Photodynamic Therapy (PDT) With Metvix Cream 160 mg/g Versus PDT With Placebo Cream in Patients With Primary Nodular Basal Cell Carcinoma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00472108
Recruitment Status : Completed
First Posted : May 11, 2007
Last Update Posted : September 3, 2010
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Brief Summary:

Photodynamic therapy (PDT) is the selective destruction of abnormal cells through light activation of a photosensitiser in the presence of oxygen. These cells accumulate more photosensitiser than normal cells. The photosensitiser generates reactive oxygen species upon illumination.

For skin diseases, there has been an increasing interest in using precursors of the endogenous photosensitiser protoporphyrin IX (PpIX). The most commonly used precursors have been 5-aminolevulinic acid (ALA) and its derivatives. The present test drug, Metvix, contains the methyl ester of ALA, which penetrates the lesions well and shows high lesion selectivity.

In vitro studies of animal and human tissues have shown significant intracellular formation of photoactive porphyrins after addition of Metvix. The increased photoactive porphyrins levels induced cytotoxic effects in tumour cells after photoactivation.

The primary objective is to compare PDT with Metvix cream to PDT with placebo cream in terms of patient complete response rates based on histologically verified disappearance of the lesions at 6 months after last treatment cycle. Secondary objectives are to compare the two treatments in terms of histological and clinical mean patient response weighted by the number of lesions within a patient, lesion response rates across patients, clinical complete patient response, cosmetic outcome and adverse events.

Condition or disease Intervention/treatment Phase
Basal Cell Carcinoma Procedure: PDT with Metvix 160 mg/g cream Procedure: PDT with placebo cream Phase 3

Detailed Description:
A patient will be randomised to PDT with Metvix cream or PDT with placebo cream. All eligible BCC lesions within a patient will get the same treatment. All patients will get two consecutive treatments one week apart. At the 3-months follow-up visit, lesions with no clinical response or progression will be surgically excised. Lesions with partial response (50% or greater reduction on lesion area) will be re-treated; if they do not show complete response three months later, they will be surgically excised. Lesions with complete response will be surgically excised 6 months after the first or second PDT cycle. All excised tissue specimens will be histologically examined.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 65 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: A Multicenter, Phase III, Double Blind Study of Photodynamic Therapy (PDT) With Metvix 160 mg/g Cream in Comparison to PDT With Placebo Cream in Patients With Primary Nodular Basal Cell Carcinoma
Study Start Date : December 2000
Actual Study Completion Date : April 2002

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U.S. FDA Resources

Primary Outcome Measures :
  1. The primary end-point will be the histologically confirmed complete response rate within a patient (100% of the basal cell carcinoma [BCC] lesions must disappear completely). [ Time Frame: 6 months after last treatment ]

Secondary Outcome Measures :
  1. Histological and clinical mean patient response rates weighted for the number of lesions within a patient. [ Time Frame: 3 and 6 months after last treatment ]
  2. Histological and clinical number of lesions across patients that show complete response [ Time Frame: 3 and 6 months after last treatment ]
  3. Complete patient response [ Time Frame: 3 and 6 months after last treatment ]
  4. Evaluation of cosmetic outcome. [ Time Frame: 3 and 6 months after last treatment ]
  5. Adverse events [ Time Frame: 2 weeks, 4 weeks and 3 months after each treatment cycle ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

A patient with primary, nodular BCC lesion(s) suitable for entry is defined as a patient with

  • Clinically diagnosed primary nodular BCC lesion(s)
  • Histologically confirmed diagnosis of BCC
  • BCC lesions suitable for simple excision surgery.
  • Males or females above 18 years of age.
  • Written informed consent

Exclusion Criteria:

A patient that is ineligible for inclusion is a patient fulfilling any of the following criteria:

  • Patient with porphyria.
  • Patient with Gorlin's syndrome.
  • Patient with Xeroderma pigmentosum
  • Patients concurrently receiving immunosuppressive medication
  • Patients with a history of arsenic exposure.
  • Patients with BCC arising in a previous radiated area
  • Known allergy to Metvix, a similar PDT compound or excipients of the cream
  • Participation in other clinical studies either concurrently or within the last 30 days.
  • Pregnant or breast-feeding: All women of child-bearing potential must use adequate contraception (e.g. barrier methods, oral contraceptives or intrauterine device) during the treatment period and one month thereafter. In addition, they must have a negative pregnancy test prior to treatment..
  • Conditions associated with a risk of poor protocol compliance.

Lesion Exclusion Criteria:

  • A nodular BCC lesion in periorbital area, ears and nasolabial fold.
  • A nodular BCC lesion with the longest diameter less than 6 mm or larger than 15 mm in face/scalp, larger than 20 mm on extremities and neck and larger than 30 mm on truncus.
  • Pigmented nodular BCC lesion(s)
  • Morpheaform nodular BCC lesion(s).
  • Infiltrating nodular BCC lesion(s).
  • Prior treatment of the BCC lesion(s).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00472108

United States, California
Clinical Research Specialists Inc
Santa Monica, California, United States, 90404-2115
United States, Minnesota
Department of Dermatology, University of Minnesota Hospital and Clinic
Minneapolis, Minnesota, United States, 55455
Department of Dermatology, Mayo Medical School, Mayo Clinic
Rochester, Minnesota, United States, 55905
United States, New Mexico
Academic Dermatology Associates
Albuquerque, New Mexico, United States, 87106
United States, New York
Department of Dermatology, Roswell Park Cancer Institue
Buffalo, New York, United States, 14263
United States, Oregon
Northwest Cutaneous Research Specialists
Portland, Oregon, United States, 97210
United States, Texas
DermResearch, Inc.
Austin, Texas, United States, 78759
Texas Dermatology Research Institute
Dallas, Texas, United States, 75230
United States, Virginia
Virginia Clinical Research, Inc.
Norfolk, Virginia, United States, 230507
Sponsors and Collaborators
Principal Investigator: Whitney Tope, MPhil, MD University of Minnesota Hospital and Clinic Identifier: NCT00472108     History of Changes
Obsolete Identifiers: NCT00022503
Other Study ID Numbers: PC T307/00
First Posted: May 11, 2007    Key Record Dates
Last Update Posted: September 3, 2010
Last Verified: September 2010

Keywords provided by Galderma:
Nodular Basal Cell Carcinoma
Basal Cell Carcinoma
PDT with Metvix 160 mg/g cream
PDT with placebo cream
Histological verification

Additional relevant MeSH terms:
Carcinoma, Basal Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms, Basal Cell
Methyl 5-aminolevulinate
Photosensitizing Agents
Dermatologic Agents