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Topical Calcipotriene Treatment for Breast Cancer Immunoprevention

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Topical Calcipotriene Ointment
Topical Vaseline
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Participants must have histologically confirmed benign, premalignant or early malignant breast lesions on core biopsy that will proceed directly to surgical removal without any intervening neoadjuvant chemotherapy.
  • Patients diagnosed with benign breast lesions (papilloma and sclerosing lesion), flat epithelial atypia, atypical ductal hyperplasia, lobular carcinoma in situ (Tis N0 M0; stage 0), ductal carcinoma in situ (Tis N0 M0; stage 0), primary invasive ductal and lobular carcinoma (T1or2 N0or1 M0; stage I-II), who will directly receive surgery and no neoadjuvant chemotherapy.
  • Patients with hormone receptor positive, Her2 positive and triple negative cancers will be eligible.
  • Patients with multicentric and multifocal tumors will be eligible.
  • Age 45 years. To avoid the impact of menstrual cycles-associated alterations in the immune environment of the breast, the age is limited to post-menopausal women.
  • Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Participants scheduled to undergo neoadjuvant therapy for breast cancer.
  • Participants with metastatic breast cancer.
  • Participants with history of breast cancer in the past 5 years.
  • Participants with immunosuppression (e.g., organ transplant recipients and patients with autoimmune diseases requiring immunosuppressive medications including >5mg daily prednisone, methotrexate, cyclosporine, azothioprine, tacrolimus and TNFα blocking agents)
  • Participants with the history of hypercalcemia or clinical evidence of vitamin D toxicity.
  • Participants who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier.
  • Participants who are receiving any other investigational agents.
  • Participants with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to topical calcipotriene ointment.
  • Pregnant women are excluded from this study because topical calcipotriol ointment is a category C agent and its impact on developing fetus is unknown. In addition, premenopausal women are excluded from this study due to the impact of menstrual cycles on immune environment of the breast.

Sites / Locations

  • Massachusetts General HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Topical Calcipotriene Ointment

Topical Vaseline

Arm Description

-Topical Calcipotriene Ointment will be administered by the participants to their upper extremities twice a day for the period between core biopsy and surgical removal of their breast lesion

-Topical Vaseline will be administered by the participants to their upper extremities twice a day for the period between core biopsy and surgical removal of their breast lesion

Outcomes

Primary Outcome Measures

The changes in the magnitude of CD3+ T cell infiltration in tumor microenvironment
The change in the number of CD3+ T cells per high power microscope field in tumor microenvironment from the time of initial needle core biopsy to surgical excision.

Secondary Outcome Measures

The comprehensive changes in tumor immune microenvironment
The changes in tumor immune microenvironment in patients with neoplastic tumors versus benign lesions
The changes in tumor immune microenvironment in patients with stage I-II, versus stage 0 tumors
The changes in tumor immune microenvironment in patients with hormone receptor and Her2 positive versus triple negative tumors
Serum Serum Thymic Stromal Lymphopoietin (TSLP) levels (picogram/milliliter) before and after topical calcipotriene treatment compared to Vaseline control group
Disease free survival
The duration of time measured from the start of treatment until the time of disease progression or death, whichever occurs first.
Number of Participants with Treatment Related Adverse Events
Adverse events will be assessed using Common Terminology Criteria for Adverse Events (CTCAE v4).

