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Treatment of Field Cancerization for Reduction in Tumor Burden - A Prospective Study

Primary Purpose

Extensive Photodamage, Actinic Keratosis, History of Numerous Skin Cancers

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Ultrapulse Carbon Dioxide Laser
Cellutome epidermal harvesting system
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Extensive Photodamage focused on measuring actinic keratosis, field cancerization, organ transplant patients

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria

  1. Subjects with ages between 18 and 85 years, male or female.
  2. Subjects with at least 4 clinically diagnosed actinic keratoses (AKs) per treatment site ( up to 200 sq cm), excluding the face and neck
  3. Subjects with history of at least 1 non-melanoma skin cancer within the past year
  4. Willingness to participate in the study
  5. Informed consent agreement signed by the subject
  6. Willingness to follow the treatment schedule and post treatment care requirements
  7. Willingness to not use topical or systemic (oral) TREATMENT medications including imiquimod, 5-Fluorouracil, photodynamic therapy, during the treatment period.
  8. Has not had treatment for AKs in the treatment area for 4 weeks prior to enrollment

Exclusion criteria

  1. Subjects with active skin cancer in the treatment area. Once the non-melanoma skin cancer has been treated, the subject can be immediately enrolled.
  2. Infection of the area to be treated
  3. An open wound in the area to be treated
  4. Presence of suntan in the area to be treated, or active tanning during the study
  5. Subjects who have taken medication known to induce photosensitivity in the previous 3 months
  6. The patient has any contraindication to use of the carbon dioxide laser, including but not limited to, intake of isotretinoin in past 12 months; patients with reduced adnexal structures (eg, scleroderma, irradiation or burns); patients with history of vitiligo or psoriasis (risk of Koebnerization); history of keloids/hypertrophic scarring.
  7. Subject is unable to comply with treatment, home care or follow-up visits
  8. Subject is pregnant or breast feeding
  9. Prior use of topical retinoids, 5 fluorouracil, or imiquimod in treated areas within one month of initial treatment
  10. Prior skin treatment with laser or other devices in the treated area within two months of initial treatment or during the course of the study;
  11. Adverse reactions to compounds of any external agent (e.g., gels, lotions or anesthetic creams) required for use in the study, if no alternative to the said agent exists;
  12. Concurrent inflammatory skin conditions, including, but not limited to, eczema, contact dermatitis of any severity;
  13. Active Herpes Simplex at the time of treatment;
  14. Multiple dysplastic nevi in area to be treated;
  15. Having a bleeding disorder or taking anticoagulation medications, including heavy use of aspirin, in a manner which does not allow for a minimum 10 day washout period prior to each treatment (as per the patient's physician discretion);
  16. Significant concurrent illness, such as uncontrolled diabetes, (i.e., any disease state that in the opinion of the Investigator would interfere with the anesthesia, treatment, or healing process);
  17. Mentally incompetent, prisoner or evidence of active substance or alcohol abuse;
  18. Any condition which, in the Investigator's opinion, would make it unsafe (for the subject or study personnel) to treat the subject as part of this research study;

Sites / Locations

  • Massachusetts General Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

No Intervention

Arm Label

Ultrapulse laser alone

Ultrapulse laser plus Cellutome Harvesting system

Control

Arm Description

Outcomes

Primary Outcome Measures

Count of the Number of Actinic Keratosis and Non Melanoma Skin Cancers in the Treatment Area
This is done at every visit over the 3 year period

Secondary Outcome Measures

Full Information

First Posted
March 10, 2014
Last Updated
October 29, 2019
Sponsor
Massachusetts General Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02150863
Brief Title
Treatment of Field Cancerization for Reduction in Tumor Burden - A Prospective Study
Official Title
Treatment of Field Cancerization for Reduction in Tumor Burden - A Prospective Study
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Terminated
Why Stopped
Difficulty enrolling participants due to exclusion and inclusion criteria
Study Start Date
August 2014 (undefined)
Primary Completion Date
April 2018 (Actual)
Study Completion Date
April 2018 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This project aims to treat field cancerization ( pre-skin cancers) in a manner that will reduce the future pre-skin cancers and non-melanoma skin cancers in patients with significant photodamage. This is 3 year prospective, randomized, controlled comparison of a single treatment with carbon dioxide laser resurfacing vs. carbon dioxide resurfacing plus autologous epidermal skin graft from a non sun exposed site vs. control. Thirty subjects will receive treatment with each of the modalities. The primary measures of efficacy are (a) count of the number of actinic keratosis and non melanoma skin cancers, (b) blinded evaluation of severity from standard digital photographs taken before and after the treatments, and (c) change in histology before and after treatment. Safety measures include (a) pain, (b) scarring, (c) wound healing, (d) and infection

