A Study of Chlorophyllin for the Management of Brain Radio-necrosis in Patients With Diffuse Glioma

Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexAll
Age18-70
SponsorTata Memorial Centre

About this trial

Diffuse gliomas are common tumors involving the brain. They are usually treated by surgery followed by radiation and chemotherapy. Radiotherapy is used for the treatment of brain tumors which causes damage to the tumor cells. However, radiotherapy can also affect the surrounding healthy cells in the brain, causing inflammation and swelling in the region, which is known as radio necrosis (RN). This is considered a late side effect of radiation and is seen in 10-25% of patients treated with radiation for brain tumors. Sometimes, radionecrosis can be detected on routine imaging during follow-up without new symptoms (asymptomaticRN).

At the same time, in some patients, it can give rise to new symptoms like headaches, weakness, seizures,etc (symptomatic RN). The standard treatment of RN includes steroid medicines called dexamethasone, which is helpful in a proportion of patients.

This is a prospective phase 2 study. This study is being conducted to investigate the ability of the drug Chlorophyllin in the treatment of radionecrosis.

Chlorophyllin is a water-soluble compound obtained from the green plant pigment called chlorophyll. It has been shown to have anti-cancer, anti-bacterial, anti-viral, anti-inflammatory, and antioxidant properties. It is also used as an oral formulation and is an over-the-counter drug in various countries, and also as a food colouring agent.

This is the first time chlorophyllin will be used in the setting of brain radionecrosis. Our primary aim of the study is to assess whether CHL will improve the clinical-radiological response rates. This study will be conducted on a population of 118 patients for a duration of 3 months. The total study duration is 2 years.

The study is funded by Bhabha Atomic Research Centre (BARC).

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Histological diagnosis of diffuse glioma.

Radionecrosis on imaging with new neurological symptoms/ worsening of prior deficits (Stratum A) or

without new symptoms (Stratum B).

Karnofsky Performance Scale (KPS) ≥ 50.

Disqualifiers

No tissue diagnosis.

KPS< 50.

Disease progression

Contraindications to corticosteroids.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Chlorophyllin

    Drug

    Chlorophyllin is a water-soluble compound obtained from the green plant pigment called chlorophyll. It has been shown to have anti-cancer, anti-bacterial, anti-viral, anti-inflammatory, and antioxidant properties. It is also used as an oral formulation and is an over-the-counter drug in various countries, and also as a food coloring agent.

Treatment groups

118 Participants
are divided into 2 treatment groups
Group A: Stratum A (Symptomatic)Experimental treatment 1 intervention
Group B: Stratum B (Asymptomatic)Experimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Response rates

Clinical-radiological

Time frame
1 month post treatment with chlorophyllin

Secondary outcomes

1

Survival Analysis

Progression-Free Survival and Overall Survival using Kaplan-Meier survival plot.

Time frame
3 months
2

Health Questionnaire

EORTC QOL C -30 and (Brain module) BN-20 questionnaire. The global score and scores of subdomains will be calculated and compared with baseline.

Time frame
3 months
3

Response rates

Radiological response rates at 3 months using Response Assessment in Neuro-Oncology (RANO) criteria.

Time frame
3 months

Other outcomes

1

Biological response rate

Using functional imaging (PET \& MRI) to describe the difference of SUV maximum (Maximum Standardized Uptake Value)or T/W ratio for PET scan and perfusion values e.g., rCBV ( relative Cerebral Blood Volume) for MRI.

Time frame
3 months

Sponsors and contacts

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Tata Memorial Centre

Lead sponsor

Bhabha Atomic Research Centre

Collaborator