Topical Imiquimod 5% Cream for Treatment of Cutaneous Neurofibromas in Adults With Neurofibromatosis 1
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Purpose
The purpose of this study is to determine if imiquimod cream can reverse the growth of neurofibromas. Imiquimod is a skin cream that works by stimulating the body's immune system to respond to tumors. Imiquimod cream is approved for use in patients with various skin lesions, including actinic keratosis, superficial basal cell carcinoma, and external genital warts. Information from these studies, as well as previous laboratory studies, suggest that imiquimod cream may help shrink neurofibromas or keep them from growing.
| Condition | Intervention |
|---|---|
|
Neurofibromatosis Type 1 Cutaneous Neurofibromas |
Drug: Imiquimod 5% Cream |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Pilot Study of Topical Imiquimod 5% Cream for Treatment of Cutaneous Neurofibromas in Adults With Neurofibromatosis 1 |
- To determine the effect of topical imiquimod 5% cream on tumor volume of cutaneous neurofibromas in adult subjects with neurofibromatosis 1 [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- To correlate the inflammatory infiltrate adjacent to treated lesions during treatment with tumor response and to determine the number of circulating Tregs in this patient population [ Time Frame: 2 years ] [ Designated as safety issue: No ]
| Enrollment: | 11 |
| Study Start Date: | March 2009 |
| Estimated Study Completion Date: | December 2013 |
| Primary Completion Date: | April 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Imiquimod |
Drug: Imiquimod 5% Cream
Applied topically to three tumors 5 times per week for a full 6 weeks
|
Detailed Description:
- Three of the participant's tumors will be treated with imiquimod cream and one tumor (out of all the remaining tumors) will be followed without treatment (control tumor).
- Participants will be given a tube of imiquimod cream and be asked to apply it to the three tumors 5 times per week, for a full 6 weeks (Monday through Friday).
- Participants will be required to come to the hospital for examinations on Week 1, 2, 4 and 6 (+/- 3 calendar days) and after their last dose of imiquimod cream on Weeks 9, 12 and 18 (+/- 5 calendar days. The following tests and procedures will be performed: skin test; vital signs and measurements and photographs of the tumors. Participants will be asked to participate in an optional skin biopsy on Week 4 and research blood tests wil lbe taken on Day 1.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients must have a diagnosis of NF1 based on NIH criterial with two or more of the following characteristics:
- six or more cafe-au-lait macules (1.5cm or greater in size)
- skin fold freckling in the axilla or groin
- optic pathway glioma
- two or more Lisch nodules of the iris
- distinctive bony lesions such as dysplasia of the sphenoid wing or of a long bone such as the tibia
- two or more neurofibromas of any type of 1 or more plexiform neurofibroma
- first degree relative with NF1
Participants must have at least four cutaneous neurofibromas on skin exam with the following qualities:
- the lesion must be discrete by clinical exam and must not be contact with another skin tumor
- the lesion must be amenable to measurement with calipers with minimum dimension of 5mm and maximum dimension of 30mm
- the lesions must be located on the trunk, neck, or extremities (excluding the hands and feet) and must be located in an area that can be photographed
- histologic confirmation of tumor type is not required in the setting of compatible clinical setting
- No treatment with an investigation agent for cutaneous neurofibromas within the last 3 months
- 18 years of age or older
Exclusion Criteria:
- Pregnant and nursing women
- Patients who have had chemotherapy or radiotherapy within 6 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 6 weeks earlier
- Patients may not be receiving any other investigational agents
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to imiquimod
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Contacts and Locations| United States, Massachusetts | |
| Massachusetts General Hospital | |
| Boston, Massachusetts, United States, 02114 | |
| Principal Investigator: | Scott R. Plotkin, MD, PhD | Massachusetts General Hospital |
More Information
No publications provided
| Responsible Party: | Scott Randall Plotkin, MD, PhD, Associate Professor, Massachusetts General Hospital |
| ClinicalTrials.gov Identifier: | NCT00865644 History of Changes |
| Other Study ID Numbers: | 08-347 |
| Study First Received: | March 17, 2009 |
| Last Updated: | March 4, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Massachusetts General Hospital:
|
imiquimod 5% cream |
Additional relevant MeSH terms:
|
Neurofibroma Neurofibromatosis 1 Osteitis Fibrosa Cystica Neurofibromatoses Nerve Sheath Neoplasms Neoplasms, Nerve Tissue Neoplasms by Histologic Type Neoplasms Peripheral Nervous System Neoplasms Nervous System Neoplasms Nervous System Diseases Peripheral Nervous System Diseases Neuromuscular Diseases Neoplastic Syndromes, Hereditary Neurocutaneous Syndromes |
Heredodegenerative Disorders, Nervous System Neurodegenerative Diseases Genetic Diseases, Inborn Bone Diseases, Endocrine Bone Diseases Musculoskeletal Diseases Imiquimod Adjuvants, Immunologic Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antineoplastic Agents Therapeutic Uses Interferon Inducers |
ClinicalTrials.gov processed this record on May 16, 2013