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Topical Tazarotene in Treating Patients With Basal Cell Skin Cancer and Basal Cell Nevus Syndrome on the Face

Primary Purpose

Neoplastic Syndrome

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
tazarotene
Sponsored by
UCSF Benioff Children's Hospital Oakland
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neoplastic Syndrome focused on measuring nevoid basal cell carcinoma syndrome, basal cell carcinoma of the skin

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

List of Inclusion Criteria:

  1. Study subjects must have at least one basal cell carcinoma ≥ 3mm in diameter (target lesion) on any area of the skin except the face, chest, and back (and not impinging on vital sites) diagnosed clinically by a Study Investigator at the baseline visit.
  2. Study subjects must meet diagnostic criteria for basal cell nevus syndrome including major criterion #1 plus one additional major criterion or two of the minor criteria outlined in Table I. A first degree relative would satisfy BCNS diagnostic criteria with any two major criteria or any single major plus two minor criteria.

Table I. BCNS Diagnostic Criteria

Major criteria

  1. More than 2 BCCs or one under the age of 20 years
  2. Odontogenic keratocysts of the jaw proven by histology
  3. Three or more palmar and/or plantar pits
  4. Bilamellar calcification of the falx cerebri (if less than 20 years old)
  5. Fused, bifid, or markedly splayed ribs.
  6. First degree relative with basal cell nevus syndrome (BCNS)
  7. PTCH1 gene mutation in normal tissue*

Minor criteria

  1. Macrocephaly determined after adjustment for height
  2. Congenital malformations: cleft lip or palate, frontal bossing, "coarse face."
  3. Skeletal abnormalities: Sprengel deformity, marked pectus deformity
  4. Radiological abnormalities: bridging of the sella turcica, vertebral anomalies such as hemivertebrae, fusion or elongation of the vertebral bodies.
  5. Ovarian fibroma
  6. Medulloblastoma

3.The subject is from 18-75 years of age, inclusive.

4. If the subject is female and of child-bearing potential (women are considered not of childbearing potential if they are at least 2 years post-menopausal and/or surgically sterile), she:

i. has been using adequate contraception (abstinence, IUD, birth control pills, or spermicidal gel with diaphragm or condom) since her last menses and will use adequate contraception during the study, and ii. is not lactating, and iii. has documented one negative serum pregnancy test within 14 days prior to study entry.

5. The subject is willing to abstain from application of non-study topical medications to the skin of the face for the duration of the study, including prescription and over the counter preparations.

6. The subject is willing not to have targeted BCCs treated by their PSCP unless the BCCs are documented by Study Investigators, preferably on two separate visits, except when the PSCP believes that delay in treatment potentially might compromise the health of the subject.

List of Exclusion Criteria:

  1. The subject has used topical or systemic therapies that might interfere with the evaluation of the study medication during the study.
  2. The subject has a history of hypersensitivity to any of the ingredients in the study medication formulations.
  3. The subject is unable to return for follow-up tests.
  4. The subject has uncontrolled systemic disease, including known HIV positive patients.
  5. The subject has a history of other skin conditions or significant illness that would interfere with evaluation of the study medication.
  6. Any condition or situation which in the Investigator's opinion may put the subject at significant risk, could confound the study results, or could interfere significantly with the subject's participation in the study.
  7. The subject has a history of invasive cancer within the past five years excluding non-melanoma skin cancer, Stage I cervical cancer, or CLL Stage 0.

Sites / Locations

  • Children's Hospital and Research Center Oakland
  • Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Tazarotene Cream

Arm Description

Open label

Outcomes

Primary Outcome Measures

Complete Response Rate
The primary endpoint used to evaluate tazarotene efficacy for BCC chemotherapy was the complete response (CR) rate, defined as the complete visible disappearance of a patient's "target" lesion during the the 18 months of tazarotene application and its failure to recur during the ensuing 18-months. We defined surgical removal of a target lesion as a treatment failure. The primary endpoint was assessed based on intention to treat analysis such that any subject who underwent the baseline evaluation and applied at least 1 dose of tazarotene was included in the analysis. Drop-outs were considered non-responders. A priori treatment success for tazarotene was defined as a CR rate of at least 50%, and treatment failure was defined as a CR rate of 25% or less.

Secondary Outcome Measures

Time to Lesion Clearance
Time to Progression
Estimated Duration of Complete Response
Overall Response at Treated Lesions

