- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00644384
Acitretin in Preventing Skin Cancer in Patients at High Risk for Skin Cancer
Chemoprevention Trial of Acitretin Versus Placebo in Patients at High Risk for Basal Cell Carcinoma or Squamous Cell Carcinoma
RATIONALE: Chemoprevention is the use of certain drugs to keep cancer from forming. The use of acitretin may stop cancer from growing in patients at high risk for basal cell carcinoma or squamous cell carcinoma of the skin.
PURPOSE: This randomized trial is studying how well acitretin works in preventing skin cancer in patients at high risk for skin cancer.
Study Overview
Status
Conditions
Detailed Description
OBJECTIVES:
- Determine the chemopreventive efficacy of acitretin, a synthetic retinoid, in patients at high risk for basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) of the skin.
- Evaluate human papillomavirus (HPV) as a possible etiologic cofactor in the development of cutaneous epidermal dysplasia/carcinoma from skin tissues of patients at high risk for BCC or SCC of the skin.
- Determine the effect of acitretin on a series of potential surrogate endpoint biomarkers (SEBs), including specific retinoid receptors; the Fos/Jun family of proto-oncogenes and products; the Fos/Jun family of transcription factor complexes known as activating protein 1 (AP-1); and HPV DNA in normal (sun-protected), sun-exposed dysplastic and carcinoma (SCC/BCC) skin specimens.
- Correlate standard clinical and histopathological dermatologic evaluation with modulation of SEBs.
OUTLINE: This is a multicenter study. Patients are stratified according to age (18-49 years vs 50-59 years vs 60-69 years vs ≥ 70 years), number of skin cancers within the past 5 years (2-5 vs 6-10 vs 11-20 vs 21-30 vs > 30), most recent skin cancer occurrence (< 12 months ago vs ≥ 12 months ago), patient-reported sunburn susceptibility by Fitzpatrick skin type (1 vs 2 vs 3 vs 4 vs 5 vs 6), and assessment of visible skin damage (minimal vs moderate vs extensive). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral acitretin 5 days a week for 2 years in the absence of unacceptable toxicity.
- Arm II: Patients receive oral placebo 5 days a week for 2 years in the absence of unacceptable toxicity.
Tissue samples of normal skin, excised squamous cell or basal cell carcinoma, or excised actinic keratoses are obtained at baseline and periodically during study. Tissue samples are analyzed for surrogate endpoint biomarkers, including RARγ, RXRα, Fos/Jun family of proto-oncogenes and products, AP-1 DNA binding activity, and presence, identification, and quantification of HPV DNA. mRNA and protein expression levels of RARγ, RXRα, and Fos/Jun family members are analyzed by northern blotting and/or quantitative polymerase chain reaction (PCR) methods. HPV is analyzed by PCR.
After completion of study treatment, patients are followed every 6 months for up to 5 years.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
At high risk for basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) of the skin, defined as a prior history of ≥ 3 nonmelanoma skin lesions
- All visible BCC or SCC must have been resected prior to study entry
PATIENT CHARACTERISTICS:
- Life expectancy > 5 years
- Alkaline phosphatase ≤ 2.5 times upper limit of normal (ULN)
- SGOT ≤ 2 times ULN
- Creatinine ≤ 1.5 times ULN
- Cholesterol < 250 mg/dL
- Triglycerides < 2.5 times ULN
- Not pregnant
- No history of significant, uncontrolled hyperlipidemia
- No history of oral retinoid intolerance
- No history of other significant medical condition that, in the opinion of the physician, would contraindicate retinoid use
PRIOR CONCURRENT THERAPY:
- More than 1 year since prior retinoid therapy
At least 4 weeks since prior and no other concurrent use of oral vitamin A supplements, topical retinoids, or other potentially irritating skin preparations
- Concurrent multivitamin supplements allowed
- No prior organ transplantation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Masking: Double
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
Rate of new non-melanoma skin cancer development
|
Secondary Outcome Measures
Outcome Measure |
---|
Time to new non-melanoma skin cancer development
|
Gene expression (RAR/RXR, Fos/Jun, and AP-1)
|
HPV DNA detection, sequencing, and quantification
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Mark R. Pittelkow, MD, Mayo Clinic
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CDR0000582327
- P30CA015083 (U.S. NIH Grant/Contract)
- MC02C8 (Other Identifier: Mayo Clinic Cancer Center)
- 1153-98 (Other Identifier: Mayo Clinic IRB)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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