Study to Determine the Effects Treatment With Amlexanox 0.5% Oral Rinse Solution on Oral Mucositis Associated With Radiation Therapy for Cancer of the Head and Neck Region

A Double-blind, Randomized, Vehicle-controlled Phase II Study to Determine the Effects of Concomitant Treatment With Amlexanox 0.5% Oral Rinse Solution on Oral Mucositis Associated With Radiation Therapy for Cancer of the Head and Neck Region

The purpose of this study was to determine the effect of 0.5% amlexanox oral rinse compared to a vehicle control on mucositis-related ulceration and erythema (objective score)and on mucositis-related oral pain (subjective score).

A secondary objective was to evaluate the safety of 0.5% amlexanox oral rinse by determining the frequency of treatment-emergent drug-related adverse events or clinical laboratory abnormalities.

Study Overview

• Status: Completed
• Conditions: Oral Mucositis
• Intervention / Treatment: Drug: amlexanox; Drug: Vehicle rinse

• Study Type: Interventional
• Enrollment (Actual): 58
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Mobile, Alabama, United States, 36607
      • Mobile Infirmary Medical Center
  • Arkansas
    • Little Rock, Arkansas, United States, 72205
      • University of Arkansas Medical School
  • California
    • Bakersfield, California, United States, 93301
      • Florence Wheeler Cancer Center
  • Connecticut
    • Farmington, Connecticut, United States, 06030
      • University of Connecticut Health Center
  • Florida
    • Melbourne, Florida, United States, 32935
      • ICSL Clinical Studies
  • Illinois
    • Maywood, Illinois, United States, 60115
      • Loyola University Medical Center
  • Massachusetts
    • Boston, Massachusetts, United States, 02215
      • Beth Israel Deaconess Medical Center
  • Michigan
    • Detroit, Michigan, United States, 48201
      • Wayne State University School of Medicine
  • Tennessee
    • Memphis, Tennessee, United States, 38163
      • University of Tennessee
    • Nashville, Tennessee, United States, 37202
      • St. Thomas Hospital
  • Texas
    • Arlington, Texas, United States, 76012
      • Arlington Cancer Center
    • Corpus Christi, Texas, United States, 78412
      • Corpus Christi Cancer Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Patient is 18 years of age or older;
2. Patient has a histologically documented diagnosis of cancer of the head and neck region;
3. Patient is about to receive a course of radiation therapy (with or without concomitant chemotherapy) with a planned dose of at least 60 Gy over 6-7 weeks, and with planned fields to involve at least 50% of the oral mucosa;

This criterion was amended (Amendment 01 dated August 28, 2000) to read as follows:

3. Amended: Patient is at a high risk of developing radiation-induced mucositis. For the purpose of this study, high-risk patients will be defined as:

1. patients about to receive a course of radiation therapy (with or without concomitant chemotherapy) with a planned dose of at least 60 Gy over 6-7 weeks, and

2. with planned fields to involve at least 40% of the oral and oropharyngeal mucosa visible by direct inspection;

   4. Patient has a Karnofsky Performance Scale (KPS) score of 60% or more;

   5. Patient is willing and able to cooperate with the protocol including rinsing of the oral cavity with the investigational or vehicle oral rinse 6 times per day.

   6. The patient or guardian is capable of providing informed consent.

   7. If female, the subject has undergone a urine pregnancy test with negative results, and has agreed to practice effective methods of contraception for the duration of the study.

   Exclusion criteria

   1. Patient has had previous radiation therapy to the oral mucosa;
   2. Patient is about to receive hyperfractionated radiation therapy;
   3. Patient has active oral H. simplex lesions, oral candidiasis, or oral mucositis due to other disease processes;
   4. Patient has uncontrolled infection;
   5. Patient has HIV, Hepatitis B (HBV) (as measured by HBs-Ag) or Hepatitis C (HCV) infection;
   6. Patient has not recovered from oral toxicity attributable to prior treatment;

   7. Patient has abnormal laboratory values that meet the following criteria:

      • Serum creatinine greater than 2 x upper limit of normal
      • Total bilirubin greater than 3 x upper limit of normal;
      • SGOT greater than 3 x upper limit of normal;
      • LDH greater than 3 x upper limit of normal;
   8. Patient has known sensitivities to any of the study preparation ingredients;
   9. Patient has participated in a clinical research study within the last 30 days prior to enrollment;
   10. Patient is unable to communicate or cooperate with the investigator due to language problems, poor mental development, or other reasons.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: DOUBLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: 0.5% amlexanox oral rinse; Patients treated with an oral rinse containing the active 0.5% amlexanox	Drug: amlexanox; 0.5% amlexanox oral rinse; use 5 ml every 2-3 hours during the awake hours of each day (a minimum of 6 times each day). The liquid was be swirled around the mouth then to be swallowed. Repeated daily until completion of radiation therapy: approximately 7-8 weeks.
PLACEBO_COMPARATOR: Vehicle; Patients treated with an oral rinse containing no active	Drug: Vehicle rinse; use 5 ml of the vehicle rinse every 2-3 hours during the awake hours of each day (a minimum of 6 times each day). The liquid is be swirled around the mouth then swallowed.; Other Names: MuGard

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Evaluation of mucositis using the Oral Mucositis Assessment Score	7 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
Frequency of treatment-emergent, drug-related Serious Adverse Events	7 weeks

Collaborators and Investigators

• Sponsor: Access Pharmaceuticals, Inc.
• Collaborators: Advanced Clinical Research Services, LLC
• Investigators: Principal Investigator: Paul Busse, M.D., Ph.D., Beth Israel Deaconess Medical Center

Study record dates

Study Major Dates

• Study Start: February 1, 2000
• Study Completion (ACTUAL): June 1, 2001

Study Registration Dates

• First Submitted: March 8, 2010
• First Submitted That Met QC Criteria: March 9, 2010
• First Posted (ESTIMATE): March 10, 2010

Study Record Updates

• Last Update Posted (ESTIMATE): March 18, 2010
• Last Update Submitted That Met QC Criteria: March 16, 2010
• Last Verified: March 1, 2010

More Information

Terms related to this study

• Keywords: mucositis; Radiation; amlexanox; head and neck carcinoma; oral rinse; MuGard
• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms; Neoplasms by Site; Gastrointestinal Diseases; Gastroenteritis; Stomatognathic Diseases; Mouth Diseases; Head and Neck Neoplasms; Mucositis; Stomatitis; Anti-Allergic Agents; Amlexanox
• Other Study ID Numbers: AP-C-9U01