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Extensive Photodamage, Actinic Keratosis, History of Numerous Skin Cancers
Keywords
actinic keratosis, field cancerization, organ transplant patients

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ultrapulse laser alone
Arm Type
Active Comparator
Arm Title
Ultrapulse laser plus Cellutome Harvesting system
Arm Type
Active Comparator
Arm Title
Control
Arm Type
No Intervention
Intervention Type
Device
Intervention Name(s)
Ultrapulse Carbon Dioxide Laser
Other Intervention Name(s)
Lumenis Ultrapulse
Intervention Type
Device
Intervention Name(s)
Cellutome epidermal harvesting system
Primary Outcome Measure Information:
Title
Count of the Number of Actinic Keratosis and Non Melanoma Skin Cancers in the Treatment Area
Description
This is done at every visit over the 3 year period
Time Frame
Entire study period (3 years)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria Subjects with ages between 18 and 85 years, male or female. Subjects with at least 4 clinically diagnosed actinic keratoses (AKs) per treatment site ( up to 200 sq cm), excluding the face and neck Subjects with history of at least 1 non-melanoma skin cancer within the past year Willingness to participate in the study Informed consent agreement signed by the subject Willingness to follow the treatment schedule and post treatment care requirements Willingness to not use topical or systemic (oral) TREATMENT medications including imiquimod, 5-Fluorouracil, photodynamic therapy, during the treatment period. Has not had treatment for AKs in the treatment area for 4 weeks prior to enrollment Exclusion criteria Subjects with active skin cancer in the treatment area. Once the non-melanoma skin cancer has been treated, the subject can be immediately enrolled. Infection of the area to be treated An open wound in the area to be treated Presence of suntan in the area to be treated, or active tanning during the study Subjects who have taken medication known to induce photosensitivity in the previous 3 months The patient has any contraindication to use of the carbon dioxide laser, including but not limited to, intake of isotretinoin in past 12 months; patients with reduced adnexal structures (eg, scleroderma, irradiation or burns); patients with history of vitiligo or psoriasis (risk of Koebnerization); history of keloids/hypertrophic scarring. Subject is unable to comply with treatment, home care or follow-up visits Subject is pregnant or breast feeding Prior use of topical retinoids, 5 fluorouracil, or imiquimod in treated areas within one month of initial treatment Prior skin treatment with laser or other devices in the treated area within two months of initial treatment or during the course of the study; Adverse reactions to compounds of any external agent (e.g., gels, lotions or anesthetic creams) required for use in the study, if no alternative to the said agent exists; Concurrent inflammatory skin conditions, including, but not limited to, eczema, contact dermatitis of any severity; Active Herpes Simplex at the time of treatment; Multiple dysplastic nevi in area to be treated; Having a bleeding disorder or taking anticoagulation medications, including heavy use of aspirin, in a manner which does not allow for a minimum 10 day washout period prior to each treatment (as per the patient's physician discretion); Significant concurrent illness, such as uncontrolled diabetes, (i.e., any disease state that in the opinion of the Investigator would interfere with the anesthesia, treatment, or healing process); Mentally incompetent, prisoner or evidence of active substance or alcohol abuse; Any condition which, in the Investigator's opinion, would make it unsafe (for the subject or study personnel) to treat the subject as part of this research study;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rox Anderson, MD
Organizational Affiliation
Massachusetts General Hospital/ Wellman Center for Photomedicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States

12. IPD Sharing Statement

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Treatment of Field Cancerization for Reduction in Tumor Burden - A Prospective Study

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