Actinic Keratosis Clinical Trial
Official title:
Biological Effects of LEO 43204 in Actinic Keratosis Assessed by Histopathology
Verified date | April 2018 |
Source | LEO Pharma |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This is a Phase I, single-centre, open label, within-subject comparison trial to explore the biological effects of LEO 43204 Gel, 0.037%, applied once daily for 3 consecutive days in patients with actinic keratosis on the upper extremity. The treatment area for each patient will be as defined as a contiguous area of 250 cm2 of skin on the upper extremity (including the dorsum manus) that contains a minimum of 5 AK lesions. Additionally there must be at least one AK lesion located in a non-treated area on the contralateral arm. All eligible subjects will receive LEO 43204 Gel, 0.037%, on the treatment area on Days 1, 2 and 3. Study medication application will be (sub)investigator applied. A total of 30 patients will be enrolled into this study (n=15 in each of the two groups). Patients will be divided into two groups with different biopsy schedules.
Status | Completed |
Enrollment | 24 |
Est. completion date | January 16, 2017 |
Est. primary completion date | December 27, 2016 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - 1. Signed and dated informed consent has been obtained. - 2. Subjects with at least 5 non-keratotic, clinically typical, visible and discrete AK lesions within a contiguous 250 cm2 area (AK Treatment Area) on the upper extremity, - 3. Subjects with one additional AK lesion located on the contralateral arm. - 4. Subjects with an area of normal skin in close proximity to the AK Treatment Area or on the contralateral arm. - 5. Male and female subjects, 18 years or older. - 6. Agreement from the patient to allow photographs of the selected treatment area to be taken and used as part of the study data package - 7. Ability to follow study instructions and likely to complete all study requirements - 8. Female Subjects must be of either - non-childbearing potential, i.e. post-menopausal or have a confirmed clinical history of sterility (e.g. the subject is without a uterus or has tubal litigation) or, - child-bearing potential* provided there is a confirmed negative pregnancy test prior to trial treatment to rule out pregnancy. - Female subjects are considered of child-bearing potential unless they have had a hysterectomy or have undergone tubal litigation or have been post-menopausal for at least one year prior to first visit. - 9. Female subjects of child-bearing potential must be willing to use effective contraception at trial entry and until completion. Effective contraception is defined as follows: - Abstinence (when this is in line with the preferred and usual life style of the subject). - Vasectomised partner (given that the subject is monogamous). - An intrauterine device. - Double barrier method defined as two distinct methods (two actual barrier methods). - Hormonal contraceptive (oral hormonal birth control, oestrogenic vaginal ring, percutaneous contraceptive patches, implants and injectables) for at least one menstrual cycle prior to enrolment. Exclusion Criteria: - 1. Prior treatment with ingenol mebutate gel in the treatment area within the last 12 months. - 2. Previously assigned treatment in this clinical trial or previously participated in a clinical trial in the LEO 43204 programme (presently LP0084-68, LP0084-1013, LP0084-1014, LP0084-1015, LP0084-1148, LP0084-1077, LP0084-1193, LP0084-1194, LP0084-1195, LP0084-1196). - 3. Location of the selected treatment area within 5 cm of an incompletely healed wound or infected area of the skin (excl. study related biopsies) or within 5 cm of a suspected basal cell carcinoma (BCC) or SCC. - 4. History or evidence of skin conditions other than the study indication that would interfere with the histologically- or biomarker evaluation of the study medication (e.g. eczema, unstable psoriasis, xeroderma pigmentosum). - 5. Treatment area lesions that have an atypical clinical appearance (e.g. hypertrophic, hyperkeratotic, recalcitrant disease [had cryosurgery on two previous occasions] and/or cutaneous horns). - 6. Known sensitivity or allergy to any of the ingredients of LEO 43204 Gel (e.g. citric acid) - 7. Clinical diagnosis/history or evidence of any medical condition that would expose a subject to an undue risk of a significant AE or interfere with assessments of safety during the course of the study, as determined by Investigator clinical judgment. - 8. Anticipated need for in-patient hospitalisation or in-patient