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Study of the Effects of Brilacidin Oral Rinse on Radiation-induced Oral Mucositis in Patients With Head and Neck Cancer (Brilacidin)

Primary Purpose

Head and Neck Neoplasms, Mucositis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Brilacidin
Placebo
Sponsored by
Innovation Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Head and Neck Neoplasms focused on measuring Oral Mucositis, Brilacidin, Chemoradiation

Eligibility Criteria

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

Inclusion Criteria:

  1. Willing and able to read, understand and sign an informed consent form (ICF)
  2. Have recently diagnosed (within previous 6 months) pathologically confirmed, non-metastatic squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or supraglottic larynx that will be treated with CRT therapy as first line non-surgical treatment. Scans (CT, PET, and/or MRI) obtained within 120 days prior to consent for screening can be used to determine the subject's eligibility.
  3. Have a plan to receive a continuous course of conventional external beam irradiation delivered by intensity-modulated radiotherapy (IMRT) as single daily fractions of 2.0 Gy to 2.2 Gy with a cumulative radiation dose ≥55 Gy and ≤72 Gy. Planned radiation treatment fields must include at least two oral sites (buccal mucosa, floor of mouth, ventral/lateral tongue, soft palate). [Note: the independent RTQA consultant must confirm that the planned radiation treatment meets the protocol criteria]
  4. Have a plan to receive a standard cisplatin chemotherapy regimen administered weekly (30-40 mg/m2) or approximately every 21 days (80-100 mg/m2)
  5. Have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2. However, potential subjects with an ECOG of 3 may be enrolled provided their condition does not preclude performing the actions required by study participation (e.g., opening medication bottles, swishing the oral rinse and spitting out, completing or participating in completion of daily diaries and FACT-H&N forms).
  6. Have adequate hematopoietic, hepatic, and renal function at a screening visit
  7. Urine or serum pregnancy test: negative for female patients of childbearing potential
  8. Agree to utilize medically accepted methods of birth control during study participation and for 90 days following the last treatment with study drug if a female subject is of childbearing potential or if a male subject has an opposite sex partner of child bearing potential.
  9. Males or females aged ≥18 years on day of consent.

Exclusion Criteria:

  1. Has tumor(s) of the lips, sinuses, salivary glands, nasopharynx, glottic larynx, subglottic larynx or unknown primary tumor
  2. Has metastatic disease (M1) Stage IV C
  3. Has had prior radiation to the head and neck
  4. Plan to be treated with cetuximab (Erbitux®)
  5. Planned use of cisplatin as induction chemotherapy.
  6. Has a history of other malignant tumors within the last 5 years, except non melanoma skin cancer or in situ cervical carcinoma curatively excised
  7. Has had a major surgical procedure, other than for HNC, or significant traumatic injury within 4 weeks prior to the initiation of RT; anticipation of need for major surgical procedure during the course of the study
  8. Has incompletely healed sites of dental extractions
  9. Has an 12-lead ECG obtained at screening visit which shows medically significant abnormality(ies) (e.g. left bundle branch block, frequent premature ventricular contractions, QTc interval prolongation > 450 msec for males and > 470 msec for females)
  10. Has untreated hypertension or has hypertension under treatment that meets protocol definitions.
  11. Has active infectious disease undergoing systemic treatment excluding oral candidiasis
  12. Has oral mucositis (of any severity) prior to initiation of radiation therapy
  13. Has a diagnosis of an immunosuppressive illness or a condition requiring chronic immunosuppression
  14. Has known seropositivity for HIV or hepatitis C antibody, or known to be hepatitis B surface antigen positive (testing for these serologic markers is not required for enrollment in this protocol)
  15. Use of any investigational agent within 30 days of randomization
  16. Is pregnant or breastfeeding
  17. Has known allergies or intolerance to brilacidin, cisplatin or carboplatin
  18. Has inability to give informed consent or comply with study requirements
  19. Has any other condition or prior therapy that in the opinion of the Investigator would make the patient unsuitable for the study and/or unable to comply with requirements for follow-up visits.
  20. Is unwilling or unable to agree to swish and spit the study oral rinse three times per day during the study period

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Placebo Comparator Oral Rinse

Active Comparator Oral Rinse

Arm Description

Water for Injection

Brilacidin 3 mg/mL in Water for Injection

Outcomes

Primary Outcome Measures

Incidence of Severe OM During Radiation Therapy in Subjects Receiving a Cumulative IMRT Dose of at Least 55 Gy
Incidence of severe oral mucositis, defined as grade 3 or 4 on the WHO Oral Mucositis score, experienced during radiation therapy by patients with head and neck cancer receiving a cumulative radiation dose of at least 55 Gy. The higher the score the more severe the mucositis.

