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A Two-Stage Phase 2 Study Of A-007 Topical Gel in High-Grade Squamous Intraepithelial Lesions (HSIL) (TG-003)

Primary Purpose

Cervical Intraepithelial Neoplasia, Uterine Cervical Dysplasia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
A-007
Sponsored by
Tigris Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Intraepithelial Neoplasia focused on measuring Cervical Intraepithelial Neoplasia (CIN), High-grade Cervical Intraepithelial Neoplasia, High-grade Squamous Intraepithelial Lesions (HSIL), Human Papilloma Virus (HPV), High-Grade Cervical Intraepithelial Lesions (CIN 2/3)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • 18 years of age or older
  • The patient or her authorized representative must sign and date an Ethical Review Board-approved informed consent document. All aspects of the protocol must be explained and written informed consent obtained.
  • Patients must have histologic proof of CIN 2/3 disease documented within the last 12 weeks. If patient is enrolled using prior local biopsy, local slides and pathology report must be sent to the central laboratory. Patient may be enrolled into the study based on local laboratory results of CIN 2/3 and will not be discontinued if central laboratory results differ.
  • Cervical swabs must test positive for high risk HPV (by Hybrid Capture 2). If the patient tests negative for high risk HPV and has proof of CIN 2/3, the patient should be retested one additional time for high-risk HPV.
  • Patients must have a Hgb ≥ 9 g/dl, a peripheral WBC ≥ 3000 mm3 and platelet counts ≥100,000 mm3.
  • Normal hepatic and renal functions - AST and ALT <2.5 x ULN and creatinine <1.5 x ULN, respectively.
  • Females of childbearing potential must use one of the following birth control methods during the study (until performance of the LEEP at month 4): oral, implantable, injectable contraceptives; abstinence (celibacy). Contraceptive sponges, IUD, vaginal contraceptive rings, spermacides, sponges, condoms, or partner's vasectomy are not acceptable methods of birth control.

Exclusion Criteria:

  • Patients with CIN 1 or with invasive squamous cell carcinoma (SCC).
  • CIN appearing to involve the endocervix, as assessed colposcopically
  • CIN not amenable to adequate colposcopic follow-up evaluations, i.e. unsatisfactory colposcopy.
  • CIN 3 involving more than two cervical quadrants on colposcopy.
  • Patients treated for cervical SIL within the past year.
  • Patients who have had a LEEP performed in the past 12 months
  • Patients with other malignancy (except non-melanoma skin) within the past 5 years.
  • Patients with any chronic, active infections (including HIV) other than HPV.
  • Patients with known clinically relevant immunological deficiency.
  • Concurrent treatment with cytotoxic, radiation, or immuno-stimulative therapy, or with systemic corticosteroids at a dose >5 mg/d of prednisone (or its equivalent).
  • Participation in another investigational medication trial concurrently or within 30 days, or prior administration of a prophylactic HPV vaccine or participation in an HPV vaccine trial. Treatment within the last 30 days with a medication that has not received regulatory approval at the time of study entry.
  • Concomitant use of topical vaginal medications.
  • Significant acute or chronic medical or psychiatric illness that, in the judgment of the Investigator, could compromise subject safety, limit the subject's ability to complete the study, and/or compromise the objectives of the study.
  • History of allergy or hypersensitivity to cosmetics, toiletries, or other topical or dermatologic products.
  • Pregnant or lactating females who are nursing and will not consent to cease nursing.
  • Investigators, site personnel directly affiliated with this study, and their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biological or legally adopted.
  • Patients with known menstrual irregularity that is not resolved with cycling on hormonal contraception.

Sites / Locations

  • Visions Clinical Research-Tucson
  • Robin Black OGNP
  • Visions Clinical Research
  • Montefiore Medical Center-Weiler Division Dept of OB/GYN & Women's Health
  • NYU School of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

A-007

Arm Description

Single arm open label

Outcomes

Primary Outcome Measures

Determine overall pathological response (complete and partial, based on independent review at month 4) of A-007 when applied topically for two 28-day cycles of 14 consec. days of treatment each to the uterine cervix of women with HSIL [CIN 2/3].

