Clinical Trial of Patidegib Gel 2%, 4%, and Vehicle Applied Once or Twice Daily to Decrease the GLI1 Biomarker in Sporadic Nodular Basal Cell Carcinomas

NCT02828111 | Completed Phase 2 Results

• 1 other identifier: Pelle-926-202
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

This is a double-blind, dose escalating, randomized, vehicle-controlled study designed to compare the efficacy and safety of patidegib gel 2% and 4% applied once or twice daily in comparison with that of vehicle in patients with Basal Cell Carcinoma. One investigational center (metasite) in the United States will participate in this study. Approximately 36 subjects who meet the study entry criteria will be enrolled into one of four sequential cohorts. Within each cohort subjects will be randomized in a 2:1 ratio to receive active or vehicle gel.

Conditions

Basal Cell Carcinomas

Keywords

Gorlin Syndrome; Basal Cell Nevus Syndrome BCNS; nevoid basal cell carcinoma syndrome; Basal cell carcinoma; Hedgehog inhibitor; Surgically Eligible Basal Cell Carcinomas; High Frequency Basal Cell Carcinomas

Outcome Measures

Primary Outcomes (2)

• Number of Treatment-emergent Adverse Events (Including Both Serious and Non-Serious) Causally Related to Study Drug

  All serious adverse events (SAEs) and all other non-serious adverse events (AEs) regardless of causality are located in the Reported AE Module. The number of AEs (including both serious and non-serious) considered related to study drug by the Investigator are presented below. Treatment-emergent AEs are those with an onset after use of study drug.

  Baseline through Week 12

• Molecular Efficacy: Percent Change From Baseline in the Hedgehog (HH) Signaling Pathway Target Gene Glioma-associated Oncogene Homolog 1 (GLI1) Messenger Ribonucleic Acid (mRNA) Levels at Week 12

  GLI1 change is a biomarker of the HH signaling pathway. A change in GLI1 mRNA levels reflect a change in the HH pathway. Surgically eligible basal cell carcinomas (SEBs) were defined as clinically diagnosed basal cell carcinoma (BCC) 5 to 20 millimeters (mm) in diameter on the face, excluding the nose and periorbital skin, and 9 to 20 mm at sites other than the face. A single baseline BCC designated as a treatment-targeted tumor at Baseline was biopsied first at Baseline and again following 12 weeks of treatment. This was used to assess percent change in GLI1 mRNA levels as follows: (Baseline - Week 12) / Baseline \* 100, with positive numbers to represent increases and negative numbers to represent decreases. Any missing values were not imputed; all available data is summarized.

  Baseline, Week 12

Secondary Outcomes (2)

• Clinical Efficacy: Percent Change From Baseline in Tumor Size of Treatment-targeted SEBs at Week 12

  Baseline, Week 12

• Clinical Efficacy: Percentage of SEBs Showing Complete or Partial Response at Week 12 as Determined by Blinded Photographic Review

  Baseline, Week 12

Other Outcomes (2)

• Percentage of Treatment-targeted SEBs Achieving Clear or Almost Clear on the Investigator Static Global Tumor Assessment (ISGTA) Scale

  Baseline and Weeks 2, 6, 8, 10, and 12

• Percent Change in Treatment-targeted SEBs Tumor Size From Baseline as Determined by Blinded Photographic Review

  Baseline, Week 12

Study Arms (8)

Patidegib gel 2% - Cohort 1

EXPERIMENTAL

Patidegib gel 2%, applied topically, once daily for 12 weeks (Cohort 1)

Drug: Patidegib

Patidegib gel 4% - Cohort 2

EXPERIMENTAL

Patidegib gel 4%, applied topically, once daily for 12 weeks (Cohort 2)

Drug: Patidegib

Vehicle gel - Cohort 1

PLACEBO COMPARATOR

Vehicle gel, applied topically, once daily for 12 weeks (Cohort 1)

