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Effectiveness of Imiquimod Topical Cream in Early Stage Cutaneous T-cell Lymphoma (CTCL)

Primary Purpose

Mycosis Fungoides

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
3.75% Imiquimod Cream
0.1% Fluocinonide Cream
Sponsored by
Rochester General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mycosis Fungoides focused on measuring CTCL, Mycosis Fungoides, Cutaneous T-cell Lymphoma, MF, topical therapy, early stage

Eligibility Criteria

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

Inclusion Criteria:

  1. Male and female subjects aged ≥18 years.
  2. Willing and able to give informed consent
  3. Diagnosis of Mycosis Fungoides In cases with equivocal histological features, the diagnosis may be confirmed through the use of clonal T-cell gamma gene rearrangement, as detected by PCR amplification and primer sets specific for the T-cell receptor gamma chain genes.
  4. Subjects must have at least one target lesion
  5. Subjects will be able to comply with the study instructions, apply the study medication as directed and attend all visits.
  6. Females of child-bearing potential must have a negative urine pregnancy test before randomization and must agree to use an adequate method of contraception (abstinence, condoms, hormonal therapy, barrier methods) during the study.
  7. Patients must be otherwise healthy with an ECOG Performance status of 0 or 1.
  8. The patient must not have had topical (2 weeks) or systemic therapy (4 weeks), radiotherapy (4 weeks) or phototherapy therapy (4 weeks) for Mycosis Fungoides within the stated number of weeks prior to start of treatment.
  9. Eligible patients will be those who topical corticosteroid would be a preferred treatment and include patients newly diagnosed with stage IA, IB, or IIA disease, or those patients currently stable on therapy, in whom topical corticosteroids are being newly added to the regimen (i.e. recurrence or resistant lesions not currently treated with topical corticosteroids)

Exclusion Criteria:

To be eligible for inclusion in this study the subjects must not meet any of the following criteria:

  1. Female who is pregnant, nursing an infant, or planning a pregnancy during the study period.
  2. Have concomitant dermatologic or medical condition(s) which may interfere with the investigator's ability to evaluate the subject's response to the study drug.
  3. Received any investigational drug or taking part in any clinical study within one month prior to this study.
  4. Known reaction or allergy to test drug or excipient.
  5. Presence of major medical illness or symptoms of a clinically significant illness that may influence the study.
  6. Have any reason which, in the opinion of the investigator, interferes with the ability of the subject to participate in or complete the trial, or which places the subject at undue risk such as a history of drug, alcohol or other substance abuse or other factors limiting the ability to co-operate and to comply with this protocol.
  7. Lesions on the genitals, axillae and face will not be selected for study treatment and evaluation.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Fluocinonide (Vanos) cream 0.1%

    3.75% Imiquimod (Zyclara) Cream

    Arm Description

    Fluocinonide (Vanos) cream 0.1% will be applied as currently approved by the FDA for treatment of corticosteroid responsive disorders of the skin. Treatment will continue for 4 months with a follow up at 6 and 12 months.

    3.75% Imiquimod (Zyclara) Cream will be used as currently labeled by the FDA for treatment of actinic keratoses. Treatment will continue for 4 months with follow up at 6 and 12 months.

    Outcomes

    Primary Outcome Measures

    Response Rate between baseline and week 16
    Treatment phase will last 4 months with follow up at 6 and 12 months after initiation of therapy

    Secondary Outcome Measures

    Response Rate 24 and 52 weeks after baseline
    Patients will be treated for 4 months and response rate assessed at 6 and 24 months after initiation of therapy.
    Safety and tolerabiliy of Imiquimod in patients with CTCL (adverse events)
    We will record any adverse events that occur during the course of the study.
    Learn about T cell dysregulation in the skin from patients with CTCL (Using left over tissue from biopsies)
    Using left over tissue from biopsies done at baseline, two weeks after initiation of therapy, and optional one done at week16. We are interested in making our tissue bank.

    Full Information

    First Posted
    November 19, 2014
    Last Updated
    April 23, 2021
    Sponsor
    Rochester General Hospital
    Collaborators
    Bausch Health Americas, Inc., Rochester Skin Lymphoma Medical Group, PLLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02301494
    Brief Title
    Effectiveness of Imiquimod Topical Cream in Early Stage Cutaneous T-cell Lymphoma
    Acronym
    CTCL
    Official Title
    Feasibility Study to Determine Effectiveness of 3.75% Topical Imiquimod Cream and Topical Vanos (Fluocinonide) Cream 0.1% in the Treatment of Early Stage Cutaneous T-cell Lymphoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    No participants were enrolled in the study.
    Study Start Date
    April 2020 (Anticipated)
    Primary Completion Date
    April 2022 (Anticipated)
    Study Completion Date
    April 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Rochester General Hospital
    Collaborators
    Bausch Health Americas, Inc., Rochester Skin Lymphoma Medical Group, PLLC

    4. Oversight

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

    5. Study Description

    Brief Summary
    This study is being conducted by Brian Poligone, MD PhD. The purpose of this study is to determine safety, effectiveness, and tolerability of two topical therapies, imiquimod and fluocinonide, for patients with early stage Cutaneous T-cell Lymphoma (CTCL).
    Detailed Description
    The purpose of the study is to compare the safety, effectiveness, and tolerability of two topical therapies, imiquimod and fluocinonide, for patients with early stage CTCL.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Mycosis Fungoides
    Keywords
    CTCL, Mycosis Fungoides, Cutaneous T-cell Lymphoma, MF, topical therapy, early stage