surgery during the study period. Note that cosmetic/therapeutic procedures are not excluded if they fall outside of the criteria detailed in the Prohibited Therapies or Medications (listed below). - 9. Anticipated excessive or prolonged exposure to ultraviolet light (e.g. sunlight) or use of tanning beds for the duration of the study - 10. Current participation in any other interventional clinical trial - 11. Subjects who have received treatment with any non-marketed drug product (i.e. an agent which has not yet been made available for clinical use following registration) within the last two months. - 12. Subjects known to be infected with Human Immunodeficiency Virus (HIV). - 13. Subject known or, in the opinion of the investigator, is unlikely to comply with the Clinical Study Protocol (e.g. alcoholism, drug dependency or psychotic state). - 14. Females who are pregnant, of child-bearing potential and wishing to become pregnant during the trial, or are breast feeding. - 15. Females of child-bearing potential with positive pregnancy test at [screening or visit 1]. - 16. Previous enrolment in this clinical trial. Prohibited Therapies and/or Medications: within 2 weeks prior to the Screening visit - 17. Cosmetic or therapeutic procedures (e.g. use of liquid nitrogen, surgical excision, curettage, dermabrasion, medium or greater depth chemical peel, laser resurfacing): within 2 cm of the selected treatment areas and within 2 cm of the selected AK lesion outside the treatment area - 18. Use of acid-containing therapeutic products (e.g. salicylic acid or fruit acids, such as alpha and beta hydroxy acids and glycolic acids), topical retinoids or light chemical peels: within 2 cm of the selected treatment areas and within 2 cm of the selected AK lesion outside the treatment area - 19. Use of topical salves (non-medicated/non-irritant lotion/cream are acceptable) or topical steroids: within 2 cm of the selected treatment areas and within 2 cm of the selected AK lesion outside the treatment area; artificial tanners: within 5 cm of the selected treatment areas and within 5 cm of the selected AK lesion outside the treatment area Prohibited Therapies and/or Medications: within 4 weeks prior to the Screening visit - 20. Treatment with immunomodulators (e.g. azathioprine), cytotoxic drugs (e.g. cyclophosphamide, vinblastine, chlorambucil, methotrexate, podophyllin, camptothecin) or interferon/interferon inducers. - 21. Treatment with systemic medications that suppress the immune system (e.g. cyclosporine, prednisone, methotrexate, infliximab). - 22. Treatment/therapy with UVB Prohibited Therapies and/or Medications: within 8 weeks prior to the Screening visit - 23. Treatment with 5-FU, imiquimod, diclofenac, or photodynamic therapy: within 2 cm of the selected treatment areas and within 2 cm of the selected AK lesion outside the treatment area Prohibited Therapies and/or Medications: within 6 months prior to the Screening visit - 24. Use of systemic retinoids (e.g. isotretinoin, acitretin, bexarotene) |
Country | Name | City | State |
---|---|---|---|
United States | Beacon Clinical Research, LLC | Quincy | Massachusetts |
United States | Long Island Skin Cancer and Dermatology Surgery | Smithtown | New York |
Lead Sponsor | Collaborator |
---|---|
LEO Pharma |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of CD3+ T lymphocytes assessed by immunohistochemistry in biopsies from AK lesions 56 days after first treatment. | 56 days | ||
Secondary | Number of infiltrating cells assessed by immunohistochemical staining | 8 weeks | ||
Secondary | Expression of inflammatory and skin matrix modulation markers assessed by RNA expression and immunohistochemistry | 8 weeks | ||
Secondary | Expression of ICAM-1 (marker of vascular endothelium activation) assessed by immunohistochemical staining as area of section with positive staining. | 8 weeks | ||
Secondary | Expression of Ki-67 and K16 (markers of cell proliferation and differentiation) assessed by immunohistochemical staining as area of section with positive staining. | 8 weeks | ||
Secondary | Expression of cleaved caspase-3 (apoptosis) assessed by immunohistochemical staining as area of section with positive staining | 8 weeks | ||
Secondary | Necrosis of the epidermis and dermis in haematoxylin & eosin-stained sections (scored on 0-3 scale). | 8 weeks | ||
Secondary | Number of p53 gene mutations determined by DNA sequencing in normal and AK skin and blood at baseline and in a treated AK lesion at Week 8. | 8 weeks |
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