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12-week Study of NFX-179 Gel in Subjects With Epidermal Nevi

Primary Purpose

Epidermal Nevi, Nevus Sebaceus

Status
Not yet recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
NFX-179 Gel 1.50%
Sponsored by
Albert Chiou
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Epidermal Nevi

Eligibility Criteria

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

Inclusion Criteria

In order to be eligible to participate in this study, all of the following criteria must be met:

  1. Subject is at least 18 years of age
  2. Subject must provide written informed consent prior to any study procedures
  3. Subject has a Target Epidermal Nevi for treatment that:

    • Is a documented, biopsy proven, keratinocytic epidermal nevi (KEN) or nevus sebaceous (NS) or has a 3mm punch biopsy taken for histologic examination to determine KEN or NS status
    • Is a discrete lesion surrounded with at least 5mm of non-involved skin
    • Is not irritated
    • Does not have an active cutaneous infection
    • Has a Length ≥15mm
    • Has a surface area ≤100cm2
    • Has an Investigator's Lesion Assessment grade ≥2
    • Is located at an anatomical site that the subject can reach to apply the study medication
    • Has never been surgically treated
  4. Subject is willing to have hair in the area surrounding the Target EN shaved, if necessary, to obtain photographs
  5. Subject is willing to minimize exposure of the Target EN to natural or artificial ultraviolet radiation
  6. Subject is willing to abstain from application of non-study topical prescription and over the counter medications to the Target EN during the study
  7. Subject is willing to forego treatment of the Target EN, except protocol specified therapy, during the study
  8. Female subjects who are women of childbearing potential must have a negative urine pregnancy test result and be willing to use a protocol approved, contraceptive method for the duration of the study.
  9. Subject is willing and able to follow all study instructions and to attend all study visits.

No waivers to the inclusion criteria are permitted.

Exclusion Criteria A potential subject who meets any of the following criteria will be excluded from participation in this study:

  1. Subject has applied any of the following topical products in the previous 30 days on or in proximity to the Target EN that, in the investigator's opinion, impairs evaluation of the Target EN or which exposes the subject to an unacceptable risk by study participation:

    • Topical glucocorticoid steroids
    • Topical retinoids (e.g., tazarotene, tretinoin, adapalene)
    • > 5% of an alpha-hydroxy acid (e.g., glycolic acid, lactic acid)
    • Fluorouracil
    • Imiquimod
  2. The Target EN has ever been treated with a topical MEK inhibitor or a topical BRAF inhibitor
  3. The Subject has used any of the following systemic medications in the noted time period:

    • Systemic retinoids (e.g., etretinate, isotretinoin) in the previous 90 days
    • Systemic MEK inhibitors in the previous 180 days
    • Systemic BRAF inhibitors in the previous 180 days
  4. Subject has a history of hypersensitivity to any of the ingredients in the study medications
  5. Subject has any know intercurrent illness or physical condition that would, in the investigator's opinion, impair evaluation of the Target EN or which exposes the subject to an unacceptable risk by study participation
  6. Subject has, in the Investigator's opinion, a clinically relevant history of liver disease, including viral hepatitis, current alcohol abuse, or cirrhosis
  7. Subject has a history of metastatic disease, or active cancer (excluding non-melanoma skin cancer, Stage I cervical cancer, ductal carcinoma in situ of the breast, or Stage 0 chronic lymphocytic lymphoma) within the previous 5 years
  8. Subject has any condition (e.g., other skin conditions or diseases, metabolic dysfunction, physical examination findings, clinical laboratory findings) or situation (e.g., vacation, scheduled surgery) that would, in the Investigator's opinion, impair evaluation of the Target EN or which exposes the subject to an unacceptable risk by study participation
  9. Subject has participated in an investigational drug trial in which administration of an investigational study medication occurred within the previous 30 days No waivers to the exclusion criteria are permitted.

Sites / Locations

  • Stanford University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Patients receiving NFX-179 Gel

Arm Description

NFX-179 Gel 1.50% applied QD for 12 weeks

Outcomes

Primary Outcome Measures

The frequency of dermal safety and tolerability assessments including pain/burning, pruritus, erythema, edema, scabbing/crusting, and vesiculation/erosion
To determine the safety and tolerability of treatment with NFX-179 gel applied QD for 12 weeks of treatment.
The frequency of adverse events and serious adverse events as assessed by CTCAE v4.0
To determine the safety and tolerability of treatment with NFX-179 gel applied QD for 12 weeks of treatment.

