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Green Tea Extract in Preventing Cervical Cancer in Patients With Human Papillomavirus and Low-Grade Cervical Intraepithelial Neoplasia

Purpose


This randomized phase II trial is studying green tea extract to see how well it works compared to a placebo in preventing cervical cancer in patients with human papillomavirus and low-grade cervical intraepithelial neoplasia. Chemoprevention is the use of certain substances to keep cancer from forming, growing, or coming back. The use of green tea extract may stop cervical cancer from forming in patients with human papillomavirus and low-grade cervical intraepithelial neoplasia. It is not yet known whether green tea extract is more effective than a placebo in preventing cervical cancer in patients with human papillomavirus and low-grade cervical intraepithelial neoplasia.

Condition Intervention Phase
Cervical Cancer
Cervical Intraepithelial Neoplasia Grade 1
Human Papilloma Virus Infection
Drug: placebo
Dietary Supplement: defined green tea catechin extract
Other: laboratory biomarker analysis
Phase 2

 

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Prevention
Official Title: A Phase II Trial of Polyphenon E for Cervical Cancer Prevention

 

Further study details as provided by National Cancer Institute (NCI):


Primary outcome measures:

  • Complete Response – Clearance of Oncogenic Human Papillomavirus (HPV) and Complete Colposcopic, Histologic and Cytologic Clearance of Disease [ Time Frame: 4 months ] [ Designated as safety issue: No ]
  • Partial Response – Clearance of Oncogenic HPV With Evidence of Low Grade Cervical Intraepithelial Neoplasia [ Time Frame: 4 months ] [ Designated as safety issue: No ]
  • No Response – Persistent Oncogenic HPV Positivity, With or Without Evidence of Low Grade Cervical Intraepithelial Neoplasia [ Time Frame: 4 months ] [ Designated as safety issue: No ]
  • Progression – Persistent Oncogenic HPV Positivity, With Evidence of Progression to Worsening Cervical Intraepithelial Neoplasia or Invasive Cancer [ Time Frame: 4 months ] [ Designated as safety issue: No ]

Enrollment: 98

Study Start Date: September 2005

Study Completion Date: February 2011

Primary Completion Date: November 2010 (Final data collection date for primary outcome measure)

Arm Assigned Interventions
Experimental: Arm I
Patients receive oral green tea extract once daily for 16 weeks in the absence of unacceptable toxicity.
Dietary Supplement: defined green tea catechin extract
Given orally
Other Name: Polyphenon E
Other: laboratory biomarker analysis
Correlative studies
Placebo Comparator: Arm II
Patients receive oral placebo once daily for 16 weeks in the absence of unacceptable toxicity.
Drug: placebo
Given orally
Other Name: PLCB
Other: laboratory biomarker analysis
Correlative studies

Detailed Description:

PRIMARY OBJECTIVES:

  1. Assess the effect of green tea extract (Polyphenon E®) in patients with human papillomavirus (HPV) expression and low-grade cervical intraepithelial neoplasia (CIN 1) in a pre- and post-treatment setting.

SECONDARY OBJECTIVES:

  1. Compare the toxicity of green tea extract vs placebo among patients with CIN 1.

TERTIARY OBJECTIVES:

  1. Evaluate the utility of karyometry as an intermediate endpoint biomarker for cervical chemoprevention studies.

OUTLINE:

This is a randomized, double-blind, placebo-controlled study. Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive oral green tea extract (Polyphenon E®) once daily for 16 weeks in the absence of unacceptable toxicity.

ARM II: Patients receive oral placebo once daily for 16 weeks in the absence of unacceptable toxicity.

After completion of study treatment, patients are followed for 2 weeks.

 

Eligibility


Ages Eligible for Study:   18 Years and older

Genders Eligible for Study:   Female

Accepts Healthy Volunteers:   No

 

Criteria


 

Inclusion Criteria:

  • Histologically confirmed cervical intraepithelial neoplasia 1 (CIN 1) AND oncogenic human papillomavirus (HPV) positivity
  • At increased risk for developing cervical cancer due to >= 1 of the following criteria (documented 6-12 months ago)*:
    • Positive oncogenic HPV on DNA hybrid capture
    • Low-grade squamous intraepithelial lesion cytology
    • Histopathologically documented CIN 1 on cervical biopsy [Note: *Patients must now have current CIN 1 by histology or colposcopy AND HPV positivity]
  • Cervical dysplasia by colposcopy OR positive biopsy
  • No invasive cervical cancer or high-grade intraepithelial neoplasia on cervical biopsy or endocervical curettage
  • ECOG performance status < 2
  • Total bilirubin < 2 times upper limit of normal (ULN)
  • AST < 2 times ULN
  • ALT normal
  • Creatinine < 2.0 mg/dL
  • Able and willing to return to clinic for study visits once every 4 weeks for the duration of the study
  • No history of allergic reaction to tea or related dietary products
  • No HIV positive patients (or AIDS/HIV-associated complex)
  • No uncontrolled intercurrent illness including, but not limited to, any of the following:
    • Ongoing or active infection other than HPV
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness/social situation that would limit compliance with study requirements
  • No history of any cancer except nonmelanoma skin cancer
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No regular intake of 6 or more servings of tea per week within 1 month prior to study entry
  • No treatment for genital condyloma within 30 days prior to study entry
  • No prior pelvic irradiation
  • No concurrent tea (green, black, or oolong) or tea-derived products
  • No other concurrent investigational agents

More Information


Garcia FA, Cornelison T, Nuño T, Greenspan DL, Byron JW, Hsu CH, Alberts DS, Chow HH. Results of a phase II randomized, double-blind, placebo-controlled trial of Polyphenon E in women with persistent high-risk HPV infection and low-grade cervical intraepithelial neoplasia. Gynecol Oncol. 2014 Feb;132(2):377-82. doi: 10.1016/j.ygyno.2013.12.034. Epub 2014 Jan 2.

Responsible Party: National Cancer Institute (NCI)

ClinicalTrials.gov Identifier: NCT00303823

Other Study ID Numbers: NCI-2009-00893  NCI-2009-00893  CDR0000458081  HSC 05-40  05-0144-01  UAZ03-1-02  P30CA023074  N01CN35158

Study First Received: March 15, 2006

Results First Received: July 13, 2012

Last Updated: April 14, 2015

Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:

Carcinoma in Situ
Cervical Intraepithelial Neoplasia
Neoplasms
Papillomavirus Infections
Uterine Cervical Dysplasia
Uterine Cervical Neoplasms
Virus Diseases
Warts
Carcinoma
DNA Virus Infections
Genital Diseases, Female
Genital Neoplasms, Female
Neoplasms by Histologic Type
Neoplasms by Site
Neoplasms, Glandular and Epithelial
Precancerous Conditions
Skin Diseases
Skin Diseases, Infectious
Skin Diseases, Viral
Tumor Virus Infections
Urogenital Neoplasms
Uterine Cervical Diseases
Uterine Diseases
Uterine Neoplasms
Epigallocatechin gallate
Anticarcinogenic Agents
Antimutagenic Agents
Antineoplastic Agents
Antioxidants
Molecular Mechanisms of Pharmacological Action