Benign Prostatic Hyperplasia Clinical Trial
Official title:
A Phase I/II Dose Escalation Study to Assess the Safety, Tolerability, and Preliminary Efficacy of Transurethral Photodynamic Therapy With QLT0074 for Benign Prostatic Hyperplasia
The primary objective of this study is to assess the safety and tolerance of transurethral
photodynamic therapy (PDT) with QLT0074.
Secondary objectives are:
1. To determine if transurethral PDT with QLT0074 has a therapeutic effect on benign
prostatic hyperplasia (BPH), evaluated by the American Urological Association Symptom
Index (AUA SI), urinary flow rate (Qmax), and post-void residual volume (PVR).
2. To determine the extent of systemic exposure to QLT0074 following transurethral
intraprostatic injection.
3. To select up to two transurethral PDT drug-light regimens for further clinical
development.
This will be a multicenter, uncontrolled, dose escalation, exploratory study in subjects
with symptomatic BPH. Six study centers are planned.
Each subject will receive a fixed dose of QLT0074 (0.4 mg) injected transurethrally into the
prostate followed by transurethral light application to activate the drug. Five light dose
cohorts will be investigated sequentially (25, 50, 80, 120, and 150 J/cm2), with 3 subjects
in the first cohort and 6 subjects in cohorts 2-5 for a total of 27 subjects. The follow-up
period for each subject is 180 days. There will be a minimum 30-day interval between
treatment of the last subject in one cohort (Day 0) and treatment of the first subject in
the next cohort to monitor predefined toxicities and ensure safety and tolerance in subjects
of the previous cohort.
A Safety Monitoring Committee will evaluate toxicity related to PDT effects, and approve
escalation of the light dose for each cohort. The light dose will not be escalated if any of
the following predefined toxicity criteria occur and are judged to be related to a PDT
effect by the Safety Monitoring Committee:
1. 1 or more subjects in the cohort experience macroscopic urinary bleeding not resolved
by Day 14, or
2. 2 or more subjects in the cohort experience intolerable urinary pain not controlled
with over-the-counter medication by Day 14, or
3. 1 or more subjects in the cohort experience any other clinically significant urological
adverse event, as judged by the Investigator and confirmed by the Safety Monitoring
Committee.
In addition to the above events, the Safety Monitoring Committee will evaluate the
incidence, timing, severity, and frequency of other adverse events and serious adverse
events to assess the safety of transurethral PDT and the treatment procedures (such as the
use of the cystoscope, InjectTx device, treatment balloon-catheter, etc).
To prevent treating subjects with a light dose greater than that which already provides
substantial clinical benefit, the Safety Monitoring Committee will review preliminary
efficacy data (AUA SI scores and Qmax values) after all subjects in a cohort (for each of
the first 4 cohorts) have completed the Day 90 visit. Further enrollment will be curtailed
if more than 75% of subjects in a cohort experience both of the following efficacy stopping
criteria by Day 90:
1. greater or equal to 75% reduction in the AUA SI score and,
2. greater or equal to 100% increase in Qmax.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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