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Ultraviolet Light Therapy Using Methoxsalen With or Without Bexarotene in Treating Patients With Mycosis Fungoides

This study is currently recruiting participants.
Study NCT00056056.   Last updated on July 23, 2008.   Information provided by National Cancer Institute (NCI)

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Descriptive Information Fields
Brief Title  Ultraviolet Light Therapy Using Methoxsalen With or Without Bexarotene in Treating Patients With Mycosis Fungoides
Official Title  A Randomized, Open-Label Phase III Trial to Evaluate the Efficacy and Safety of Bexarotene (Targretin) Capsules Combined With PUVA, Compared to PUVA Treatment Alone in Patients With Mycosis Fungoides
Brief Summary

RATIONALE: Ultraviolet light therapy uses light and drugs that make cancer cells more sensitive to light to kill tumor cells. It is not yet known whether ultraviolet light therapy is more effective with or without bexarotene in treating mycosis fungoides.

PURPOSE: Randomized phase III trial to compare the effectiveness of ultraviolet light therapy using methoxsalen with or without bexarotene in treating patients who have mycosis fungoides.

Detailed Description

OBJECTIVES:

  • Compare the cumulative dose of ultraviolet A light required to achieve a complete clinical response (CCR) in patients with mycosis fungoides treated with ultraviolet A light therapy with methoxsalen (PUVA) with or without bexarotene.
  • Compare the overall response rate (CCR and partial response) in patients treated with these regimens.
  • Compare the duration of CCR and time to relapse of patients treated with these regimens.
  • Compare the number of PUVA sessions necessary to achieve a CCR in these patients.
  • Determine the percentage of dropouts by patients treated with these regimens.
  • Determine the safety of these regimens in these patients.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to participating center, age (60 and under vs over 60), and stage of disease (IB vs IIA). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive PUVA comprising oral methoxsalen given 2 hours before whole body ultraviolet A therapy. PUVA is given 3 times per week.
  • Arm II: Patients receive oral bexarotene once daily and PUVA as in arm I. In both arms, treatment repeats for up to 16 weeks in the absence of complete clinical response, disease progression, or unacceptable toxicity.

Patients are followed every 8 weeks until the first documented progression or relapse.

PROJECTED ACCRUAL: A total of 134 patients (67 per treatment arm) will be accrued for this study within 17 months.

Study Phase Phase III
Study Type  Interventional
Study Design  Treatment, Randomized, Open Label, Active Control
Primary Outcome Measure  Cumulative dose of UVA necessary to achieve a complete clinical response (CCR) by Tumor Burden Index and appearance or disappearance of extracutaneous lesions every 4 weeks during treatment and then every 8 weeks until progression [ Designated as safety issue: No ]
Secondary Outcome Measure  Overall response rate (CCR + partial response [PR]) by Tumor Burden Index and appear. or disappear. of extracutaneous lesions every 4 weeks during treatment and then every 8 weeks until progression [ Designated as safety issue: No ]
Time to relapse as measured by Logrank every 4 weeks during treatment, then every 8 weeks [ Designated as safety issue: No ]
Duration of CCR as measured by Logrank every 4 weeks during treatment and then every 8 weeks until progression [ Designated as safety issue: No ]
Number of UVA light therapy with methoxsalen (PUVA) sessions necessary to achieve a CCR by median and range at the completion of treatment [ Designated as safety issue: No ]
Safety as assessed by CTC v2.0 every 4 weeks during treatment, then every 8 weeks [ Designated as safety issue: Yes ]
Percentage of dropouts as measured by the percentage of cases not completing treatment due to toxicity at the completion of treatment [ Designated as safety issue: Yes ]
Condition  Lymphoma
Intervention  Drug: bexarotene
Drug: methoxsalen
Procedure: UV light therapy
MEDLINE PMIDs
Links Clinical trial summary from the National Cancer Institute's PDQ® database This link exits the ClinicalTrials.gov site
Recruitment Information Fields
Recruitment Status  Recruiting
Enrollment  134
Start Date  January 2003
Completion Date
Eligibility Criteria 

DISEASE CHARACTERISTICS:

  • Histologically confirmed mycosis fungoides

    • Stage IB or IIA
    • Confirmed by current or prior diagnostic lesion biopsy

PATIENT CHARACTERISTICS:

Age

  • Over 18

Performance status

  • Karnofsky 60-100%

Life expectancy

  • Not specified

Hematopoietic

  • WBC at least 2,000/mm^3
  • Hemoglobin at least 9 g/dL

Hepatic

  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • AST and ALT no greater than 2.5 times ULN

Renal

  • Creatinine no greater than 2 times ULN
  • Calcium no greater than 11.5 mg/dL

Cardiovascular

  • No New York Heart Association grade III or IV cardiac insufficiency

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for at least 3 months after study participation* NOTE: *Women using hormonal contraception must also use a non-hormonal treatment
  • Fasting triglycerides normal (prior antilipemic agents allowed to reach normalization)
  • Willing and able to avoid prolonged exposure to the sun

    • Willing to limit sun exposure on day of PUVA therapy
  • No prior intolerance of or unresponsiveness to PUVA therapy
  • No other prior or concurrent malignant tumor except adequately treated carcinoma in situ of the cervix or basal cell or squamous cell skin cancer
  • No prior pancreatitis
  • No other concurrent serious illness or infection that would preclude study participation
  • No concurrent excessive alcohol consumption
  • No photosensitivity due to intrinsic (e.g., lupus) or extrinsic (e.g., photosensitive drugs) factors
  • No psychological, familial, sociological, or geographical condition that would preclude study compliance
  • No known contraindications to study drug
  • No known hypersensitivity to retinoids or hypervitaminosis A
  • No uncontrolled diabetes mellitus
  • No uncontrolled thyroid disease

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 3 months since prior interferon therapy

Chemotherapy

  • No prior systemic combination chemotherapy
  • No prior participation in another study of bexarotene
  • At least 3 months since prior topical chemotherapy

Endocrine therapy

  • At least 1 month since prior topical corticosteroids

Radiotherapy

  • At least 6 months since prior total skin electron beam therapy
  • At least 1 month since prior superficial radiotherapy

Surgery

  • Not specified

Other

  • At least 30 days since prior participation in another investigational drug study
  • At least 3 months since prior photopheresis
  • At least 1 month since prior UVB/PUVA phototherapy
  • At least 1 month since prior retinoid class drugs
  • At least 1 month since prior beta-carotene compounds
  • At least 1 month since other prior topical medications (e.g., tar baths)
  • No prior participation in this study
  • No other concurrent anticancer therapy
  • No other concurrent investigational drug therapy
  • No concurrent drugs associated with pancreatic toxicity or known to increase triglyceride concentrations
Gender Both
Ages 18 Years and older
Accepts Healthy Volunteers No
Contacts ††
Location Countries  Austria,   Belgium,   Finland,   France,   Germany,   Hungary,   Israel,   Italy,   Netherlands,   Spain,   Switzerland,   United Kingdom
Administrative Information Fields
NCT ID  NCT00056056
Organization ID CDR0000271933
Secondary IDs †† EORTC-21011
Study Sponsor  European Organization for Research and Treatment of Cancer
Collaborators ††
Investigators 
Investigator:     Sean J. Whittaker, MD     St. Thomas' Hospital    
Information Provided By National Cancer Institute (NCI)
Verification Date April 2008
First Received Date  March 6, 2003
Last Updated Date July 23, 2008

 †    Required WHO trial registration data element.
††   WHO trial registration data element that is required only if it exists.




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