CClinicalTrials.gg
Status unknownNCT05587088PA001Updated Oct 19, 2022

Evaluation of the Safety and Efficacy of Esperanza Extract (PA001)

A Phase 1/2 interventional study of Petiveria Alliacea Preparation and Placebo in Neoplasm, Stomach, Gastric Neoplasms Malignant and Pancreatic Neoplasms, sponsored by Hospital Universitario San Ignacio. Status unknown at 1 site in Colombia. Open to participants aged 18 Years to 99 Years. Per ClinicalTrials.gov, last updated 2022-10-19.

Sponsored by Hospital Universitario San Ignacio · Phase 1/2, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Oct 2022), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Phase 1/2
Study type
Interventional
Enrollment
82
Allocation
Randomized
Ages
18 Years to 99 Years
Sex
All
01

Study summary

This is a phase Ib/II clinical study that has two phases. In phase Ib, the safety evaluation of the extract of Petiveria alliacea (Esperanza) will be carried out in patients with metastatic gastrointestinal tumors (colon, pancreas, stomach, and biliary tract) and patients with newly diagnosed and relapsed acute leukemia. In phase IIb, the safety will continue to be evaluated, and the efficacy of the Esperanza extract will be explored in combination with chemotherapy in patients with metastatic gastrointestinal tumors (colon, pancreas, stomach, and biliary tract) with newly diagnosed acute leukemias and relapses.

Read the detailed description

Anamú, Petiveria alliacea, has been used by traditional medicine to treat leukemia and breast cancer. However, its activity on tumor metabolism makes it a therapeutic candidate for many tumors with alterations in glycolytic metabolism, but also uses the mitochondria to produce energy.

Given the glycolytic nature of some tumor cells, the modulating activity of cell metabolism exerted by anamú extract may be partly responsible for the anti-tumor activity.

Previous reports show that some patients with ALL or AML whose response to treatment was evaluated in vitro are sensitive to a standardized extract of Petiveria alliacea. Even more interesting is the fact that when we treat the cells with allopathic therapy, explicitly established for each of these pathologies, the sensitivity of the blasts increases when they are treated concomitantly with the extract, which suggests that the intrinsic resistance of each one of tumor cells in the different tissues evaluated can be reduced by the action of the phytomedicine. The same thing was observed when spheres obtained from human breast cancer were co-treated with the anamú extract and anthracyclines. These observations allow to validate the traditional use of anamú in the treatment of some tumors, such as leukemia and breast cancer, among others. However, to observe the safety and effects on patients, it is necessary to develop a clinical study that would allow the anamú phytomedicine produced in the appropriate pharmaceutical conditions, to be included as a complementary therapy based on a standardized extract of the plant and that can overcome the resistance of tumor cells to conventional treatments, improving response and increasing overall survival of patients in Colombia.

Although the explosion of new therapies in solid tumors and hematological alterations is not so high, countries such as Germany, France, and Italy have used traditional medicine from which herbal pharmaceutical preparations are derived in the treatment of different types of diseases, including cancer. , estimating the use of these products between 30 and 75% of patients worldwide. These herbal products are mainly used to reduce allopathic therapies' side effects and organic toxicity, protect and stimulate the immune system, or prevent future neoplasms or their recurrence. Currently, various extracts from natural products are in clinical trials in the United States, and there is significant evidence about some plants' role in leukemia's evolution.

This is a phase Ib/II clinical study that has two phases. In phase Ib, the safety evaluation of the extract of Petiveria alliacea (Esperanza) will be carried out in patients with metastatic gastrointestinal tumors (colon, pancreas, stomach, and biliary tract) and patients with newly diagnosed and relapsed acute leukemia. In phase IIb, the safety will continue to be evaluated, and the efficacy of the Esperanza extract will be explored in combination with chemotherapy in patients with metastatic gastrointestinal tumors (colon, pancreas, stomach, and biliary tract) with newly diagnosed acute leukemias and relapses.

02

Conditions studied

  • Neoplasm, Stomach
  • Gastric Neoplasms Malignant
  • Pancreatic Neoplasms
  • Colorectal Neoplasms
  • Acute Leukemia
  • Acute Leukemia in Relapse
  • Acute Leukemia Lymphoid
  • Acute Myeloid Leukemia
  • Acute Myeloid Leukemia, in Relapse
03

In context

Leukemia

5,441 studies on the registry are indexed under Leukemia; 636 are open to participants now.

