Evaluating a Fasting-mimicking Diet in Combination With Immunotherapy in Patients With Non-small Cell Lung Cancer

NCT ID: NCT06671613

Last Updated: 2025-11-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

66 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-27

Study Completion Date

2030-12-31

Brief Summary

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The purpose of this study is to learn the effects of fasting on cancer cells while you get maintenance treatment.

Detailed Description

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Cancer cells use an increased supply of glucose to make energy and do not have protection against fasting that normal cells do. Because of this, researchers would like to study how fasting may help immunotherapy target cancer cells. Initial studies suggest that fasting may decrease the side effects of immunotherapy and increase the chances of your cancer responding to the immunotherapy. Patient populations will have non-small cell lung cancer in which pembrolizumab have been recommended to treat the cancer as part of standard care

Conditions

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Stage IV NSCLC NSCLC Immunotherapy Fasting Mimicking Diet

Keywords

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PD1 inhibitors Phase 2 Open Label NSCLC Fasting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Multi-center, open label, phase 2, randomized (partial crossover design) study evaluating the feasibility of FMD in stage IV NSCLC patients receiving single agent checkpoint inhibitors. Participants will be randomized 1:1 in blocks of 3. There is no blinding or stratification. Patients with high PDL1 NSCLC will be randomized to two arms: (Arm 1) 3 cycles of RD+PD1 inhibitors followed by 3 cycles of FMD+PD1 inhibitors or (Arm 2) 3 cycles of FMD+PD1 inhibitors.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Regular Diet

Patients will eat a RD with the first 3 cycles, then receive 3 cycles of FMD as they continue cycles 4-6.

Group Type ACTIVE_COMPARATOR

Regular Diet Plus FMD

Intervention Type COMBINATION_PRODUCT

Patients will eat a RD with the first 3 cycles, then receive 3 cycles of FMD as they continue cycles 4-6

FMD

Plant based diet program.

Group Type EXPERIMENTAL

FMD

Intervention Type DIETARY_SUPPLEMENT

Plant-based diet program

Regular Diet Plus FMD

Intervention Type COMBINATION_PRODUCT

Patients will eat a RD with the first 3 cycles, then receive 3 cycles of FMD as they continue cycles 4-6

Interventions

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FMD

Plant-based diet program

Intervention Type DIETARY_SUPPLEMENT

Regular Diet Plus FMD

Patients will eat a RD with the first 3 cycles, then receive 3 cycles of FMD as they continue cycles 4-6

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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Xentigen Regular Diet Plus Xentigen

Eligibility Criteria

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Inclusion Criteria

* 18 years at the time of informed consent
* Ability to provide written informed consent and HIPAA authorization.
* Eastern cooperative group (ECOG) performance status of 0 to 2
* Newly diagnosed histologically or cytologically confirmed stage IV Non-Small Cell Lung Cancer (NSCLC). Patients with locally advanced NSCLC that are not candidates for definitive therapy but are candidates for trial are allowed per investigator discretion.
* BMI 19 kg/m2
* Patients should be enrolled prior to starting standard of care immunotherapy for the treatment of stage IV NSCLC. Patients should be on PD (L)1 inhibitor alone (i.e., with PD-L1 expression 50%) in the metastatic setting. The investigators will allow single agent pembrolizumab only as the checkpoint inhibitor.
* Patients requiring palliative radiation or definitive radiation to an oligometastatic disease prior to the initiation of single agent checkpoint inhibitors are allowed once radiation has been completed and patients have recovered from toxicities.

Exclusion Criteria

* Self-reported weight loss of \> 10% in the 6 weeks prior to study entry
* History of symptomatic hypoglycemia or uncontrolled diabetes
* Prior therapies with inhibitors of insulin growth factor I(IGF-1) such as Linsitinib or Picropodophyllin
* Concurrent use of somatostatin
* Concurrent use of immunosuppressive medications including sirolimus, tacrolimus, mycophenolate mofetil, azathioprine, prednisone, dexamethasone, or cyclosporine
* Significant food allergies which would make the subject unable to consume the food provided.
* History or current evidence of any uncontrolled medical or psychiatric condition, therapy that may confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the participating subject as deemed by the treating investigator.
* Pregnant or lactating females are not eligible.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Indiana University

OTHER

Sponsor Role collaborator

US Department of Veterans Affairs Cooperative Studies Program

NETWORK

Sponsor Role collaborator

L-Nutra Inc

INDUSTRY

Sponsor Role collaborator

VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Shadia Jalal, MD

Role: PRINCIPAL_INVESTIGATOR

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Locations

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VA Long Beach Healthcare System, Long Beach, CA

Long Beach, California, United States

Site Status RECRUITING

Jesse Brown VA Medical Center, Chicago, IL

Chicago, Illinois, United States

Site Status RECRUITING

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Indianapolis, Indiana, United States

Site Status RECRUITING

St. Louis VA Medical Center John Cochran Division, St. Louis, MO

St Louis, Missouri, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Shadia Jalal, MD

Role: CONTACT

Phone: (317) 274-5500

Email: [email protected]

Aleksandra Radovanovich, RN

Role: CONTACT

Phone: (317) 988-3338

Email: [email protected]

Facility Contacts

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Pankaj Gupta, MD

Role: primary

Neha Shah, PhD

Role: backup

Larry Feldman, MD

Role: primary

Cindy Chan

Role: backup

Shadia Jalal, MD

Role: primary

Aleksandra Radovanovich, RN

Role: backup

Theodore Thomas, MD

Role: primary

Carla Prost

Role: backup

Other Identifiers

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14094145/CX002843

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

ONCB-014-24S

Identifier Type: -

Identifier Source: org_study_id