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NFX-179 Topical Gel Treatment for Adults With Neurofibromatosis 1 (NF1) and Cutaneous Neurofibromas (cNF)

Primary Purpose

Cutaneous Neurofibroma, Neurofibromatosis 1

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
NFX-179 gel
Vehicle gel
Sponsored by
NFlection Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cutaneous Neurofibroma

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject is at least 18 years of age
  2. Subject must provide written informed consent prior to any study procedures
  3. Subject must have a clinical diagnosis of NF1
  4. Subject has 10 clinically diagnosed Target cNFs with preferably 2 Target cNFs located on the face and 8 Target cNFs located on the anterior trunk or upper extremities. Alternatively, at least 1 Target cNF is located on the face, in which case 9 Target cNFs must be located on the anterior trunk or upper extremities. Each Target cNF must meet the following criteria:

    • Has, in the investigator's opinion, a clinically typical appearance
    • Is not within 1 cm of the orbital rim
    • Is not covered with hair that might, in the investigator's opinion, interfere with obtaining photographs or impair evaluation of the cNF
    • Has a Physician's Tumor Assessment grade ≥2
    • Is dome shaped
    • Is not pedunculated
    • Is a discrete cNF surrounded by sufficient non-affected skin that, in the investigator's opinion:
    • The dimensions can be measured
    • The perimeter can be outlined in the study photographs
    • Is not irritated (e.g., bleeding, inflamed)
    • Is not in an area subject to repeated trauma (e.g., area that is shaved, on the beltline, under a bra strap, etc.)
    • Does not have an active cutaneous infection
    • Target cNFs on the face must have the following tumor dimensions:
    • Has a length that is ≥5mm and ≤14mm
    • Has a width that is ≥5mm and ≤14mm
    • Has a height that is ≥2mm.
    • Target cNFs on the anterior trunk or upper extremities must have the following tumor dimensions:
    • Has a length that is ≥7mm and ≤14mm
    • Has a width that is ≥5mm and ≤14mm
    • Has a height that is ≥2mm.
  5. Subject agrees to avoid exposure of Target cNFs to excessive sunlight and to use her/his routine sunscreen if excessive exposure cannot be avoided
  6. Subject agrees NOT to use tanning beds
  7. Subject is willing to forego treatment of each Target cNF, 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.

Exclusion Criteria:

  1. Subject has used any of the following topical therapies within the specified period prior to Visit 1 on or in proximity to any Target cNF that, in the investigator's opinion, impairs evaluation of any the cNFs or which exposes the subject to an unacceptable risk by study participation:

    • Corticosteroids; 30 days
    • Prescription retinoids (e.g., tazarotene, tretinoin, adapalene); 30 days
    • > 5% of an alpha-hydroxy acid (e.g., glycolic acid, lactic acid); 30 days
    • Fluorouracil; 30 days
    • Imiquimod; 30 days
    • LASER, light (e.g., intense pulsed light [IPL], photo-dynamic therapy [PDT]) or other energy-based therapy; 180 days
    • MEK inhibitor or BRAF inhibitor; ever.
  2. The subject has used any of the following systemic medications therapies within the specified period prior to Visit 1:

    • Retinoids (e.g., etretinate, isotretinoin); 90 days
    • MEK inhibitors; 180 days
    • BRAF inhibitors; 180 days
  3. Subject has a history of hypersensitivity to any of the ingredients in the study medications
  4. Subject has any known intercurrent illness or physical condition that would, in the investigator's opinion, impair evaluation of a Target cNF or which exposes the subject to an unacceptable risk by study participation
  5. Subject has, in the investigator's opinion, clinically relevant history of liver disease, including viral hepatitis, current alcohol abuse, or cirrhosis
  6. Subject has a history of metastatic disease, or active cancer (excluding nonmelanoma skin cancer, Stage I cervical cancer, ductal carcinoma in situ of the breast, or Stage 0 chronic lymphocytic lymphoma) within the previous 5 years
  7. 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 a Target cNF or which exposes the subject to an unacceptable risk by study participation
  8. Subject has participated in an investigational drug trial in which administration of an investigational study medication occurred within the previous 30 days

