Description:
This is an open label, dose escalation study to evaluate the safety and efficacy of
intralesional injection of STP705 in adult patients with Cutaneous Squamous Cell Carcinoma in
situ (isSCC, Bowen's disease). The purpose of this trial is to evaluate the safety,
tolerability and efficacy of various doses of STP705 administered as Intralesional injection
in subjects with isSCC.
Goals:
- To determine the safe and effective recommended dose of STP705 for the treatment of
isSCC.
- Analysis of biomarkers common to isSCC formation pathway including TGF-β1 and COX-2.
Title
- Brief Title: Open Label, Dose Escalation Study for the Safety and Efficacy of STP705 in Adult Patients With isSCC
- Official Title: An Open Label, Dose Escalation Study to Evaluate the Safety and Efficacy of Intralesional Injection of STP705 in Adult Patients With Cutaneous Squamous Cell Carcinoma in Situ (isSCC)
Clinical Trial IDs
- ORG STUDY ID:
SRN-705-004
- NCT ID:
NCT04293679
Conditions
- Bowen's Disease
- Cutaneous Squamous Cell Carcinoma in Situ
Interventions
Drug | Synonyms | Arms |
---|
STP705 | | Cohort A: STP705 10 μg dose |
Purpose
This is an open label, dose escalation study to evaluate the safety and efficacy of
intralesional injection of STP705 in adult patients with Cutaneous Squamous Cell Carcinoma in
situ (isSCC, Bowen's disease). The purpose of this trial is to evaluate the safety,
tolerability and efficacy of various doses of STP705 administered as Intralesional injection
in subjects with isSCC.
Goals:
- To determine the safe and effective recommended dose of STP705 for the treatment of
isSCC.
- Analysis of biomarkers common to isSCC formation pathway including TGF-β1 and COX-2.
Detailed Description
This open label, dose escalation study is designed to evaluate the safety and efficacy of
various doses of STP705 administered as an intralesional injection in subjects with cutaneous
in situ squamous cell carcinoma (isSCC).
The primary objective of this study is to evaluate the safety, tolerability, and efficacy of
various doses of STP705 administered as an Intralesional injection in subjects with cutaneous
squamous cell carcinoma in situ skin cancer (isSCC). This study seeks to establish a safe and
effective recommended dose of STP705 for the treatment of isSCC. Expression of biomarkers
common to the isSCC formation pathway, including TGF-β1 and COX-2, will be evaluated.
The primary endpoint will be the proportion of participants with histological clearance of
treated isSCC lesion at the End of Treatment (EOT). Histological clearance (HC) will be
defined as the absence of detectable evidence of isSCC tumor cell nests as determined by
central pathology review.
Secondary endpoints will include i) time to histological clearance of treated isSCC lesion
over the 6 week treatment period, ii) proportion of participants with complete clinical
clearance of treated isSCC lesion based on investigator assessment at the End of Treatment
(EOT), iii) time to complete clinical clearance of treated isSCC lesion based on investigator
assessment over the 6 week treatment period, and iv) the change in size of the treated isSCC
lesion over the 6 week treatment period.
Safety and tolerability will be assessed by the number of incidence of adverse events (AEs)
and serious adverse events (SAEs); the incidence of AEs and SAEs leading to discontinuation
of trial medication; the incidence and severity of Local Skin Response (LSR);
hypopigmentation and hyperpigmentation following treatment; and the tolerability of repeated
Intralesional administration of STP705 as assessed by investigator-evaluation of injection
site reactions for all patients and within each cohort.
In addition, safety measures will include clinically relevant changes or new abnormal
findings in laboratory values, vital signs, electrocardiograms (ECGs), and physical
examination variables.
25 adult patients are planned to be enrolled in the study. They will be divided equally among
5 cohorts (10, 20, 30, 60 and 120 μg dose levels) of 5 subjects each. Enrollment of the first
two subjects in each dosing cohort will be staggered by at least 48 hours. Participants in
the first cohort will attend the study center once weekly for an injection of STP705 into the
isSCC lesion. The participants will receive injections of STP705 once a week for up to 6
weeks. The clinician will evaluate the tumor for clinical changes and reduction in size at
each treatment visit for up to 6 weeks. If during the 6 weeks of treatment there is complete
clinical clearance of the tumor, the treatments will end. At the End of Treatment visit, the
residual tumor, or former tumor location will be excised for analysis. In the absence of dose
limiting toxicities (DLT), the subsequent cohorts will receive increasing doses of STP705,
following the same schedule of administration as the first cohort.
If any of the SAEs or dose limiting toxicities outlined above has occurred, the Data Safety
Monitoring Board (DSMB) will conduct independent review of the data and will make a final
decision for dose escalation to the next cohort.
Trial Arms
Name | Type | Description | Interventions |
---|
Cohort A: STP705 10 μg dose | Experimental | Cohort A: STP705 10 μg dose, intradermal injection, given once a week for up to 6 weeks | |
Cohort B: STP705 20 μg dose | Experimental | Cohort B: STP705 20 μg dose, intradermal injection, given once a week for up to 6 weeks | |
Cohort C: STP705 30 μg dose | Experimental | Cohort C: STP705 30 μg dose, intradermal injection, given once a week for up to 6 weeks | |
Cohort D: STP705 60 μg dose | Experimental | Cohort D: STP705 60 μg dose, intradermal injection, given once a week for up to 6 weeks | |
Cohort E: STP705 120 μg dose | Experimental | Cohort E: STP705 120 μg dose, intradermal injection, given once a week for up to 6 weeks | |
Eligibility Criteria
Inclusion Criteria:
- 1. Male or female adult ≥ 18 years of age.
