Phase II Trial of Investigational Agents to Modulate Intermediate Endpoint Biomarkers, Including Pulmonary Nodules, in Former and Current Smokers
Evaluate the effectiveness of Curcumin C3 complex® combined with Lovaza® at 2 dose arms vs. placebo for 6 months to asymptomatic former and current smokers with lung nodules detected during LDCT or standard CT screening
We will provide combination of Curcumin C3 complex (8,000 mgs or 4,000 mgs) + Lovaza (4 grams or 2 grams) (w-3 -Acid Ethyl Esters) administered in 2 dose arms vs. placebo for 6 months to asymptomatic former smokers with lung nodules detected during LDCT screening (Lung-RADS 3) and evaluate:
2.1 Primary Objectives
Effectiveness of the combination of Curcumin C3 complex + Lovaza (w-3 -Acid Ethyl Esters) at 2 dose arms vs. placebo for 6 months to asymptomatic former smokers with lung nodules detected during LDCT screening (Lung-RADS 3) as indicated by:
(a) Change in size of CT-detected lung nodules.
(b) Number of nodules¡Ý4 mm, and lung nodule density of partially solid and non-solid Lung-RADS 3 nodules between the treatment and placebo arms.
2.2 Secondary Objectives
Safety of the combined agents (Curcumin C3 complex +Lovaza (w-3 -Acid Ethyl Esters) at these 2 dose arms vs. Placebo as indicated by incidence of adverse events and toxicities, monitored using Common Toxicity Criteria version 5.0, Safety Lab (CBC & CMP) at baseline, midpoint, and end of intervention.
2.2.1 Bioavailability of the combination agents in the 2 dose arms vs. Placebo, we will measure change in curcumin and its metabolites in plasma and urine as well as plasma n-3 Index at baseline, midpoint, and at the end of intervention.
2.2.2 Adherence and acceptability of the combination agents at the 2 dose arms vs. Placebo, we will conduct pill counts, collect diet and pill logs at baseline, midpoint and at the end of intervention.
2.2.3 Effect of the combination agents (Curcumin C3 complex + Lovaza (w-3 -Acid Ethyl Esters) at the 2 dose arms vs. Placebo as indicated by modulation of other IEBs including: (a) inflammation- associated chemokines and cytokines; (b) pro-resolving lipid mediators; (c) targeted pathways NF-kB and the (d) correlation of these findings with modulation of size of lung nodules.
Former and current smokers enrolled in LDCT lung cancer screening or those who are detected using a regular CT, and have Lung-RADS 3 category lesion(s), that would get a 6 month f/u LDCT or regular CT based on Lung-RADS recommendations or former smokers enrolled in LDCT lung cancer screening, and have Lung-RADS 2 category lesions with persistent or slowly increasing part-solid or non-solid lung nodule >4mm mean diameter detected by two serial yearly screening low dose CT scans.
History of cigarette smoking > 20 pack years
All current smokers should accept to receive smoking cessation
Eastern Cooperative Oncology Group (ECOG) Performance Status of less than or equal to 1
Able to swallow study pills
Able to undergo CT
Not allergic to components of study agents
Willing to discontinue current vitamin/mineral supplement use containing components of study agents. A standard multivitamin supplement provided for the study
Willing to comply with proposed visit and treatment schedule
Able to understand and willing to sign a written informed consent document
Participants must have normal organ and marrow function
Willing to use contraception during the intervention period of 6 months (males and females)
Not pregnant or lactating nor planning to become pregnant or lactate during the 6 month study intervention period.
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