Prevention of Skin Cancer in High Risk Patients After Conversion to a Sirolimus-based Immunosuppressive Protocol

NCT ID: NCT00866684

Last Updated: 2025-03-14

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-01-01

Study Completion Date

2011-04-19

Brief Summary

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Transplant recipients have a high risk to develop skin malignancies. This effect depends on the one hand on the immunosuppressive drugs themselves (i.e., azathioprine) and relates on the other hand on the dosage (i.e., calcineurin-inhibitors). Based on the encouraging results of previous, retrospective studies on patients treated with Sirolimus (SRL), these patients should be switched to an immunosuppressive regime including SRL, decreasing the dosage of calcineurin-inhibitors or converting from former immunosuppression. A conversion to a SRL-based therapy is effective in immunosuppression and safe regarding graft and patient survival.

This study was designed to assess whether a switch to a SRL-immunosuppressive therapy decreases the incidence/reoccurrence of skin neoplasm.

Detailed Description

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Patients who meet all inclusion criteria will be included into the study and randomised. If converted to SRL, patients will take SRL according to the investigator's instructions and medication label, once daily preferably 4 hours after calcineurin-inhibitor medication or in case without calcineurin-inhibitor co-medication in the morning. The dose of SRL will be correlated to the former immunosuppressive therapy according to the study's conversion protocol.

Conditions

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Skin Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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1 Sirolimus

Patients will receive Sirolimus in addition to their previous immunosuppressive therapy.

Group Type EXPERIMENTAL

Sirolimus

Intervention Type DRUG

Treatment arm Dosage: 4-8 micrograms/litre; Route of administration: oral use; Frequency: one tablet per day

2 Standard

Patients will stay on their previous immunosuppressive regimen.

Group Type ACTIVE_COMPARATOR

Azathioprine

Intervention Type DRUG

control arm Dosage form: Coated tablet; dosage: 1-4 milligrams/kilogram; Frequency: daily; Duration: 24 month

Mycophenolate

Intervention Type DRUG

Control arm Dosage form: Tablet; dosage: 2 gram; Frequency: daily; Duration: 24 month

Ciclosporin

Intervention Type DRUG

Control arm Dosage form: Capsule; Dosage: 50-80 micrograms/litre; Frequency: daily; Duration: 24 month

Tacrolimus

Intervention Type DRUG

Control arm Dosage form: Capsule; dosage: 3-5 micrograms/litre; Frequency: daily; Duration: 24 month

Interventions

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Sirolimus

Treatment arm Dosage: 4-8 micrograms/litre; Route of administration: oral use; Frequency: one tablet per day

Intervention Type DRUG

Azathioprine

control arm Dosage form: Coated tablet; dosage: 1-4 milligrams/kilogram; Frequency: daily; Duration: 24 month

Intervention Type DRUG

Mycophenolate

Control arm Dosage form: Tablet; dosage: 2 gram; Frequency: daily; Duration: 24 month

Intervention Type DRUG

Ciclosporin

Control arm Dosage form: Capsule; Dosage: 50-80 micrograms/litre; Frequency: daily; Duration: 24 month

Intervention Type DRUG

Tacrolimus

Control arm Dosage form: Capsule; dosage: 3-5 micrograms/litre; Frequency: daily; Duration: 24 month

Intervention Type DRUG

Other Intervention Names

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Rapamune, ATC code: L04AA10 ATC code: L04AX01 ATC code: L04AA06 ATC code: L04AA01 ATC code: L04AA05

Eligibility Criteria

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Inclusion Criteria

* Recipients of renal allograft with current actinic keratosis I or II or successfully treated actinic keratosis III (inclusion possible immediately after completed wound healing from surgical excision), invasive squamous cell carcinoma (SCC), basal cell carcinoma and/or premalignant neoplastic skin lesions
* Age 18 years and older
* Minimum period of 6 month after renal transplantation
* Stable renal function and a calculated creatinine clearance of at least 40 ml/min
* Written informed consent
* Proteinuria ≤ 800 mg/d at time of enrolment
* Successfully treated solid tumor (no recurrence or metastasis in the last 2 years)

* All contraindications to SRL (see package insert, appendix)
* Persons who are detained officially or legally to an official institute

Exclusion Criteria

* Current Sirolimus- or Everolimus- intake
* Instable graft function (creatinine clearance \< 40 ml/min)
* Graft rejection within the 3 previous months
* Proteinuria \> 800 mg/d
* Non-controlled hyperlipidemia (Cholesterol \>7,8 mmol/l, Triglycerides \> 4)
* Leucopenia \< 2500/nl
* Thrombocytopenia \< 90/nl
* Pregnancy or breastfeeding
* Women of childbearing age without highly effective contraception (= defined as those which result in a low failure rate (i.e. less than 1 % per year))
* Known allergy to macrolides
* Current participation in other studies
* Refusal to sign informed consent form
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Charite University, Berlin, Germany

OTHER

Sponsor Role lead

Responsible Party

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Prof. Dr. Petra Reinke

Prof. Dr. med.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Petra Reinke, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Charite University, Berlin, Germany

Locations

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Universitätsklinikum Erlangen, Hautklinik

Erlangen, Bavaria, Germany

Site Status

Universitätsklinikum Erlangen, Medizinische Klinik IV

Erlangen, Bavaria, Germany

Site Status

Klinikum der LMU München, Medizinische Poliklinik Innenstadt

München, Bavaria, Germany

Site Status

Klinikum der LMU München, Klinik und Poliklinik für Dermatologie

München, Bavaria, Germany

Site Status

Klinikum rechts der Isar, Klinik und Poliklinik für Dermatologie und Allergologie

München, Bavaria, Germany

Site Status

Klinikum rechts der Isar, II. Medizinische Klinik und Poliklinik

München, Bavaria, Germany

Site Status

Universität Regensburg, Dermatologie

Regensburg, Bavaria, Germany

Site Status

Universität Regensburg, Nephrologie Innere Medizin II

Regensburg, Bavaria, Germany

Site Status

Kliniken der Stadt Köln, Medizinische Klinik I

Cologne, North Rhine-Westphalia, Germany

Site Status

Universitätsklinikum Münster, Klinik und Poliklinik für Hautkrankheiten

Münster, North Rhine-Westphalia, Germany

Site Status

Universitätsklinikum Münster, Med. Klinik und Poliklinik D

Münster, North Rhine-Westphalia, Germany

Site Status

HELIOS Klinikum Wuppertal, Zentrum für Dermatologie, Allergologie und Umweltmedizin

Wuppertal, North Rhine-Westphalia, Germany

Site Status

Universitätsklinikum Schleswig-Holstein, Klinik für Dermatologie, Venerologie und Allergologie

Kiel, Schleswig-Holstein, Germany

Site Status

Universitätsklinikum Schleswig-Holstein, Klinik für Nieren- und Hochdruckkrankheiten

Kiel, Schleswig-Holstein, Germany

Site Status

Charité Universitätsmedizin, Klinik für Dermatologie, Venerologie und Allergologie

Berlin, , Germany

Site Status

Countries

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Germany

Other Identifiers

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PROSKIN 01

Identifier Type: -

Identifier Source: org_study_id

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