Human / Clinical Studies
continued...
In 2001, a phase II trial (AETERNA-AE-MM-00-02) of AE-941/Neovastat was initiated in patients with relapsed or refractory multiple myeloma. This trial closed approximately 1 year later, and no results have been reported.[19]
Two randomized phase III trials of AE-941/Neovastat in patients with advanced cancer have been approved by the U.S. Food and Drug Administration (FDA). In one trial (MDA-ID-99303), which is completed, treatment with oral AE-941/Neovastat plus chemotherapy and radiation therapy was compared with treatment with placebo plus the same chemotherapy and radiation therapy in patients with stage III NSCLC. In the second trial, which closed to patient recruitment in 2002, treatment with oral AE-941/Neovastat was compared with treatment with placebo in patients with metastatic renal cell carcinoma. Results from this second phase III trial have not been reported in the peer-reviewed scientific literature.[20] Despite AE-941/Neovastat being granted orphan drug status by the FDA in 2002 for use in the treatment of renal cell carcinoma, the company that produces AE-941/Neovastat, Aeterna Laboratories, announced in early 2004 that this application would be discontinued in favor of a focus on the treatment of NSCLC.[20,21]
In 2010, the results of a randomized, double-blind, placebo-controlled phase III trial aimed at assessing the effect of adding AE-941 to chemotherapy and radiation therapy on the overall survival of patients with nonresectable stage III NSCLC were reported. A total of 379 eligible patients received induction chemotherapy followed by concurrent chemotherapy with chest radiation therapy; participating centers used one of two chemotherapy regimens, either carboplatin and paclitaxel, or cisplatin and vinorelbine. No statistically significant difference in overall survival was observed between the group (n = 188) receiving chemotherapy and radiation therapy plus AE-941 (120 mL administered orally twice daily) and the group receiving chemotherapy and radiation therapy plus placebo (n = 191). Both AE-941 and placebo were well tolerated.[22]
Cartilage Use in Cancer Treatment: Clinical Studies With Therapeutic Endpointsa,b
| Reference Citation(s) | Type of Study | Type(s) of Cancer | Cartilage Product (Source) | No. of Patients: Treated; Control | Strongest Benefit Reportedc | Concurrent Therapyd | Level of Evidence Scoree |
| [1] | Nonconsecutive case series | Various advanced or recurrent | Catrix (bovine) | 31; None | Complete response, 19 patients | Yes | 3iiiDiii |
| [2] | Phase II trial | Various metastatic | Catrix (bovine) | 9; None | Complete response, 1 patient, metastatic renal cell carcinoma | No | 3iiiDiii |
| [3] | Phase II trial | Metastatic renal cell | Catrix (bovine) | 35; None | Partial response, 3 of 22 evaluable patients | Unknown | Nonef |
| [10,17] | Two phase I/II trialsg | Various advanced, refractory solid tumors | AE-941/ Neovastat (shark) | 331; None | Improved survival, higher versus lower doses, patients with stage III/IV non-small cell lung cancer (unplanned retrospective analysis), and patients with refractory renal cell carcinoma (prospective analysis) | Unknown | Nonef |
| [9] | Phase I/II trial | Advanced non-small cell lung cancer | AT-941/Neovastat (shark) | 80; None | No dose-limiting toxicity found. Improved survival time in patients receiving the highest doses when survival analysis was conducted, and stable disease for greater number of patients receiving higher doses. No tumor response observed. | Yes or refused standard therapy | None |
| [4] | Phase I/II trial | Various advanced solid tumors | Cartilade (shark) | 60; None | Stable disease for 12 wk or more, 10 of 50 evaluable patients | No | 3iiiDiii |
| [5] | Phase II trial | Metastatic, refractory breast | Unknown (shark) | 20; None | Stable disease for 8 wk or more, 2 of 10 evaluable patients | No | Nonef |
| [5] | Phase II trial | Metastatic, hormone- refractory prostate | Unknown (shark) | 12; None | Stable disease for 20 wk or more, 3 of 10 evaluable patients | No | Nonef |
| [6] | Phase II trial | Various advanced brain | BeneFin (shark) | 12; None | Stable disease for 20 wk or more, 2 of 10 evaluable patients | No | Nonef |
| [8] | Phase III randomized, placebo-controlled, double-blind trial (2 arms) | Breast and colorectal | BeneFin (shark) | 42; 41 | No statistically significant difference | No | 1i |
| [22] | Randomized controlled phase III trial | NSCLC | AE-941 (shark) | 188; 191 | None | Cisplatin and vinorelbine; carboplatin and paclitaxel | 1iA |
References:
- Prudden JF: The treatment of human cancer with agents prepared from bovine cartilage. J Biol Response Mod 4 (6): 551-84, 1985.
