Study of Pomalidomide in Anal Cancer Precursors

NCT ID: NCT03113942

Last Updated: 2022-03-31

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-14

Study Completion Date

2022-12-31

Brief Summary

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This is a single centre open label phase II trial to determine the antitumor efficacy of the oral immunomodulatory agent pomalidomide in persistent human papillomavirus (HPV) -associated high grade squamous intra-epithelial lesions (HSIL) in patients with and without human immunodeficiency virus (HIV) infection.

Detailed Description

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Conditions

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High Grade Squamous Intra-epithelial Lesion (HSIL)

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Open label, phase 2 trial, single-arm
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pomalidomide group

Open label - all participants will receive pomalidomide 2mg orally once a day for 6 cycles (21 days on treatment and a 7 day rest period constitutes a cycle).

Group Type EXPERIMENTAL

Pomalidomide 2 MG Oral Capsule [Pomalyst]

Intervention Type DRUG

Pomalidomide is an oral immunomodulatory derivative of thalidomide. Thalidomide and its derivatives are small molecules with broad effects on immune activation, including T-cell activation and responsiveness. Pomalidomide augments T cell responsiveness and proliferation by several mechanisms, many mediated by transcriptional regulation downstream of its primary target, cereblon. Effects include increased production of IL-2 and interferon-γ (IFN-γ), enhanced CD4+ and CD8+ T cell co-stimulation.

Interventions

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Pomalidomide 2 MG Oral Capsule [Pomalyst]

Pomalidomide is an oral immunomodulatory derivative of thalidomide. Thalidomide and its derivatives are small molecules with broad effects on immune activation, including T-cell activation and responsiveness. Pomalidomide augments T cell responsiveness and proliferation by several mechanisms, many mediated by transcriptional regulation downstream of its primary target, cereblon. Effects include increased production of IL-2 and interferon-γ (IFN-γ), enhanced CD4+ and CD8+ T cell co-stimulation.

Intervention Type DRUG

Other Intervention Names

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pomalidomide Pomalyst

Eligibility Criteria

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Inclusion Criteria

1. Persistent high grade squamous intra-epithelial lesion (HSIL) which must meet all of the following criteria:

i. Pathologically confirmed grade 2 or 3 AIN demonstrated by high resolution anoscopy with grade on each occasion re-confirmed at screening by nominated study pathologist from Douglas Hanly Moir (DHM) (pathology case review to be conducted prior to enrolment) ii. Lesion must have been visualised on at least three sequential occasions over at least 12 months, including the pre enrolment screening high resolution anoscopy (HRA).

iii. Lesion must have persistent geographical characteristics consistent with a single lesion observed over time (as defined in the Manual of Operations).
2. No history of thromboembolic disease
3. No evidence of anal cancer or Superficially Invasive Squamous Cell Carcinoma of the Anus (SISCCA)
4. Willingness to use appropriate contraception (including refraining from sperm donation)
5. Age 18 years or older
6. Provision of written informed consent

In addition, for subjects with HIV:
7. Adherence to a stable suppressive antiretroviral therapy (ART) regimen, unchanged for at least two months
8. CD4+ count ≥ 200 cells/µl
9. HIV viral load \< 200 copies/mL for at least six months

Exclusion Criteria

1. Absolute neutrophil count (ANC) \<1000 cells/μL
2. Haemoglobin \<10.0 g/dL
3. Platelet count \<75,000 cells/μL
4. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \> three times upper limit of normal
5. Calculated or measured creatinine clearance (CLCr) ≤ 50 mL/min (calculated by Cockcroft-Gault formula)
6. Patients with significant cardiac dysfunction including congestive heart failure, NY Heart Association Class II; Myocardial infarction within 12 months of starting study; unstable of poorly controlled angina
7. Current pregnancy or breastfeeding
8. Any condition not already outlined above which, in the opinion of the clinical investigator, would place the subject at risk if they participated or would jeopardise adherence or follow up
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kirby Institute

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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St Vincent's Hospital

Darlinghurst, New South Wales, Australia

Site Status

Countries

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Australia

References

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World Health Organization International Agency for Reseach on Cancer. IARC Monograph on the Evaluation of Carcinogenic Risks to Humans: Volume 90, Human Papillomavirus. World Health Organization, Geneva 2007.

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POMALYST® (pomalidomide) capsules Product Information. Department of Health Therapeutic Goods Administration (TGA) April 2016. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf accessed 23 Nov 2016.

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Other Identifiers

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SPACE

Identifier Type: -

Identifier Source: org_study_id

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