Metvix PDT in Patients With "High Risk" Basal Cell Carcinoma - Full Text View

Sponsored by:	PhotoCure
Information provided by:	PhotoCure
ClinicalTrials.gov Identifier:	NCT00473343

Purpose

Photodynamic therapy (PDT) is the selective destruction of abnormal cells through light activation of a photosensitiser in the presence of oxygen. These cells accumulate more photosensitiser than normal cells. The photosensitiser generates reactive oxygen species upon illumination.

For skin diseases, there has been an increasing interest in using precursors of the endogenous photoactive porphyrins. The most commonly used precursors have been 5-aminolevulinic acid (ALA) and its derivatives. The present test drug, Metvix®, contains the methyl ester of ALA, which penetrates the lesions well and shows high lesion selectivity .

BCC is a highly frequent skin malignancy, and accounts for approximately 75% of all non-melanoma skin cancers . It is the most common cancer in humans . Several non-pharmacological treatment modalities are used for BCC, including excision surgery, curettage and electrodesiccation, cryosurgery and more advanced modalities like radiation therapy, plastic surgery with reconstruction and Moh’s surgery. The treatment used depends on the type, size, depth and localisation of the BCC lesion. Treatment options for BCC give good response rates in the majority of patients but are inadequate in a small group of patients defined as “high-risk” BCC.

In this particular patient group, even a moderate complete response rate with good cosmetic results may be considered beneficial, since the number of patients who have to receive more advanced therapy with the possibility of high morbidity and poor cosmetic outcome will be reduced. Even a partial response is of clinical interest since the remaining tumour will require less extensive surgery. In the case of treatment failure, Metvix PDT does not interfere with the use of other treatment modalities.

The variable “complete response” after one or two Metvix treatment cycles will be used as the basis for the justification of sample size. The following hypothesis will be tested:

H0: Complete response rate of Metvix is less or equal to 65 % versus the alternative hypothesis HA: Complete response rate of Metvix is greater than 65 %

Condition	Intervention	Phase
Basal Cell Carcinoma	Procedure: Photodynamic therapy with Metvix 160 mg/g cream	Phase III

MedlinePlus related topics: Cancer Cosmetics

Drug Information available for: Methyl aminolevulinate

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title:	An Open Multicenter, Phase III Study of Photodynamic Therapy With Metvix Cream 160 mg/g in Patients With "High Risk" Basal Cell Carcinoma

Further study details as provided by PhotoCure:

Primary Outcome Measures:

The primary end-point will be the histologically confirmed complete response rate within a patient (No BCC cells in the biopsy taken 3 months after the last treatment). [ Time Frame: 3 months after last treatment ]

Secondary Outcome Measures:

Safety evaluation during the first 13 weeks or 6 months (if two treatment cycles) after the first Metvix treatment [ Time Frame: 13 weeks or 6 months after first freatment ]
Cosmetic outcome [ Time Frame: 12, 24, 36, 48 and 60 months after the first treatment ]
Recurrence rate [ Time Frame: 12, 24, 36, 48 and 60 months after the first treatment ]

Enrollment:	102
Study Start Date:	September 2000
Study Completion Date:	June 2006

Detailed Description:

Prospective, open, multicenter study. The high risk BCC lesions will be treated with Metvix cream. A biopsy confirming the diagnosis of each BCC lesion should have been taken within 6 months prior to treatment. The patients will receive one or two treatment cycles each consisting of two Metvix PDT treatments 7 days apart (Lesion that show non-complete response at 3 months will have a second PDT treatment cycle).

The primary end-point will be the histologically confirmed complete response rate within a patient (No BCC cells in the biopsy taken 3 months after the last treatment).

Secondary endpoints are safety evaluation during the first 13 weeks or 6 months (if two treatment cycles) after the first Metvix treatment, cosmetic outcome and recurrence rates 12, 24, 35, 48 and 60 months after the first Metvix treatment.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Clinical diagnosis of BCC lesions verified by histology (2-3 mm punch biopsy)
Males or females above 18 years of age.
Written informed consent. AND

Patients with high risk of surgical complications due to:

Anticoagulant medication or bleeding disorders
Cardiac risk factors
Anaesthetic contraindications
Poor surgical compliance because of patient refusal, dementia, or inability to perform wound care.

OR

• Patients with “high-risk BCC lesion(s). A “high-risk” BCC lesion is defined as:

A large BCC lesion with the largest diameter:

Equal to or greater than 15 mm on extremities, except below the knees, where largest diameter should be equal to or greater than 10 mm
Equal to or greater than 20 mm on the trunk
Equal to or greater than 15 mm in the face, or A lesion in the mid-face region (H-zone according to Swanson) or on the ear In patients with more then 6 eligible lesions, the 6 lesions to be treated will be randomly chosen.

Exclusion Criteria:

Prior treatment of the lesion within 4 weeks.
A pure morpheaform and/or highly infiltrated lesion assessed clinically and/or by histology. A mixed nodular/morpheaform lesion which is not highly infiltrated (clinically) may be included.
Patient with porphyria.
Pigmented lesions.
Known allergy to Metvix® or a similar compound.
Participation in another clinical study either concurrently or within the last 30 days
Patient with Gorlin’s syndrome.
Patient with Xeroderma pigmentosum
Pregnant or breast-feeding (all women of child-bearing potential must document a negative pregnancy test and use contraception during the treatments and for at least one month thereafter).
Conditions associated with a risk of poor protocol compliance.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00473343

Locations

Australia, New South Wales
Department of Dermatology, St. George Hospital
Kogarah, New South Wales, Australia, NSW 2217
Australia, Queensland
South East Dermatology, The Belmont Specialist Clinic
Carnia, Queensland, Australia, 4152
Australia, South Australia
Dermatology Department, The Queen Elisabeth Hospital
Adelaide, South Australia, Australia, SA 5011
Department of Dermatology, Royal Adelaide Hospital
Adelaide, South Australia, Australia, SA 5000
Australia, Victoria
Clinic B, Repatriation Campus, Austin & Repatriation Medical Centre
Heidelberg, Victoria, Australia, VIC 3081
Australia, Western Australia
Dermatology Surgery & Laser Centre, The Perth Surgicentre
Perth, Western Australia, Australia, WA 6151
Fremantle Dermatology
Fremantle, Western Australia, Australia, WA 6106

Sponsors and Collaborators

PhotoCure

Investigators

Principal Investigator:

Carl Vinciullo, MD

Dermatology Surgery & Laser Centre, Perth

More Information

Study ID Numbers:	PC T310/00
Study First Received:	May 14, 2007
Last Updated:	May 14, 2007
ClinicalTrials.gov Identifier:	NCT00473343
Health Authority:	Australia: Department of Health and Ageing Therapeutic Goods Administration

Keywords provided by PhotoCure:

Photodynamic therapy (PDT)
PDT with Metvix cream
"High risk" BCC
Basal Cell carcinoma
Histologically confirmed complete response

Study placed in the following topic categories:

Methyl 5-aminolevulinate
Carcinoma, Basal Cell
Aminolevulinic Acid
Neoplasms, Glandular and Epithelial
Carcinoma

Additional relevant MeSH terms:

Photosensitizing Agents
Neoplasms
Neoplasms by Histologic Type
Radiation-Sensitizing Agents
Therapeutic Uses

Physiological Effects of Drugs
Neoplasms, Basal Cell
Dermatologic Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 14, 2009