Role of N-Acetylcysteine for Prevention of Cisplatin-induced Nephrotoxicity

NCT06019520 | Unknown

• 1 other identifier: FUI/CTR/2023/14
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

Cisplatin is one of the first-line drugs used against many malignancies, such as lung cancer, head and neck cancer, esophageal cancer, gastric cancer, colorectal cancer, urothelial cancer, bladder cancer and testicular cancer. The usage of Cisplatin is limited by its severe nephrotoxicity, which particularly affects the proximal tubule epithelial cells (PTEC).Several studies suggest role of NAC in ameliorating Cisplatin induced nephrotoxicity, although definitive data is lacking. N-Acetylcysteine (NAC) is a thiol-containing antioxidant, which not only acts as a precursor of glutathione but also as a direct antioxidant .There are multiple postulated mechanisms for NAC's nephroprotection. NAC is a low-cost, easily available drug with a very good safety profile and therefore can be added as a support medication during treatment with cisplatin. The investigators plan to administer 1200 mg oral NAC 12 hours before chemotherapy and then daily at night for the subsequent 6 days, with an objective to ascertain its nephroprotective role in population receiving Cisplatin/-based chemotherapy.

Conditions

Drug Toxicity

Outcome Measures

Primary Outcomes (4)

• Serum creatinine of participant

  Blood samples collected and measured in laboratory with the unit mg/dL

  18 weeks

• Creatinine clearance of participant

  It will be calculated using Cockroft-Gault formula , unit ml/min

  18 weeks

• Estimation of Acute kidney injury to participant

  Acute kidney injury will be assessed by RIFLE criteria that will be calculated for patients

  18 weeks

• Blood urea nitrogen of participant

  Blood samples collected and measured in laboratory with the unit mg/dl

  18 weeks

Study Arms (2)

Cisplatin group

ACTIVE COMPARATOR

This group of Patients will receive Cisplatin-base chemotherapy as per the designated schedule, alongside standard hydration protocol

Drug: Chemotherapy

N-acetylcysteine group

EXPERIMENTAL

Patients in the NAC arm to be given N-acetylcysteine 1200 mg/day starting 12 hrs before till 6 days after Cisplatin-based chemotherapy administration. Hydration according to standard hydration protocol will be given.

Drug: N-Acetylcysteine; Drug: Chemotherapy

Interventions

N-Acetylcysteine DRUG

Patients in the NAC arm will receive1200 mg of NAC (water-soluble granule Preparation) administered orally once daily at night for 7 consecutive days (1 days before chemotherapy, on the day of chemotherapy, and 5 days after chemotherapy) in each cycle of chemotherapy.

N-acetylcysteine group

Chemotherapy DRUG

Cisplatin-base chemotherapy as per the designated schedule, alongside standard hydration protocol.

Cisplatin group; N-acetylcysteine group

Eligibility Criteria

• Age: 18 Years - 70 Years
• Gender Eligibility Details: The study includes adult female outpatients with non-hematological malignancies
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult female outpatients with non-hematological malignancies (Breast, ovary and head and neck squamous cell carcinomas)
• Having Eastern Cooperative Oncology Group(ECOG) Performance Status ≤2 who had never received platinum based Chemotherapy in past and were now scheduled to receive high-dose cisplatin chemotherapy.
• Patients were required to have estimated glomerular filtration rate (GFR)(according to Cockcroft-Gault formula) ≥ 60 ml/min at start of chemotherapy regimen with normal Blood Counts, Liver, and kidney function tests

You may not qualify if:

• Patients who had poor performance status i.e., ECOG Performance Status 3 or 4
• Who declined to participate at any time during the course of the study
• Patients having hepatic failure (Liver Function tests \>3 times of upper limit normal)
• Patients who did not tolerate the use of NAC or were administered the drug \<70% of the time
• Patient who were receiving concurrent nephrotoxic drugs, or having history of Hypersensitivity to N-Acetyl cysteine.

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Medical Oncology department, Fauji Foundation Hospital

Rawalpindi, Punjab Province, 46000, Pakistan

Location

MeSH Terms

Conditions

Drug-Related Side Effects and Adverse Reactions

Interventions

Acetylcysteine; Drug Therapy

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders

Intervention Hierarchy (Ancestors)

Cysteine; Amino Acids, Sulfur; Sulfur Compounds; Organic Chemicals; Amino Acids; Amino Acids, Peptides, and Proteins; Therapeutics

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: It will be a two-arm study with 35 patients in each arm. After taking informed consent, a total of 70 patients will be enrolled. The patients will be enrolled by convenience nonprobability sampling technique. Then they will be randomized to the N-Acetylcysteine plus chemotherapy and chemotherapy-alone arms.

Study Record Dates

• First Submitted: August 18, 2023
• First Posted: August 31, 2023
• Study Start: August 9, 2023
• Primary Completion: February 9, 2024
• Study Completion: March 9, 2024
• Last Updated: August 31, 2023

Record last verified: 2023-08

Locations

PA (1)