In Vivo and In Vitro Pharmacology of Sirolimus in Subjects With Basal Cell Nevus Syndrome
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 16
- 主要终点
- Alterations in RNA as measured by microarray analysis
研究概览
简要总结
RATIONALE: Studying samples of blood and tissue from patients with basal cell nevus syndrome and from healthy participants in the laboratory may help doctors learn more about changes that may occur in DNA and identify biomarkers related to basal cell nevus syndrome. Chemoprevention is the use of certain drugs to keep cancer from forming, growing, or coming back. The use of sirolimus may keep basal cell skin cancer from forming in patients with basal cell nevus syndrome.
PURPOSE: This phase I trial is studying topical sirolimus in patients with basal cell nevus syndrome and in healthy participants.
详细描述
OBJECTIVES:
Primary
- Compare messenger RNA and protein expression patterns in patients with basal cell nevus syndrome (BCNS) vs in cultured cells of healthy participants (control) before treatment to identify a set of genes that are differentially expressed in BCNS.
- Assess the effects of topical sirolimus on gene expression (genes identified in the primary objective) in vivo using keratinocytes, fibroblasts, and lymphocytes from patients with BCNS and from healthy participants (controls) by targeted expression methods.
OUTLINE: Patients and healthy participants receive topical sirolimus ointment twice daily for 12 weeks.
Blood and skin biopsies are obtained at baseline and at week 12 for gene and protein expression studies. Alterations in RNA are measured by microarray analysis. Alterations in protein expression are measured by 2-dimensional gel electrophoresis and matrix-assisted laser desorption ionization time-of-flight mass spectrometry.
研究设计
- 研究类型
- Interventional
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 120 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •DISEASE CHARACTERISTICS:
- •Confirmed diagnosis of basal cell nevus syndrome (BCNS)
- •Known patched (PTCH) gene mutation
- •Must have full sequence of coding exons with intron/exon junctions in the PTCH gene OR prior genetic testing confirming PTCH mutation by the Yale University DNA Diagnostics Laboratory
- •Age- and sex-matched healthy participant (control)
- •Unaffected relative of patient OR normal healthy volunteer with no family history of BCNS or features of BCNS
- •No unrelated healthy participant meeting any of the following clinical criteria for BCNS:
- •Lamellar calcification of the falx cerebri
- •Prior odontogenic keratocyst or any jaw cyst for which a histopathologic diagnosis cannot be ascertained
- •Palmar or plantar pits typical of BCNS
- •More than 3 basal cell carcinomas (BCC) in a lifetime or 1 BCC under the age of 30
- •History of medulloblastoma
- •No unrelated healthy participant with 2 or more of the following features:
- •History of ovarian or cardiac fibroma
- •Mesenteric or pleural cysts
- •Polydactyly
- •Macrocephaly determined after adjustment for height
- •Craniofacial features of BCNS, including cleft palate, frontal bossing, hypertelorism, iris coloboma or other developmental defects of the eye, or coarse facies
- •Vertebral anomalies, including spina bifida occulta outside the lumbar region
- •Bifid or splayed ribs
- •Other radiographic findings, including bridging of the sella turcica, nonlamellar calcification of the falx cerebri, or flame-shaped lucencies in the phalanges = 1-3 BCCs over the age of 30
- •PATIENT CHARACTERISTICS:
- •WBC ≥ 4,000/mm³
- •Neutrophil count ≥ 2,000/mm³
- •Platelet count ≥ 150,000/mm³
- •Hemoglobin ≥ 11.5 g/dL
- •Bilirubin 0.3-1.0 mg/dL
- •AST 17-59 U/L
- •PTT 10-13 seconds OR INR 1.0-1.4
- •Creatinine clearance > 50 mL/min
- •Cholesterol < 350 mg/dL
- •Triglycerides < 400 mg/dL
- •Not pregnant or nursing
- •Negative pregnancy test
- •Fertile participants must use effective contraception for ≥ 1 month before, during, and for ≥ 12 weeks after study treatment
- •No active infection
- •No alcohol or drug abuse
- •No psychiatric disorder or mental deficiency that would preclude study compliance
- •No uncontrolled hypertension (i.e., blood pressure > 140/90 mm Hg on > 2 measurements)
- •No chronic active infection requiring treatment
- •No untreated reactive purified protein derivative of tuberculin (PPD)
- •No HIV-1 infection
- •No infection requiring antibiotics within the past 30 days
- •No other skin disease affecting broad areas of the body, including the region to be treated and biopsied
- •No known hepatitis B or C infection (detectable RNA off antiviral therapy)
- •No immune deficiency disorder
- •No known hypersensitivity to sirolimus or macrolide antibiotics (e.g., erythromycin, azithromycin, or clarithromycin)
- •No cancer within the past 5 years except basal cell skin cancer
- •PRIOR CONCURRENT THERAPY:
- •At least 1 month since prior investigational drugs
- 另有 27 项未显示
排除标准
- 未提供
结局指标
主要结局
Alterations in RNA as measured by microarray analysis
Alterations in protein expression as measured by 2-dimensional gel electrophoresis and matrix-assisted laser desorption ionization time-of-flight mass spectroscopy
次要结局
未报告次要终点