Overview

Defined Green Tea Catechin Extract in Preventing Liver Cancer in Patients With Cirrhosis

Status:
Recruiting
Trial end date:
2022-09-30
Target enrollment:
0
Participant gender:
All
Summary
This phase I trial studies the side effects and best dose of defined green tea catechin extract and to see how well it works in preventing liver cancer in patients with cirrhosis. Higher levels of the molecule gamma-OHPdG may be found in patients with cirrhosis, which may mean a higher risk of the development of liver cancer. Defined green tea catechin extract may work better to lower levels of gamma-OHPdG and prevent the development of liver cancer.
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
National Cancer Institute (NCI)
Treatments:
Epigallocatechin gallate
Criteria
Inclusion Criteria:

- Participants with a clinical diagnosis of cirrhosis based on the investigators
evaluation, confirmed by ANY ONE of the three following methods to define cirrhosis:

- Established cirrhosis on liver biopsy (Meta-analysis of Histological Data in
Viral Hepatitis [METAVIR] F4);

- Ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) findings
consistent with cirrhosis; nodular appearing liver with or without evidence of
portal hypertension

- Transient elastography (FibroScan) with a result > 12.5 kPa Etiology of cirrhosis
will not be considered in determining inclusion in the study

- Participant is able and willing to comply with study procedures, and signed and dated
informed consent is obtained

- Participant agrees to consume no more than 2 cups of green tea per day and refrain
from taking supplements or foods labeled as containing green tea

- Eastern Cooperative Oncology Group (ECOG) performance status =< 1 (Karnofsky >= 70%)

- Platelets >= 75,000 / uL

- Hemoglobin >= 8 g/dL

- Serum creatinine OR measured or calculated creatinine clearance within normal
institutional limits; glomerular filtration rate (GFR) can also be used in place of
creatinine or creatinine clearance (CrCl) within normal institutional limits as
adjusted for age and sex

- Serum direct bilirubin within normal institutional limits

- AST (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase
(ALT) (serum glutamic pyruvic transaminase [SGPT]) =< 2.5 X upper normal level (UNL)

- Albumin >= 3.0 mg/dL

- International normalized ratio (INR) =< 1.3

- Ascites absent

- Encephalopathy absent

- Only participants found to express high levels (immunohistochemistry [IHC] score 3 and
above) of gamma-OHPdG (gamma-OHPdG-high HCC) in baseline or archival liver biopsy will
be registered to receive Polyphenon E treatment

- Participant is able to undergo radiographic evaluation with ultrasound, CT, or MRI

- The effects of Polyphenon E on the developing human fetus at the recommended
therapeutic dose are unknown; for this reason,women of child-bearing potential and men
must agree to use adequate contraception (hormonal or barrier method of birth control;
abstinence); contraception must be used prior to study entry and for the duration of
study participation; should a woman become pregnant or suspect she is pregnant while
participating in this study, she should inform her study physician immediately; female
participants of childbearing potential should have a negative urine or serum pregnancy
test within 72 hours prior to receiving the first dose of study medication (if a urine
test is positive or cannot be confirmed as negative, a serum pregnancy test will be
required)

Exclusion Criteria:

- Participant has confirmed HCC by ultrasound/CT/MRI; participants who have previously
had HCC but have been treated and have been recurrence free for 5 years are eligible

- Participant has or has had other cancer(s) within 3 years of study; however, in situ
breast, in situ cervical, and basal cell/squamous cell skin cancers are allowed;
participant with active, other cancer that requires systemic therapy will be excluded
from this study; participant with early stage cancer that requires local therapy, such
as cervical ablation for early stage cervical cancer, are allowed to be registered in
the study and are allowed to receive local therapy

- Inability to swallow capsules

- Participant has a known diagnosis of mental incapacitation that may affect their
ability to consent and be compliant with the protocol

- Participant has ever experienced one or more hepatic decompensation events or a
history of decompensated liver disease as listed below:

- Clinical ascites

- Variceal bleeding documented by endoscopy

- Spontaneous bacterial peritonitis documented by positive culture

- Hepatic encephalopathy

- Hepatorenal syndrome (type 1 or 2)

- Porto-pulmonary hypertension

- Hepato-pulmonary hypertension

- Any liver-related event which led to a hospitalization or a grade 4 event

- Participant has an underlying predisposition to gastrointestinal (GI) or rectal
bleeding are considered ineligible for study participation

- History of allergic reactions attributed to compounds of similar chemical composition
to Polyphenon E (or green tea); note that participants who are unable to tolerate
intravenous contrast for CT scans should have MRIs or ultrasounds during the study
instead of CT scans

- Participant is receiving any other investigational agents

- Participants have taken supplements or foods that are labelled as containing green tea
for 8 weeks before start of treatment

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements; hepatitis b virus (HBV) and hepatitis C virus (HCV) infections are
allowed

- Green tea has been consumed by humans for thousands of years and teratogenic or
abortifacient effects have not been reported; however, subjects in this study will
take high doses of Polyphenon E; the teratogenic or abortifacient effects of high dose
Polyphenon E is unknown; therefore pregnant women are excluded from this study;
because there is an unknown but potential risk for adverse events (AEs) in nursing
infants secondary to treatment of the mother with Polyphenon E, breastfeeding should
be discontinued if the mother is treated with this study agent