Evaluation of Innovative Therapeutic Approaches of Vaginal and Sexual Dysfunction After Breast Cancer Treatment

NCT ID: NCT04713917

Last Updated: 2023-11-28

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

RECRUITING

Clinical Phase

NA

Total Enrollment

330 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-21

Study Completion Date

2024-02-01

Brief Summary

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Many studies have shown that locoregional treatment (surgery, radiotherapy) and systemic treatment (endocrine therapy and chemotherapy) for breast cancer (BC) may impact sexuality by causing physical and/or psychological damages.

Approximately 50-75 % of BC survivors suffer from vulvovaginal atrophy (VVA). The earliest symptoms of VVA are decreased vaginal lubrication, followed by other vaginal and urinary symptoms, such as burning, itching, bleeding, leucorrhoea, dyspareunia and dysuria symptoms. Various surveys have shown that VVA symptoms lead to female sexual disorder and on their partners through sexual unsatisfactory. However, it appears that sexuality is a little discussed topic during the follow-up of BC survivors. Most of patients relate a poor satisfaction with information and counselling related to sexuality and vaginal health, which are denied by many practitioners.

Patients treated for BC cannot find relief in hormonal replacement therapy (HRT), which is considered the gold standard treatment for VVA symptoms. The usual treatments for these women are topics such as ovula or gel (lubricant, hyaluronic acid (HA)…) with however, a short term effect even when these topics are applied regularly and correctly during at least 2 to 3/weeks.In the literature, there is a significant impact on VVA at one month but later data are lacking . Moreover, patients' compliance and daily application are paramount of importance for efficacy that could disappear when the treatment is stopped.

No randomized controlled trial has compared this treatment to innovative strategies. In this context, it is important to establish management strategies for VVA and sexual disorder after BC.

Our objective is to assess prevalence rate of VVA among breast cancer survivors after the loco regional treatment and chemotherapy, and to compare the efficacy of innovative treatments namely, new biophysical inductor (Laser CO2) and chemical bio inductor (Hyaluronic acid injections) treatments to the efficacy of standard non-hormonal topic treatment for improving the VVA and the quality of sexual life on a long-term.

Detailed Description

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An open-label multicentre controlled trial randomized in 3 parallel groups (1:1:1) to assess the one-year superiority of bio physical inductor (C02 laser, D0 and M6, group laser) compared to the standard treatment currently recommended (Mucogyne, 2 times a week for one year, control group) in the one hand, and of chemical bio inductor (Desirial, injection of 1 mL of hyaluronic acid in the first 3 cm of the vaginal walls, D0 and M6, HA injection group) compared to the control group in the other hand in BC survivors with VVA, with blinded primary endpoint assessment.

The use of these innovative treatments (lasers and injections) for Vulvovaginal atrophy based on the bio induction and the regenerative medicine could improve the quality of the vaginal mucosa after breast cancer therapy and could be a new strategy for these women who cannot benefit from Hormone Replacement Therapy (HRT). The benefits expected are the improvement of the quality of vulvo-vaginal mucosa and the improvement of the sexual quality of life of the patient.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

An open-label multicentre controlled trial randomized in 3 parallel groups (1:1:1) :

* Bio physical inductor : CO2 laser
* Standard treatment : Hyaluronic Acid gel
* Chemical bio inductor : injection of Hyaluronic Acid
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
According to the center's organization, an operator and an investigator-evaluator will be identified for each patient or for all patients.

Study Groups

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Gel Group

Two applications of HA gel (Mucogyne®) per week during one year.

Group Type ACTIVE_COMPARATOR

Hyaluronique Acid Gel

Intervention Type DEVICE

Vaginal gel based on HA with liposomal structure applicated 2 times a week

Laser Group

Laser CO2 for vulvovaginal area during 2 sessions (15 min) at visits D0 and M6.

Group Type EXPERIMENTAL

Laser CO2

Intervention Type DEVICE

The laser energy delivered along the vaginal wall heats the tissue without damaging it.

HA Injection Group

Injection of 1 mL of HA at D0 and M6 (DESIRIAL®).

Group Type EXPERIMENTAL

Hyaluronique Acid Injection

Intervention Type DEVICE

HA injection performed under the mucosae (2-3mm in depth) following one injection point every 5mm on the 3 first cm of the vagina and on the posterior part of the introitus.

Interventions

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Hyaluronique Acid Gel

Vaginal gel based on HA with liposomal structure applicated 2 times a week

Intervention Type DEVICE

Laser CO2

The laser energy delivered along the vaginal wall heats the tissue without damaging it.

Intervention Type DEVICE

Hyaluronique Acid Injection

HA injection performed under the mucosae (2-3mm in depth) following one injection point every 5mm on the 3 first cm of the vagina and on the posterior part of the introitus.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Women who present VVA with a vaginal health index \< 15
* 18 years ≤ Age ≤ 75 years
* Patient with non-metastatic breast cancer
* End of loco-regional treatments (surgery+/- radiotherapy) and chemotherapy for 6 months
* Patients with no psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
* Written consent
* Affiliation to a social security system

Exclusion Criteria

* Pregnant or breastfeeding woman (A Urinary bHCG will be performed for no menopausal women)
* Vulvo vaginal area showing signs of clinical inflammation and/or viral infection (e.g.: Papilloma, Herpes), bacterial, fungal.
* Abnormal vaginal smear within 3 years before inclusion
* History of vulvo vaginal cancer
* History of Papilloma virus
* History of vaginal herpes
* Use of topical hyaluronic acid application in the month before inclusion
* History of allergy to HA
* Hypersensitivity to the components of Mucogyne®, and Desirial®
* Patients with tendency to develop hypertrophic scars
* No contraception, or no efficient contraception(for women with non-menopausal status)
* Patients under legal protection
* Prisoners
* Participation to another interventional study
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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INTERmedic

UNKNOWN

Sponsor Role collaborator

Laboratoires Vivacy

INDUSTRY

Sponsor Role collaborator

Laboratoires IPRAD PHARMA

UNKNOWN

Sponsor Role collaborator

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Barbara HERSANT, MD

Role: STUDY_DIRECTOR

Assistance Publique - Hôpitaux de Paris

Yazid BELKACEMI, MD, PhD

Role: STUDY_DIRECTOR

Assistance Publique - Hôpitaux de Paris

Locations

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Henri-Mondor Hospital

Créteil, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Barbara HERSANT, MD

Role: CONTACT

1 49 81 45 33 ext. +33

Yazid BELKACEMI, MD, PhD

Role: CONTACT

1 49 81 45 22 ext. +33

Facility Contacts

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YAZID BELKACEMI

Role: primary

01 49 81 45 22

Other Identifiers

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2018-A01678-47

Identifier Type: OTHER

Identifier Source: secondary_id

P170927J

Identifier Type: -

Identifier Source: org_study_id