Sites / Locations

  • University of Arkansas for Medical Sciences
  • Northwest Arkansas Clinical Trials Center, PLLC
  • Center for Dermatology Clinical Research, Inc.
  • Children's Hospital Los Angeles
  • University Clinical Trials, Inc.
  • Children's National Hospital
  • University of Florida
  • Northshore University HealthSystem
  • Dawes Fretzin Clinical Research Group
  • The Johns Hopkins School of Medicine
  • Massachusetts General Hospital
  • Minnesota Clinical Study Center
  • Skin Specialists, P.C.
  • Sadick Research Group, LLC
  • Skin Search of Rochester, Inc.
  • Wake Forest School of Medicine
  • Apex Clinical Research Center, LLC
  • Oregon Health & Science University
  • Derm Dox Center for Dermatology
  • Dermatology Treatment and Research Center
  • UTHealth McGovern Medical School
  • University of Utah
  • The Education & Research Foundation, Inc.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

0.5% NFX-179 gel

1.5% NFX-179 gel

Vehicle gel

Arm Description

Topical gel applied once daily to target cNFs

Topical gel applied once daily to target cNFs

Topical gel applied once daily to target cNFs

Outcomes

Primary Outcome Measures

Safety and effectiveness of once daily NFX-179 gel treatment for 182 days measured by local tolerability assessments, safety laboratory tests, and target cNF volume reduction
Safety will be measured by routine safety laboratory tests (CBC/differential, serum chemistry, urinalysis), and local tolerability assessment where the investigator will assess erythema, edema, scabbing/crusting, vesiculation, and erosion. The subject will assess stinging, burning, and pruritus. All assessments are performed using a 4-point scale (0 none, 1 mild, 2 moderate, 3 severe). Effectiveness will be measured by the percent of treated subjects with at least a 50% reduction in cNF volume after 6 months of treatment.
Safety of once daily NFX-179 gel treatment for 182 days by adverse events and serious adverse events assessments
Safety of NFX-179 gel compared to the vehicle group will be measured by the assessment and occurrence of new and ongoing adverse events (AEs)/serious adverse events (SAEs).

Secondary Outcome Measures

Percent of subjects with at least 50% Target cNF volume reduction after 182 days
Treatment effectiveness will be measured by the percent of treated subjects with at least a 50% reduction in cNF volume after 6 months of treatment. Tumor volume will be measured by ruler measurements and two-dimensional photography. All modes of tumor volume measurement are reported in cubic millimeters.
Percent change in cNF volume over 182 days
Percent change of tumor volume will be calculated through ruler measurements and two-dimensional photography throughout the course of treatment. All modes of tumor volume measurement are reported in cubic millimeters.
Physician's Tumor Assessment of Target cNF severity over 182 days
Effect of treatment with The Physician Tumor Assessment is the investigator's assessment of the average overall severity of each Target cNF tumor at a particular time point. The Physician Tumor Assessment is a 5-point measuring tumor severity (0 clear/none, 1 almost clear, 2 mild, 3 moderate, 4 severe). This assessment is performed at Screening, Baseline/Day 1, Days 58, 183, and 211.
Subject's Self-Assessment of Target cNF severity over 182 days
The Subject Self-Assessment is the subject's assessment of the average overall severity of each Target cNF at a particular time point and is not a comparison with any other time point. The Subject Self-Assessment is a 5-point measuring tumor severity (0 clear/none, 1 almost clear, 2 mild, 3 moderate, 4 severe). This assessment is performed at Screening, Baseline/Day 1, Days 58, 183, and 211.

Full Information

First Posted
August 2, 2021
Last Updated
March 9, 2023
Sponsor
NFlection Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05005845
Brief Title
NFX-179 Topical Gel Treatment for Adults With Neurofibromatosis 1 (NF1) and Cutaneous Neurofibromas (cNF)
Official Title
A Randomized, Double-Blind, Vehicle-Controlled, Parallel Group Phase 2 Dose-Response Study to Determine Safety and Effectiveness of Two Concentrations of NFX-179 Gel in Subjects With Cutaneous Neurofibromas
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 20, 2021 (Actual)
Primary Completion Date
September 1, 2023 (Anticipated)
Study Completion Date
September 7, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NFlection Therapeutics, Inc.