- 2. Primary, histologically confirmed trunk or extremity
(non-peri-orbital/-anogenital/-facial/-scalp) isSCC lesion suitable for excision with
a minimum diameter of 0.5cm and with a maximum diameter of 2.0cm.
- 3. Histological diagnosis made no more than 6 months prior to the screening visit.
- 4. Histological biopsy removed ≤25% of the original area of the target lesion.
- 5. No other dermatological disease in the isSCC target site or surrounding area, which
in the opinion of the investigator, could interfere with the study.
- 6. Willing to refrain from using non-approved lotions or creams on the target site and
surrounding area during the treatment period.
- 7. Willing to refrain from exposure to excessive direct sunlight or ultraviolet light
and to avoid the use of tanning parlors for the duration of the study.
- 8. Laboratory values for the tests (listed in the Study Schedule) within the reference
ranges as defined by the central laboratory, or "out of range" test results that is
clinically acceptable to the investigator. Acceptable "out of range" values are
generally those within 2 standard deviations of the mean or explainable due to
concurrent medications or disease processes.
- 9. Ability to follow study instructions and likely to complete all study requirements.
- 10. Written informed consent obtained, including consent for tissue to be examined and
stored by the Central Histology Lab.
- 11. Written consent to allow photographs of the target isSCC lesion to be used as part
of the study data and documentation.
- 12. For females of childbearing potential, a negative pregnancy test at screening and
using an acceptable form of birth control (oral / implant/ injectable/ transdermal
contraceptives, intrauterine device, condom, diaphragm, abstinence, or a monogamous
relationship with a partner who has had a vasectomy).
Exclusion Criteria:
- 1. Pregnant or lactating.
- 2. Presence of known or suspected systemic cancer.
- 3. Histological evidence of nBCC, sBCC, invasive SCC, or any other non-isSCC tumor in
the biopsy specimen.
- 4. Histological evidence of severe squamous metaplasia, infiltrative, desomoplastic or
micronodular growth patterns in the biopsy specimen.
- 5. History of recurrence of the target isSCC lesion.
- 6. Prior exposure to STP705.
- 7. Evidence of dermatological disease or confounding skin condition in the treatment
area, e.g., BCC, actinic keratosis, rosacea, psoriasis, atopic dermatitis, eczema,
xeroderma pigmentosa.
- 8. Concurrent disease or treatment that suppresses the immune system;
- 9. Patients with baseline QTC > 480 msec using Frederica's formula
- 10. Chronic medical condition that in the judgment of the investigator(s) would
interfere with the performance of the study or would place the patient at undue risk.
- 11. Known sensitivity to any of the ingredients in the study medication.
- 12. Use of a tanning beds or other excessive or prolonged exposure to ultraviolet
light or direct sunlight during the study.
- 13. Treatment with systemic chemotherapeutic agents within the 6 months prior to the
screening visit.
- 14. Use of systemic retinoids within the 6 months prior to the screening period.
- 15. Treatment with systemic immunomodulators or immunosuppressants within the 6 months
prior to the screening period.
- 16. Use of topical immunomodulators within 2cm of the target isSCC lesion within the 4
weeks prior to the screening period.
- 17. Treatment with the following topical agents within 2cm of the target isSCC lesion
within the 4 weeks prior to the screening visit: amino-levulanic acid, 5-fluorouracil,
corticosteroids, retinoids, diclofenac, ingenol mebutate, or imiquimod.
- 18. Treatment with liquid nitrogen, surgical excision (excluding diagnostic incisional
biopsy) or curettage within 2cm of the target isSCC lesion during the 4 weeks prior to
the screening visit.
- 19. Elective surgery within 4 weeks prior to the screening visit, during the study, or
4 weeks after the study period.
- 20. Evidence of current chronic alcohol or drug abuse.
- 21. Current enrollment in an investigational drug or device study or participation in
such a study within 4 weeks of the screening visit.
- 22. In the investigator's opinion, evidence of unwillingness, or inability to follow
the restrictions and requirements of the protocol and complete the study.
- 23. Taking any investigational product within 1 month of first dose of STP705.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Proportion of participants with histological clearance of treated isSCC lesion at the End of Treatment (EOT). |
Time Frame: | 6 weeks |
Safety Issue: | |
Description: | Proportion of participants with histological clearance of treated isSCC lesion at the End of Treatment (EOT).
Histological clearance (HC) will be defined as the absence of detectable evidence of isSCC tumor cell nests as determined by central pathology review. |
Secondary Outcome Measures
Measure: | Time to histological clearance of treated isSCC lesion over the 6 week treatment period. |
Time Frame: | over the 6 week treatment period |
Safety Issue: | |
Description: | |
Measure: | Proportion of participants with complete clinical clearance of treated isSCC lesion based on investigator assessment at the End of Treatment (EOT). |
Time Frame: | 6 weeks |
Safety Issue: | |
Description: | |
Measure: | Time to complete clinical clearance of treated isSCC lesion based on investigator assessment over the 6 week treatment period. |
Time Frame: | over the 6 week treatment period |
Safety Issue: | |
Description: | |
Measure: | Change in size of the treated isSCC lesion over the 6 week treatment period. |
Time Frame: | over the 6 week treatment period |
Safety Issue: | |
Description: | Change in size of the treated isSCC lesion over the 6 week treatment period. A base line assessment of lesion size will be made by investigator at T1 (first visit, Day 0). The change in size will be assessed every week until the surgical excision of isSCC at the End of Treatment visit (EOT, Day 42) . |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | Sirnaomics |
Trial Keywords
- isSCC
- Cutaneous Squamous Cell Carcinoma
- STP705
- Cutaneous Squamous Cell Carcinoma in situ
- Bowen's disease
- Bowen's
Last Updated
December 11, 2020