Secondary Outcome Measures

Determine the local tolerability and systemic safety of A-007.
Evaluate the effects of A-007 gel treatment on human papillomavirus (HPV) eradication.

Full Information

First Posted
January 4, 2008
Last Updated
May 21, 2009
Sponsor
Tigris Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00596258
Brief Title
A Two-Stage Phase 2 Study Of A-007 Topical Gel in High-Grade Squamous Intraepithelial Lesions (HSIL)
Acronym
TG-003
Official Title
A Two-Stage Phase 2 Study Of Dose-Intense 4,4'-Dihydroxybenzophenone-2,4-Dinitrophenyl-Hydrazone (A-007) Topical Gel in the Treatment of High-Grade Squamous Intraepithelial Lesions (HSIL) of the Cervix
Study Type
Interventional

2. Study Status

Record Verification Date
May 2009
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
July 2008 (Actual)
Study Completion Date
August 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Tigris Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A-007 is an investigational therapy which may be effective in the treatment of pre-cancerous cervical dysplasia (abnormal cell growth). The purpose of this study is to evaluate the safety and efficacy of A-007, when used to treat high-grade cervical dysplasia.
Detailed Description
This is a non-randomized, two-stage phase II study with pathological response rate as the primary objective. Following biopsy confirmation of CIN 2/3 within the last 12 weeks, women will treat themselves with gel applied to the cervix via an intravaginal applicator. Patients will apply gel once daily for 14 consecutive days of a 28-day cycle for 2 cycles. Women will return to clinic for safety assessments, colposcopy, cytology, and virologic and immunologic testing (see schedule of events in attachment TG-003.01 for visit intervals). Following the two cycles of treatment with A-007, treating physicians will perform a LEEP at the month 4 visit. The investigator is responsible for ensuring that the LEEP is conducted according to the procedures and guidelines of their institution.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Intraepithelial Neoplasia, Uterine Cervical Dysplasia
Keywords
Cervical Intraepithelial Neoplasia (CIN), High-grade Cervical Intraepithelial Neoplasia, High-grade Squamous Intraepithelial Lesions (HSIL), Human Papilloma Virus (HPV), High-Grade Cervical Intraepithelial Lesions (CIN 2/3)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A-007
Arm Type
Experimental
Arm Description
Single arm open label
Intervention Type
Drug
Intervention Name(s)
A-007
Intervention Description
applied topically for two 28-day cycles of 14 consecutive days of treatment each to the uterine cervix
Primary Outcome Measure Information:
Title
Determine overall pathological response (complete and partial, based on independent review at month 4) of A-007 when applied topically for two 28-day cycles of 14 consec. days of treatment each to the uterine cervix of women with HSIL [CIN 2/3].
Time Frame
Over the course of the trial
Secondary Outcome Measure Information:
Title
Determine the local tolerability and systemic safety of A-007.
Time Frame
over the course of the trial
Title
Evaluate the effects of A-007 gel treatment on human papillomavirus (HPV) eradication.
Time Frame
over the course of the trial

