Curative Efficacy of Pravastatine in Patients Presented Delayed Cutaneous and Subcutaneous Radio-induced Fibrosis

Fibrosis Clinical Trial

— PRAVACUR  

Official title:

Curative Efficacy of Pravastatine in Patients Presented Delayed Cutaneous and Subcutaneous Radio-induced Fibrosis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01268202
• Other study ID #: CSET 1383 - PRAVACUR
• Status: Completed
• Phase: Phase 2
• Start date: December 17, 2010
• Est. completion date: April 18, 2019

Study information

• Verified date: June 2019
• Source: Gustave Roussy, Cancer Campus, Grand Paris
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Molecular mechanisms involved in radio-induced fibrosis are assessed in UPRES EA 27-10 since 10 years. Besides the canonical TGFbeta/ Smad pathway involved in radio-induced fibrosis (RIF), the Rho/ROCK/CTGF cascade has been shown to be also implicated in molecular mechanisms of RIF. Curative administration of Pravastatin or ROCK specific inhibitors inhibits the chronically activated Rho/ROCK/CTGF pathway in vitro in human cells lines and ex vivo in human samples. In addition, the curative administration of Pravastatin improves established RIF in vivo. The investigators data suggest that the pravastatin-based strategy is an efficient and safe antifibrotic therapy, easily transferable into the clinic to improve the quality of life of long-term cancer survivors without interfering with prior anticancer treatment.

This clinical trial evaluates the curative efficacy of Pravastatine in patients who presented a cutaneous and/ or subcutaneous fibrosis (grade >= 2 according to NCI-CTCAE v4 toxicities scale) and who were treated by radiotherapy for a head and neck cancer. Patients will be treated by Pravastatin during 12 months. An intermediate evaluation of efficacy by ultrasound will be assessed at 6 months and at last, at the end of the treatment. Patients assessment will be performed at 6 and 12 months after the end of the treatment to look at a potential rebound effect.

Objective(s) of the clinical study

Main objective: To assess Pravastatin efficacy in established cutaneous and subcutaneous radio-induced fibrosis revealed from 6 to 24 months after head and neck radiotherapy.

Second objective: To evaluate radio-induced fibrosis regression during the year following treatment stop.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 61
• Est. completion date: April 18, 2019
• Est. primary completion date: April 18, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Grade >= 2 cutaneous and/or subcutaneous fibrosis (NCI-CTCAE v4 toxicities scale) revealed from 6 to 24 months after head and neck radiotherapy.

2. Head and neck cancers treated by radiation therapy +/- chemotherapy, +/- surgery, with no evidence of progressive disease.

3. Age >= 18

4. Karnofsky PS = 70

5. normal renal function (plasmatic creatinine <= 130 micromol/l), normal cholesterol, normal hepatic function (total bilirubin <= 1.5 UNL, SGOT and SGPT <= 2 UNL)

6. Written informed consent of the patient.

Exclusion Criteria:

1. any chronic treatment by corticoids

2. severe cardiac pathology

3. patients already treated by statins or treated by fibrates, cyclosporine

4. history of muscular toxicities when treated by fibrates or by statins

5. Personal or familial history of hereditary muscular pathology

6. Plasmatic CPK >3 UNL

7. patient already included in another therapeutic trial with an experimental drug,

8. pregnant patient or susceptible to pregnancy or breast feeding (patients in age to give birth must be placed under efficient contraception),

9. a social or psychological condition that does not allow a positive patient's participation in the treatment and necessary medical follow-up to be envisaged,

10. the patient is under legal restrained or tutelage.

Related Conditions & MeSH terms

• Fibrosis

Intervention

Drug:
• Pravastatin
Pravastatin 40mg/day during 12 months

Locations

Country	Name	City	State
France	Centre Val d'Aurelle	Montpellier
France	Hôpital Européen Georges Pompidou	Paris
France	Institut Gustave Roussy	Villejuif

Sponsors (2)

Lead Sponsor	Collaborator
Gustave Roussy, Cancer Campus, Grand Paris	Ministry of Health, France

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	regression of radio-induced fibrosis (RIF) evaluated by high frequency ultrasound	a decrease of the maximal thickness more than 30% compared to RIF before treatment.	12 months
Secondary	Fibrosis grade according to NCI-CTCAE v4 toxicities scale.		12 months
Secondary	Quality of life	VQ-Dermato scale	12 months

External Links

•   Institut Gustave Roussy