NFX-179 Topical Gel Treatment in Adults With Neurofibromatosis 1 (NF1) and Cutaneous Neurofibromas (cNF)

Phase 2

Completed

• Conditions: Neurofibromatosis 1; Cutaneous Neurofibroma
• Interventions: Drug: NFX-179 Gel; Drug: Vehicle Gel

• Registration Number: NCT04435665
• Lead Sponsor: NFlection Therapeutics, Inc.

Brief Summary

This study will enroll and treat subjects with cutaneous neurofibromas with NFX-179, a topical study drug. Eligible subjects will receive treatment for 28 days and be observed by a study doctor for approximately 56 days. Subjects will be randomly assigned to 1 of 4 treatment groups. 3 of the treatment groups will receive a specific dose NFX-179, and 1 group will receive placebo. The subject, study doctor, and NFlection Therapeutics will not know what treatment group each subject is assigned. Study participation requires at least 7 clinic visits, blood, urine, and tissue collection, images of the treated cutaneous neurofibromas, electrocardiograms, and information regarding the subject's medical and disease history.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-06-08
• Study First Submitted QC: 2020-06-16
• Study First Posted: 2020-06-17
• Study Start: 2020-08-21
• Primary Completion: 2021-04-08
• Study Completion: 2021-04-14
• Results First Submitted: 2021-08-25
• Status Verified: 2022-07
• Results First Submitted QC: 2022-07-13
• Last Update Submitted: 2022-07-13
• Results First Posted: 2022-08-09
• Last Update Posted: 2022-08-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 48

Inclusion Criteria

1. Subject is at least 18 years of age

2. Subject must provide written informed consent prior to any study procedures

3. Subject must have a clinical diagnosis of NF1

4. Subject has 6 Study cNF Tumors (5 Target cNF Tumors [1 on the face; 4 on the anterior trunk or upper extremities] that will be treated with the assigned study medication;1 Untreated cNF Tumor on the anterior trunk or upper extremities) that each meet the following criteria:

   • Has, in the investigator's opinion, a clinically typical appearance
   • Is dome shaped
   • Is not pedunculated
   • Is a discrete tumor
   • Is not irritated
   • Is not in an area subject to repeated trauma (e.g., area that is shaved, on the beltline, under a bra strap, etc.)
   • Does not have an active cutaneous infection
   • Has a diameter that is ≥5mm and ≤10mm
   • Has a height of ≥2mm
   • Is, when centered in the center of the provided template, the only cNF tumor visible
   • Is not within 5mm of the orbital rim.

5. Subject is willing to have the 5 Target cNF Tumors and the 1 Untreated cNF Tumor excised at the end of the treatment period

6. Subject is willing to have hair in the area surrounding the Target cNF Tumors shaved, if necessary, to obtain photographs

7. Subject is willing to minimize exposure of each Target cNF to natural and artificial ultraviolet radiation

8. Subject is willing to forego treatment of the Target cNF Tumors, except protocol specified therapy, during the study

9. Female subjects who are women of childbearing potential must have a negative urine pregnancy test result and be willing to use a protocol approved, contraceptive method for the duration of the study

10. Subject is willing and able to follow all study instructions and to attend all study visits.

Exclusion Criteria

1. Subject has applied any of the following topical products in the previous 30 days on or in proximity to any Study cNF Tumor that, in the investigator's opinion, impairs evaluation of any the tumor or which exposes the subject to an unacceptable risk by study participation:

   • Corticosteroids
   • Retinoids (e.g., tazarotene, tretinoin, adapalene)
   • > 5% of an alpha-hydroxy acid (e.g., glycolic acid, lactic acid)
   • Fluorouracil
   • Imiquimod

2. Any Study cNF Tumor has ever been treated with an MEK inhibitor or a BRAF inhibitor

3. The subject has used any of the following systemic medications in the noted time period:

   • Retinoids (e.g., etretinate, isotretinoin) within the previous 90 days
   • MEK inhibitors within the previous 180 days
   • BRAF inhibitors within the previous 180 days

4. Subject has a history of hypersensitivity to any of the ingredients in the study medications

5. Subject has any known intercurrent illness or physical condition that would, in the investigator's opinion, impair evaluation of a Target cNF Tumor or which exposes the subject to an unacceptable risk by study participation

