Trial Outcomes & Findings for Melatonin Effect in Combination With Neoadjuvant Chemotherapy to Clinical Response in Locally Advanced Oral Squamous Cell Carcinoma (NCT NCT04137627)

NCT ID: NCT04137627

Last Updated: 2019-12-09

Results Overview

Clinical Response is measured using RECIST 1.1. criteria. CR (Complete response) is defined as disappearance of all target lesion, and pathological lymph node showing reduction of its shortest axis to less than 10 mm. PR (Partial response) is defined as reduction of total target lesion diameter at least by 30%. PD (Progressive disease) is defined as total target lesion diameter increased in size atleast by 20% or 5 mm OR occurence of one new lesion. SD (Stable disease) is defined as absence of reduction or increasing of target lesion. Patients with PR and CR are considered as positive response. Patients with SD and PD are considered as negative response.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

50 participants

Primary outcome timeframe

1 Year

Results posted on

2019-12-09

Participant Flow

Participant milestones

Participant milestones
Measure
Melatonin
The group received standard treatment with the oral administration of Melatonin Melatonin 20 MG Oral Capsule: The administration of Melatonin 20 mg in addition to neoadjuvant chemotherapy to observe the antioxidant and onco-static effect.
Placebo
The group received standard treatment with the oral administration of Placebo Placebo oral capsule: The administration of placebo capsule in addition to neoadjuvant chemotherapy
Overall Study
STARTED
25
25
Overall Study
COMPLETED
13
12
Overall Study
NOT COMPLETED
12
13

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Melatonin Group
n=13 Participants
Participants who received Melatonin (treatment arm) who finished study protocol
Placebo Group
n=12 Participants
Participants who received Placebo (control arm) who finished study protocol
Total
n=25 Participants
Total of all reporting groups
Age, Customized
Less than or equal to 50 years
5 Participants
n=13 Participants
7 Participants
n=12 Participants
12 Participants
n=25 Participants
Age, Customized
Greater than 50 years
8 Participants
n=13 Participants
5 Participants
n=12 Participants
13 Participants
n=25 Participants
Sex: Female, Male
Female
5 Participants
n=13 Participants
5 Participants
n=12 Participants
10 Participants
n=25 Participants
Sex: Female, Male
Male
8 Participants
n=13 Participants
7 Participants
n=12 Participants
15 Participants
n=25 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
Indonesia
13 Participants
n=13 Participants
12 Participants
n=12 Participants
25 Participants
n=25 Participants
Tumor Location
Tongue
10 Participants
n=13 Participants
9 Participants
n=12 Participants
19 Participants
n=25 Participants
Tumor Location
Buccal
1 Participants
n=13 Participants
1 Participants
n=12 Participants
2 Participants
n=25 Participants
Tumor Location
Palate
0 Participants
n=13 Participants
1 Participants
n=12 Participants
1 Participants
n=25 Participants
Tumor Location
Mandible
1 Participants
n=13 Participants
1 Participants
n=12 Participants
2 Participants
n=25 Participants
Tumor Location
Gingiva (Gum)
1 Participants
n=13 Participants
0 Participants
n=12 Participants
1 Participants
n=25 Participants
Stage
Stage IV A
12 Participants
n=13 Participants
10 Participants
n=12 Participants
22 Participants
n=25 Participants
Stage
Stage IV B
1 Participants
n=13 Participants
2 Participants
n=12 Participants
3 Participants
n=25 Participants
Keratinized/non-keratinized
Keratinized
12 Participants
n=13 Participants
6 Participants
n=12 Participants
18 Participants
n=25 Participants
Keratinized/non-keratinized
Non-keratinized
1 Participants
n=13 Participants
6 Participants
n=12 Participants
7 Participants
n=25 Participants
Differentiation
Well Differentiated
5 Participants
n=13 Participants
4 Participants
n=12 Participants
9 Participants
n=25 Participants
Differentiation
Moderately Differentiated
5 Participants
n=13 Participants
3 Participants
n=12 Participants
8 Participants
n=25 Participants
Differentiation
Poorly Differentiated
3 Participants
n=13 Participants
5 Participants
n=12 Participants
8 Participants
n=25 Participants
Grade
High Grade
6 Participants
n=13 Participants
11 Participants
n=12 Participants
17 Participants
n=25 Participants
Grade
Low Grade
7 Participants
n=13 Participants
1 Participants
n=12 Participants
8 Participants
n=25 Participants
Medication adherence
Strict adherence
10 Participants
n=13 Participants
9 Participants
n=12 Participants
19 Participants
n=25 Participants
Medication adherence
Poor adherence
3 Participants
n=13 Participants
3 Participants
n=12 Participants
6 Participants
n=25 Participants

