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Colo-rectal CancerNCT06576986

Effect of Synbiotic Supplementation on the Prevention of Mucositis in Cancer Patients Undergoing Chemotherapy

A study testing Symbiotic and Maltodextrin in people with Colo-rectal Cancer, run by Federal University of Minas Gerais at 1 site in Brazil.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Introduction: In the 2023-2025 period, colorectal cancer (CRC) will be the third most common type of cancer in Brazil. The most commonly used therapeutic approaches are chemotherapy (QTx) and radiotherapy (RTx). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Colo-rectal Cancer
What is being tested?
Symbiotic and Maltodextrin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
1 siteBrazil
Study dates
12 Dec 2023to 12 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Colorectal tumor in the first oncological treatment
  • Age over 18 years old
  • Both sexes
  • Eligible for protocol with capecitabine alone or associated with oxaliplatin
  • Patients WITHOUT colostomy or WITH colostomy in the transverse/descending/sigmoid region
  • Patient undergoing Radiotherapy treatment associated with Chemotherapy
  • Patients residing in Belo Horizonte and the metropolitan region
  • Patients who Accept and sign the Informed Consent Form (TCLE)

Who cannot join

  • Diagnosis of gastrointestinal carcinoid and stromal tumor (GIST)
  • Patients with Ileostomy
  • Patients with colostomy in the ascending region of the colon
  • Inflammatory bowel diseases: Crohn's and Colitis
  • Use of antibiotics and antifungals in the last 15 days
  • Use of prebiotic/probiotic and/or synbiotic in the last 15 days
Show all 10Show fewer
  • Use of antidiarrheal medication in the last 15 days
  • Presence of fever and mucus discharge
  • Pregnant or breastfeeding women
  • Patients who refuse to participate in the study.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Simone de Vasconcelos Generoso contact

988128650 ext. +55(031)

simonenutufmg@gmail.com

Brazil1 site, 1 recruiting
  • Escola de Enfermagem - UFMG

    Belo Horizonte, Minas Gerais, 30130-100

    Simone V Generoso, 988128650 ext. +55(31), simonenutufmg@gmail.com

    Recruiting

Other trials in Brazil

About this study

Official title: Effect of Synbiotic Supplementation on the Prevention of Mucositis in Cancer Patients Undergoing Chemotherapy: Randomized, Double-masked, Parallel, Single-center Clinical Trial

Introduction: In the 2023-2025 period, colorectal cancer (CRC) will be the third most common type of cancer in Brazil. The most commonly used therapeutic approaches are chemotherapy (QTx) and radiotherapy (RTx). QTx agents, such as capecitabine, affect both malignant cells and normal cells such as gastrointestinal, capillary and immune cells. Cellular damage in the gastrointestinal tract (GIT) results in various symptoms, such as mucositis and diarrhea. Diarrhea is linked to mucosal damage and can result in dehydration, malnutrition and hospitalization, leading to cardiovascular complications and death. Mucositis is inflammation that affects the GIT. This condition makes treatment difficult, leading to reductions, delays or interruption of QTx. These scenarios harm the patient's prognosis and quality of life, resulting in high costs for symptom control, nutritional assistance, management of secondary infections and hospitalization. The Mucositis Study Group (MASCC/ISOO) guidelines recommend the use of probiotics as a preventive measure against diarrhea in cancer patients undergoing QTx and/or RTx. However, the safety of using probiotics in immunosuppressed patients is still controversial and hypotheses are based on epidemiological and experimental studies. This makes it necessary to evaluate whether supplementation with pro- or synbiotics before chemotherapy would have the same beneficial results. Objective: To evaluate the effect of synbiotic supplementation on the prevention, incidence and severity of mucositis in cancer patients undergoing QTx. Method: This is a single-center parallel double-masked randomized clinical trial to be carried out at the Borges da Costa/UFMG Outpatient Clinic at Hospital das Clínicas in Belo Horizonte - Minas Gerais (HC-BH/MG). The inclusion criteria are patients diagnosed with CRC eligible for first-line treatment with Capecitabine, aged ≥ 18 years, both sexes, signed the informed consent form. The study was approved by CEP-UFMG. Expected results: It is expected that supplementation with synbiotics in the pre-QTx period will promote modulation of the microbiota and strengthening of the intestinal barrier, resulting in a lower incidence and severity of mucositis and diarrhea, improving the quality of life of these patients.