This study's planned enrollment of 82 is above the median of 38 across 4,247 interventional studies indexed under Leukemia.

Browse Leukemia studies →

Lead sponsor

Hospital Universitario San Ignacio is the lead sponsor of 25 studies on the registry; 8 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 99 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria Solid Tumors:

  1. Patients must be over 18 years of age, with no upper age limit
  2. Histological diagnosis of gastrointestinal cancer may include stomach, colon, bile ducts, and pancreas.
  3. Measurable disease through diagnostic tests and who will receive chemotherapy as primary treatment for their disease.
  4. At least one discrete metastatic site identified
  5. ECOG scale status from 0 to 2 with survival more significant than two months.
  6. Subject can swallow and retain oral medication and does not have uncontrolled emesis or persistent diarrhea.
  7. Adequate renal, hematological, hepatic, and cardiac function at the investigator's discretion.
  8. Without uncontrolled or significant comorbidities determined by clinical history, physical examination, and screening laboratories at the investigator's discretion.
  9. Patients of childbearing age and without safe non-hormonal planning methods must have a negative pregnancy test before the screening.
  10. Fertile female subjects (those who have not been postmenopausal for at least 12 months or are surgically sterile by bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) and their male partners must use at least one of the contraceptive methods listed below during study entry, throughout the study, and for at least six months after use of the P2Et extract (the effects of the P2Et extract on the developing human fetus are unknown):

a. Complete abstinence from sexual intercourse, beginning at least one complete menstrual cycle before administration of study drug; (It should be noted: sexual abstinence as a contraceptive method should be limited to those cases where it is already established as the patient's pre-existing lifestyle choice).

b. Vasectomy in the partner of a female subject c. Intrauterine device (IUD) d. Double-barrier method (condom, contraceptive sponge, diaphragm, or vaginal ring with spermicidal jelly or cream).

k) Desire to complete the study and follow-up interventions.

Inclusion Criteria Acute Leukemia:

  1. Patients must be over 18 years of age, with no upper age limit
  2. Patients who have had a new diagnosis of acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) will be eligible for the study and are eligible for chemotherapy treatment.

    • Patients must be newly diagnosed
    • Patients must have failed initial therapy, which may manifest in any of the following ways:

      • Demonstration of primary refractory disease (primary induction failure) as evidenced by mid-cycle bone marrow analysis showing lack of complete tumor clearance (CTC).
      • Relapse of the initial disease after a period of achieving complete remission.
  3. Subject can swallow and retain oral medication and does not have uncontrolled emesis or persistent diarrhea.
  4. Adequate renal, hematological, and hepatic function at the investigator's discretion.
  5. Without uncontrolled or significant comorbidities determined by clinical history, physical examination, and screening laboratories at the investigator's discretion.
  6. Patients of childbearing age and without safe non-hormonal planning, methods must have a negative pregnancy test before the screening.
  7. Fertile female subjects (those who have not been postmenopausal for at least 12 months or are surgically sterile by bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) and their male partners must use at least one of the contraceptive methods listed below. Listed below during study entry, throughout the study, and for at least six months after use of the P2Et extract (the effects of the P2Et extract on the developing human fetus are unknown):

a. Complete abstinence from sexual intercourse, beginning at least one complete menstrual cycle before administration of study drug; (It should be noted: sexual abstinence as a contraceptive method should be limited to those cases where it is already established as the patient's pre-existing lifestyle choice).

b. Vasectomy in the partner of a female subject c. Intrauterine device (IUD) d. Double-barrier method (condom, contraceptive sponge, diaphragm, or vaginal ring with spermicidal jelly or cream).

h) Desire to complete the study and follow-up interventions.

Exclusion Criteria:

The exclusion criteria apply to solid tumors as well as hematological tumors.

Subjects with one or more conditions are not eligible for this study.

  1. Subjects treated in any other therapeutic clinical protocol 30 days prior to study entry or during study participation.
  2. Patients receiving other investigational agents.
  3. The female subject is pregnant or nursing. A negative serum or urine pregnancy test obtained at screening should confirm that the woman is not pregnant. Pregnancy tests are not required for postmenopausal or surgically sterilized women.
  4. Serious concomitant morbidity, active at the discretion of the investigator
  5. Subjects with a confirmed diagnosis of HIV before enrollment or a positive diagnosis of HIV at the time of screening.
  6. Recipients of solid organ transplants.
  7. Any condition that, in the opinion of the principal investigator, makes the subject ineligible to participate in this study.
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Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Sequential assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
82 participants (estimated)

Study arms

  • Experimental
    Metastatic gastrointestinal tumors and acute leukemia patients

    Patients with metastatic gastrointestinal tumors (colon, pancreas, stomach, and bile ducts) and newly diagnosed/relapse acute leukemias who meet the inclusion criteria will take the anamu extract with chemotherapy to evaluate the adverse drug-related side effects.

