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Brief Title: Manuka Honey in Preventing Esophagitis-Related Pain in Patients Receiving Chemotherapy and Radiation Therapy For Lung Cancer
Official Title: Phase II Randomized Trial of Prophylactic Manuka Honey for the Reduction of Chemoradiation Therapy Induced Esophagitis-Related Pain During the Treatment of Lung Cancer
Study ID: NCT01262560
Brief Summary: RATIONALE: Manuka honey may prevent or reduce esophagitis-related pain caused by chemotherapy and radiation therapy. It is not yet known whether Manuka honey is more effective than standard care in preventing pain. PURPOSE: This randomized phase II clinical trial is studying Manuka honey to see how well it works in preventing esophagitis-related pain in patients receiving chemotherapy and radiation therapy for lung cancer.
Detailed Description: OBJECTIVES: Primary * Evaluate the relative efficacy of 4 times a day consumption of liquid or lozenge Manuka honey to delay or prevent radiation esophagitis-related pain (during combined chemotherapy and radiation therapy for lung cancer) as compared to standard supportive treatment, as measured at week 4 by Numerical Rating Pain Scale (NRPS) for pain upon swallowing. Secondary * Evaluate the trend of severity of radiation esophagitis-related pain during combined chemotherapy and radiation therapy for lung cancer using weekly measurements of the NRPS. * Evaluate the adverse events associated with Manuka honey, as measured by CTCAE, v. 4. * Evaluate the severity of radiation esophagitis (grade 3-4, CTCAE, v. 4). * Assess weight loss (percent weight change from baseline to 4 weeks). * Assess quality of life (QOL) and pain, as measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-30) global QOL score and pain symptom subscale. * Assess patient-reported dysphagia via a daily patient log. * Assess nutritional status, as measured by the mean change in serum prealbumin levels from baseline to 4 weeks. * Assess opioid use by collecting the patient's narcotic use in the previous 24-hour period at each weekly evaluation. * Evaluate patient-reported adverse events associated with Manuka honey using the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). OUTLINE: This is a multicenter study. Patients are stratified according to the percentage of esophagus in the radiation field (V60 \< 30% vs V60 ≥ 30%). Patients are randomized to 1 of 3 treatment arms. * Arm I: Patients receive standard supportive care for esophagitis-related pain as needed during chemoradiotherapy. * Arm II: Patients swallow liquid Manuka honey slowly over 3-5 minutes. Patients must refrain from eating and drinking for 1 hour after administration. Treatment continues 4 times per day during chemoradiotherapy. * Arm III: Patients place Manuka honey lozenges in their mouth one at a time and swallow the honey as it dissolves (no chewing or swallowing it whole). Patients must refrain from eating and drinking for 1 hour after administration. Treatment continues 4 times per day during chemoradiotherapy. Patients complete quality of life, pain swallowing diary, and pain assessments (Numerical Rating Pain Scale, EORTC QLQ-30 and Pain Subscale, and PRO-CTCAE) periodically during study treatment. Patients are followed up at 12 weeks from the start of study treatment.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Providence Cancer Center at Providence Hospital, Mobile, Alabama, United States
UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, United States
Stanford Cancer Center, Stanford, California, United States
CCOP - Christiana Care Health Services, Newark, Delaware, United States
Baptist Cancer Institute - Jacksonville, Jacksonville, Florida, United States
CCOP - Mount Sinai Medical Center, Miami Beach, Florida, United States
Florida Cancer Center - Palatka, Palatka, Florida, United States
Piedmont Fayette Hospital, Fayetteville, Georgia, United States
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler, Savannah, Georgia, United States
Queen's Cancer Institute at Queen's Medical Center, Honolulu, Hawaii, United States
Hawaii Medical Center - East, Honolulu, Hawaii, United States
OSF St. Francis Medical Center, Peoria, Illinois, United States
CCOP - Carle Cancer Center, Urbana, Illinois, United States
Parkview Regional Cancer Center at Parkview Health, Fort Wayne, Indiana, United States
Cancer Center at Ball Memorial Hospital, Muncie, Indiana, United States
Lucille P. Markey Cancer Center at University of Kentucky, Lexington, Kentucky, United States
Cape Cod Hospital, Hyannis, Massachusetts, United States
CentraCare Clinic - River Campus, Saint Cloud, Minnesota, United States
Regional Cancer Center at Singing River Hospital, Pascagoula, Mississippi, United States
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis, Saint Louis, Missouri, United States
David C. Pratt Cancer Center at St. John's Mercy, Saint Louis, Missouri, United States
Payson Center for Cancer Care at Concord Hospital, Concord, New Hampshire, United States
Seacoast Cancer Center at Wentworth - Douglass Hospital, Dover, New Hampshire, United States
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
Elliot Regional Cancer Center at Elliot Hospital, Manchester, New Hampshire, United States
Monmouth Medical Center, Long Branch, New Jersey, United States
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton, Marlton, New Jersey, United States
CCOP - Hematology-Oncology Associates of Central New York, East Syracuse, New York, United States
Highland Hospital of Rochester, Rochester, New York, United States
James P. Wilmot Cancer Center at University of Rochester Medical Center, Rochester, New York, United States
Presbyterian Cancer Center at Presbyterian Hospital, Charlotte, North Carolina, United States
Duke Cancer Institute, Durham, North Carolina, United States
Pardee Memorial Hospital, Hendersonville, North Carolina, United States
FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center, Pinehurst, North Carolina, United States
Rex Cancer Center at Rex Hospital, Raleigh, North Carolina, United States
Wake Forest University Comprehensive Cancer Center, Winston-Salem, North Carolina, United States
Trinity CancerCare Center, Minot, North Dakota, United States
Mercy Cancer Center at Mercy Medical Center, Canton, Ohio, United States
Case Comprehensive Cancer Center, Cleveland, Ohio, United States
Cleveland Clinic Cancer Center at Fairview Hospital, Cleveland, Ohio, United States
Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio, United States
Cleveland Clinic Cancer Center, Independence, Ohio, United States
Hillcrest Cancer Center at Hillcrest Hospital, Mayfield Heights, Ohio, United States
Parma Community General Hospital, Parma, Ohio, United States
Rosenfeld Cancer Center at Abington Memorial Hospital, Abington, Pennsylvania, United States
Bryn Mawr Hospital, Bryn Mawr, Pennsylvania, United States
Geisinger Cancer Institute at Geisinger Health, Danville, Pennsylvania, United States
Northeast Radiation Oncology Center, Dunmore, Pennsylvania, United States
Adams Cancer Center, Gettysburg, Pennsylvania, United States
Cherry Tree Cancer Center, Hanover, Pennsylvania, United States
Cancer Center of Paoli Memorial Hospital, Paoli, Pennsylvania, United States
Lankenau Cancer Center at Lankenau Hospital, Wynnewood, Pennsylvania, United States
York Cancer Center at Apple Hill Medical Center, York, Pennsylvania, United States
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center, Spartanburg, South Carolina, United States
University of Texas Medical Branch, Galveston, Texas, United States
University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
St. Joseph Cancer Center, Bellingham, Washington, United States
St. Mary's Hospital Medical Center - Green Bay, Green Bay, Wisconsin, United States
St. Vincent Hospital Regional Cancer Center, Green Bay, Wisconsin, United States
Name: Lawrence B. Berk, MD, PhD
Affiliation: Tampa General Hospital, University of South Florida
Role: PRINCIPAL_INVESTIGATOR