Determine the Efficacy of Topical Tretinoin Cream for the Prevention of Nonmelanoma Skin Cancer

NCT ID: NCT00007631

Last Updated: 2009-01-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1131 participants

Study Classification

INTERVENTIONAL

Study Start Date

1998-03-31

Study Completion Date

2006-07-31

Brief Summary

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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, 1131 patients with a recent history of squamous cell and/or basal cell carcinoma were enrolled at six participating centers over a four-year period and were randomly assigned to either 0.1% tretinoin cream or placebo. They were followed for a minimum of two years to determine if topical tretinoin is effective in reducing the risk of new occurrences.

Detailed Description

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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

Conditions

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Carcinoma, Basal Cell Carcinoma, Squamous Cell Skin Neoplasms

Keywords

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NMSC nonmelanoma skin cancer topical tretinoin cream

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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1

Topical Tretinoin

Group Type ACTIVE_COMPARATOR

Tretinoin 0.1% cream or placebo

Intervention Type DRUG

2

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Patients receive placebo for same amount of time

Interventions

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Tretinoin 0.1% cream or placebo

Intervention Type DRUG

Placebo

Patients receive placebo for same amount of time

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

High risk individuals (at least 2 NMSC?S in last 5 years).
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ortho Dermatologics

INDUSTRY

Sponsor Role collaborator

US Department of Veterans Affairs

FED

Sponsor Role lead

Responsible Party

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Department of Veterans Affairs

Principal Investigators

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Martin A. Weinstock, MD

Role: STUDY_CHAIR

VA Medical Center, Providence

Locations

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Carl T. Hayden VA Medical Center

Phoenix, Arizona, United States

Site Status

VA Medical Center, Long Beach

Long Beach, California, United States

Site Status

VA Medical Center, Miami

Miami, Florida, United States

Site Status

Edward Hines, Jr. VA Hospital

Hines, Illinois, United States

Site Status

VA Medical Center, Durham

Durham, North Carolina, United States

Site Status

VA Medical Center, Oklahoma City

Oklahoma City, Oklahoma, United States

Site Status

VA Medical Center, Providence

Providence, Rhode Island, United States

Site Status

Countries

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United States

References

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Weinstock MA, Bingham SF, Lew RA, Hall R, Eilers D, Kirsner R, Naylor M, Kalivas J, Cole G, Marcolivio K, Collins J, Digiovanna JJ, Vertrees JE; Veterans Affairs Topical Tretinoin Chemoprevention (VATTC) Trial Group. Topical tretinoin therapy and all-cause mortality. Arch Dermatol. 2009 Jan;145(1):18-24. doi: 10.1001/archdermatol.2008.542.

Reference Type DERIVED
PMID: 19153339 (View on PubMed)

Dore DD, Lapane KL, Trivedi AN, Mor V, Weinstock MA. Association between statin use and risk for keratinocyte carcinoma in the veterans affairs topical tretinoin chemoprevention trial. Ann Intern Med. 2009 Jan 6;150(1):9-18. doi: 10.7326/0003-4819-150-1-200901060-00004.

Reference Type DERIVED
PMID: 19124815 (View on PubMed)

Other Identifiers

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402

Identifier Type: -

Identifier Source: org_study_id