    Drug: Petiveria Alliacea Preparation

  • Experimental
    Stage II Metastatic gastrointestinal tumors including pancreas

    For solid metastatic tumors, 30 patients will be recruited, which can be from the colon, pancreas, stomach, and bile ducts, divided into two groups of 15 patients, an intervention group and a placebo group. The intervention group will receive the Esperanza extract at DMT for three continuous treatment cycles (approximately 12 weeks), and the other group will receive the placebo.

    Drug: Petiveria Alliacea Preparation

  • Placebo comparator
    Stage II Placebo Metastatic gastrointestinal tumors including pancreas

    For solid metastatic tumors, 30 patients will be recruited, which can be from the colon, pancreas, stomach, and bile ducts, divided into two groups of 15 patients, an intervention group and a placebo group. The intervention group will receive the Esperanza extract at DMT for three continuous treatment cycles (approximately 12 weeks), and the other group will receive the placebo. Both groups will receive standard chemotherapy treatment for their underlying disease. The safety evaluation will be carried out in each treatment cycle, and the efficacy evaluation will be carried out at the end of the three cycles.

    Drug: Placebo

  • Experimental
    Acute leukemia (Newly/Relapse)

    For newly diagnosed hematological tumors, 28 patients will be recruited and will receive the Esperanza extract at DMT. The intervention group will continuously receive the Esperanza extract at DMT for four weeks with the standard chemotherapy regimen for their underlying disease. The safety and efficacy evaluation will be carried out at the end of the treatment cycle. Patients with relapsed or refractory acute leukemias will be admitted to receive the calculated DMT in phase Ib; A total of 6 patients will be recruited, and safety and efficacy evaluations will be performed during three treatment cycles or progression and death of the patient. For the analysis of the response in patients with acute leukemia, a comparison will be made with a group followed historically. A propensity score matching will be performed for statistical analysis in case of differences in their baseline characteristics.

    Drug: Petiveria Alliacea Preparation

Interventions

  • DrugPetiveria Alliacea Preparation

    Petiveria Alliacea Preparation in pill

  • DrugPlacebo

    Placebo in pill

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What researchers measure

Primary outcomes

  1. Safety and efficacy

    Evaluate the adverse drug reactions of cancer patients treated with anamú extract and chemotherapy through the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0

    Time frame: 12 months

Secondary outcomes

  1. Quality of life in patients

    Changes of at least 5 points above the difference between the groups of the functional scales of the patients evaluated using the EORTC QLQ-C-30 scale

    Time frame: 12 months

  2. Tumor response

    To determine the impact of treatment with Esperanza extract in combination with chemotherapy on the number and size of metastases.

    Time frame: 12 months

  3. Survival

    To determine event/progression-free survival in patients with metastatic gastrointestinal tumors (colon, pancreas, stomach, and bile ducts) and patients with newly diagnosed and relapsed acute leukemias.