Read the detailed description

Introduction: In the triennium 2023-2025, colorectal cancer (CRC) will be the third most common type of cancer in Brazil. The most used therapeutic approaches are chemotherapy (QTx) and radiotherapy (RTx). Chemotherapeutic agents, such as capecitabine, affect both malignant cells and normal cells such as gastrointestinal, capillary, and immune cells. Cellular damage in the gastrointestinal tract (GIT) results in various symptoms, such as mucositis and diarrhea. Diarrhea is linked to mucosal injury and can lead to dehydration, malnutrition, hospitalization, cardiovascular complications, and death. Mucositis, on the other hand, is inflammation that affects the GIT. This condition hinders treatment, leading to reductions, delays, or interruption of QTx. These scenarios impair the prognosis and quality of life of the patient, resulting in high costs for symptom control, nutritional support, management of secondary infections, and hospitalization. The Mucositis Study Group guidelines (MASCC/ISOO) recommend the use of probiotics as a preventive measure against diarrhea in cancer patients undergoing QTx and/or RTx. However, the safety of probiotic use in immunosuppressed patients is still controversial, and hypotheses are based on epidemiological and experimental studies. Therefore, it is necessary to evaluate whether supplementation with probiotics or symbiotics before chemotherapy would have the same beneficial results. Objective: The general objective of this study is to evaluate if symbiotic supplementation can reduce the incidence and severity of oral mucositis in cancer patients undergoing chemotherapy. Specific objectives include assessing the tolerability of supplementation, analyzing clinical and laboratory parameters related to mucositis, and investigating the impact of the intervention on the quality of life of patients. Methodology: This is a randomized, double-blind, parallel, single-center clinical trial to be conducted at the Borges da Costa Outpatient Clinic located at the Hospital das Clínicas of the Federal University of Minas Gerais in Belo Horizonte (HC-UFMG). Inclusion criteria involve adult patients, aged ≥ 18 years, of both sexes, diagnosed with colorectal cancer and candidates for first-line chemotherapy treatment with Capecitabine alone or in combination with Oxaliplatin, treated at HC/UFMG under the signature of the Informed Consent Form (ICF) and able to follow the research guidelines. The study was approved by the Research Ethics Committee of UFMG (CEP-UFMG) under protocol number CAAE 30177920.2.0000.5149. The study involves 80 participants distributed according to the chemotherapy protocol. Patients will be randomly divided into two groups designated as A and B: one control group receiving Maltodextrin, and the other intervention group receiving Symbiotic. The supplementation will be administered for 10 days, twice a day, before the start of chemotherapy treatment. Biological samples, such as feces and blood, will be collected for analysis of intestinal microbiota, short-chain fatty acid (SCFA) levels, presence of infection, intestinal permeability, and inflammatory markers. Biological collections will be performed at different time points throughout the study, including before supplementation (D0-D1), on the 10th day of supplementation (D10 pre-QTx), and on days 14 and 21 of the first chemotherapy cycle (D14-QTx and D21-QTx). Data will be collected through nutritional, anthropometric, and dietary assessments, including the Subjective Global Assessment (SGA), Anthropometric Assessment, Dietary Assessment (24h Recall and Food Frequency Questionnaire), as well as assessment of intestinal function and digestive complaints. Patients will be monitored daily, along with follow-up during treatment and data recording in the electronic medical record. Statistical analysis of the data will include sample size calculation, appropriate statistical tests, and an exploratory approach to evaluate clinical outcomes and study results. Expected Results It is expected that the results of this study will provide evidence on the efficacy of symbiotic supplementation in preventing oral mucositis in CRC patients undergoing chemotherapy. If the intervention proves to be effective, it could contribute to the development of more effective nutritional strategies in managing the side effects of oncological treatment, improving the quality of life and well-being of patients.

Being tested
Symbiotic, Maltodextrin
Keywords
colorectal cancer, symbiotic, Mucositis, diarrhea, chemotherapy
Medical subject headings
Colonic Neoplasms, Colorectal Neoplasms, Mucositis, Diarrhea

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SymbioticDietary supplement

    Also called Simbioflora

    The synbiotic used will be Simbioflora® (commercial preparation containing 5.5g of FOS added with four species of probiotic, Lactobacillus paracasei LPC-31; Lactobacillus rhamnosus HN001; Lactobacillus acidophilus NCFM; Bifidobacterium lactis HN019, at a concentration of 109 UFC per strain) supplied by Farmoquímica S.A. Supplementation will be administered orally, twice a day, before lunch and dinner, for ten days before chemotherapy treatment. Patients will be guided by researchers on dilution (100 mL of filtered water) and the correct purchase of the modules. Consumption control will be carried out daily, via telephone contact.