Full Information

First Posted
July 10, 2018
Last Updated
November 2, 2021
Sponsor
Massachusetts General Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03596073
Brief Title
Topical Calcipotriene Treatment for Breast Cancer Immunoprevention
Official Title
A Pilot Trial of Topical Calcipotriene Treatment for Breast Cancer Immunoprevention
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Recruiting
Study Start Date
November 7, 2018 (Actual)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
July 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study is studying a topical ointment called calcipotriene to see if it can stimulate the immune cells against the breast lesion in ways that would prevent its recurrence after surgical removal
Detailed Description
The investigators are doing this research study to find out how topical calcipotriene ointment affect people who have breast cancer, and what impact that may have on those who are at risk of developing breast cancer in the future. The investigators hope that what they learn will lead to the development of a new medication for the treatment and prevention of breast cancer. Abnormal breast lesions can be benign, premalignant or malignant. These lesions are being targeted by the topical calcipotriene ointment. The investigators aim to determine whether this topical treatment can stimulate the immune cells against the breast lesion in ways that would prevent its recurrence after surgical removal. Calcipotriene ointment is approved by the U.S. Food and Drug Administration (FDA) to treat psoriasis, but calcipotriene ointment is not approved by the FDA to treat breast cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Topical Calcipotriene Ointment
Arm Type
Experimental
Arm Description
-Topical Calcipotriene Ointment will be administered by the participants to their upper extremities twice a day for the period between core biopsy and surgical removal of their breast lesion
Arm Title
Topical Vaseline
Arm Type
Placebo Comparator
Arm Description
-Topical Vaseline will be administered by the participants to their upper extremities twice a day for the period between core biopsy and surgical removal of their breast lesion
Intervention Type
Drug
Intervention Name(s)
Topical Calcipotriene Ointment
Intervention Description
Calcipotriene is a form of vitamin D. It works by slowing down the growth of skin cells.
Intervention Type
Other
Intervention Name(s)
Topical Vaseline
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
The changes in the magnitude of CD3+ T cell infiltration in tumor microenvironment
Description
The change in the number of CD3+ T cells per high power microscope field in tumor microenvironment from the time of initial needle core biopsy to surgical excision.
Time Frame
3 Weeks
Secondary Outcome Measure Information:
Title
The comprehensive changes in tumor immune microenvironment
Time Frame
3 Weeks
Title
The changes in tumor immune microenvironment in patients with neoplastic tumors versus benign lesions
Time Frame
3 Weeks
Title
The changes in tumor immune microenvironment in patients with stage I-II, versus stage 0 tumors
Time Frame
3 Weeks
Title
The changes in tumor immune microenvironment in patients with hormone receptor and Her2 positive versus triple negative tumors
Time Frame
3 Weeks
Title
Serum Serum Thymic Stromal Lymphopoietin (TSLP) levels (picogram/milliliter) before and after topical calcipotriene treatment compared to Vaseline control group
Time Frame
3 Weeks
Title
Disease free survival
Description
The duration of time measured from the start of treatment until the time of disease progression or death, whichever occurs first.
Time Frame
From the start of treatment up to 15 years
Title
Number of Participants with Treatment Related Adverse Events
Description
Adverse events will be assessed using Common Terminology Criteria for Adverse Events (CTCAE v4).
Time Frame
From the start of treatment until 30 days after the end of treatment, up to 2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must have histologically confirmed benign, premalignant or early malignant breast lesions on core biopsy that will proceed directly to surgical removal without any intervening neoadjuvant chemotherapy. Patients diagnosed with benign breast lesions (papilloma and sclerosing lesion), flat epithelial atypia, atypical ductal hyperplasia, lobular carcinoma in situ (Tis N0 M0; stage 0), ductal carcinoma in situ (Tis N0 M0; stage 0), primary invasive ductal and lobular carcinoma (T1or2 N0or1 M0; stage I-II), who will directly receive surgery and no neoadjuvant chemotherapy. Patients with hormone receptor positive, Her2 positive and triple negative cancers will be eligible. Patients with multicentric and multifocal tumors will be eligible. Age 45 years. To avoid the impact of menstrual cycles-associated alterations in the immune environment of the breast, the age is limited to post-menopausal women. Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Participants scheduled to undergo neoadjuvant therapy for breast cancer. Participants with metastatic breast cancer. Participants with history of breast cancer in the past 5 years. Participants with immunosuppression (e.g., organ transplant recipients and patients with autoimmune diseases requiring immunosuppressive medications including >5mg daily prednisone, methotrexate, cyclosporine, azothioprine, tacrolimus and TNFα blocking agents) Participants with the history of hypercalcemia or clinical evidence of vitamin D toxicity. Participants who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier. Participants who are receiving any other investigational agents. Participants with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. History of allergic reactions attributed to compounds of similar chemical or biologic composition to topical calcipotriene ointment. Pregnant women are excluded from this study because topical calcipotriol ointment is a category C agent and its impact on developing fetus is unknown. In addition, premenopausal women are excluded from this study due to the impact of menstrual cycles on immune environment of the breast.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shadmehr Demehri, MD
Phone
617-643-6436
Email
sdemehri1@mgh.harvard.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shadmehr Demehri, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shadmehr Demehri, MD
Phone
617-643-6436
Email
sdemehri1@mgh.harvard.edu
First Name & Middle Initial & Last Name & Degree
Shadmehr Demehri, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Topical Calcipotriene Treatment for Breast Cancer Immunoprevention

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