    Time frame: 12 months

07

Study locations

1 site
  • Pontificia Universidad Javeriana
    Bogotá, 110221, Colombia
08

References and documents

Publications

  • Di Martino MT, Zazzeroni F, Donadelli M, Chiodoni C, Caraglia M, Scotlandi K, Meschini S, Leonetti C. Reprogramming Tumor-Immune Cell Interface in Solid and Hematological Malignancies to Enhance Response to Therapy. J Exp Clin Cancer Res. 2018 Mar 5;37(1):48. doi: 10.1186/s13046-018-0710-x. No abstract available. PubMed 29506548 ↗
  • Uruena C, Sandoval TA, Lasso P, Tawil M, Barreto A, Torregrosa L, Fiorentino S. Evaluation of chemotherapy and P2Et extract combination in ex-vivo derived tumor mammospheres from breast cancer patients. Sci Rep. 2020 Nov 12;10(1):19639. doi: 10.1038/s41598-020-76619-9. PubMed 33184339 ↗
  • Sharma SV, Lee DY, Li B, Quinlan MP, Takahashi F, Maheswaran S, McDermott U, Azizian N, Zou L, Fischbach MA, Wong KK, Brandstetter K, Wittner B, Ramaswamy S, Classon M, Settleman J. A chromatin-mediated reversible drug-tolerant state in cancer cell subpopulations. Cell. 2010 Apr 2;141(1):69-80. doi: 10.1016/j.cell.2010.02.027. PubMed 20371346 ↗
  • Bergers G, Fendt SM. The metabolism of cancer cells during metastasis. Nat Rev Cancer. 2021 Mar;21(3):162-180. doi: 10.1038/s41568-020-00320-2. Epub 2021 Jan 18. PubMed 33462499 ↗
  • Fong MY, Zhou W, Liu L, Alontaga AY, Chandra M, Ashby J, Chow A, O'Connor ST, Li S, Chin AR, Somlo G, Palomares M, Li Z, Tremblay JR, Tsuyada A, Sun G, Reid MA, Wu X, Swiderski P, Ren X, Shi Y, Kong M, Zhong W, Chen Y, Wang SE. Breast-cancer-secreted miR-122 reprograms glucose metabolism in premetastatic niche to promote metastasis. Nat Cell Biol. 2015 Feb;17(2):183-94. doi: 10.1038/ncb3094. Epub 2015 Jan 26. PubMed 25621950 ↗
  • Eddy RJ, Weidmann MD, Sharma VP, Condeelis JS. Tumor Cell Invadopodia: Invasive Protrusions that Orchestrate Metastasis. Trends Cell Biol. 2017 Aug;27(8):595-607. doi: 10.1016/j.tcb.2017.03.003. Epub 2017 Apr 12. PubMed 28412099 ↗
  • Kang X, Wang J, Li C. Exposing the Underlying Relationship of Cancer Metastasis to Metabolism and Epithelial-Mesenchymal Transitions. iScience. 2019 Nov 22;21:754-772. doi: 10.1016/j.isci.2019.10.060. Epub 2019 Oct 31. PubMed 31739095 ↗
  • Xian ZY, Liu JM, Chen QK, Chen HZ, Ye CJ, Xue J, Yang HQ, Li JL, Liu XF, Kuang SJ. Inhibition of LDHA suppresses tumor progression in prostate cancer. Tumour Biol. 2015 Sep;36(10):8093-100. doi: 10.1007/s13277-015-3540-x. Epub 2015 May 16. PubMed 25983002 ↗
  • Zhu J, Ma J, Wang X, Ma T, Zhang S, Wang W, Zhou X, Shi J. High Expression of PHGDH Predicts Poor Prognosis in Non-Small Cell Lung Cancer. Transl Oncol. 2016 Dec;9(6):592-599. doi: 10.1016/j.tranon.2016.08.003. PubMed 27916294 ↗
  • Butler LM, Perone Y, Dehairs J, Lupien LE, de Laat V, Talebi A, Loda M, Kinlaw WB, Swinnen JV. Lipids and cancer: Emerging roles in pathogenesis, diagnosis and therapeutic intervention. Adv Drug Deliv Rev. 2020;159:245-293. doi: 10.1016/j.addr.2020.07.013. Epub 2020 Jul 23. PubMed 32711004 ↗
  • Shah US, Dhir R, Gollin SM, Chandran UR, Lewis D, Acquafondata M, Pflug BR. Fatty acid synthase gene overexpression and copy number gain in prostate adenocarcinoma. Hum Pathol. 2006 Apr;37(4):401-9. doi: 10.1016/j.humpath.2005.11.022. Epub 2006 Feb 7. PubMed 16564913 ↗
  • Koundouros N, Poulogiannis G. Reprogramming of fatty acid metabolism in cancer. Br J Cancer. 2020 Jan;122(1):4-22. doi: 10.1038/s41416-019-0650-z. Epub 2019 Dec 10. PubMed 31819192 ↗
