Evaluation of Ingenol Mebutate for Actinic Cheilitis Treatment (EIMAC)

Instituto Nacional de Cancer, Brazil

Status and phase: Withdrawn; Phase 2; Phase 1

Conditions: Actinic Cheilitis

Treatments: Drug: Ingenol mebutate gel

Study type: Interventional

Funder types: Other

Identifiers

NCT03452566

82279418.6.0000.5274

Details and patient eligibility

About

Actinic cheilitis is a major potentially carcinogenic disorder of the lower lip and several reports of clinical cases with excellent results for the treatment of this lesion that can differentiate to squamous cell carcinoma of the lip. However, clinical trials are lacking to define the optimal dosage of the drug for a therapeutic modality and to define its true efficacy in controlled studies of this pre-malignant labial lesion.

Full description

Squamous cell carcinoma is the most common malignant neoplasm in the head and neck region, and when present in the lower lip, it is usually associated with prolonged exposure to UV radiation of lip vermilion surface especially in white patients (patients with genodermatosis such as xeroderma pigmentosum have extreme sensitivity to UV radiation, characterized by an even higher risk and patients presenting radiodermatites that can evolve to squamous cell carcinoma). Ingenol mebutate is a natural medicine derived from the sap of the pepense euphoria and much used for its medicinal properties.

The objective of this study was to determine the toxicity profile and the maximum tolerated dose (MTD) of ingenol mebutate for treatment of actinic cheilitis in patients of the Oncology Dermatology Session of the National Cancer Institute of Brazil (INCA) through a phase 1 clinical trial of type 3 + 3 and to determine the therapeutic response with a dose below the maximum tolerated dose (MTD) of metamato of ingenuity, for the treatment of aortic cheilitis in patients of the Oncology Dermatology Session of the National Cancer Institute (INCA) through a prospective clinical trial and phase randomized trial (phase 2).

Actinic cheilitis is a major potentially carcinogenic disorder of the lower lip and several reports of clinical cases with excellent results for the treatment of this lesion that can differentiate to squamous cell carcinoma of the lip. However, clinical trials are lacking to define the optimal dosage of the drug for a therapeutic modality and to define its true efficacy in controlled studies of this pre-malignant labial lesion.

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with diagnosis of actinic cheilitis .
• Histopathological report compatible with the clinical diagnosis.
• Sign the informed consent to be a part of the study.
• Comply with the attendance at the clinical settings during the days the patient will be medicated (D1, D2 and D3), D5, D8, two months, six months and one year after treatment.

Exclusion criteria

• Patients younger than 18 years of age.
• Patients without confirmed diagnosis of actinic cheilitis.
• Patients previously treated with ingenol mebutate for actinic cheilitis, including those in the present study, previously excluded at some point during phases 1 or 2.
• Presence of recurrent lesions, prior or during treatment.
• Immunosuppression.
• Use of topical corticosteroids.
• Presence of markedly hyperkeratotic or ulcerated lesions in the clinical evaluation
• Patients presenting with atypical histology (moderate to severe epithelial dysplasia) at the lips.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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0 participants in 1 patient group

ingenol mebutate gel

Experimental group

Description:

Phase 1/2, always 3 consecutive days, with 24 hours interval, dosage from 5 mg/cm2 to 18 mg/cm2 in a 3+3 design.

Treatment:

Drug: Ingenol mebutate gel