Brief Title
Photodynamic Therapy for Benign Dermal Neurofibromas- Phase II
Official Title
Topical Photodynamic Therapy (PDT) With Levulan® Kerastick® for Benign Dermal Neurofibromas Phase II
Brief Summary
The investigators wish to determine the time to disease progression for benign neurofibromas treated with Levulan Kerastick topical photosensitizer and red light photodynamic therapy (PDT) in patients with neurofibromatosis type 1 (NF1). The investigators also wish to measure tumor size for control and treatment tumors in order to gain insights into tumor growth rates.
Detailed Description
Neurofibromas contain a large quantity of fibrous matter, and it is not anticipated that significant reductions in tumor size can be achieved in large, long established, tumors. Cutaneous neurofibromas, which do not usually become apparent until puberty, continue to increase in size and number throughout adulthood. The psychosocial burden of these disfiguring tumors is significant, and the targeted age group (14-30) is at a life period associated with an acceleration in tumor growth. It is for these reasons that the investigators hope to affect the growth rate of less established tumors, in order to prevent or lessen this burden as the patient progresses further into adulthood. Therefore, the investigators wish to determine the time to disease progression (defined as 50% growth in size over baseline) for benign neurofibromas treated with PDT in patients with neurofibromatosis type 1 (NF1) in subjects aged 14-30. The treatment will consist of choosing several neurofibromas of similar size, and applying a topical drug called Levulan, or just the topical application alone (a placebo). Within 24 hours of drug treatment, the neurofibromas will be illuminated with red light (both Levulan and placebo). The Levulan is what is known as a photosensitizer, and will be activated by the red light to potentially kill some of the tumor cells. Approximately every 6 months after, for three years, the tumors will be measured by digital photography and ultrasound to see if they are growing more slowly than the ones with the placebo application alone.
Study Phase
Phase 2
Study Type
Interventional
Primary Outcome
Time to disease progression
Secondary Outcome
Tumor growth rate
Condition
NEUROFIBROMATOSIS 1
Intervention
aminolevulinic acid
Study Arms / Comparison Groups
PDT Treatment
Description: Each subject will have either placebo or Levulan Kerastick topical application applied to matched sets of neurofibromas. Each subject will have both sets, in order to serve as his/her own control subject. 16 to 24 hours post study drug treatment, both sets of neurofibromas, Levulan and placebo treated, will be irradiated with red light (630 nm) from an Omnilux Revive light device at 100 mW/cm2 for 1000 seconds (16.7 minutes).
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Drug
Estimated Enrollment
30
Start Date
August 2016
Completion Date
August 2023
Primary Completion Date
August 2022
Eligibility Criteria
Inclusion Criteria: 1. Patient is 14 years or older. 2. Diagnosed NF1, determined by American Academy of Neurology Guidelines (see Diagnosis section). 3. Tumor Location: cutaneous, trunk, or limbs only. 4. Tumor Type: superficial dermal neurofibromas ≤4mm deep. 5. Patient has provided written informed consent. 6. Patient is willing to and can comply with study follow-up requirements. 7. Absence of any other malignancy. Exclusion Criteria: 1. Life expectancy less than 3 years. 2. Pregnancy. 3. Cutaneous photosensitivity to the wavelengths used to active PDT. 4. A diagnosis of porphyria. 5. Allergy to aminolevulinic acid or any of the topical solution vehicle components. 6. Previous chemotherapy within 6 weeks of proposed PDT. 7. Other concurrent tumor therapy.
Gender
All
Ages
14 Years - 30 Years
Accepts Healthy Volunteers
No
Contacts
Harry T Whelan, MD, 414-266-7540, [email protected]
Location Countries
United States
Location Countries
United States
Administrative Informations
NCT ID
NCT02728388
Organization ID
PRO00026795
Responsible Party
Sponsor-Investigator
Study Sponsor
Harry T Whelan, MD
Study Sponsor
Harry T Whelan, MD, Principal Investigator, Medical College of Wisconsin
Verification Date
November 2021