  • Itkonen HM, Brown M, Urbanucci A, Tredwell G, Ho Lau C, Barfeld S, Hart C, Guldvik IJ, Takhar M, Heemers HV, Erho N, Bloch K, Davicioni E, Derua R, Waelkens E, Mohler JL, Clarke N, Swinnen JV, Keun HC, Rekvig OP, Mills IG. Lipid degradation promotes prostate cancer cell survival. Oncotarget. 2017 Jun 13;8(24):38264-38275. doi: 10.18632/oncotarget.16123. PubMed 28415728 ↗
  • Zadra G, Photopoulos C, Tyekucheva S, Heidari P, Weng QP, Fedele G, Liu H, Scaglia N, Priolo C, Sicinska E, Mahmood U, Signoretti S, Birnberg N, Loda M. A novel direct activator of AMPK inhibits prostate cancer growth by blocking lipogenesis. EMBO Mol Med. 2014 Apr;6(4):519-38. doi: 10.1002/emmm.201302734. Epub 2014 Feb 4. Erratum In: EMBO Mol Med. 2014 Oct;6(10):1357. PubMed 24497570 ↗
  • Song K, Li M, Xu X, Xuan LI, Huang G, Liu Q. Resistance to chemotherapy is associated with altered glucose metabolism in acute myeloid leukemia. Oncol Lett. 2016 Jul;12(1):334-342. doi: 10.3892/ol.2016.4600. Epub 2016 May 17. PubMed 27347147 ↗
  • Song K, Li M, Xu XJ, Xuan L, Huang GN, Song XL, Liu QF. HIF-1alpha and GLUT1 gene expression is associated with chemoresistance of acute myeloid leukemia. Asian Pac J Cancer Prev. 2014;15(4):1823-9. doi: 10.7314/apjcp.2014.15.4.1823. PubMed 24641416 ↗
  • Herst PM, Howman RA, Neeson PJ, Berridge MV, Ritchie DS. The level of glycolytic metabolism in acute myeloid leukemia blasts at diagnosis is prognostic for clinical outcome. J Leukoc Biol. 2011 Jan;89(1):51-5. doi: 10.1189/jlb.0710417. Epub 2010 Oct 19. PubMed 20959411 ↗
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  • Bokil A, Sancho P. Mitochondrial determinants of chemoresistance. Cancer Drug Resist. 2019 Sep 19;2(3):634-646. doi: 10.20517/cdr.2019.46. eCollection 2019. PubMed 35582564 ↗
  • Panina SB, Baran N, Brasil da Costa FH, Konopleva M, Kirienko NV. A mechanism for increased sensitivity of acute myeloid leukemia to mitotoxic drugs. Cell Death Dis. 2019 Aug 13;10(8):617. doi: 10.1038/s41419-019-1851-3. PubMed 31409768 ↗
  • Sriskanthadevan S, Jeyaraju DV, Chung TE, Prabha S, Xu W, Skrtic M, Jhas B, Hurren R, Gronda M, Wang X, Jitkova Y, Sukhai MA, Lin FH, Maclean N, Laister R, Goard CA, Mullen PJ, Xie S, Penn LZ, Rogers IM, Dick JE, Minden MD, Schimmer AD. AML cells have low spare reserve capacity in their respiratory chain that renders them susceptible to oxidative metabolic stress. Blood. 2015 Mar 26;125(13):2120-30. doi: 10.1182/blood-2014-08-594408. Epub 2015 Jan 28. PubMed 25631767 ↗
  • Yang J, Ren B, Yang G, Wang H, Chen G, You L, Zhang T, Zhao Y. The enhancement of glycolysis regulates pancreatic cancer metastasis. Cell Mol Life Sci. 2020 Jan;77(2):305-321. doi: 10.1007/s00018-019-03278-z. Epub 2019 Aug 20. PubMed 31432232 ↗
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  • Lu W, Hu Y, Chen G, Chen Z, Zhang H, Wang F, Feng L, Pelicano H, Wang H, Keating MJ, Liu J, McKeehan W, Wang H, Luo Y, Huang P. Novel role of NOX in supporting aerobic glycolysis in cancer cells with mitochondrial dysfunction and as a potential target for cancer therapy. PLoS Biol. 2012;10(5):e1001326. doi: 10.1371/journal.pbio.1001326. Epub 2012 May 8. Erratum In: PLoS Biol. 2017 Dec 11;15(12):e1002616. doi: 10.1371/journal.pbio.1002616. PubMed 22589701 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 19, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05587088
Lead sponsor
Hospital Universitario San Ignacio
Collaborators
Pontificia Universidad Javeriana
Responsible party
Sponsor
First posted
Oct 19, 2022
Start date
Dec 15, 2022 (estimated)
Primary completion
Mar 15, 2023 (estimated)
Completion
Jun 15, 2023 (estimated)
Last update
Oct 19, 2022

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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