A Phase-1b Dose Escalation Study to Assess the Effect of NG11-2 on Radiation Induced Oral Mucositis in Patients With Head & Neck Cancer
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 发起方
- 入组人数
- 15
- 试验地点
- 4
- 主要终点
- Occurence of Dose Limiting Toxicities (DLT)
研究概览
简要总结
This study is looking at a new medication called NG11-2 to see if it can reduce a side effect called severe Radiation-induced Oral Mucositis (RIOM) that can happen to people getting radiation treatment for head and neck cancer. Severe RIOM can make patients very sick and make it hard for them to finish their cancer treatment. Right now, there are no approved drugs that can prevent or treat severe RIOM. This study will test different doses of NG11-2 to find the best one, and then more patients will take that dose to see if it works. This study is being done at multiple hospitals in the UK.
详细描述
The main objective of the trial is to see if the use of NG11-2, when administered as a mouthwash in head and neck cancer patients prior to their radiotherapy, is tolerable and can reduce or prevent the development of severe radiation induced oral mucositis. More specifically, the trial aims to identify an appropriate dose of NG11-2 IMP based on safety and activity/preliminary efficacy for subsequent assessment in follow-up clinical trials.
Although the primary objective of the trial is to evaluate the safety & tolerability of NG11-2 mouthwash, the secondary objective is to obtain preliminary data on the activity/efficacy of NG11-2 mouthwash in the reduction of severe RIOM.
This is a Phase-1b unblinded, dose escalation, multi-centre study of NG11-2 for the reduction of severe RIOM in Head and Neck cancer patients undergoing radiotherapy, with or without concurrent chemotherapy.
The study design is a "2+4" Dose Escalation design with the following escalation schema (a) If 0 out of 2 enrolled patients have a Dose Limiting Toxicity (DLT) , then escalate to the next Dose Level and enroll 2 more patients (b) if 1 out of 2 patients has a DLT, then add 4 more patients at the same Dose Level (c) if 2 out of 2, or 2 or more out of 6 patients experience a DLT, then stop the dose escalation.
The Maximum Tolerated Dose (MTD) is one dose level below the level at which 2/2 or 2+/6 patients experienced a DLT.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Male or female head and neck cancer patients scheduled for radiotherapy, aged 18 or over on day of signing informed consent;
- •Histologically confirmed head and neck cancer with or without previous resective surgery, having not been previously treated with radiation therapy
- •Scheduled to receive a mean radiation dose of no less than 30 Gy on either (a) Extended Oral Cavity, or (b) Buccal Mucosa, or (c) Lips, according to CT-based delineation of Organ-At-Risk (OAR) Guideline, with or without concurrent chemotherapy (Section 13.8 for guidance);
- •Rendered dentally fit for radiotherapy;
- •Have a Performance Status >60 on the Karnofsky scale
- •No evidence of active systemic infections at the time of screening;
- •No oral fungal infection by visual examination or swab test;
- •Body Mass Index >=18.5 kg/m²
- •Normalcy of diet evaluated with the Performance Status Scale for Head and Neck cancer patients (PSSHN) >=30;
- •Ability to retain and swill liquid inside the oral cavity for at least 90 seconds;
- •Female patients of childbearing potential must have a negative urine or serum pregnancy test during the 2 week Screening period
- •Provide written informed consent for the trial.
- •Consent to utilize medically acceptable methods of contraception throughout the study period if of child-bearing potential;
- •Be able to comply with protocol procedures (such as Oral Mucositis assessment and swish/spit) and study schedule
排除标准
- •Tumour of the larynx
- •Mentally or legally incapacitated, in the opinion of the PI, which could interfere with the ability of the patient to understand or adhere to the requirements of the study;
- •Open or unhealed non-cancerous wounds or ulcers in the oral cavity;
- •WHO Oral Mucositis grade of 2 or more
- •Uncontrolled Hypertension, defined as blood pressure in adults >150/100mm Hg at screening;
- •A known clinically significant abnormal ECG, such as arrhythmia and active ischemia,within 6 months prior to treatment;
- •Xerostomia or hyposalivation;
- •Known allergy or intolerance to sympathomimetic drugs (e.g., pseudoephedrine, epinephrine), alcohol, or any NG11-2 excipient;
- •Receiving monoamine oxidase (MAO) inhibitors or antidepressants (triptyline or imipramine types); Use of MAO inhibitor in the 14 days prior to treatment, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine;
- •History or current evidence of clinically significant laboratory abnormality or any disease condition that might confound the results of the study, or interfere with the patient's participation for the full duration of the study
- •Current participation in any other oral mucositis studies or completion/ withdrawal from any other oral mucositis studies within the last 3 months
- •Patient is, at the time of signing informed consent, a regular user of any illicit drugs, which would interfere with cooperation with the requirements of the trial;
- •Patient is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the study;
- •Any other condition which, in the opinion of the Investigator, means that the patient is not a good candidate for study enrolment
研究组 & 干预措施
NG11-2 Treatment
Patients will undergo daily treatment with NG11-2 immediately prior to radiotherapy for 5 days/week (Mon-Fri) for up to 7 weeks.
干预措施: NG11-2 (Drug)
结局指标
主要结局
Occurence of Dose Limiting Toxicities (DLT)
时间窗: Dose Limiting Toxicities will be evaluated throughout the study from time of patient consent until 42 days after last IMP dose
Occurence of Serious Adverse Events (SAE)
时间窗: Serious Adverse Events will be evaluated throughout the study from time of patient consent until 42 days after last IMP dose
次要结局
- Duration of severe Radiation-Induced Oral Mucositis (World Health Organisation Grade 0-4, higher = worse)(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Duration of severe Radiation-Induced Oral Mucositis (Radiation Therapy Oncology Group Grade 0-4, higher = worse)(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Duration of severe Radiation-Induced Oral Mucositis (National Cancer Institute - Common Toxicity Criteria for Adverse Events V5 Grade 1-5, higher = worse)(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Incidence of severe Radiation-Induced Oral Mucositis (World Health Organisation Grade 0-4, higher = worse(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Incidence of severe Radiation-Induced Oral Mucositis (Radiation Therapy Oncology Group Grade 0-4, higher = worse)(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Incidence of severe Radiation-Induced Oral Mucositis (National Cancer Institute - Common Toxicity Criteria for Adverse Events V5 Grade 1-5, higher = worse)(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Time to onset of severe Radiation-Induced Oral Mucositis (World Health Organisation Grade 0-4, higher = worse(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Time to onset of severe Radiation-Induced Oral Mucositis (Radiation Therapy Oncology Group Grade 0-4, higher = worse)(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Time to Onset of severe Radiation-Induced Oral Mucositis (National Cancer Institute - Common Toxicity Criteria for Adverse Events V5 Grade 1-5, higher = worse)(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)
- Impact of Oral Mucositis on patient's oral pain and ability to eat and drink(From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.)