4. Oversight

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

5. Study Description

Brief Summary
This is a randomized, double-blind, vehicle-controlled, parallel group dose response study evaluating the safety and effectiveness of 2 concentrations of NFX-179 Gel in subjects with cutaneous neurofibromas. At Visit 1, the investigator will identify 10 Target cNFs that fulfil the enrollment criteria. The Target cNFs must be located on the subject's face, anterior trunk, or upper extremities. Two Target cNFs must be on the face and 8 must be on the anterior trunk or upper extremities. The study medication will be applied topically QD to the Target cNFs for 182days (26 weeks). During the duration of the study subjects will be evaluated for safety and efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cutaneous Neurofibroma, Neurofibromatosis 1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
199 (Actual)

8. Arms, Groups, and Interventions

Arm Title
0.5% NFX-179 gel
Arm Type
Active Comparator
Arm Description
Topical gel applied once daily to target cNFs
Arm Title
1.5% NFX-179 gel
Arm Type
Active Comparator
Arm Description
Topical gel applied once daily to target cNFs
Arm Title
Vehicle gel
Arm Type
Placebo Comparator
Arm Description
Topical gel applied once daily to target cNFs
Intervention Type
Drug
Intervention Name(s)
NFX-179 gel
Other Intervention Name(s)
NFX-179 topical gel
Intervention Description
NFX-179 topical gel is the active investigational product being studied
Intervention Type
Drug
Intervention Name(s)
Vehicle gel
Other Intervention Name(s)
NFX-179 vehicle gel
Intervention Description
NFX-179 vehicle gel is the placebo comparator for this study
Primary Outcome Measure Information:
Title
Safety and effectiveness of once daily NFX-179 gel treatment for 182 days measured by local tolerability assessments, safety laboratory tests, and target cNF volume reduction
Description
Safety will be measured by routine safety laboratory tests (CBC/differential, serum chemistry, urinalysis), and local tolerability assessment where the investigator will assess erythema, edema, scabbing/crusting, vesiculation, and erosion. The subject will assess stinging, burning, and pruritus. All assessments are performed using a 4-point scale (0 none, 1 mild, 2 moderate, 3 severe). Effectiveness will be measured by the percent of treated subjects with at least a 50% reduction in cNF volume after 6 months of treatment.
Time Frame
182 days
Title
Safety of once daily NFX-179 gel treatment for 182 days by adverse events and serious adverse events assessments
Description
Safety of NFX-179 gel compared to the vehicle group will be measured by the assessment and occurrence of new and ongoing adverse events (AEs)/serious adverse events (SAEs).
Time Frame
182 days
Secondary Outcome Measure Information:
Title
Percent of subjects with at least 50% Target cNF volume reduction after 182 days
Description
Treatment effectiveness will be measured by the percent of treated subjects with at least a 50% reduction in cNF volume after 6 months of treatment. Tumor volume will be measured by ruler measurements and two-dimensional photography. All modes of tumor volume measurement are reported in cubic millimeters.
Time Frame
182 days
Title
Percent change in cNF volume over 182 days
Description
Percent change of tumor volume will be calculated through ruler measurements and two-dimensional photography throughout the course of treatment. All modes of tumor volume measurement are reported in cubic millimeters.
Time Frame
182 days
Title
Physician's Tumor Assessment of Target cNF severity over 182 days
Description
Effect of treatment with The Physician Tumor Assessment is the investigator's assessment of the average overall severity of each Target cNF tumor at a particular time point. The Physician Tumor Assessment is a 5-point measuring tumor severity (0 clear/none, 1 almost clear, 2 mild, 3 moderate, 4 severe). This assessment is performed at Screening, Baseline/Day 1, Days 58, 183, and 211.
Time Frame
182 days
Title
Subject's Self-Assessment of Target cNF severity over 182 days
Description
The Subject Self-Assessment is the subject's assessment of the average overall severity of each Target cNF at a particular time point and is not a comparison with any other time point. The Subject Self-Assessment is a 5-point measuring tumor severity (0 clear/none, 1 almost clear, 2 mild, 3 moderate, 4 severe). This assessment is performed at Screening, Baseline/Day 1, Days 58, 183, and 211.
Time Frame
182 days
Other Pre-specified Outcome Measures:
Title
Patient Reported Outcome Measure to assess Target cNF symptoms over 182 days
Description
This assessment is performed via the subject's assessment of their experience over the previous week with 9 items for each Target cNF (sensitivity, pain, itch, noticeability, size, appearance, care to avoid irritation, how much the cNF bothers the subject, self-consciousness). Each item is assessed by using a 5-point scale.
Time Frame
