Imiquimod for Breast Cancer Patients With Chest Wall Recurrence or Skin Metastases

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
New York University School of Medicine
ClinicalTrials.gov Identifier:
NCT00899574
First received: May 11, 2009
Last updated: July 9, 2013
Last verified: July 2013
  Purpose

The purpose of this trial is to determine the safety and efficacy of Imiquimod, a Toll-like receptor 7 agonist in breast cancer (for chestwall recurrences or metastases to the skin).


Condition Intervention Phase
Breast Cancer
Breast Neoplasms
Drug: Imiquimod
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Evaluation of Imiquimod, a Topical Toll-like Receptor 7 (TLR7) Agonist in Breast Cancer Patients With Chest Wall Recurrence or Skin Metastases

Resource links provided by NLM:


Further study details as provided by New York University School of Medicine:

Primary Outcome Measures:
  • Objective Response (Complete Clinical Response+ Partial Response) [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]
    This is defined as percentage of patients who achieved complete clinical response or partial response at end of cycle 1 of treatment. The tumor size will be measured as lesion surface area (region of interest, ROI). The response to the treatment is then evaluated as a function of post-treatment over pre-treatment ROI, expressed in percentage. Response criteria for this study are based on European Organisation for Research and Treatment of Cancer definitions for chest wall tumors: complete clinical response: absence of any detectable residual disease; partial response: <50% of ROI change.


Secondary Outcome Measures:
  • Clinical Benefits [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]
    This outcome measure is defined as number of patients with improvement of symptoms after 8 weeks of treatment.


Enrollment: 10
Study Start Date: May 2009
Estimated Study Completion Date: September 2013
Primary Completion Date: April 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Imiquimod

Each treatment cycle consists of 8 weeks.

Weeks 1-8: day 1-5 of each week: 1 packet imiquimod 5% cream applied overnight, day 6-7 of each week: rest period.

Patients with responding or stable local disease (non-progressors) may continue to receive treatment following the same schedule (as outlined above for the first cycle) until complete tumor regression, unacceptable toxicity or progression of disease.

Drug: Imiquimod

Each treatment cycle consists of 8 weeks.

Weeks 1-8: day 1-5 of each week: 1 packet imiquimod 5% cream applied overnight, day 6-7 of each week: rest period.

Patients with responding or stable local disease (non-progressors) may continue to receive treatment following the same schedule (as outlined above for the first cycle) until complete tumor regression, unacceptable toxicity or progression of disease.

Other Name: Aldara

Detailed Description:

TLR agonists are novel agents for cancer therapy which modify the immune response. Imiquimod, a synthetic TLR7 agonist has proven immunomodulatory activity when applied topically, leading to clearance of human papilloma virus (HPV)-induced genital warts and primary skin malignancies. Its effects will now be examined in breast cancer metastatic to the skin. If effective, it will add a relatively non-toxic approach to the treatment armamentarium for this patient population frequently resistant to conventional therapies.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with biopsy-confirmed breast cancer (prior histological documentation is acceptable).
  • Patients with measurable skin metastases (chest wall recurrence and/or non-chest wall skin metastases are eligible).
  • Skin metastases not suitable for or patient refusing definitive surgical resection and radiation.
  • (Cohort 1) Concurrent systemic cancer therapy (hormones, biologics or chemotherapy) is allowed if distant metastases have been non-progressing (stable or responding) on that regimen for > or = 12 weeks and skin metastases are non-responsive (stable or progressing) as assessed by the investigator.

(Cohort 2) Any concurrent systemic therapy is allowed

  • Age at least 18 years.
  • Eastern Cooperative Oncology Group (ECOG) performance status < or = 2.
  • Patients must have biopsy-accessible tumor (skin metastases) and agree to biopsies required by protocol.
  • Patients must have adequate organ and bone marrow function as defined below:

    • absolute neutrophil count > or = 1,500/microliter
    • hemoglobin > or = 9.5 grams/deciliter
    • platelets >or = 75,000/microliter
    • total bilirubin < or = 1.5 X institutional upper limit of normal
    • Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT) < or = 2.5X institutional upper limit of normal
    • creatinine < or = 1.5 X institutional upper limit of normal
  • Informed consent.

Exclusion Criteria:

  • Brain metastases unless resected or irradiated and stable > or = 8 weeks.
  • Treatment with other investigational agents.
  • Patients who have received radiotherapy, high-potency corticosteroids, intralesional therapy, laser therapy or surgery other than biopsy to the target area within 4 weeks prior to first dosing of study agent.
  • Patients who have received hyperthermia to the target area within 10 weeks prior to first dosing of study agent.
  • Patients with an uncontrolled bleeding disorder.
  • Patients who will be therapeutically anticoagulated with heparins or coumadin at the time of the biopsy (they are eligible if anticoagulation can be held prior to biopsy as per investigator). Patients on aspirin and other platelet agents are eligible.
  • Patients with known immunodeficiency or receiving immunosuppressive therapies.
  • History of allergic reactions to imiquimod or its excipients.
  • Uncontrolled intercurrent medical illness or psychiatric illness/social situations that would limit compliance with study requirements.
  • Pregnancy or lactation.
  • Women of childbearing potential not using a medically acceptable means of contraception.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00899574

Locations
United States, New York
NYU Cancer Institute
New York, New York, United States, 10016
Sponsors and Collaborators
New York University School of Medicine
Investigators
Principal Investigator: Sylvia Adams, MD New York University School of Medicine
  More Information

Publications:
Responsible Party: New York University School of Medicine
ClinicalTrials.gov Identifier: NCT00899574     History of Changes
Other Study ID Numbers: NYU 09-0225
Study First Received: May 11, 2009
Results First Received: April 12, 2012
Last Updated: July 9, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by New York University School of Medicine:
toll-like receptor
toll-like receptor agonist
recurrent breast cancer
breast cancer metastasized to skin and/or chestwall
immunomodulator

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms
Neoplasm Metastasis
Recurrence
Neoplasms by Site
Breast Diseases
Skin Diseases
Neoplastic Processes
Pathologic Processes
Disease Attributes
Imiquimod
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antineoplastic Agents
Therapeutic Uses
Interferon Inducers

ClinicalTrials.gov processed this record on July 22, 2014