PRIMARY outcome

Timeframe: 1 Year

Clinical Response is measured using RECIST 1.1. criteria. CR (Complete response) is defined as disappearance of all target lesion, and pathological lymph node showing reduction of its shortest axis to less than 10 mm. PR (Partial response) is defined as reduction of total target lesion diameter at least by 30%. PD (Progressive disease) is defined as total target lesion diameter increased in size atleast by 20% or 5 mm OR occurence of one new lesion. SD (Stable disease) is defined as absence of reduction or increasing of target lesion. Patients with PR and CR are considered as positive response. Patients with SD and PD are considered as negative response.

Outcome measures

Outcome measures
Measure
Melatonin
n=13 Participants
The group received standard treatment with the oral administration of Melatonin Melatonin 20 MG Oral Capsule: The administration of Melatonin 20 mg in addition to neoadjuvant chemotherapy to observe the antioxidant and onco-static effect.
Placebo
n=12 Participants
The group received standard treatment with the oral administration of Placebo Placebo oral capsule: The administration of placebo capsule in addition to neoadjuvant chemotherapy
Clinical Response as Measured by RECIST 1.1. Criteria
Positive Response
5 Participants
5 Participants
Clinical Response as Measured by RECIST 1.1. Criteria
Negative Response
8 Participants
7 Participants

SECONDARY outcome

Timeframe: 1 Year

Expression of HIF-1⍺ is measured at the initial period of the study (baseline) and after 3 neoadjuvant chemotherapy cycles are completed using qRT-PCR Absolute Quantification. Change was calculated from two time points as the value at the later time point minus the value at the earlier time point.

Outcome measures

Outcome measures
Measure
Melatonin
n=13 Participants
The group received standard treatment with the oral administration of Melatonin Melatonin 20 MG Oral Capsule: The administration of Melatonin 20 mg in addition to neoadjuvant chemotherapy to observe the antioxidant and onco-static effect.
Placebo
n=12 Participants
The group received standard treatment with the oral administration of Placebo Placebo oral capsule: The administration of placebo capsule in addition to neoadjuvant chemotherapy
Change in Expression of HIF-1⍺ as Measured by qRT-PCR Absolute Quantification
Pre-Treatment
0.018 Picogram/microliter
Interval 0.003 to 0.142
0.0048 Picogram/microliter
Interval 0.0005 to 0.254
Change in Expression of HIF-1⍺ as Measured by qRT-PCR Absolute Quantification
Post-Treatment
0.012 Picogram/microliter
Interval 0.0014 to 0.139
0.0087 Picogram/microliter
Interval 0.0004 to 0.06
Change in Expression of HIF-1⍺ as Measured by qRT-PCR Absolute Quantification
Change (Posttreatment - Pretreatment)
-0.008 Picogram/microliter
Interval -0.131 to 0.085
0.0027 Picogram/microliter
Interval -0.238 to 0.053

SECONDARY outcome

Timeframe: 1 Year

Expression of miR-210 is measured at the initial period of the study (baseline) and after 3 neoadjuvant chemotherapy cycles are completed using qRT-PCR Absolute Quantification. Change was calculated from two time points as the value at the later time point minus the value at the earlier time point.

Outcome measures

Outcome measures
Measure
Melatonin
n=13 Participants
The group received standard treatment with the oral administration of Melatonin Melatonin 20 MG Oral Capsule: The administration of Melatonin 20 mg in addition to neoadjuvant chemotherapy to observe the antioxidant and onco-static effect.
Placebo
n=12 Participants
The group received standard treatment with the oral administration of Placebo Placebo oral capsule: The administration of placebo capsule in addition to neoadjuvant chemotherapy
Change in Expression of miR-210 as Measured by qRT-PCR Absolute Quantification
Pre-Treatment
162.8 Picogram/microliter
Standard Deviation 54.92
175.2 Picogram/microliter
Standard Deviation 34.3
Change in Expression of miR-210 as Measured by qRT-PCR Absolute Quantification
Post-Treatment
53.8 Picogram/microliter
Standard Deviation 16.65
53.5 Picogram/microliter
Standard Deviation 14.28
Change in Expression of miR-210 as Measured by qRT-PCR Absolute Quantification
Change (Posttreatment - Pretreatment)
-109.09 Picogram/microliter
Standard Deviation 51.62
-103.71 Picogram/microliter
Standard Deviation 36.24

SECONDARY outcome

Timeframe: 1 Year

Expression of CD44 is measured at the initial period of the study (baseline) and after 3 neoadjuvant chemotherapy cycles are completed using qRT-PCR Absolute Quantification. Change was calculated from two time points as the value at the later time point minus the value at the earlier time point.