  • MaltodextrinDietary supplement

    Maltodextrin, used as control, will be purchased from the company PRODIET® under the trade name Carboch®. Supplementation will be administered orally, twice a day, before lunch and dinner, for ten days before chemotherapy treatment. Patients will be guided by researchers on dilution (100 mL of filtered water) and the correct purchase of the modules. Consumption control will be carried out daily, via telephone contact.

Study groups in NCT06576986
Study groupRoleWhat they receive
Capecitabine alone controlPlacebo comparatorn the Control Group, patients received Maltodextrin as supplementation
Receives: Dietary Supplement: Maltodextrin
Capecitabine alone synbioticExperimentalIn the Intervention Group, patients received the symbiotic Simbioflora as supplementation.
Receives: Dietary Supplement: Symbiotic
Capecitabine associated with control OxaliplatinPlacebo comparatorn the Control Group, patients received Maltodextrin as supplementation
Receives: Dietary Supplement: Maltodextrin
Capecitabine associated with synbiotic OxaliplatinExperimentalIn the Intervention Group, patients received the symbiotic Simbioflora as supplementation.
Receives: Dietary Supplement: Symbiotic

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Intestinal Microbiota

    Fecal calprotectin measured by ELISA.

    Measured: six months after collecting data from all research participants

  2. Intestinal Microbiota

    production of short-chain fatty acids.

    Measured: six months after collecting data from all research participants

  3. Intestinal Microbiota

    analysis of intestinal microbiota composition by sequencing the 16S rRNA gene.

    Measured: six months after collecting data from all research participants

  4. Clinical Nutritional Diagnostic

    Body mass index BMI in kg/m²

    Measured: six months after collecting data from all research participants

  5. Nutritional Diagnostic

    body weight in kg

    Measured: six months after collecting data from all research participants

  6. Nutritional Diagnostic

    height in m

    Measured: six months after collecting data from all research participants

  7. Nutritional Diagnostic

    circumferences in cm

    Measured: six months after collecting data from all research participants

  8. Nutritional Diagnostic

    body composition via triceps skin fold thickness in mm

    Measured: six months after collecting data from all research participants

  9. Nutritional Diagnostic

    hand grip resistance assessed by dynamometry in kg

    Measured: six months after collecting data from all research participants

  10. Nutritional Diagnostic

    Food Frequency Questionnaire

    Measured: six months after collecting data from all research participants

  11. Nutritional Diagnostic

    24-hour recall

    Measured: six months after collecting data from all research participants

  12. Effect of the synbiotic in pain

    Visual Analogue Score for Pain using the Visual Analogue Scale

    Measured: six months after collecting data from all research participants

  13. inflammatory marker

    Blood samples for Tumor Necrosis Factor TNF in pg/mL

    Measured: six months after collecting data from all research participants

  14. inflammatory marker

    Fatty Acid Binding Protein FABP2 in ng/mL

    Measured: six months after collecting data from all research participants

  15. inflammatory marker

    Lipopolysaccharide Binding Protein LBP in µg/mL

    Measured: six months after collecting data from all research participants

  16. inflammatory marker

    Lipopolysaccharide LPS in µg/mL

    Measured: six months after collecting data from all research participants

  17. inflammatory marker

    leukogram White Blood Cell Count in cells/µL

    Measured: six months after collecting data from all research participants

  18. Questionnaire to assess quality of life

    EORTC QLQ-C30 for all cancer patients

    Measured: six months after collecting data from all research participants

  19. Questionnaire to assess quality of life

    EORTC QLQ-CR29 for colorectal cancer patients

    Measured: six months after collecting data from all research participants

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Aug 2024
  2. Study start12 Dec 2023
  3. Primary completion12 Dec 2025 (estimated)
  4. Study completion12 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06576986
Sponsor's protocol ID
30177920200005149
Status last verified
Aug 2024
First submitted
11 May 2024
Last updated
29 Aug 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Symbiotic and Maltodextrin in people with Colo-rectal Cancer, run by Federal University of Minas Gerais at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 29 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Simone de Vasconcelos Generoso (988128650 ext. +55(031), simonenutufmg@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Intestinal Microbiota (time frame: six months after collecting data from all research participants). The study lists 19 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Aug 2024.

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