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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT04883645
Other study ID # 103625
Secondary ID CA252441
Status Active, not recruiting
Phase Early Phase 1
First received
Last updated
Start date April 28, 2022
Est. completion date September 30, 2024

Study information

Verified date May 2024
Source Medical University of South Carolina
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this research study is to find out what effects, good and/or bad, topical application of the drug Aldara will have on patients and on their oral cancer. Aldara is a drug that activates toll-like receptor (TLR) in oral cancer cells causing self-destruction of tumor cells. It also activates immune cells to attack and eliminate cancer cells. Aldara is currently approved by the Food and Drug Administration (FDA) for treatment of skin cancer and melanoma. Its use in this study is 'off-label' (use of a drug approved by FDA for skin cancer to treat oral cancer in this study). The preliminary efficacy of topical imiquimod in a neoadjuvant setting in patients with early-stage oral squamous cell carcinoma will be determined by a reduction in tumor cellularity in post-treatment tissue compared to pre-treatment tissue. Safety and tolerability will be evaluated by CTCAE v5 criteria. The effect of imiquimod on the tumor immune microenvironment will be assessed by performing quantitative multiplex immunofluorescence.


Description:

The researchers propose an exploratory clinical trial to evaluate the efficacy of topical imiquimod, a TLR-7 agonist, in patients with early-stage oral squamous cell carcinoma. The analysis of pre- and post-treatment tumor specimen collected from patients treated on this study will be used for quantitative immunoflourescence analysis to assess the immunomodulatory activity of imiquimod in human tumor samples. The researchers hypothesize that TLR-7 stimulation will reduce the size of the tumor in patients with early-stage oral squamous cell carcinoma. The researchers anticipate that activation of immune cells will correlate with response to therapy.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 15
Est. completion date September 30, 2024
Est. primary completion date June 30, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 100 Years
Eligibility Inclusion Criteria: - Previously untreated and biopsy confirmed oral squamous cell carcinoma (OSCC) - Clinical (TNM) stage I or II - Age >= 18 years - Eastern Cooperative Oncology Group (ECOG) =< 2 Exclusion Criteria: - Patients associated with prior therapy requiring treatment with systemic immunosuppressive treatments with the exception of vitiligo, childhood asthma that has resolved, residual endocrinopathies requiring replacement therapy, or psoriasis that does not require systemic treatment - Treatment with any other investigational agents - Requirement for immunosuppressive intraoral topical or systemic corticosteroids prior to the study - Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements - HIV positive patients on combination antiretroviral therapy - Have evidence of any other significant oral mucosal condition, clinical disorder, physical examination finding, or laboratory finding that, as judged by the investigator, makes it undesirable for the patient to participate in the study - Pregnant women are excluded from this study because imiquimod may have adverse effect on the fetus (FDA pregnancy risk category C). Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with imiquimod, breastfeeding should be discontinued if the mother is receiving study treatment - Male patients unwilling or unable to comply with pregnancy prevention measures - Subjects not receiving initial surgical treatment at Medical University of South Carolina (MUSC)

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Imiquimod 5% Cream
Imiquimod as a 5% cream is being used to treat several skin cancers, including malignant melanoma, basal cell carcinoma (BCC) and SCC. With respect to SCC treatment, it has been demonstrated that imiquimod stimulates tumor destruction by recruiting T cells (cells in the immune system) from blood and by inhibiting tonic anti-inflammatory signals within the tumor. The patient will be instructed to apply imiquimod cream, 7 nights a week for 4 weeks to the oral tumor at bedtime.

Locations

Country Name City State
United States Medical University of South Carolina Charleston South Carolina

Sponsors (1)

Lead Sponsor Collaborator
Medical University of South Carolina

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Exploratory study To assess the shift in anti-tumoral immune profile from pre- to post-therapy. Following 28 days of treatment
Other Exploratory study To assess relapse-free survival Time of surgery to the end of study period.
Primary Efficacy of imiquimod therapy A minimum of 50% reduction in tumor count assessed by quantitative multiplex immunofluorescence in pre- and post-tumor tissue. Following 28 days of treatment
Secondary Safety of imiquimod therapy Defined as safe no life-threatening (Grade 4) adverse events assessed by CTCAE v5 criteria. 2 months
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