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years of age or older The patient or her authorized representative must sign and date an Ethical Review Board-approved informed consent document. All aspects of the protocol must be explained and written informed consent obtained. Patients must have histologic proof of CIN 2/3 disease documented within the last 12 weeks. If patient is enrolled using prior local biopsy, local slides and pathology report must be sent to the central laboratory. Patient may be enrolled into the study based on local laboratory results of CIN 2/3 and will not be discontinued if central laboratory results differ. Cervical swabs must test positive for high risk HPV (by Hybrid Capture 2). If the patient tests negative for high risk HPV and has proof of CIN 2/3, the patient should be retested one additional time for high-risk HPV. Patients must have a Hgb ≥ 9 g/dl, a peripheral WBC ≥ 3000 mm3 and platelet counts ≥100,000 mm3. Normal hepatic and renal functions - AST and ALT <2.5 x ULN and creatinine <1.5 x ULN, respectively. Females of childbearing potential must use one of the following birth control methods during the study (until performance of the LEEP at month 4): oral, implantable, injectable contraceptives; abstinence (celibacy). Contraceptive sponges, IUD, vaginal contraceptive rings, spermacides, sponges, condoms, or partner's vasectomy are not acceptable methods of birth control. Exclusion Criteria: Patients with CIN 1 or with invasive squamous cell carcinoma (SCC). CIN appearing to involve the endocervix, as assessed colposcopically CIN not amenable to adequate colposcopic follow-up evaluations, i.e. unsatisfactory colposcopy. CIN 3 involving more than two cervical quadrants on colposcopy. Patients treated for cervical SIL within the past year. Patients who have had a LEEP performed in the past 12 months Patients with other malignancy (except non-melanoma skin) within the past 5 years. Patients with any chronic, active infections (including HIV) other than HPV. Patients with known clinically relevant immunological deficiency. Concurrent treatment with cytotoxic, radiation, or immuno-stimulative therapy, or with systemic corticosteroids at a dose >5 mg/d of prednisone (or its equivalent). Participation in another investigational medication trial concurrently or within 30 days, or prior administration of a prophylactic HPV vaccine or participation in an HPV vaccine trial. Treatment within the last 30 days with a medication that has not received regulatory approval at the time of study entry. Concomitant use of topical vaginal medications. Significant acute or chronic medical or psychiatric illness that, in the judgment of the Investigator, could compromise subject safety, limit the subject's ability to complete the study, and/or compromise the objectives of the study. History of allergy or hypersensitivity to cosmetics, toiletries, or other topical or dermatologic products. Pregnant or lactating females who are nursing and will not consent to cease nursing. Investigators, site personnel directly affiliated with this study, and their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biological or legally adopted. Patients with known menstrual irregularity that is not resolved with cycling on hormonal contraception.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Keith A Aqua, MD
Organizational Affiliation
Visions Clinical Research
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mark H Einstein, MD
Organizational Affiliation
Montefiore Medical Center-Weiler Division
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Cynthia J Goldberg, MD
Organizational Affiliation
Visions Clinical Research-Tucson
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Robert Pfeffer, MD
Organizational Affiliation
Robin Black OGNP, Costa Mesa California
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Stephanie Blank, MD
Organizational Affiliation
NYU School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Visions Clinical Research-Tucson
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
Robin Black OGNP
City
Costa Mesa
State/Province
California
ZIP/Postal Code
92629
Country
United States
Facility Name
Visions Clinical Research
City
Boynton Beach
State/Province
Florida
ZIP/Postal Code
33437
Country
United States
Facility Name
Montefiore Medical Center-Weiler Division Dept of OB/GYN & Women's Health
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States
Facility Name
NYU School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
14521417
Citation
Morgan LR, Thangaraj K, LeBlanc B, Rodgers A, Wolford LT, Hooper CL, Fan D, Jursic BS. Design, synthesis, and anticancer properties of 4,4'-dihydroxybenzophenone-2,4-dinitrophenylhydrazone and analogues. J Med Chem. 2003 Oct 9;46(21):4552-63. doi: 10.1021/jm0301080.
Results Reference
background
Citation
Morgan, LR, Hooper, CL, Rodgers, AH, LoRusso, P, Eilender, DE and Culotta, VA. 4,4'-Dihydroxybenzophenone-2,4-dinitrophenyl-hydrazone (A-007): A CD4+ T-Lymphocyte Modulator Useful in the Treatment of Advanced Cancer. Chemotherapy - accepted 2005.
Results Reference
background
Citation
Morgan, LR, Hooper, CL, Rodgers, AH Culotta, V et al. 4,4'-Dihydroxy benzophenone -2,4-dinitrophenylhydrazone (A-007) A Modulator of CD45+ T Lymphocytes in HPV Infected Anogenital Epithelium. In: HPV Vaccines and Immune Therapy, Cambridge, United Kingdom, 2003
Results Reference
background

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A Two-Stage Phase 2 Study Of A-007 Topical Gel in High-Grade Squamous Intraepithelial Lesions (HSIL)

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