- Romano CF, Lipton A, Harvey HA, et al.: A phase II study of Catrix-S in solid tumors. J Biol Response Mod 4 (6): 585-9, 1985.
- Puccio C, Mittelman A, Chun P, et al.: Treatment of metastatic renal cell carcinoma with Catrix. [Abstract] Proceedings of the American Society of Clinical Oncology 13: A-769, 246, 1994.
- Miller DR, Anderson GT, Stark JJ, et al.: Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 16 (11): 3649-55, 1998.
- Leitner SP, Rothkopf MM, Haverstick L, et al.: Two phase II studies of oral dry shark cartilage powder (SCP) with either metastatic breast or prostate cancer refractory to standard treatment. [Abstract] Proceedings of the American Society of Clinical Oncology 17: A-240, 1998.
- Rosenbluth RJ, Jennis AA, Cantwell S, et al.: Oral shark cartilage in the treatment of patients with advanced primary brain tumors. [Abstract] Proceedings of the American Society of Clinical Oncology 18: A-554, 1999.
- Batist G, Champagne P, Hariton C, et al.: Dose-survival relationship in a phase II study of Neovastat in refractory renal cell carcinoma patients. [Abstract] Proceedings of the American Society of Clinical Oncology 21: A-1907, 2002.
- Loprinzi CL, Levitt R, Barton DL, et al.: Evaluation of shark cartilage in patients with advanced cancer: a North Central Cancer Treatment Group trial. Cancer 104 (1): 176-82, 2005.
- Latreille J, Batist G, Laberge F, et al.: Phase I/II trial of the safety and efficacy of AE-941 (Neovastat) in the treatment of non-small-cell lung cancer. Clin Lung Cancer 4 (4): 231-6, 2003.
- Falardeau P, Champagne P, Poyet P, et al.: Neovastat, a naturally occurring multifunctional antiangiogenic drug, in phase III clinical trials. Semin Oncol 28 (6): 620-5, 2001.
- AE 941--Neovastat. Drugs R D 1 (2): 135-6, 1999.
- Cassileth BR: Shark and bovine cartilage therapies. In: Cassileth BR, ed.: The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. New York, NY: WW Norton & Company, 1998, pp 197-200.
- Reviews of Therapies: Biologic/Organic/Pharmacologic Therapies: Cartilage. Houston, Tex: M.D. Anderson Cancer Center, 2003. Available online. Last accessed September 16, 2010.
- Holt S: Shark cartilage and nutriceutical update. Altern Complement Ther 1: 414-16, 1995.
- Hunt TJ, Connelly JF: Shark cartilage for cancer treatment. Am J Health Syst Pharm 52 (16): 1756, 1760, 1995.
- AE 941. Drugs R D 5 (2): 83-9, 2004.
- Batist G, Patenaude F, Champagne P, et al.: Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels. Ann Oncol 13 (8): 1259-63, 2002.
- Berbari P, Thibodeau A, Germain L, et al.: Antiangiogenic effects of the oral administration of liquid cartilage extract in humans. J Surg Res 87 (1): 108-13, 1999.
- Ryoo JJ, Cole CE, Anderson KC: Novel therapies for multiple myeloma. Blood Rev 16 (3): 167-74, 2002.
- Bukowski RM: AE-941, a multifunctional antiangiogenic compound: trials in renal cell carcinoma. Expert Opin Investig Drugs 12 (8): 1403-11, 2003.
- New treatment option for postmenopausal women with early breast cancer. Expert Rev Anticancer Ther 2 (6): 617, 2002.
- Lu C, Lee JJ, Komaki R, et al.: Chemoradiotherapy with or without AE-941 in stage III non-small cell lung cancer: a randomized phase III trial. J Natl Cancer Inst 102 (12): 859-65, 2010.
WebMD Public Information from the National Cancer Institute
