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一项评估胸膜内注射姜黄素脂质体安全性的 1 期临床试验研究方案:姜黄素作为恶性胸腔积液(IPAL-MPE)姑息治疗的研究

Study protocol of a phase 1 clinical trial establishing the safety of intrapleural administration of liposomal curcumin: curcumin as a palliative treatment for malignant pleural effusion (IPAL-MPE).

机构信息

Anatomical Pathology, Flinders University, Bedford Park, South Australia, Australia

Anatomical Pathology, Flinders University, Bedford Park, South Australia, Australia.

出版信息

BMJ Open. 2021 Mar 29;11(3):e047075. doi: 10.1136/bmjopen-2020-047075.

Abstract

INTRODUCTION

This is a phase 1, open-label, single-centre, uncontrolled, dose-escalation study to evaluate the feasibility, tolerability and pharmacokinetic profiles of a single dose of liposomal curcumin, administered via an existing tunnelled indwelling pleural catheter (TIPC) directly to the tumour site in individuals with diagnoses of malignant pleural effusion. Primarily, we aim to determine a maximum tolerated dose of liposomal curcumin administered via this method.

METHODS AND ANALYSIS

We will use a 3+3 expanded cohort for predefined dose-escalation levels or until a predefined number of dose-limiting toxicities are reached. Participants will be administered a single dose of liposomal curcumin (LipoCurc, SignPath Pharma) via their existing TIPC as a sequential enrolling case series with the following dose cohorts: 100, 200 and 300 mg/m. Primary endpoints are determination of the maximum tolerated dose within the predetermined dose range, and determination of the feasibility of intrapleural administration of liposomal curcumin via an existing TIPC. Secondary endpoints include determination of the safety and tolerability of intrapleural administration of liposomal curcumin, median overall survival, effects on quality of life and on feelings of breathlessness, and the pharmacokinetics and concentrations of curcumin from the plasma and the pleural fluid. Important inclusion criteria include age ≥18 years, an existing TIPC, a pleural biopsy or pleural fluid cytology-proven diagnosis of malignant pleural effusion and for whom no antitumour therapy of proven benefit is available or has been previously declined, eastern cooperative group performance status <2.

ETHICS AND DISSEMINATION

The study protocol has been approved by the Southern Adelaide Local Health Network Human Research Ethics Committee (HREC) (approval number: HREC/20/SAC/11). Study results will be published in peer-reviewed journals, and presented at conferences, in field of medical oncology and respiratory medicine.

TRIAL REGISTRATION NUMBER

ACTRN12620001216909.

PROTOCOL VERSION NUMBER

V.1.0.

摘要

简介

这是一项 1 期、开放标签、单中心、非对照、剂量递增研究,旨在评估通过现有经皮隧道留置胸腔导管(TIPC)直接向肿瘤部位单次给予脂质体姜黄素在恶性胸腔积液诊断个体中的可行性、耐受性和药代动力学特征。主要目的是确定通过该方法给予脂质体姜黄素的最大耐受剂量。

方法和分析

我们将使用 3+3 扩展队列进行预定义的剂量递增水平,或直到达到预定数量的剂量限制毒性。参与者将通过现有的 TIPC 序贯入组接受单次脂质体姜黄素(LipoCurc,SignPath Pharma)治疗,剂量递增队列为 100、200 和 300mg/m。主要终点是确定预定剂量范围内的最大耐受剂量,以及确定通过现有 TIPC 进行胸腔内给予脂质体姜黄素的可行性。次要终点包括确定胸腔内给予脂质体姜黄素的安全性和耐受性、中位总生存期、对生活质量和呼吸困难感觉的影响,以及从血浆和胸腔液中姜黄素的药代动力学和浓度。重要的纳入标准包括年龄≥18 岁、存在 TIPC、胸腔活检或胸腔液细胞学证实的恶性胸腔积液诊断,并且没有经过证实的有效抗肿瘤治疗可用或之前已拒绝,东部合作肿瘤组体能状态<2。

伦理和传播

该研究方案已获得南阿德莱德地区卫生网络人体研究伦理委员会(HREC)的批准(批准号:HREC/20/SAC/11)。研究结果将发表在同行评议期刊上,并在肿瘤学和呼吸医学领域的会议上展示。

试验注册编号

ACTRN12620001216909。

方案版本号

V.1.0。

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