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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04082962
Other study ID # 2019P000127
Secondary ID
Status Recruiting
Phase Phase 1
First received
Last updated
Start date April 16, 2018
Est. completion date July 2022

Study information

Verified date July 2021
Source Massachusetts Eye and Ear Infirmary
Contact Mustafa Hashmi, BS
Phone 617-573-3066
Email mustafa_hashmi@meei.harvard.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is an investigator-initiated Phase I study of a single dose of an intravitreally-administered dexamethasone implant (Ozurdex™) in subjects with uveal melanomas (UM) and exudative retinal detachments (ERD: build-up of fluid under the retina that causes it to detach) being treated with proton beam radiation (PBI) or plaque radiotherapy. Although PBI is an effective treatment for UM, ERDs may persist after radiation, leading to vision loss. Effective treatments for ERD are currently lacking. We are conducting this study to evaluate whether Ozurdex™ can help resolve ERDs that occur in patients with UM. Ozurdex™ has been approved by the Food and Drug Administration (FDA) to treat certain ocular conditions such as macular edema, non-infectious uveitis, and diabetic macular edema but it is not approved for use in patients with UM and ERD. This study will determine the safety of the dexamethasone implant and provide preliminary evidence of efficacy in this population.


Recruitment information / eligibility

Status Recruiting
Enrollment 20
Est. completion date July 2022
Est. primary completion date June 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Tumor thickness <= 10 mm. - Associated serous retinal detachment extending beyond tumor, > two clockhours in extent. - Primary treatment of ocular melanoma with proton irradiation or plaque radiotherapy. Exclusion Criteria: - Any pre-existing glaucoma. - History of elevated IOP (> 25 mm Hg). - History of steroid response glaucoma. - Active or suspected ocular or periocular infections including most viral diseases of the cornea and conjunctiva: active ocular herpes simplex, active epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, mycobacterial infections, and fungal diseases. - Any history of ocular herpes simplex. - Torn or ruptured posterior lens capsule. - Known hypersensitivity to any components of the dexamethasone intravitreal implant. - Women of child-bearing potential: pregnant or planning to become pregnant.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Dexamethasone intravitreal implant
Ozurdex™ is an intravitreal implant containing dexamethasone 0.7 mg in the NOVADUR® solid polymer drug delivery system (NOVADUR™ system contains poly (D,L-lactide-co-glycolide) PLGA intravitreal polymer matrix, which slowly degrades to lactic acid and glycolic acid.). Ozurdex™ is preservative-free. It is supplied in a foil pouch with a single-use plastic applicator.

Locations

Country Name City State
United States i. Ocular Melanoma Center, Massachusetts Eye and Ear Boston Massachusetts

Sponsors (1)

Lead Sponsor Collaborator
Ivana K. Kim

Country where clinical trial is conducted

United States, 

References & Publications (11)

Char DH, Bove R, Phillips TL. Laser and proton radiation to reduce uveal melanoma-associated exudative retinal detachments. Am J Ophthalmol. 2003 Jul;136(1):180-2. — View Citation

Collaborative Ocular Melanoma Study Group. The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28. Arch Ophthalmol. 2006 Dec;124(12):1684-93. — View Citation

Gibran SK, Kapoor KG. Management of exudative retinal detachment in choroidal melanoma. Clin Exp Ophthalmol. 2009 Sep;37(7):654-9. doi: 10.1111/j.1442-9071.2009.02127.x. — View Citation

Gragoudas ES. Proton beam irradiation of uveal melanomas: the first 30 years. The Weisenfeld Lecture. Invest Ophthalmol Vis Sci. 2006 Nov;47(11):4666-73. — View Citation

Kim IK, Lane AM, Jain P, Awh C, Gragoudas ES. Ranibizumab for the Prevention of Radiation Complications in Patients Treated With Proton Beam Irradiation for Choroidal Melanoma. Trans Am Ophthalmol Soc. 2016 Aug;114:T2. — View Citation

Kivelä T, Eskelin S, Mäkitie T, Summanen P. Exudative retinal detachment from malignant uveal melanoma: predictors and prognostic significance. Invest Ophthalmol Vis Sci. 2001 Aug;42(9):2085-93. — View Citation

Koehler PJ. Use of corticosteroids in neuro-oncology. Anticancer Drugs. 1995 Feb;6(1):19-33. Review. — View Citation

Malclès A, Nguyen AM, Mathis T, Grange JD, Kodjikian L. Intravitreal dexamethasone implant (Ozurdex®) for exudative retinal detachment after proton beam therapy for choroidal melanoma. Eur J Ophthalmol. 2017 Aug 30;27(5):596-600. doi: 10.5301/ejo.5000940. Epub 2017 Feb 8. — View Citation

Parrozzani R, Pilotto E, Dario A, Miglionico G, Midena E. Intravitreal triamcinolone versus intravitreal bevacizumab in the treatment of exudative retinal detachment secondary to posterior uveal melanoma. Am J Ophthalmol. 2013 Jan;155(1):127-133.e2. doi: 10.1016/j.ajo.2012.06.026. Epub 2012 Sep 18. — View Citation

Scotto J, Fraumeni JF Jr, Lee JA. Melanomas of the eye and other noncutaneous sites: epidemiologic aspects. J Natl Cancer Inst. 1976 Mar;56(3):489-91. — View Citation

Sturdza A, Millar BA, Bana N, Laperriere N, Pond G, Wong RK, Bezjak A. The use and toxicity of steroids in the management of patients with brain metastases. Support Care Cancer. 2008 Sep;16(9):1041-8. doi: 10.1007/s00520-007-0395-8. Epub 2008 Feb 7. — View Citation

* Note: There are 11 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Incidence of Treatment-Emergent Adverse Events Related to the Implant The primary outcome of the study will be to evaluate the safety of the implant. All adverse effects not related to the melanoma or radiation treatment identified by ocular examination, diagnostic tests, and subject reporting will be tabulated. This includes significant vision loss, other sight-threatening events, and unforeseen systemic events. Throughout 12 month study period
Secondary Exudative retinal detachment resolution Will be assessed using spectral domain optical coherence tomography, B-scan ultrasonography, and optos wide-angle color photography. 6 and 12 months after implant insertion
Secondary Visual Acuity Measured with ETDRS chart. 6 and 12 months after implant insertion
Secondary Complications The development of iris neovascularization and neovascular glaucoma. Throughout 12 month study period.