- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01522677
A Study of Neoadjuvant Photodynamic Immunomodulation for Colon Cancer
November 30, 2016 updated by: Edward Nelson
A Phase I/II Study of Neoadjuvant Photodynamic Immunomodulation for Colon Cancer
The central hypothesis for this study is that it is safe and feasible to administer intraluminal photodynamic therapy (PDT) to colon cancers by colonoscopy to induce localized inflammatory/immune response.
The objective is to demonstrate the feasibility and safety of PDT to colon cancer patients administered before surgery and to characterize the inflammatory/immune response at the tumor site and systemically.
The long-term objective of these studies is to modify he natural biology of colorectal cancers and improve patient survival.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
The central hypothesis for this study is that it is safe and feasible to administer intraluminal photodynamic therapy (PDT) to colon cancers, via colonoscopy, in the neoadjuvant setting to induce localized tumor cell death and an inflammatory/immune response with an increased Th1 component, utilizing 5-ALA as a photosensitizer.
The objective is to conduct an initial phase I/II clinical study to demonstrate the feasibility and safety of colonoscopic, neoadjuvant intraluminal PDT to colon cancer patients administered 96 hours pre-resection, to characterize the inflammatory/immune response at the PDT treated tumor site, and to evaluate the systemic anti-tumor immune response.
The long-term objective of these studies is to provide an easily administered, adjunctive, therapeutic maneuver that lacks systemic toxicity, with the potential to modulate the natural biology of colorectal cancers that have not elicited a favorable anti-tumor immune response and to improve patient survival.
Study Type
Interventional
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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California
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Orange, California, United States, 92868
- University of California, Irvine
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New York
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New York, New York, United States, 10029
- Mounst Sinai School of Medicine
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
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:
- Patients must have a histologically proven diagnosis of colorectal cancer.
- Have clinical stage I, II, or III disease.
- Expected survival must be greater than twelve (12) months.
- A Karnofsky Performance Status (KPS) must be 70 or greater (Appendix I).
- Patients must be >21 years of age.
- No prior therapy.
- Female patients must not be lactating and must be surgically sterile (via hysterectomy or bilateral tubal ligation), postmenopausal, or using acceptable methods of contraception if they are of child bearing potential. Female patients of childbearing potential must also have a negative serum pregnancy test.
- Patients must be able to understand and sign an informed consent form, which must comply with U.S. regulations (U.S. 21 CFR 50) and ICH guidelines.
- Eligible patients must have adequate initial hematologic and coagulation parameters, hemoglobin ≥ 11g/dl, platelet count >50,000, Protime and Prothrombin Time ≤ 1.5 x normal.
- Eligible patients must have adequate bone marrow, liver and renal function: ANC > 1500/μL, Platelets >100,000 x μL, total bilirubin < the upper limit of normal (ULN), and creatinine clearance (CrCl) > 45 mL/min
Exclusion Criteria:
- Any co-morbidity that precludes primary surgical resection of the colorectal tumor.
Any significant general organ system compromise including:
- Liver function, transaminases ≥ 2 x,
- Renal function, Cr ≥ 1.5 x upper limit of normal
- Pulmonary function, room air O2 saturation <90%
- Cardiovascular function, Patients with significant (Class III or IV) cardiovascular disease according to the New York Heart Association's functional criteria (Appendix II)
- Gastrointestinal function, i.e. active inflammatory bowel disease or active peptic ulcer disease.
- Any contraindication to repeat colonoscopy, such as idiosyncratic reactivity to conscious sedation medications.
- Prior treatment for the diagnosis of colorectal cancer, including surgical resection.
- Stage IV colorectal cancer, i.e. the clinical presence of metastases
- Prior malignant diagnosis except for the basal cell epithelioma of the skin.
- Persistent fever greater than 38 C.
- Mineral overload syndromes for Lead, Zinc, Copper or Iron.
- Use of any agent that modulates 5-ALA metabolism and porphyrin synthesis, e.g. St. John's Wort.
- Required use of corticosteroids or immune suppression for any reason including an organ allograft or HIV infection
- Patients with any acute or chronic illness including cardiovascular disease (e.g. history of atrial fibrillation or ventricular arrhythmias) or history of myocardial infarction, autoimmune state, or any psychiatric illness that in the opinion of the Investigators would compromise treatment.
- Use of investigational drugs within 30 days of execution of the informed consent form.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: PDT
Participants receive neoadjuvant 5-ALA and PDT.
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Patients receive neoadjuvant PDT with radiosensitizing 5-ALA 4 days prior to surgery for colon cancer.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy
Time Frame: 6 months
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Define biologic efficacy of PDT in relation to generation of an immune response at the tumor site and systemically.
This will be measured by degree of dendritic cell infiltration into tumor and regional lymph nodes, and degree of systemic immunity directed against colon cancer antigens immediately post procedure and after 6 months.
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6 months
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Safety
Time Frame: 6 months
|
Safety will be evaluated from enrollment through 6 months.
This will be measured by proportion of patients completing planned surgery, proportion of patients experiencing grade 3 or 4 toxicities, and lack of observation of serious adverse events related to the study procedure.
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quality of Life
Time Frame: 6 months after completion of participation
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Quality of life will be evaluated 6 months following completion of participation in the study
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6 months after completion of participation
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Sustained immunity
Time Frame: 1.5-6 months post completion of participation
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Immunologic parameters will be monitored following completion of the study as a measure of sustained immunity
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1.5-6 months post completion of participation
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Edward L Nelson, MD, University of California, Irvine
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
August 1, 2012
Primary Completion (ACTUAL)
May 1, 2014
Study Completion (ACTUAL)
May 1, 2014
Study Registration Dates
First Submitted
January 26, 2012
First Submitted That Met QC Criteria
January 30, 2012
First Posted (ESTIMATE)
January 31, 2012
Study Record Updates
Last Update Posted (ESTIMATE)
December 1, 2016
Last Update Submitted That Met QC Criteria
November 30, 2016
Last Verified
November 1, 2016
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UCI 10-26
- 1R21CA153594 (NIH)
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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