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Azadirachta Indica in Treating Patients With Chronic Lymphocytic Leukemia

This study has been withdrawn prior to enrollment.
(lost sponsor support)
Information provided by (Responsible Party):
Roswell Park Cancer Institute Identifier:
First received: November 30, 2010
Last updated: January 10, 2014
Last verified: January 2014
RATIONALE: Azadirachta indica may be an effective treatment for chronic lymphocytic leukemia. PURPOSE: This phase I trial is studying the side effects and best dose of Azadirachta indica in treating patients with chronic lymphocytic leukemia.

Condition Intervention Phase
Refractory Chronic Lymphocytic Leukemia
Stage II Chronic Lymphocytic Leukemia
Stage III Chronic Lymphocytic Leukemia
Stage IV Chronic Lymphocytic Leukemia
Other: laboratory biomarker analysis
Genetic: western blotting
Genetic: gene expression analysis
Other: pharmacological study
Other: flow cytometry
Genetic: fluorescence in situ hybridization
Biological: azadirachta indica
Genetic: reverse transcriptase-polymerase chain reaction
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase I Clinical Trial of Neem Leaf Extract for the Treatment of Chronic Lymphocytic Leukemia

Resource links provided by NLM:

Further study details as provided by Roswell Park Cancer Institute:

Primary Outcome Measures:
  • Lowest clinically active and tolerable dose [ Time Frame: After patients have completed at least 2 treatment courses ]

Enrollment: 0
Study Start Date: December 2010
Primary Completion Date: July 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Patients receive oral Azadirachta indica once daily on days 1-28. Treatment repeats every 28 days for up to 8 courses in the absence of disease progression or unacceptable toxicity.
Other: laboratory biomarker analysis
Correlative studies
Genetic: western blotting
Correlative studies
Other Names:
  • Blotting, Western
  • Western Blot
Genetic: gene expression analysis
Correlative studies
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies
Other: flow cytometry
Correlative studies
Genetic: fluorescence in situ hybridization
Correlative studies
Other Name: fluorescence in situ hybridization (FISH)
Biological: azadirachta indica
Given orally
Other Names:
  • neem
  • neem tree
Genetic: reverse transcriptase-polymerase chain reaction
Correlative studies
Other Name: RT-PCR

Detailed Description:
PRIMARY OBJECTIVES: I. To determine the lowest dose of neem leaf extract (NLE) with antileukemic effect and acceptable toxicity in patients with chronic lymphocytic leukemia (CLL). II. Establish the safety and toxicity of NLE in patients with CLL. SECONDARY OBJECTIVES: I. Determine the efficacy of NLE in patients with CLL defined as overall clinical response (CR + PR) by the IWCLL criterion. II. To develop a pharmacokinetic/pharmacodynamic model relating neem leaf extract exposure to toxicity and pharmacodynamic endpoints in CLL patients that will allow personalized dosing to target optimal drug exposure. III. To conduct correlative studies. OUTLINE: This is a dose-escalation study. Patients receive oral Azadirachta indica once daily on days 1-28. Treatment repeats every 28 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 3 months for 1 year.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients must have a definitive diagnosis of CLL as defined by the IWCLL criteria
  • Patients may not have received any prior treatment for management of CLL; (no more than 30 patients with treatment naive disease will be included in this study)
  • Patients with advance stage disease (Rai Stage II-IV) may be included in this clinical trial if they refuse to take standard chemotherapeutic regimens
  • Patients with relapsed or relapsed/ resistant may be included in this clinical trial if they refuse to take standard chemotherapeutic regimens
  • Patients must understand and voluntarily sign an informed consent form
  • Have an ECOG Performance Status of =< 2 at study entry
  • Able to adhere to the study visit schedule and other protocol requirements
  • Leukocytes >= 3,000/mcL
  • Absolute neutrophil count >= 1,500/mcL
  • Hemoglobin >= 10g/dl
  • Platelets >= 50,000/mcl
  • Total bilirubin within normal institutional limits
  • AST (SGOT)/ ALT (SGPT) =< 2.5 X institutional ULN
  • Patients of childbearing potential must agree to use acceptable contraceptive methods (e.g., double barrier) during treatment
  • Patient or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study
  • Trying to conceive, pregnant or breast feeding female patients
  • Unwilling or unable to follow protocol requirements
  • Any condition which in the Investigator's opinion deems the patient an unsuitable candidate to receive study drug
  • Patients who are consuming other herbals or non-traditional therapies (i.e. green tea extracts and cumin) within the last 4 weeks(28 days) of initiating this clinical study; note: patient must have stopped herbal or other non-traditional therapies for CLL at least 28 days prior to initiating therapy on this study
  • Patients with high-risk cytogenetic (del 17p, del 11q) determined by FISH analysis
  • Prior organ transplant
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01251250

Sponsors and Collaborators
Roswell Park Cancer Institute
Principal Investigator: Asher Chanan-Khan Roswell Park Cancer Institute
  More Information

Responsible Party: Roswell Park Cancer Institute Identifier: NCT01251250     History of Changes
Other Study ID Numbers: I 169009
Study First Received: November 30, 2010
Last Updated: January 10, 2014

Additional relevant MeSH terms:
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, Lymphoid
Neoplasms by Histologic Type
Leukemia, B-Cell
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases processed this record on April 26, 2017