- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05838599
Combining Topical Imiquimod With Local Radiotherapy for Treatment of Mycosis Fungoides
March 8, 2024 updated by: Xiaolong (Alan) Zhou, Northwestern University
Mycosis fungoides (MF) is the most common subtype of cutaneous T cell lymphoma (MF) and presents as cutaneous patches, plaques, and tumors.
Radiation therapy (RT) is a frequently pursued management option for CTCL, especially in patients with more advanced skin disease.
Imiquimod stimulates a Th1 lymphocyte response with increased IL-2 and IFN-α, but also induces IFN-α, TNF-α, IL-1α, IL-6, and IL-8, thereby bridging both innate and adaptive immunity.
Dosing of both radiotherapy (RT) and imiquimod are based on standard-of-care doses/frequencies for CTCL.
The reason imiquimod topical is given for a week before giving RT is to prime innate immune activity for when RT is delivered.
It is believed that this serves as an adjuvant for the CD8+ antitumor response generated by RT.
The primary aim of this study is to assess the safety and efficacy of a combination local radiotherapy and topical imiquimod approach for the treatment of conventional (CD4+) MF.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
25
Phase
- Early 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 Contact
- Name: Dermatology Clinical Trials Unit
- Phone Number: 312-503-5944
- Email: NUderm-research@northwestern.edu
Study Locations
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Illinois
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Chicago, Illinois, United States, 60611
- Recruiting
- Northwestern University Department of Dermatology
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Contact:
- Dermatology CTU
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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
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Patients must have confirmed stage IA-IIB mycosis fungoides.
- Patients must be 18-90 years of age.
- Patients must have failed at least one standard therapy for MF.
- Patients must have active, but stable disease for >6 months.
- Patients must have 4 or more discrete MF lesions with at least 2 of them with minimum combined surface area of >50cm2.
- POCBP must have a negative pregnancy test prior to registration on study.
- Patients must have the ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Patients who are on current systemic or topical CTCL therapy, unless stable on the treatment for >6 months.
- Patients who have received antibiotic therapy within 4 weeks of study enrollment.
- Patients who are pregnant or nursing. Pregnant people are excluded from this study because IMQ is an agent with potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the gestational parent with IMQ, breastfeeding should be discontinued if the parent is treated with IMQ.
- Patients with psychiatric illness/social situations that would limit compliance with study requirements.
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: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Topical IMQ and localized RT
After the initial study visit, patients will immediately begin use of imiquimod cream at designated lesions (those with combined size >50cm2) nightly for 5 consecutive days a week over 6 weeks.
One week into the imiquimod treatment course, radiation therapy will be administered at Northwestern Medicine by radiation oncologists familiar with MF in 2 fractions of 4 Gy (total 8 Gy) over 2 days to the same designated lesions.
|
5% cream applied topically 5 days/week for 6 weeks
2 fractions of 4 Gys (total of 8 Gys) starting 1 week after Imiquimoid course over 2 days.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy of a combination local radiotherapy and topical imiquimod approach for the treatment of conventional (CD4+) MF as measured by mSWAT at week 8.
Time Frame: 8 weeks
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The primary efficacy endpoint will be skin disease response as measured by mSWAT (Modified Severity-Weighted Assessment Tool) at week 8.
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8 weeks
|
Incidence of treatment-emergent adverse events (safety and tolerability) of a combination local radiotherapy and topical imiquimod approach for the treatment of conventional (CD4+) MF.
Time Frame: 12 weeks
|
Adverse event occurrence during study.
|
12 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Microbiome alterations before and after treatment
Time Frame: 12 weeks
|
To measure alterations in lesional (tumor-associated) skin, nasal, and gut microbiomes before and after combination RT/imiquimod treatment and associate these differences in microbiomes with clinical response (and any toxicity).
Differences in microbiome bacterial species will be measured by alpha and beta diversity metrics.
Alpha diversity quantifies within sample diversity.
Beta diversity compares between sample diversity (before and after treatment).
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12 weeks
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Tumor-associated and serum immune alterations before and after treatment
Time Frame: 12 weeks
|
To correlate quantitative changes in tumor-associated and serum immune response profiles with clinical response to RT/imiquimod treatment (and any toxicity).
