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Safety Study of Amphinex Based Photochemical Internalisation (PCI) of Bleomycin in Patients With Cutaneous Cancer

Primary Purpose

Head and Neck Neoplasms, Skin Neoplasms

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Amphinex (TPCS2a)
Bleomycin
Illumination with CeramOptec laser
Sponsored by
PCI Biotech AS
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Neoplasms focused on measuring photochemical internalisation, photosensitiser, cutaneous tumour, sub-cutaneous tumour, dose escalation

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female aged 18 years or above who have given written informed consent.
  • Skin type I- IV according to the Fitzpatrick skin classification (see appendix G).
  • With a diagnosis of local recurrence or advanced/metastatic, cutaneous or subcutaneous malignancy
  • Lesion measurement must not be done more than 2 weeks before the beginning of treatment. More than one field with lesion can be illuminated, but care must be taken to avoid overlap of the fields illuminated.
  • Have discontinued all previous therapies for cancer, including chemotherapy, radiotherapy, anticancer hormone therapy, or other investigational therapy for at least 2 weeks prior to study entry, and have recovered from the acute effects of therapy.
  • Have a performance status of 0-2 on the Eastern Cooperative Oncology Group (ECOG) Scale (see appendix D).
  • Clinically assessed as eligible for bleomycin chemotherapy.
  • Have a predicted life expectancy of at least 3 months.
  • Geographic proximity that allow adequate follow-up.
  • If female: have had childbearing potential either terminated by surgery, radiation, or menopause or attenuated by the use of an approved contraceptive method during and for 3 months after the trial.
  • If male: have had reproductive potential either terminated or attenuated by the use of an approved contraceptive method during and for 3 months after the trial.

Exclusion Criteria:

  • Have received prior PCI.
  • Tumours known to be eroding into a major blood vessel in or adjacent to the illumination site.
  • Planned surgery in first 28 days after treatment, except for planned surgical removal of the treated lesion.
  • Planned dentist appointments in first 28 days after treatment.
  • Anticancer therapy within the first 28 days after treatment.
  • Therapy with drugs that induce light sensitivity (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylurea, hypoglycemic agents, thiazide diuretics, and griseofulvin) within the first 14 days after treatment.
  • Co-existing ophthalmic disease likely to require slit-lamp examination within the first 28 days after treatment.
  • History of hypersensitivity/anaphylactic reactions.
  • Previous cumulative dose of Bleomycin received over 200 000 IE
  • Known allergy or sensitivity to photosensitisers.
  • Known allergy to Cremophor.
  • Known allergy to bleomycin.
  • Conditions contraindicated for bleomycin treatment (lung infection, impaired pulmonary function).
  • Conditions that worsen when exposed to light (including porphyria).
  • Conditions associated with a risk of poor protocol compliance.
  • Pregnancy or breastfeeding.

Sites / Locations

  • University College London Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TPCS2a

Arm Description

No comparative treatment is given in this open-label phase I, dose escalating safety study

Outcomes

Primary Outcome Measures

Dose limiting toxicity

Secondary Outcome Measures

Tumour response according to Response Evaluation Criteria in Solid Tumors (RECIST)

Full Information

First Posted
October 9, 2009
Last Updated
April 25, 2019
Sponsor
PCI Biotech AS
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1. Study Identification

Unique Protocol Identification Number
NCT00993512
Brief Title
Safety Study of Amphinex Based Photochemical Internalisation (PCI) of Bleomycin in Patients With Cutaneous Cancer
Official Title
Phase I, Dose-escalating Study to Evaluate Safety and Tolerance of Amphinex Based Photochemical Internalisation (PCI) of Bleomycin in Patients With Local Recurrence or Advanced/Metastatic, Cutaneous or Sub-cutaneous Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
April 2019
Overall Recruitment Status
Completed
Study Start Date
August 2009 (undefined)
Primary Completion Date
May 2011 (Actual)
Study Completion Date
May 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PCI Biotech AS

