Precancerous Condition Clinical Trial
Official title:
Phase 2a Randomized, Placebo-Controlled, Double-Blind Trial of Topical Perillyl Alcohol in Sun Damaged Skin
RATIONALE: Drugs used in chemotherapy, such as perillyl alcohol, work in different ways to
stop the growth of abnormal cells, either by killing the cells or by stopping them from
dividing. It is not yet known which dose of topical perillyl alcohol is more effective in
stopping the development of cancer in sun damaged skin.
PURPOSE: This randomized phase II trial is studying high-dose topical perillyl alcohol to
see how well it works compared with low-dose topical perillyl alcohol in treating patients
with sun damaged skin and actinic keratoses.
OBJECTIVES:
Primary
- To determine if topical administration of perillyl alcohol (POH) cream can reverse
actinic damage as evidenced by normalization of quantitative skin histopathology scores
in skin tissue biopsy samples from patients with moderate to severe sun damage.
Secondary
- To determine if topical POH can be administered safely to the forearms of these
patients.
OUTLINE: Patients are randomized to 1 of 3 arms.
- Placebo: Patients apply a placebo cream topically to each dorsal forearm twice daily
for 3 months in the absence of unacceptable toxicity.
- Low Dose: Patients apply perillyl alcohol (POH) cream (0.3%) topically to each dorsal
forearm twice daily for 3 months in the absence of unacceptable toxicity.
- High Dose: Patients apply POH cream (0.76%) as in arm II. Patients undergo tissue
sampling of the right or left dorsal forearm and of physician-selected representative
actinic keratoses (AK) at baseline and after completion of study therapy. Tissue
samples are assessed for changes in patterns of biomarker expression (i.e., p53,
apoptosis, c-Fos histopathology) and karyometry. After completion of study therapy,
patients undergo tissue sampling of the opposite forearm as well as blood sample
collection to determine perillyl alcohol (POH) levels in blood and biopsy samples.
Urine is also collected and analyzed for safety at the end of treatment. Digital
photographs of the forearms and hands are obtained at baseline and after 3 months of
study treatment. Optical coherence tomography imaging is also performed on pre- and
post-biopsy sites to quantify the effect of POH on sun damage and AK in skin.
After completion of study treatment, patients are followed monthly.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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