Secondary Outcome Measures

Change in ILA (Investigator's Lesion Assessment)
Change in Investigator's Lesion Assessment after 12 weeks of QD application, assessed at screening, baseline, treatment period at week 2, 3, 4, and 8, and end of treatment at week 12.
Percent change in EN volume
Percent change in EN volume after 12 weeks of QD application as determined based on EN size derived from ruler measurements, and/or digital images from standardized photography performed at screening, baseline, treatment period at week 2, 3, 4, and 8, and end of treatment at week 12.

Full Information

First Posted
December 13, 2021
Last Updated
October 25, 2022
Sponsor
Albert Chiou
Collaborators
NFlection Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05195762
Brief Title
12-week Study of NFX-179 Gel in Subjects With Epidermal Nevi
Official Title
12-Week Clinical Study to Determine the Safety, Tolerability, and Clinical Effect of NFX-179 Gel in Subjects With Epidermal Nevi
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 2023 (Anticipated)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Albert Chiou
Collaborators
NFlection Therapeutics, Inc.

4. Oversight

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

5. Study Description

Brief Summary
This study of NFX-179 is an open-label study, evaluating safety, tolerability, pharmacodynamic activity, and the clinical effect in subjects with Epidermal Nevus(ENS). NFX-179 is formulated as a gel for topical administration. NFX-179 has been shown in animal studies and in human extracts to suppress p-ERK with systemic absorption of NFX-179 following topical application to be extremely low, based on serum values observed in animal studies. Primary objectives: To determine the pharmacodynamic activity of NFX-179 Gel as defined by suppression of phospho-ERK (p-ERK) levels in Target EN in treatment group after 12 weeks of once-daily (QD) application To determine the safety and tolerability of treatment with NFX-179 Gel 1.50% applied QD for 12 weeks. Secondary objectives: -Clinical effect of NFX-179 Gel 1.5% defined as the percent change in EN volume after 12 weeks of QD application
Detailed Description
This is a 12-week clinical study to determine safety, tolerability, and clinical effect of NFX-179 Gel 1.50% Gel in subjects with EN. At Visit 1 (Screening), the Investigator will select 1 Target EN lesion for treatment that meet the inclusion criteria. A biopsy tissue sample of the Target EN will be taken for histological confirmation of an EN diagnosis if required, to assess p-ERK levels and for genetic testing. Subjects will be seen at Visit 2 for management of the Visit 1 biopsy wounds. At Visit 3 (Baseline) eligible subjects will be provided study medication and start the 12-week, QD treatment period. Target EN assessments will be collected. Subjects will be seen for treatment period visits, Visits 4-7, when Target EN assessments will be collected. At Visit 8, subjects will be seen for the final treatment period visit. Target EN assessments, a biopsy sample for genetic testing and p-ERK levels will be. Subjects will start a 4-week no-treatment follow-up period. Subjects will be seen at Visit 9, for management of the Visit 8 biopsy wound. At Visit 10 (end of study), subjects will be seen for the final study visit and will be discharged from the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epidermal Nevi, Nevus Sebaceus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Open-label, all participants will apply NFX-179 gel for 12 weeks
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Patients receiving NFX-179 Gel
Arm Type
Experimental
Arm Description
NFX-179 Gel 1.50% applied QD for 12 weeks
Intervention Type
Drug
Intervention Name(s)
NFX-179 Gel 1.50%
Intervention Description
Stanford University (Stanford) is studying a selective mitogen-activated protein kinase kinase (MEK) inhibitor (NFX-179) that has been chemically engineered for topical application to treat epidermal nevus syndromes (ENS). Preclinical studies evaluating topical application of NFX-179 to human nevus sebaceous explants demonstrated that NFX-179 can penetrate the tissue and suppress the p-ERK biomarker. It was also determined that NFX-179, when incubated with the tissues in medium, also suppressed ERK phosphorylation in human keratinocytic epidermal nevi. This clinical study is designed to evaluate the safety, tolerability, and clinical effect of NFX-179 Gel in Subjects with Epidermal Nevi.
Primary Outcome Measure Information:
Title
The frequency of dermal safety and tolerability assessments including pain/burning, pruritus, erythema, edema, scabbing/crusting, and vesiculation/erosion
Description
To determine the safety and tolerability of treatment with NFX-179 gel applied QD for 12 weeks of treatment.
Time Frame
12 weeks
Title
The frequency of adverse events and serious adverse events as assessed by CTCAE v4.0
Description
To determine the safety and tolerability of treatment with NFX-179 gel applied QD for 12 weeks of treatment.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Change in ILA (Investigator's Lesion Assessment)
