (eCRF)	Up to 4 weeks
Secondary	Diarrhoea rate of grade 2 and above	Proportion of subjects experiencing diarrhoea of grade 2 and above, as defined by the NCI CTCAE, version 4.03 and recorded as AEs in the eCRF	Up to 4 weeks
Secondary	Diarrhoea rate of grade 3 and above	Proportion of subjects experiencing diarrhoea of grade 3 and above, as defined by the NCI CTCAE, version 4.03 and recorded as AEs in the eCRF	Up to 4 weeks
Secondary	Days of diarrhoea of all grades	Number of days of subjects experiencing diarrhoea of all grades, as defined by the NCI CTCAE, version 4.03 and recorded as AEs in the eCRF	Up to 4 weeks
Secondary	Days of diarrhoea of grade 2 and above	Number of days of subjects experiencing diarrhoea of grade 2 and above, as defined by the NCI CTCAE, version 4.03 and recorded as AEs in the eCRF	Up to 4 weeks
Secondary	Days of diarrhoea of grade 3 and above	Number of days of subjects experiencing diarrhoea of grade 3 and above, as defined by the NCI CTCAE, version 4.03 and recorded as AEs in the eCRF	Up to 4 weeks
Secondary	Proportion of subjects taking anti-diarrheal medication	Proportion of subjects taking anti-diarrhoeal medication as recorded in the eCRF	Up to 4 weeks
Secondary	Proportion of subjects with AEs and SAEs	Proportion of subjects with AEs and SAEs were assessed from the start of the study until end of study as recorded in the eCRF	Up to 4 weeks