Dose-finding Study of Hexaminolevulinate (HAL) Photodynamic Therapy (PDT) to Treat Cervical Neoplasia

Photocure

Status and phase: Completed; Phase 2

Conditions: Cervical Intraepithelial Neoplasia

Treatments: Drug: HAL 1% with illumination; Drug: Placebo ointment without illumination; Drug: HAL 5% with illumination; Drug: HAL 0.2% with illumination

Study type: Interventional

Funder types: Industry

Identifiers

NCT01256424

PC CE203/10

Details and patient eligibility

About

An effective and safe medical therapy would be most welcome to reduce the need for surgical interventions and related adverse events and psychological impact on patients with cervical cancer precursors. In this clinical trial, the investigators propose to evaluate the efficacy and safety of photodynamic therapy (PDT) using hexaminolevulinate (HAL) for mild to moderate-grade CIN (grade 1-2).

Enrollment: 262 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with ectocervical CIN1 or CIN2 as verified by local pathology (biopsy) obtained within the last month

• Satisfactory colposcopy examination including:

  • visibility of entire transformation zone including the squamocolumnar junction and
  • visibility of entire lesion margin

• Negative endocervical os by colposcopy

• Colposcopical visible lesion at visit 2, before treatment

• Patients with an average sized uterine cervix (approximately 27mm diameter) suitable for application of the Klemcap

• Age 18 or above

• Written informed consent signed

Exclusion criteria

• Previous treatment of CIN or invasive disease
• Lesion(s) extending to the vaginal vault
• Atypical glandular cells (AGC) or adenocarcinoma in situ (AIS) on cytology, malignant cells on cytology or histology or other suspicion of either micro-invasive or invasive disease
• Suspicion of endocervical disease on colposcopy
• Current severe pelvic inflammatory disease, severe cervicitis, or other severe gynaecological infection as per colposcopy and clinical examination
• Undiagnosed vaginal bleeding
• History of toxic shock syndrome
• Known or suspected porphyria
• Known allergy to hexaminolevulinate or similar compounds (e.g. methyl aminolevulinate or aminolevulinic acid)
• Pregnancy, or intention to become pregnant during the study period
• Nursing
• Childbirth or miscarriage within six weeks of enrolment
• Use of heart pacemaker
• Participation in other clinical studies either concurrently or within the last 30 days
• Risk of poor protocol compliance. Patient participation should be considered with respect to living far away from the hospital, plans for moving to another city/state, frequent travelling, planning to become pregnant, drug abuse/alcoholic, difficult working hours, family obligations, other illness (e.g. psychiatric), etc.
• Unwillingness to use adequate birth control (not abstinence) from screening until last PDT
• Patient is the investigator or any sub-investigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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262 participants in 4 patient groups, including a placebo group

HAL 5% with illumination

Experimental group

Description:

HAL PDT 5%

Treatment:

Drug: HAL 5% with illumination

HAL 1% with illumination

Experimental group

Description:

HAL PDT 1%

Treatment:

Drug: HAL 1% with illumination

HAL 0.2% with illumination

Experimental group

Description:

HAL PDT 0.2%

Treatment:

Drug: HAL 0.2% with illumination

Placebo ointment without illumination

Placebo Comparator group

Description:

Placebo without illumination

Treatment:

Drug: Placebo ointment without illumination