182 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is at least 18 years of age Subject must provide written informed consent prior to any study procedures Subject must have a clinical diagnosis of NF1 Subject has 10 clinically diagnosed Target cNFs with preferably 2 Target cNFs located on the face and 8 Target cNFs located on the anterior trunk or upper extremities. Alternatively, at least 1 Target cNF is located on the face, in which case 9 Target cNFs must be located on the anterior trunk or upper extremities. Each Target cNF must meet the following criteria: Has, in the investigator's opinion, a clinically typical appearance Is not within 1 cm of the orbital rim Is not covered with hair that might, in the investigator's opinion, interfere with obtaining photographs or impair evaluation of the cNF Has a Physician's Tumor Assessment grade ≥2 Is dome shaped Is not pedunculated Is a discrete cNF surrounded by sufficient non-affected skin that, in the investigator's opinion: The dimensions can be measured The perimeter can be outlined in the study photographs Is not irritated (e.g., bleeding, inflamed) Is not in an area subject to repeated trauma (e.g., area that is shaved, on the beltline, under a bra strap, etc.) Does not have an active cutaneous infection Target cNFs on the face must have the following tumor dimensions: Has a length that is ≥5mm and ≤14mm Has a width that is ≥5mm and ≤14mm Has a height that is ≥2mm. Target cNFs on the anterior trunk or upper extremities must have the following tumor dimensions: Has a length that is ≥7mm and ≤14mm Has a width that is ≥5mm and ≤14mm Has a height that is ≥2mm. Subject agrees to avoid exposure of Target cNFs to excessive sunlight and to use her/his routine sunscreen if excessive exposure cannot be avoided Subject agrees NOT to use tanning beds Subject is willing to forego treatment of each Target cNF, 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. Exclusion Criteria: Subject has used any of the following topical therapies within the specified period prior to Visit 1 on or in proximity to any Target cNF that, in the investigator's opinion, impairs evaluation of any the cNFs or which exposes the subject to an unacceptable risk by study participation: Corticosteroids; 30 days Prescription retinoids (e.g., tazarotene, tretinoin, adapalene); 30 days > 5% of an alpha-hydroxy acid (e.g., glycolic acid, lactic acid); 30 days Fluorouracil; 30 days Imiquimod; 30 days LASER, light (e.g., intense pulsed light [IPL], photo-dynamic therapy [PDT]) or other energy-based therapy; 180 days MEK inhibitor or BRAF inhibitor; ever. The subject has used any of the following systemic medications therapies within the specified period prior to Visit 1: Retinoids (e.g., etretinate, isotretinoin); 90 days MEK inhibitors; 180 days BRAF inhibitors; 180 days Subject has a history of hypersensitivity to any of the ingredients in the study medications Subject has any known intercurrent illness or physical condition that would, in the investigator's opinion, impair evaluation of a Target cNF or which exposes the subject to an unacceptable risk by study participation Subject has, in the investigator's opinion, 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 nonmelanoma 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 a Target cNF 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
Facility Information:
Facility Name
University of Arkansas for Medical Sciences
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205-7199
Country
United States
Facility Name
Northwest Arkansas Clinical Trials Center, PLLC
City
Rogers
State/Province
Arkansas
ZIP/Postal Code
72758
Country
United States
Facility Name
Center for Dermatology Clinical Research, Inc.
City
Fremont
State/Province
California
ZIP/Postal Code
94538
Country
United States
Facility Name
Children's Hospital Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
University Clinical Trials, Inc.
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Children's National Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Northshore University HealthSystem
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60077
Country
United States
Facility Name
Dawes Fretzin Clinical Research Group
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46250
Country
United States
Facility Name
The Johns Hopkins School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Minnesota Clinical Study Center
City
New Brighton
State/Province
Minnesota
ZIP/Postal Code
55112
Country
United States
Facility Name
Skin Specialists, P.C.
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68144
Country
United States
Facility Name
Sadick Research Group, LLC
City
New York
State/Province
New York
ZIP/Postal Code
10075
Country
United States
Facility Name
Skin Search of Rochester, Inc.
City
Rochester
State/Province
New York
ZIP/Postal Code
14623
Country
United States
Facility Name
Wake Forest School of Medicine
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Apex Clinical Research Center, LLC
City
Mayfield Heights
State/Province
Ohio
ZIP/Postal Code
44124
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Derm Dox Center for Dermatology
City
Sugarloaf
State/Province
Pennsylvania
ZIP/Postal Code
18249
Country
United States
Facility Name
Dermatology Treatment and Research Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
UTHealth McGovern Medical School
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
Facility Name
The Education & Research Foundation, Inc.
City
Lynchburg
State/Province
Virginia
ZIP/Postal Code
24501
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

NFX-179 Topical Gel Treatment for Adults With Neurofibromatosis 1 (NF1) and Cutaneous Neurofibromas (cNF)

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