“I think it’s really important that people keep signing up to these type of trials to push research forward.”
A trial looking at curcumin and FOLFOX for advanced bowel cancer (CUFOX)
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This trial is looking at curcumin with FOLFOX chemotherapy for bowel cancer (colorectal cancer) that has spread to the liver.
More about this trial
Doctors often treat bowel cancer that has spread with chemotherapy. The combination of chemotherapy they usually use is called FOLFOX. It is made up of the drugs folinic acid (leucovorin), fluorouracil (5FU) and oxaliplatin. But this doesn’t always work very well. And it often causes side-effects such as numbness and tingling in hands and feet (peripheral neuropathy). This means the doctors sometimes need to lower the dose or even stop chemotherapy, so they are keen to improve treatment.
Curcumin is a plant extract found in the spice turmeric and is found in many everyday foods. We know from research that curcumin can help shrink tumours in the laboratory. It has also been used in several studies involving patients with a range of conditions, including cancer.
Researchers hope that curcumin might help FOLFOX work better as a treatment for advanced bowel cancer, and that it might also reduce peripheral neuropathy. If it does, it may mean that patients can have treatment for longer.
The aims of this early phase trial are to find out
- The best dose of curcumin to give with FOLFOX chemotherapy
- About the side effects of having curcumin and FOLFOX together
- If curcumin can reduce chemotherapy side effects
- More about what happens to curcumin in the body
- How well curcumin and FOLFOX work as a treatment for advanced bowel cancer
Who can enter
You may be able to enter this trial if you
- Have bowel cancer (colorectal cancer) that has spread to the liver
- Have an area of cancer that can be measured on a scan
- Are not able to have surgery to treat your cancer
- Are due to have FOLFOX chemotherapy
- Are well enough to carry out all your normal activities, apart from heavy physical work (performance status of 0 or 1)
- Are prepared to use reliable contraception while you are taking part in the trial
- Have satisfactory blood test results
- Are at least 18 years old
You cannot enter this trial if you
- Have bowel cancer that has spread to your bones
- Have bowel cancer that has spread to your brain, unless you have had radiotherapy or surgery and it has now stopped growing
- Are not able to have FOLFOX chemotherapy
- Are due to have cetuximab for bowel cancer that has spread to the liver
- Have had a major operation, chemotherapy, hormone therapy or biological therapy in the last 4 weeks
- Have had radiotherapy in the last 4 weeks, unless it was for symptom control only
- Have had a lot of radiotherapy which has affected your bone marrow (your doctor can tell you about this)
- Are taking part in any other clinical trial
- Have had any other cancer in the last 5 years (apart from basal cell skin cancer or carcinoma in situ of the cervix)
- Have heart problems such as congestive heart failure or angina, or you have had a heart attack in the last 6 months
- Have a condition, such as a bowel obstruction, which means you can’t absorb medication from your stomach
- Have Hepatitis B, Hepatitis C or HIV
- Have any other serious medical condition
- Are pregnant or breast feeding
This is an early phase trial and will be run in 2 parts – phase 1 and phase 2. It will recruit about 42 people altogether. Everyone taking part will have bowel cancer that has spread to the liver.
The people who took part in phase 1 started taking curcumin capsules 7 days before they started FOLFOX chemotherapy. They took the curcumin capsules every day while they were having chemotherapy.
The first few people taking part had the lowest dose of curcumin. Then the next few people started at a slightly higher dose. Then a third group of people took the highest dose. The research team were able to decide the best dose to give in phase 2. This is called a dose escalation trial.
The trial is now in phase 2, which will recruit 33 people. This part is randomised and will recruit people into one of two groups – group A and group B. The people taking part are put into treatment groups by a computer. Neither you nor your doctor will be able to decide which group you are in.
- Group A will recruit 22 people to have FOLFOX and curcumin
- Group B will recruit 11 people to have FOLFOX alone
If you are in group A you start taking curcumin capsules 7 days before starting FOLFOX chemotherapy. The dose of curcumin you have will be the best dose found in phase 1 of the trial. You take curcumin capsules every day for as long as you have chemotherapy.
Everyone in group A and group B will have FOLFOX chemotherapy through a drip into a vein once every 2 weeks. Each 2 weeks is one cycle of treatment. You will have up to 12 cycles over 6 months.
You will see the doctors and have some tests before you can take part in this trial. These include the standard tests you have before starting chemotherapy, such as
- Physical examination
- CT scan
- Heart trace (ECG)
- Blood tests
You have more blood tests before each cycle of chemotherapy. You have a CT scan every 3 months for 2 years, and then every 6 months for another 2 years.
You fill out a diary every day for the first 4 weeks of treatment. It will ask you about any side effects you are having.
At various stages of the trial you complete 3 short questionnaires.
- The first asks you if you are having any changes in feeling in your hands or feet such as numbness or tingling. You do this one every second cycle of chemotherapy.
- The second asks you how you are feeling, about your quality of life and what, if any, symptoms you are having. You fill this one in before you start treatment and again when you finish treatment.
- The third asks you about curcumin and how you feel about taking it in this trial, and with chemotherapy. You fill this one in before you start treatment and again when you finish treatment.
Curcumin is a new potential treatment for cancer, so there may be side effects we don’t know about yet. It has been used in about 40 or so small clinical trials so far - some used doses similar to those in this trial, some used higher doses.
From this research we know that the possible side effects include
- Mild bowel disturbance, such as looser stools or diarrhoea
- Bloating and increased wind
Some people who had a higher dose of curcumin had no severe side effects, but some had diarrhoea and abdominal pain.
We have more information about the side effects of FOLFOX.
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Prof Anne Thomas
Bowel Disease Research Foundation (BDRF)
Experimental Cancer Medicine Centre (ECMC)
Hope against cancer
NIHR Clinical Research Network: Cancer
Royal College of Surgeons of England
University Hospitals of Leicester NHS Trust
University of Leicester