Outcome measures

Outcome measures
Measure
Melatonin
n=13 Participants
The group received standard treatment with the oral administration of Melatonin Melatonin 20 MG Oral Capsule: The administration of Melatonin 20 mg in addition to neoadjuvant chemotherapy to observe the antioxidant and onco-static effect.
Placebo
n=12 Participants
The group received standard treatment with the oral administration of Placebo Placebo oral capsule: The administration of placebo capsule in addition to neoadjuvant chemotherapy
Change in Expression of CD44 as Measured by qRT-PCR Absolute Quantification
Pre-Treatment
0.0349 Picogram/microliter
Interval 0.0048 to 0.144
0.0095 Picogram/microliter
Interval 0.0002 to 0.117
Change in Expression of CD44 as Measured by qRT-PCR Absolute Quantification
Post-Treatment
0.0115 Picogram/microliter
Interval 0.0003 to 0.204
0.0187 Picogram/microliter
Interval 0.0012 to 0.278
Change in Expression of CD44 as Measured by qRT-PCR Absolute Quantification
Change (Posttreatment - Pretreatment)
-0.0114 Picogram/microliter
Interval -0.0994 to 0.1736
0.0082 Picogram/microliter
Interval -0.1109 to 0.2773

SECONDARY outcome

Timeframe: 1 Year

Expression of CD133 is measured at the initial period of the study (baseline) and after 3 neoadjuvant chemotherapy cycles are completed using qRT-PCR Absolute Quantification. Change was calculated from two time points as the value at the later time point minus the value at the earlier time point.

Outcome measures

Outcome measures
Measure
Melatonin
n=13 Participants
The group received standard treatment with the oral administration of Melatonin Melatonin 20 MG Oral Capsule: The administration of Melatonin 20 mg in addition to neoadjuvant chemotherapy to observe the antioxidant and onco-static effect.
Placebo
n=12 Participants
The group received standard treatment with the oral administration of Placebo Placebo oral capsule: The administration of placebo capsule in addition to neoadjuvant chemotherapy
Change in Expression of CD133 as Measured by qRT-PCR Absolute Quantification
Pre-Treatment
1.13 Picogram/microliter
Interval 0.14 to 4.73
1.07 Picogram/microliter
Interval 0.04 to 5.64
Change in Expression of CD133 as Measured by qRT-PCR Absolute Quantification
Post-Treatment
1.42 Picogram/microliter
Interval 0.11 to 2.85
1.88 Picogram/microliter
Interval 0.22 to 20.9
Change in Expression of CD133 as Measured by qRT-PCR Absolute Quantification
Change (Posttreatment - Pretreatment)
0.43 Picogram/microliter
Interval -3.5 to 1.37
0.55 Picogram/microliter
Interval -2.33 to 18.2

Adverse Events

Melatonin

Serious events: 0 serious events
Other events: 13 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Melatonin
n=13 participants at risk
The group received standard treatment with the oral administration of Melatonin Melatonin 20 MG Oral Capsule: The administration of Melatonin 20 mg in addition to neoadjuvant chemotherapy to observe the antioxidant and onco-static effect.
Placebo
n=12 participants at risk
The group received standard treatment with the oral administration of Placebo Placebo oral capsule: The administration of placebo capsule in addition to neoadjuvant chemotherapy
Nervous system disorders
Sleep Pattern Disturbance
15.4%
2/13 • 56 Weeks
16.7%
2/12 • 56 Weeks
General disorders
Fatigue
15.4%
2/13 • 56 Weeks
25.0%
3/12 • 56 Weeks
Nervous system disorders
Headache
23.1%
3/13 • 56 Weeks
8.3%
1/12 • 56 Weeks
Nervous system disorders
Decreased Alertness
15.4%
2/13 • 56 Weeks
0.00%
0/12 • 56 Weeks
Nervous system disorders
Sleepiness
30.8%
4/13 • 56 Weeks
25.0%
3/12 • 56 Weeks
Psychiatric disorders
Emotional Changes
15.4%
2/13 • 56 Weeks
25.0%
3/12 • 56 Weeks
Nervous system disorders
Hallucination
7.7%
1/13 • 56 Weeks
0.00%
0/12 • 56 Weeks

Additional Information

Dr. dr. Diani Kartini, Sp.B-K(Onk)

Universitas Indonesia

Phone: +628122684919

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place