Full Information

First Posted
June 20, 2007
Last Updated
October 8, 2020
Sponsor
UCSF Benioff Children's Hospital Oakland
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00489086
Brief Title
Topical Tazarotene in Treating Patients With Basal Cell Skin Cancer and Basal Cell Nevus Syndrome on the Face
Official Title
A Phase II Single Arm Open-Label Clinical Trial of Chemotherapy of BCC's With Tazarotene 0.1% in Subjects With Basal Cell Nevus Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
July 2004 (undefined)
Primary Completion Date
June 2012 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
UCSF Benioff Children's Hospital Oakland
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as tazarotene, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. PURPOSE: This phase II trial is studying topical tazarotene to see how well it works in treating patients with basal cell skin cancer and basal cell nevus syndrome on the face.
Detailed Description
OBJECTIVES: Determine whether topical tazarotene, administered over a period of 18 months as a chemopreventive agent, reduces the incidence of basal cell carcinomas (BCCs) on treated skin in patients with basal cell nevus syndrome (BCNS). Expand and refine chemopreventive strategies in patients with BCNS who are at high risk for the development of BCCs. OUTLINE: This is an open-label, multicenter study. Patients apply topical tazarotene cream to the face once daily for 18 months in the absence of unacceptable toxicity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neoplastic Syndrome
Keywords
nevoid basal cell carcinoma syndrome, basal cell carcinoma of the skin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Tazarotene Cream
Arm Type
Other
Arm Description
Open label
Intervention Type
Drug
Intervention Name(s)
tazarotene
Other Intervention Name(s)
tazorac
Intervention Description
Tazarotene is a member of the acetylenic class of retinoids.
Primary Outcome Measure Information:
Title
Complete Response Rate
Description
The primary endpoint used to evaluate tazarotene efficacy for BCC chemotherapy was the complete response (CR) rate, defined as the complete visible disappearance of a patient's "target" lesion during the the 18 months of tazarotene application and its failure to recur during the ensuing 18-months. We defined surgical removal of a target lesion as a treatment failure. The primary endpoint was assessed based on intention to treat analysis such that any subject who underwent the baseline evaluation and applied at least 1 dose of tazarotene was included in the analysis. Drop-outs were considered non-responders. A priori treatment success for tazarotene was defined as a CR rate of at least 50%, and treatment failure was defined as a CR rate of 25% or less.
Time Frame
36 months
Secondary Outcome Measure Information:
Title
Time to Lesion Clearance
Time Frame
36 months
Title
Time to Progression
Time Frame
36 months
Title
Estimated Duration of Complete Response
Time Frame
36 months
Title
Overall Response at Treated Lesions
Time Frame
36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
List of Inclusion Criteria: Study subjects must have at least one basal cell carcinoma ≥ 3mm in diameter (target lesion) on any area of the skin except the face, chest, and back (and not impinging on vital sites) diagnosed clinically by a Study Investigator at the baseline visit. Study subjects must meet diagnostic criteria for basal cell nevus syndrome including major criterion #1 plus one additional major criterion or two of the minor criteria outlined in Table I. A first degree relative would satisfy BCNS diagnostic criteria with any two major criteria or any single major plus two minor criteria. Table I. BCNS Diagnostic Criteria Major criteria More than 2 BCCs or one under the age of 20 years Odontogenic keratocysts of the jaw proven by histology Three or more palmar and/or plantar pits Bilamellar calcification of the falx cerebri (if less than 20 years old) Fused, bifid, or markedly splayed ribs. First degree relative with basal cell nevus syndrome (BCNS) PTCH1 gene mutation in normal tissue* Minor criteria Macrocephaly determined after adjustment for height Congenital malformations: cleft lip or palate, frontal bossing, "coarse face." Skeletal abnormalities: Sprengel deformity, marked pectus deformity Radiological abnormalities: bridging of the sella turcica, vertebral anomalies such as hemivertebrae, fusion or elongation of the vertebral bodies. Ovarian fibroma Medulloblastoma 3.The subject is from 18-75 years of age, inclusive. 4. If the subject is female and of child-bearing potential (women are considered not of childbearing potential if they are at least 2 years post-menopausal and/or surgically sterile), she: i. has been using adequate contraception (abstinence, IUD, birth control pills, or spermicidal gel with diaphragm or condom) since her last menses and will use adequate contraception during the study, and ii. is not lactating, and iii. has documented one negative serum pregnancy test within 14 days prior to study entry. 5. The subject is willing to abstain from application of non-study topical medications to the skin of the face for the duration of the study, including prescription and over the counter preparations. 6. The subject is willing not to have targeted BCCs treated by their PSCP unless the BCCs are documented by Study Investigators, preferably on two separate visits, except when the PSCP believes that delay in treatment potentially might compromise the health of the subject. List of Exclusion Criteria: The subject has used topical or systemic therapies that might interfere with the evaluation of the study medication during the study. The subject has a history of hypersensitivity to any of the ingredients in the study medication formulations. The subject is unable to return for follow-up tests. The subject has uncontrolled systemic disease, including known HIV positive patients. The subject has a history of other skin conditions or significant illness that would interfere with evaluation of the study medication. Any condition or situation which in the Investigator's opinion may put the subject at significant risk, could confound the study results, or could interfere significantly with the subject's participation in the study. The subject has a history of invasive cancer within the past five years excluding non-melanoma skin cancer, Stage I cervical cancer, or CLL Stage 0.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ervin Epstein, MD
Organizational Affiliation
UCSF Benioff Children's Hospital Oakland
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
David R. Bickers, MD
Organizational Affiliation
Herbert Irving Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Children's Hospital and Research Center Oakland
City
Oakland
State/Province
California
ZIP/Postal Code
94609
Country
United States
Facility Name
Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24441673
Citation
Tang JY, Chiou AS, Mackay-Wiggan JM, Aszterbaum M, Chanana AM, Lee W, Lindgren JA, Raphael MA, Thompson BJ, Bickers DR, Epstein EH Jr. Tazarotene: randomized, double-blind, vehicle-controlled, and open-label concurrent trials for basal cell carcinoma prevention and therapy in patients with basal cell nevus syndrome. Cancer Prev Res (Phila). 2014 Mar;7(3):292-9. doi: 10.1158/1940-6207.CAPR-13-0305. Epub 2014 Jan 17.
Results Reference
result

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Topical Tazarotene in Treating Patients With Basal Cell Skin Cancer and Basal Cell Nevus Syndrome on the Face

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