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12 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Alan Zhou, Northwestern University
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 (Actual)
July 24, 2023
Primary Completion (Estimated)
August 1, 2025
Study Completion (Estimated)
February 1, 2026
Study Registration Dates
First Submitted
February 6, 2023
First Submitted That Met QC Criteria
April 29, 2023
First Posted (Actual)
May 1, 2023
Study Record Updates
Last Update Posted (Actual)
March 12, 2024
Last Update Submitted That Met QC Criteria
March 8, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Infections
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Bacterial Infections and Mycoses
- Lymphoma
- Lymphoma, T-Cell, Cutaneous
- Lymphoma, T-Cell
- Mycoses
- Mycosis Fungoides
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Immunologic Factors
- Adjuvants, Immunologic
- Interferon Inducers
- Toll-Like Receptor Agonists
- Immunomodulating Agents
- Imiquimod
Other Study ID Numbers
- AZ10312022
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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.
Clinical Trials on Mycosis Fungoides
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Vanderbilt-Ingram Cancer CenterNational Cancer Institute (NCI)RecruitingRecurrent Mycosis Fungoides | Refractory Mycosis Fungoides | Stage I Mycosis Fungoides | Stage II Mycosis Fungoides | Stage III Mycosis FungoidesUnited States
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National Cancer Institute (NCI)Active, not recruitingMycosis Fungoides | Sezary Syndrome | Stage IB Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage II Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage III Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage IV Mycosis Fungoides and Sezary Syndrome AJCC v8 | Recurrent Mycosis Fungoides... and other conditionsUnited States
-
Mayo ClinicNational Cancer Institute (NCI)Active, not recruitingMycosis Fungoides | Sezary Syndrome | Stage IB Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage II Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage IIA Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage IIB Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage III Mycosis Fungoides... and other conditionsUnited States
-
National Cancer Institute (NCI)CompletedRecurrent Mycosis Fungoides and Sezary Syndrome | Refractory Mycosis Fungoides and Sezary Syndrome | Stage IB Mycosis Fungoides and Sezary Syndrome AJCC v7 | Stage IIA Mycosis Fungoides and Sezary Syndrome AJCC v7 | Stage IIB Mycosis Fungoides and Sezary Syndrome AJCC v7 | Stage IIIA Mycosis... and other conditionsUnited States
-
City of Hope Medical CenterNational Cancer Institute (NCI)RecruitingSezary Syndrome | Stage IB Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage II Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage IIA Mycosis Fungoides and Sezary Syndrome AJCC v8 | Stage IIB Mycosis Fungoides and Sezary Syndrome AJCC v8 | Transformed Mycosis Fungoides | Folliculotropic... and other conditionsUnited States
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Northwestern UniversityAmgenTerminatedRecurrent Cutaneous T-cell Non-Hodgkin Lymphoma | Recurrent Mycosis Fungoides/Sezary Syndrome | Stage III Cutaneous T-cell Non-Hodgkin Lymphoma | Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma | Stage I Cutaneous T-cell Non-Hodgkin Lymphoma | Stage IA Mycosis Fungoides/Sezary Syndrome | Stage... and other conditionsUnited States
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National Cancer Institute (NCI)CompletedRecurrent Mycosis Fungoides and Sezary Syndrome | Refractory Mycosis Fungoides and Sezary Syndrome | Stage IB Mycosis Fungoides and Sezary Syndrome AJCC v7 | Stage IIA Mycosis Fungoides and Sezary Syndrome AJCC v7 | Stage IIB Mycosis Fungoides and Sezary Syndrome AJCC v7 | Stage IIIA Mycosis... and other conditionsUnited States
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Sidney Kimmel Cancer Center at Thomas Jefferson...WithdrawnRecurrent Mycosis Fungoides and Sezary Syndrome | Cutaneous T-Cell Non-Hodgkin Lymphoma | Stage IIB Mycosis Fungoides and Sezary Syndrome | Stage IIIA Mycosis Fungoides and Sezary Syndrome | Stage IIIB Mycosis Fungoides and Sezary Syndrome | Stage IVA Mycosis Fungoides and Sezary Syndrome | Stage...
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Rochester Skin Lymphoma Medical Group, PLLCRochester General HospitalCompletedMycosis Fungoides | Cutaneous T-cell Lymphoma | Transformed Mycosis Fungoides | Cutaneous T-cell Lymphoma Stage I | Folliculotropic Mycosis Fungoides | Granulomatous Slack Skin | Syringotropic Mycosis Fungoides | Mycosis Fungoides VariantUnited States
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Memorial Sloan Kettering Cancer CenterRecruitingMycosis Fungoides | Sezary Syndrome | Mycosis Fungoides/Sezary Syndrome | Sézary | Advanced Mycosis FungoidesUnited States
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