Secondary Outcome Measures

Duration of Severe Oral Mucositis (WHO Grade ≥3) [Overall Duration]
Overall duration of severe OM was defined as the number of days from initial WHO Grade ≥3 during radiation therapy to the day prior to the next OM assessment after the last WHO Grade ≥3 during/after radiation therapy.
Incidence of Severe Oral Mucositis (WHO Grade ≥3) for Subjects Receiving Cisplatin Every 21 Days
Incidence of severe oral mucositis (WHO Grade ≥3) for subjects receiving cisplatin every 21 days
Time to Onset of Severe Oral Mucositis (WHO Grade ≥3)
Time to onset of severe oral mucositis (WHO Grade ≥3) analyzed using Kaplan-Meier methods.

Full Information

First Posted
December 17, 2014
Last Updated
January 15, 2019
Sponsor
Innovation Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02324335
Brief Title
Study of the Effects of Brilacidin Oral Rinse on Radiation-induced Oral Mucositis in Patients With Head and Neck Cancer
Acronym
Brilacidin
Official Title
Phase 2 Study to Evaluate the Efficacy & Safety of Brilacidin Oral Rinse Administered Daily for 7 Weeks in Attenuating Oral Mucositis in Patients With Head & Neck Cancer Receiving Chemoradiation
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
August 14, 2014 (Actual)
Primary Completion Date
October 25, 2017 (Actual)
Study Completion Date
November 22, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Innovation Pharmaceuticals, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Oral Mucositis (OM) is a painful and debilitating side effect of many of the drug/radiation regimens used to treat cancer. This study examines the investigational drug brilacidin and its possible application in prevention of oral mucositis in patients undergoing chemoradiation for treatment of head and neck cancer.
Detailed Description
This study will examine whether daily oral rinses with a solution containing brilacidin will prevent the occurrences of OM or lessen the severity of OM if it occurs. Patients will use an oral rinse 3 times daily for up to seven weeks during chemoradiation for head and neck cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Neoplasms, Mucositis
Keywords
Oral Mucositis, Brilacidin, Chemoradiation