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Masking Description
    Open Label
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Fluocinonide (Vanos) cream 0.1%
    Arm Type
    Experimental
    Arm Description
    Fluocinonide (Vanos) cream 0.1% will be applied as currently approved by the FDA for treatment of corticosteroid responsive disorders of the skin. Treatment will continue for 4 months with a follow up at 6 and 12 months.
    Arm Title
    3.75% Imiquimod (Zyclara) Cream
    Arm Type
    Experimental
    Arm Description
    3.75% Imiquimod (Zyclara) Cream will be used as currently labeled by the FDA for treatment of actinic keratoses. Treatment will continue for 4 months with follow up at 6 and 12 months.
    Intervention Type
    Drug
    Intervention Name(s)
    3.75% Imiquimod Cream
    Other Intervention Name(s)
    Zyclara 3.75%
    Intervention Description
    CTCL specific assessments to measure response in lesions will be done at each visit. Therapy initiates at day 1 followed by a visit at day 15. Visits will then be once a month for four months with a follow up at 6 and 12 months.
    Intervention Type
    Drug
    Intervention Name(s)
    0.1% Fluocinonide Cream
    Other Intervention Name(s)
    Vanos
    Intervention Description
    CTCL specific assessments to measure response in lesions will be done at each visit. Therapy initiates at day 1 followed by a visit at day 15. Visits will then be once a month for four months with a follow up at 6 and 12 months.
    Primary Outcome Measure Information:
    Title
    Response Rate between baseline and week 16
    Description
    Treatment phase will last 4 months with follow up at 6 and 12 months after initiation of therapy
    Time Frame
    16 weeks
    Secondary Outcome Measure Information:
    Title
    Response Rate 24 and 52 weeks after baseline
    Description
    Patients will be treated for 4 months and response rate assessed at 6 and 24 months after initiation of therapy.
    Time Frame
    Baseline to up to one year
    Title
    Safety and tolerabiliy of Imiquimod in patients with CTCL (adverse events)
    Description
    We will record any adverse events that occur during the course of the study.
    Time Frame
    From Randomization to up to 30 days after end of treatment
    Title
    Learn about T cell dysregulation in the skin from patients with CTCL (Using left over tissue from biopsies)
    Description
    Using left over tissue from biopsies done at baseline, two weeks after initiation of therapy, and optional one done at week16. We are interested in making our tissue bank.
    Time Frame
    Samples may be stored indefinitely from time of collection ( two weeks after initiation of therapy, and optional one done at week16)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male and female subjects aged ≥18 years. Willing and able to give informed consent Diagnosis of Mycosis Fungoides In cases with equivocal histological features, the diagnosis may be confirmed through the use of clonal T-cell gamma gene rearrangement, as detected by PCR amplification and primer sets specific for the T-cell receptor gamma chain genes. Subjects must have at least one target lesion Subjects will be able to comply with the study instructions, apply the study medication as directed and attend all visits. Females of child-bearing potential must have a negative urine pregnancy test before randomization and must agree to use an adequate method of contraception (abstinence, condoms, hormonal therapy, barrier methods) during the study. Patients must be otherwise healthy with an ECOG Performance status of 0 or 1. The patient must not have had topical (2 weeks) or systemic therapy (4 weeks), radiotherapy (4 weeks) or phototherapy therapy (4 weeks) for Mycosis Fungoides within the stated number of weeks prior to start of treatment. Eligible patients will be those who topical corticosteroid would be a preferred treatment and include patients newly diagnosed with stage IA, IB, or IIA disease, or those patients currently stable on therapy, in whom topical corticosteroids are being newly added to the regimen (i.e. recurrence or resistant lesions not currently treated with topical corticosteroids) Exclusion Criteria: To be eligible for inclusion in this study the subjects must not meet any of the following criteria: Female who is pregnant, nursing an infant, or planning a pregnancy during the study period. Have concomitant dermatologic or medical condition(s) which may interfere with the investigator's ability to evaluate the subject's response to the study drug. Received any investigational drug or taking part in any clinical study within one month prior to this study. Known reaction or allergy to test drug or excipient. Presence of major medical illness or symptoms of a clinically significant illness that may influence the study. Have any reason which, in the opinion of the investigator, interferes with the ability of the subject to participate in or complete the trial, or which places the subject at undue risk such as a history of drug, alcohol or other substance abuse or other factors limiting the ability to co-operate and to comply with this protocol. Lesions on the genitals, axillae and face will not be selected for study treatment and evaluation.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Brian Poligone, M.D. Ph.D.
    Organizational Affiliation
    Rochester General Hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    32632956
    Citation
    Valipour A, Jager M, Wu P, Schmitt J, Bunch C, Weberschock T. Interventions for mycosis fungoides. Cochrane Database Syst Rev. 2020 Jul 7;7(7):CD008946. doi: 10.1002/14651858.CD008946.pub3.
    Results Reference
    derived

    Learn more about this trial

    Effectiveness of Imiquimod Topical Cream in Early Stage Cutaneous T-cell Lymphoma

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