6. Subject has, in the investigator's opinion, clinically relevant history of liver disease, including viral hepatitis, current alcohol abuse, or cirrhosis

7. Subject has a history of metastatic disease, or active cancer (excluding nonmelanoma skin cancer, Stage I cervical cancer, ductal carcinoma in situ of the breast, or Stage 0 chronic lymphocytic lymphoma) within the previous 5 years

8. Subject has any condition (e.g., other skin conditions or diseases, metabolic dysfunction, physical examination findings, clinical laboratory findings) or situation (e.g., vacation, scheduled surgery) that would, in the investigator's opinion, impair evaluation of a Target cNF Tumor or which exposes the subject to an unacceptable risk by study participation

9. Subject has participated in an investigational drug trial in which administration of an investigational study medication occurred within the previous 30 days

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
NFX-179 Gel Low	NFX-179 Gel	NFX-179 Gel for topical administration, once daily for 28 days
NFX-179 Gel Mid	NFX-179 Gel	NFX-179 Gel for topical administration, once daily for 28 days
NFX-179 Gel High	NFX-179 Gel	NFX-179 Gel for topical administration, once daily for 28 days
Vehicle Arm	Vehicle Gel	Vehicle Gel, for topical administration, once daily for 28 days

Primary Outcome Measures

Name	Time	Method
Phospho-erk (p-ERK) Levels of Target cNF Tumors in NFX-179 Gel Group and Vehicle Gel Group After 28 Days of Once-daily (QD) Application	Baseline through Week 4	Pharmacodynamic activity (biochemical and physiologic effects of drugs) of NFX-179 Gel as defined by suppression of phospho-ERK (p-ERK) levels in Target cNF Tumors in each NFX-179 Gel group compared with the Vehicle Gel group after 28 days of once-daily (QD) application will be measured at Week 4
Safety and Tolerability of NFX-179 Gel Measured by Local Tolerability Assessment	Baseline through Week 4	Safety and tolerability will be measured via a local tolerability assessment. The investigator will assess erythema, edema, scabbing/crusting, vesiculation, and erosion. The subject will assess stinging, burning, and pruritus. All assessments are performed using a 4-point scale (0 none, 1 mild, 2 moderate, 3 severe).
Assessment of Adverse Events	Baseline through Week 8	Assessment of adverse events (AEs)

Secondary Outcome Measures

Name	Time	Method
Percent Change in cNF Tumor Volume (Cubic Millimeters)	Baseline through Week 4	Percent change in cNF tumor volume after 28 days of QD applications of NFX-179 gel based on tumor volume derived from ruler measurements.
Systemic Exposure of NFX-179 Gel Measured by Plasma Concentration	Baseline through Week 4	Systemic exposure of NFX-179 will be measured during the 28 days of QD applications at select investigative sites. Pharmacokinetic samples will be drawn at the baseline visit and week 4 visit. 5 time point samples will be collected at the week 4 visit.
Change in Physician Assessment of Tumor Severity Score	Baseline through Week 4	Effect of treatment with The Physician Tumor Assessment is the investigator's assessment of the average overall severity of each Target cNF tumor at a particular time point. The Physician Tumor Assessment is a 5-point measuring tumor severity (0 clear/none, 1 almost clear, 2 mild, 3 moderate, 4 severe). The assessment is performed at the Baseline visit and week 4 visit.
Change in Subject Self-Assessment of Tumor Severity Score	Baseline through Week 4	The Subject Self-Assessment is the subject's assessment of the average overall severity of each Target cNF at a particular time point and is not a comparison with any other time point. The Subject Self-Assessment is a 5-point measuring tumor severity (0 clear/none, 1 almost clear, 2 mild, 3 moderate, 4 severe). The assessment is performed at the Baseline visit and week 4 visit.

Trial Locations

Locations (6)

Skin Search of Rochester, Inc.; 🇺🇸 Rochester, New York, United States

Center for Dermatology Clinical Research, Inc.; 🇺🇸 Fremont, California, United States

University of Texas Southwestern Medical Center; 🇺🇸 Dallas, Texas, United States

Minnesota Clinical Study Center; 🇺🇸 New Brighton, Minnesota, United States

DermResearch; 🇺🇸 Austin, Texas, United States

The Education & Research Foundation, Inc.; 🇺🇸 Lynchburg, Virginia, United States