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
61 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo Comparator Oral Rinse
Arm Type
Placebo Comparator
Arm Description
Water for Injection
Arm Title
Active Comparator Oral Rinse
Arm Type
Active Comparator
Arm Description
Brilacidin 3 mg/mL in Water for Injection
Intervention Type
Drug
Intervention Name(s)
Brilacidin
Other Intervention Name(s)
PMX30063
Intervention Description
Oral Rinse used 3 times daily for 7 weeks
Intervention Type
Other
Intervention Name(s)
Placebo
Other Intervention Name(s)
Water for Injection
Primary Outcome Measure Information:
Title
Incidence of Severe OM During Radiation Therapy in Subjects Receiving a Cumulative IMRT Dose of at Least 55 Gy
Description
Incidence of severe oral mucositis, defined as grade 3 or 4 on the WHO Oral Mucositis score, experienced during radiation therapy by patients with head and neck cancer receiving a cumulative radiation dose of at least 55 Gy. The higher the score the more severe the mucositis.
Time Frame
7 weeks
Secondary Outcome Measure Information:
Title
Duration of Severe Oral Mucositis (WHO Grade ≥3) [Overall Duration]
Description
Overall duration of severe OM was defined as the number of days from initial WHO Grade ≥3 during radiation therapy to the day prior to the next OM assessment after the last WHO Grade ≥3 during/after radiation therapy.
Time Frame
11 weeks
Title
Incidence of Severe Oral Mucositis (WHO Grade ≥3) for Subjects Receiving Cisplatin Every 21 Days
Description
Incidence of severe oral mucositis (WHO Grade ≥3) for subjects receiving cisplatin every 21 days
Time Frame
7 weeks
Title
Time to Onset of Severe Oral Mucositis (WHO Grade ≥3)
Description
Time to onset of severe oral mucositis (WHO Grade ≥3) analyzed using Kaplan-Meier methods.
Time Frame
7 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to read, understand and sign an informed consent form (ICF) Have recently diagnosed (within previous 6 months) pathologically confirmed, non-metastatic squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or supraglottic larynx that will be treated with CRT therapy as first line non-surgical treatment. Scans (CT, PET, and/or MRI) obtained within 120 days prior to consent for screening can be used to determine the subject's eligibility. Have a plan to receive a continuous course of conventional external beam irradiation delivered by intensity-modulated radiotherapy (IMRT) as single daily fractions of 2.0 Gy to 2.2 Gy with a cumulative radiation dose ≥55 Gy and ≤72 Gy. Planned radiation treatment fields must include at least two oral sites (buccal mucosa, floor of mouth, ventral/lateral tongue, soft palate). [Note: the independent RTQA consultant must confirm that the planned radiation treatment meets the protocol criteria] Have a plan to receive a standard cisplatin chemotherapy regimen administered weekly (30-40 mg/m2) or approximately every 21 days (80-100 mg/m2) Have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2. However, potential subjects with an ECOG of 3 may be enrolled provided their condition does not preclude performing the actions required by study participation (e.g., opening medication bottles, swishing the oral rinse and spitting out, completing or participating in completion of daily diaries and FACT-H&N forms). Have adequate hematopoietic, hepatic, and renal function at a screening visit Urine or serum pregnancy test: negative for female patients of childbearing potential Agree to utilize medically accepted methods of birth control during study participation and for 90 days following the last treatment with study drug if a female subject is of childbearing potential or if a male subject has an opposite sex partner of child bearing potential. Males or females aged ≥18 years on day of consent. Exclusion Criteria: Has tumor(s) of the lips, sinuses, salivary glands, nasopharynx, glottic larynx, subglottic larynx or unknown primary tumor Has metastatic disease (M1) Stage IV C Has had prior radiation to the head and neck Plan to be treated with cetuximab (Erbitux®) Planned use of cisplatin as induction chemotherapy. Has a history of other malignant tumors within the last 5 years, except non melanoma skin cancer or in situ cervical carcinoma curatively excised Has had a major surgical procedure, other than for HNC, or significant traumatic injury within 4 weeks prior to the initiation of RT; anticipation of need for major surgical procedure during the course of the study Has incompletely healed sites of dental extractions Has an 12-lead ECG obtained at screening visit which shows medically significant abnormality(ies) (e.g. left bundle branch block, frequent premature ventricular contractions, QTc interval prolongation > 450 msec for males and > 470 msec for females) Has untreated hypertension or has hypertension under treatment that meets protocol definitions. Has active infectious disease undergoing systemic treatment excluding oral candidiasis Has oral mucositis (of any severity) prior to initiation of radiation therapy Has a diagnosis of an immunosuppressive illness or a condition requiring chronic immunosuppression Has known seropositivity for HIV or hepatitis C antibody, or known to be hepatitis B surface antigen positive (testing for these serologic markers is not required for enrollment in this protocol) Use of any investigational agent within 30 days of randomization Is pregnant or breastfeeding Has known allergies or intolerance to brilacidin, cisplatin or carboplatin Has inability to give informed consent or comply with study requirements Has any other condition or prior therapy that in the opinion of the Investigator would make the patient unsuitable for the study and/or unable to comply with requirements for follow-up visits. Is unwilling or unable to agree to swish and spit the study oral rinse three times per day during the study period
Facility Information:
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85234
Country
United States
City
Lakeland
State/Province
Florida
ZIP/Postal Code
33805
Country
United States
City
Columbus
State/Province
Georgia
ZIP/Postal Code
31904
Country
United States
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40207
Country
United States
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71103
Country
United States
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87131
Country
United States
City
Cheektowaga
State/Province
New York
ZIP/Postal Code
14225
Country
United States
City
Poughkeepsie
State/Province
New York
ZIP/Postal Code
11794
Country
United States
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43623
Country
United States
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53211
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of the Effects of Brilacidin Oral Rinse on Radiation-induced Oral Mucositis in Patients With Head and Neck Cancer

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