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is an open, non- randomized, phase I, dose-escalating study to evaluate the safety and tolerance of Amphinex based PCI of bleomycin in patients with local recurrent or advanced/metastatic, cutaneous or sub-cutaneous malignancies.
Detailed Description
Eligible patients will be included in cohorts of 3 patients. The initial starting dose for Amphinex will be given 4 days prior to the fixed dose of bleomycin administered by intravenous infusion. The illumination, with red light (laser 652 nm), to the tumour surface and a margin of 2-3 mm outside the tumour surface, will be performed after bleomycin administration. There will be no comparative procedure in this study. Dose escalation will proceed according to a modification of Simon's accelerated titration design. The number of patients recruited depends on the DLT experienced. A total of 6 patients will be included at each dose level if no more than 1 patient experiences DLT. Additional cohorts may be added pending the outcome of the previous cohorts and discussions between the investigators and the Sponsor. The primary goal of the study is to assess the safety and tolerance of the Amphinex and determine the maximal tolerated dose (MTD) of Amphinex as a PCI therapy in combination with bleomycin treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Neoplasms, Skin Neoplasms
Keywords
photochemical internalisation, photosensitiser, cutaneous tumour, sub-cutaneous tumour, dose escalation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TPCS2a
Arm Type
Experimental
Arm Description
No comparative treatment is given in this open-label phase I, dose escalating safety study
Intervention Type
Drug
Intervention Name(s)
Amphinex (TPCS2a)
Other Intervention Name(s)
Amphinex
Intervention Description
intravenous TPCS2a, followed by standard dose of bleomycin (iv infusion) and illumination with CeramOptec laser.
Intervention Type
Drug
Intervention Name(s)
Bleomycin
Intervention Description
intravenous TPCS2a, followed by standard dose of bleomycin (iv infusion) and illumination with CeramOptec laser.
Intervention Type
Other
Intervention Name(s)
Illumination with CeramOptec laser
Intervention Description
intravenous TPCS2a, followed by standard dose of bleomycin (iv infusion) and illumination with CeramOptec laser.
Primary Outcome Measure Information:
Title
Dose limiting toxicity
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Tumour response according to Response Evaluation Criteria in Solid Tumors (RECIST)
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female aged 18 years or above who have given written informed consent. Skin type I- IV according to the Fitzpatrick skin classification (see appendix G). With a diagnosis of local recurrence or advanced/metastatic, cutaneous or subcutaneous malignancy Lesion measurement must not be done more than 2 weeks before the beginning of treatment. More than one field with lesion can be illuminated, but care must be taken to avoid overlap of the fields illuminated. Have discontinued all previous therapies for cancer, including chemotherapy, radiotherapy, anticancer hormone therapy, or other investigational therapy for at least 2 weeks prior to study entry, and have recovered from the acute effects of therapy. Have a performance status of 0-2 on the Eastern Cooperative Oncology Group (ECOG) Scale (see appendix D). Clinically assessed as eligible for bleomycin chemotherapy. Have a predicted life expectancy of at least 3 months. Geographic proximity that allow adequate follow-up. If female: have had childbearing potential either terminated by surgery, radiation, or menopause or attenuated by the use of an approved contraceptive method during and for 3 months after the trial. If male: have had reproductive potential either terminated or attenuated by the use of an approved contraceptive method during and for 3 months after the trial. Exclusion Criteria: Have received prior PCI. Tumours known to be eroding into a major blood vessel in or adjacent to the illumination site. Planned surgery in first 28 days after treatment, except for planned surgical removal of the treated lesion. Planned dentist appointments in first 28 days after treatment. Anticancer therapy within the first 28 days after treatment. Therapy with drugs that induce light sensitivity (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylurea, hypoglycemic agents, thiazide diuretics, and griseofulvin) within the first 14 days after treatment. Co-existing ophthalmic disease likely to require slit-lamp examination within the first 28 days after treatment. History of hypersensitivity/anaphylactic reactions. Previous cumulative dose of Bleomycin received over 200 000 IE Known allergy or sensitivity to photosensitisers. Known allergy to Cremophor. Known allergy to bleomycin. Conditions contraindicated for bleomycin treatment (lung infection, impaired pulmonary function). Conditions that worsen when exposed to light (including porphyria). Conditions associated with a risk of poor protocol compliance. Pregnancy or breastfeeding.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Colin Hopper, MD
Organizational Affiliation
University College London Hospitals
Official's Role
Principal Investigator
Facility Information:
Facility Name
University College London Hospital
City
London
ZIP/Postal Code
NW1 2PG
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
27475428
Citation
Sultan AA, Jerjes W, Berg K, Hogset A, Mosse CA, Hamoudi R, Hamdoon Z, Simeon C, Carnell D, Forster M, Hopper C. Disulfonated tetraphenyl chlorin (TPCS2a)-induced photochemical internalisation of bleomycin in patients with solid malignancies: a phase 1, dose-escalation, first-in-man trial. Lancet Oncol. 2016 Sep;17(9):1217-29. doi: 10.1016/S1470-2045(16)30224-8. Epub 2016 Jul 28.
Results Reference
derived

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Safety Study of Amphinex Based Photochemical Internalisation (PCI) of Bleomycin in Patients With Cutaneous Cancer

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