Determine the Efficacy of Topical Tretinoin Cream for the Prevention of Nonmelanoma Skin Cancer
Carcinoma, Basal Cell
Carcinoma, Squamous Cell
Drug: Tretinoin 0.1% cream or placebo
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
|Official Title:||CSP #402 - VA Topical Tretinoin Chemoprevention Trial|
- Long term effect of topical tretinoin on the prevalence of premalignant actinic keratoses [ Time Frame: until the end of the study for a minimum of 2 years ] [ Designated as safety issue: No ]
|Study Start Date:||March 1998|
|Study Completion Date:||July 2006|
|Primary Completion Date:||November 2004 (Final data collection date for primary outcome measure)|
Active Comparator: 1
|Drug: Tretinoin 0.1% cream or placebo|
Placebo Comparator: 2
Patients receive placebo for same amount of time
Primary Hypothesis: To determine the efficacy of topical tretinoin cream for the prevention of nonmelanoma skin cancer (NMSC) among high risk individuals (at least 2 NMSC?S in last 5 years).
Secondary Hypothesis: Secondary objectives are: (a) to determine the long-term effect of topical tretinoin on the prevalence of premalignant actinic keratoses, and (b) to distinguish subpopulations in which topical tretinoin is particularly effective or ineffective, compared to the overall study population.
Intervention: Apply Tretinoin 0.1% cream or placebo cream to face and ears twice a day.
Primary Outcomes: New NMSC lesions on the face and ears. Number of actinic keratoses on the face and ears.
Study Abstract: One-third of all malignancies in the United States (approximately one million cases diagnosed annually) are nonmelanoma skin cancer (NMSC). NMSC causes considerable morbidity, economic burden, facial deformity and at least 1,000 deaths annually. Prevention of these malignancies with a topical agent free of serious side effects would confer substantial public health benefit. Three hundred fifty thousand veterans were expected to develop NMSC in 1994. NMSC is one of the most common conditions requiring dermatologic care in the VA system.
Topical tretinoin has been used extensively to treat photoaged skin. Retinoids administered orally in high doses appear to be effective in chemoprevention of nonmelanoma skin cancer but have unacceptable toxicity. In this study, 1200 patients with a recent history of squamous cell and/or basal cell carcinoma will be enrolled at six participating centers over a four-year period and will be randomly assigned to either 0.1% tretinoin cream or placebo. They will be followed for a minimum of two years to determine if topical tretinoin is effective in reducing the risk of new occurrences.
Weinstock, M.A., Bingham, S.F., Cole, G.W., Eilers, D., Naylor, M.F., Kalivas, J., Taylor, J.R., Gladstone, H.B., Piacquadio, D.J., and DiGiovanna, J.J. Reliability of Counting Actinic Keratoses Before and After Brief Consensus Discussion. Arch Dermatol 137:1055-1058, 2001
Please refer to this study by its ClinicalTrials.gov identifier: NCT00007631
|United States, Arizona|
|Carl T. Hayden VA Medical Center|
|Phoenix, Arizona, United States, 85012|
|United States, California|
|VA Medical Center, Long Beach|
|Long Beach, California, United States, 90822|
|United States, Florida|
|VA Medical Center, Miami|
|Miami, Florida, United States, 33125|
|United States, Illinois|
|Edward Hines, Jr. VA Hospital|
|Hines, Illinois, United States, 60141-5000|
|United States, North Carolina|
|VA Medical Center, Durham|
|Durham, North Carolina, United States, 27705|
|United States, Oklahoma|
|VA Medical Center, Oklahoma City|
|Oklahoma City, Oklahoma, United States, 73104|
|United States, Rhode Island|
|VA Medical Center, Providence|
|Providence, Rhode Island, United States, 02908|
|Study Chair:||Martin A. Weinstock, MD||VA Medical Center, Providence|