Bevonescein for Intra-Operative Nerve Visualization in Head and Neck Surgery

Bevonescein (ALM-488) For Intra-Operative Visualization of Nerves In Head And Neck Surgery

This protocol describes prospective, open-label, blinded, randomized controlled, multicenter pivotal studies to evaluate bevonescein.

Study Overview

• Status: Completed
• Conditions: Surgery
• Intervention / Treatment: Other: Intra-operative Visualization using White Light Reflectance (WLR); Other: Intraoperative Visualization using White Light Reflectance (WLR) with Fluorescence (FL) Overlay; Drug: Bevonescein

Detailed Description

This protocol describes prospective, open-label, blinded, randomized controlled, multicenter pivotal studies to evaluate bevonescein, a visualization adjunct for the real-time enhanced structural delineation of major nerves, in patients undergoing surgery of the Head and Neck.

• Study Type: Interventional
• Enrollment (Actual): 154
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • California
    • La Jolla, California, United States, 92097
      • Alume Biosciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Must be a minimum of 16 years of age.
2. Must be planning to undergo surgery in the Head and Neck.
3. The study participant's primary surgical treatment is parotidectomy or thyroidectomy (unilateral or bilateral)/parathyroidectomy or cervical neck dissection.
4. Willing and able to provide written assent as required and written informed consent by a legally authorized representative after the nature of the study has been explained, and prior to any research-related procedures.
5. Willing and able to comply with all study procedures.
6. Sexually active patients must be willing to use an acceptable method of contraception (e.g., double barrier method) while participating in the study and for 30 days after receiving the last dose of bevonescein.
7. Females of childbearing potential must have a negative pregnancy test at screening and be willing to have additional pregnancy tests during the study. Females considered not of childbearing potential include those who have been in menopause at least 2 years, or had bilateral tubal ligation at least 1 year prior to screening, or who have had total hysterectomy.

Exclusion Criteria:

1. The patient has a history of prior radiation or surgery to the intended surgical site.
2. The patient has abnormal cardiac rhythm not controlled with medication.
3. The patient has moderate to severe renal impairment as indicated by a glomerular filtration rate (GFR) < 60 mL/min.
4. The patient has decreased hepatic function defined as aspartate aminotransferase (AST)/serum glutamic/oxaloacetic transaminase (SGOT) and alanine transaminase (ALT)/serum glutamic-pyruvic transaminase (SGPT) that is higher than 20% of the institution's normal laboratory limits, and/or the patient has elevated total bilirubin that is higher than 20% of the institution's normal laboratory limits.
5. The patient has unresolved acute toxicity from prior anti-cancer therapy grade 2 or higher, as graded by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Alopecia, neuropathy ≤ Grade 2, as well as other non- acute and stable anti-cancer therapy toxicities are acceptable.
6. The patient has a history of fluorescein allergy.
7. The patient has a history of drug-related anaphylactic or severe allergic reactions.
8. Presence or history of any hypersensitivity to bevonescein or its excipients that, in the judgment of the investigator, places the patient at increased risk for adverse effects.
9. Presence of a concurrent disease or condition that may interfere with study participation including recent (within 6 months of screening) NYHA Class III or IV heart failure, myocardial infarction (MI) or cerebrovascular accident (CVA).
10. Presence or history of any condition that, in the view of the Investigator, places the patient at high risk of poor treatment compliance or of not completing the study.
11. Pregnant or breastfeeding at screening or planning to become pregnant (self or partner) at any time during the study.
12. Use of any Investigational Product or investigational medical device within 30 days prior to screening, or requirement for any investigational agent prior to completion of all scheduled study assessments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ALM-488-002a WLR only; Patients with a preoperative diagnosis of malignancy will be assigned to study ALM-488-002a. All patients will receive ALM-488 infusion. Intraoperative nerve visualization will be performed using WLR only.	Other: Intra-operative Visualization using White Light Reflectance (WLR); Intra-operative real time nerve visualization will be undertaken using WLR.; Drug: Bevonescein; Bevonescein will be infused during the pre-operative period.; Other Names: ALM-488
Experimental: ALM-488-002a WLR with FL Overlay; Patients with a preoperative diagnosis of malignancy will be assigned to study ALM-488-002a. All patients will receive ALM-488 infusion. Intraoperative nerve visualization will be performed using WLR with FL Overlay.	Other: Intraoperative Visualization using White Light Reflectance (WLR) with Fluorescence (FL) Overlay; Intra-operative real time nerve visualization will be undertaken using WLR with FL Overlay.; Drug: Bevonescein; Bevonescein will be infused during the pre-operative period.; Other Names: ALM-488
Experimental: ALM-488-002b WLR only; Patients without a preoperative diagnosis of malignancy will be assigned to study ALM-488-002b. All patients will receive ALM-488 infusion. Intraoperative nerve visualization will be performed using WLR only.	Other: Intra-operative Visualization using White Light Reflectance (WLR); Intra-operative real time nerve visualization will be undertaken using WLR.; Drug: Bevonescein; Bevonescein will be infused during the pre-operative period.; Other Names: ALM-488
Experimental: ALM-488-002b WLR with FL Overlay; Patients without a preoperative diagnosis of malignancy will be assigned to study ALM-488-002b. All patients will receive ALM-488 infusion. Intraoperative nerve visualization will be performed using WLR with FL Overlay.	Other: Intraoperative Visualization using White Light Reflectance (WLR) with Fluorescence (FL) Overlay; Intra-operative real time nerve visualization will be undertaken using WLR with FL Overlay.; Drug: Bevonescein; Bevonescein will be infused during the pre-operative period.; Other Names: ALM-488

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nerve Conspicuity	Nerve Conspicuity will be compared between WLR and WLR with FL Overlay Using the Visualization Scoring System.	During surgery
Length Measurement	Nerve Length Measurement in mm will be compared between WLR and WLR with FL Overlay Using a Metric Ruler. Higher values are better than lower values.	During Surgery

Collaborators and Investigators

• Sponsor: Alume Biosciences, Inc.
• Collaborators: Ergomed
• Investigators: Study Director: Brett Berman MD FACC, Chief Medical Officer

Study record dates

Study Major Dates

• Study Start (Actual): April 29, 2022
• Primary Completion (Actual): October 27, 2025
• Study Completion (Actual): November 24, 2025

Study Registration Dates

• First Submitted: May 12, 2022
• First Submitted That Met QC Criteria: May 12, 2022
• First Posted (Actual): May 17, 2022

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: thyroidectomy; nerve; malignancy; fluorescence; neck dissection; head and neck surgery; real-time; parotidectomy; ALM-488; intra-operative; parathyriodectomy
• Additional Relevant MeSH Terms: Neoplasms
• Other Study ID Numbers: ALM-488-002

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No