Description
Change in Investigator's Lesion Assessment after 12 weeks of QD application, assessed at screening, baseline, treatment period at week 2, 3, 4, and 8, and end of treatment at week 12.
Time Frame
12 weeks
Title
Percent change in EN volume
Description
Percent change in EN volume after 12 weeks of QD application as determined based on EN size derived from ruler measurements, and/or digital images from standardized photography performed at screening, baseline, treatment period at week 2, 3, 4, and 8, and end of treatment at week 12.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria In order to be eligible to participate in this study, all of the following criteria must be met: Subject is at least 18 years of age Subject must provide written informed consent prior to any study procedures Subject has a Target Epidermal Nevi for treatment that: Is a documented, biopsy proven, keratinocytic epidermal nevi (KEN) or nevus sebaceous (NS) or has a 3mm punch biopsy taken for histologic examination to determine KEN or NS status Is a discrete lesion surrounded with at least 5mm of non-involved skin Is not irritated Does not have an active cutaneous infection Has a Length ≥15mm Has a surface area ≤100cm2 Has an Investigator's Lesion Assessment grade ≥2 Is located at an anatomical site that the subject can reach to apply the study medication Has never been surgically treated Subject is willing to have hair in the area surrounding the Target EN shaved, if necessary, to obtain photographs Subject is willing to minimize exposure of the Target EN to natural or artificial ultraviolet radiation Subject is willing to abstain from application of non-study topical prescription and over the counter medications to the Target EN during the study Subject is willing to forego treatment of the Target EN, except protocol specified therapy, during the study Female subjects who are women of childbearing potential must have a negative urine pregnancy test result and be willing to use a protocol approved, contraceptive method for the duration of the study. Subject is willing and able to follow all study instructions and to attend all study visits. No waivers to the inclusion criteria are permitted. Exclusion Criteria A potential subject who meets any of the following criteria will be excluded from participation in this study: Subject has applied any of the following topical products in the previous 30 days on or in proximity to the Target EN that, in the investigator's opinion, impairs evaluation of the Target EN or which exposes the subject to an unacceptable risk by study participation: Topical glucocorticoid steroids Topical retinoids (e.g., tazarotene, tretinoin, adapalene) > 5% of an alpha-hydroxy acid (e.g., glycolic acid, lactic acid) Fluorouracil Imiquimod The Target EN has ever been treated with a topical MEK inhibitor or a topical BRAF inhibitor The Subject has used any of the following systemic medications in the noted time period: Systemic retinoids (e.g., etretinate, isotretinoin) in the previous 90 days Systemic MEK inhibitors in the previous 180 days Systemic BRAF inhibitors in the previous 180 days Subject has a history of hypersensitivity to any of the ingredients in the study medications Subject has any know intercurrent illness or physical condition that would, in the investigator's opinion, impair evaluation of the Target EN or which exposes the subject to an unacceptable risk by study participation Subject has, in the Investigator's opinion, a clinically relevant history of liver disease, including viral hepatitis, current alcohol abuse, or cirrhosis Subject has a history of metastatic disease, or active cancer (excluding non-melanoma skin cancer, Stage I cervical cancer, ductal carcinoma in situ of the breast, or Stage 0 chronic lymphocytic lymphoma) within the previous 5 years Subject has any condition (e.g., other skin conditions or diseases, metabolic dysfunction, physical examination findings, clinical laboratory findings) or situation (e.g., vacation, scheduled surgery) that would, in the Investigator's opinion, impair evaluation of the Target EN or which exposes the subject to an unacceptable risk by study participation Subject has participated in an investigational drug trial in which administration of an investigational study medication occurred within the previous 30 days No waivers to the exclusion criteria are permitted.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Study Coordinator, MS
Phone
6502060647
Email
phungm@stanford.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Albert S Chiou, MD, MBA
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University
City
Redwood City
State/Province
California
ZIP/Postal Code
94063
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Study Coordinator
Phone
650-206-0647
Email
phungm@stanford.edu

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
We will only be sharing participant data with the sponsor, Nflection Therapeutics.

Learn more about this trial

12-week Study of NFX-179 Gel in Subjects With Epidermal Nevi

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