Status:
TERMINATED
Interstitial Photodynamic Therapy (PDT) With Temoporfin for Advanced Head and Neck Cancers
Lead Sponsor:
University of Arkansas
Collaborating Sponsors:
Erasmus Medical Center
The Netherlands Cancer Institute
Conditions:
Squamous Cell Carcinoma of the Head and Neck
Eligibility:
All Genders
18-95 years
Phase:
PHASE2
Brief Summary
Presently, there is no effective treatment for patients with advanced head and neck cancer (AHNC) that failed to respond to the standard therapy (radiation, chemotherapy and surgery) in the US. These ...
Detailed Description
This is a non-randomize, open label, Pilot phase II study with 5 consenting subjects. The specific aims of this study are: Aim 1: Quantitate local tumor response in patients with incurable AHNC treat...
Eligibility Criteria
Inclusion
- 18 years of age and older, male or female, of all races and ethnicities.
- Prior histologically confirmed advanced squamous cell carcinoma of the head and neck that failed standard therapy (radiation, chemotherapy, surgery).
- Must have a Karnofsky performance status higher than 70%.
- Measurable disease by PET-CT, defined as maximum SUV ≥4 in FDG for the tumor.
- Must have a discrete tumor that is accessible for unrestricted illumination of interstitial photodynamic therapy (I-PDT).
- Deemed unsuitable, by multidisciplinary tumor board, for curative treatment options such as radiotherapy, surgery, chemotherapy or a combination of these modalities. This will include patients who have exceeded the maximum radiation dose and are not candidates for re-irradiation.
- Deemed likely to survive for at least 6 months.
- Able and willing to provide written informed consent to participate in the study.
- If a female of childbearing potential, the subject is willing to take a pregnancy test and practice strict birth control (estrogen-containing oral contraceptives or an intrauterine device) throughout the study and for 3 months after Temoporfin administration. Women who have had a hysterectomy are exempt from these requirements.
- Must have blood glucose level below 250 (and preferably below 200) before FDG injection, required for PET-CT.
- Willing to remain in a light-avoidance environment for a time period of at least 15 days.
- Laboratory criteria:
- Hematocrit \>= 33%, hemoglobin \>= 11 g/dl
- Platelet count \>70.000 per microliter
- BUN: 7 to 20 mg/dL
- CO2 (carbon dioxide): 20 to 29 mmol/L
- Creatinine: 0.8 to 1.4 mg/dL
- Glucose: 64 to 128 mg/dL
- Serum chloride: 101 to 111 mmol/L
- Serum potassium: 3.7 to 5.2 mEq/L
- Serum sodium: 136 to 144 mEq/L
- Liver function test: albumin, bilirrubin (direct/conjugated), ALT (alanine transaminase), AST (aspartate transaminade), GGT (gamma glutamyl transferase), ALP (alkaline phosphatase) within normal limits
- White blood count \> 3,000 per microliter or ANC \> 1500 per microliter
- Serum calcium within normal limits.
Exclusion
- A tumor that is too close to a major blood vessel (such as the carotid artery).
- A tumor invading the skull base.
- The tumor is not clearly shown on the CT image.
- The location and extension of the tumor precludes an effective I-PDT.
- Pregnant or has uncontrolled hyperglycemia.
- Has porphyria or other diseases exacerbated by light.
- With hypersensitivity to Temoporfin or to any of its excipients.
- Has known allergies/hypersensitivity to porphyrins.
- Has known sensitivity to the CT contrast agent. (Omnipaque)
- Has poor renal function as demonstrated by serum creatinine and EGFR \<40, which would preclude the using of the CT contrast agent.
- Patient with a planned surgical procedure within the next 30 days.
- Has a coexisting ophthalmic disease likely to require slit-lamp examination within the next 30 days.
- Patient with existing therapy with a photosensitizing agent (Temoporfin, protoporphyrin or derivatives of porphyrin).
- Has received prior photodynamic therapy to the proposed treatment site within the prior 3 months.
- Has distant metastasis (with the exception of single stable distant metastasis that does not decrease life expectancy to less than 6 months).
- Has a childbearing potential and will not use adequate contraceptive protection.
- A female that is breastfeeding.
- Patient of childbearing potential who has a positive (+) urine pregnancy test.
- Received treatment with an experimental drug or entered another clinical trial within the prior 30 days.
- Received radiotherapy to the head and neck region within the prior 3 months.
- Any disease, which is caused or exacerbated by light, including systemic lupus erythematosus, psoriasis, porphyria, actinic reticuloid or xeroderma pigmentosum.
- Has been treated within the prior 30 days with a light-activated therapy or other medication that may render the subject photosensitive (e.g., psoralen ultraviolet A-range \[PUVA\], Accutane, 5-Fluorouracil, tetracycline's ).
- Not willing or able to complete the visit requirements of this protocol or adhere to the instructions regarding light exposure.
- Any other condition that the PI staff feels will be an endangerment to the subject.
Key Trial Info
Start Date :
November 1 2010
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
March 1 2012
Estimated Enrollment :
1 Patients enrolled
Trial Details
Trial ID
NCT01415986
Start Date
November 1 2010
End Date
March 1 2012
Last Update
December 3 2012
Active Locations (1)
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1
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States, 72205