Drug: Vehicle gel

Patidegib gel 2% - Cohort 3

EXPERIMENTAL

Patidegib gel 2%, applied topically, twice daily for 12 weeks (Cohort 3)

Drug: Patidegib

Patidegib gel 4% - Cohort 4

EXPERIMENTAL

Patidegib gel 4%, applied topically, twice daily for 12 weeks (Cohort 4)

Drug: Patidegib

Vehicle gel - Cohort 2

PLACEBO COMPARATOR

Vehicle gel, applied topically, once daily for 12 weeks (Cohort 2)

Drug: Vehicle gel

Vehicle gel - Cohort 3

PLACEBO COMPARATOR

Vehicle gel, applied topically, twice daily for 12 weeks (Cohort 3)

Drug: Vehicle gel

Vehicle gel - Cohort 4

PLACEBO COMPARATOR

Vehicle gel, applied topically, twice daily for 12 weeks (Cohort 4)

Drug: Vehicle gel

Interventions

Patidegib DRUG

Also known as: Study drug

Patidegib gel 2% - Cohort 1; Patidegib gel 2% - Cohort 3; Patidegib gel 4% - Cohort 2; Patidegib gel 4% - Cohort 4

Vehicle gel DRUG

Also known as: Placebo

Vehicle gel - Cohort 1; Vehicle gel - Cohort 2; Vehicle gel - Cohort 3; Vehicle gel - Cohort 4

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• The participant is from 18 to 85 years of age, inclusive.
• The participant must provide electronic informed consent prior to any study procedures.
• If the participant is a woman of childbearing potential, she is willing to use two effective methods of birth control during the duration of the trial and for one month after the last application of the gel. The two forms of birth control authorized are defined as the use of a barrier method of contraception (condom with spermicide) in association with one of the following methods of birth control: bilateral tubal ligation; combined oral contraceptives (estrogens and progesterone) or implanted or injectable contraceptives with a stable dose for at least 1 month prior to Baseline; hormonal intra-uterine device (IUD) inserted at least 1 month prior to Baseline. This proscription is based on the key role of the hedgehog (HH) pathway in embryogenesis, the known preclinical teratogenic effects of systemic cyclopamine, a naturally occurring inhibitor of smoothened (SMO), and the unknown level of systemic exposure following topical application of patidegib in humans.
• One or two previously untreated basal cell carcinomas (BCCs) with the clinical features of a nodular BCC confirmed by a biopsy done at or prior to screening confirming nodular BCC. These tumors must be suitable for surgical excision. The BCCs prior to biopsy must be no less than 5 millimeters (mm) or greater than 15 mm in greatest diameter on the face and no less than 9 mm or more than 20 mm in greatest diameter at sites other than the face. Tumors on the nose, periorbital skin, or on or below the knee are excluded.
• The participant is willing to abstain from application of non-study topical prescription and over the counter medications within 5 centimeters (cm) of a treatment-targeted BCC for the duration of the study except as prescribed by the Investigator. Moisturizers and emollients are allowable. Subjects will be encouraged to use sunscreen with a sunscreen protection factor (SPF 15 or higher) at least once daily on all exposed skin sites.
• Female participant must have negative serum pregnancy test at Screening.
• The participant is willing to contact the study center after each primary skin care physician (PSCP) visit to provide the study center details of the visit and any treatment of skin tumors.
• The participant is willing to forego alternative treatment of the treatment-targeted baseline BCC for the duration of the trial.

You may not qualify if:

• Participants with basal cell nevus syndrome (BCNS, Gorlin syndrome, nevoid basal cell carcinoma syndrome; Online Mendelian Inheritance in Man \[OMIM\] #109400).
• The participant has used topical products within 5 cm of a treatment- targeted BCC or systemic therapies that might interfere with the evaluation of the study medication during the study. Specifically, these include the use of:
• Topical glucocorticoids 30 days prior to screening
• Retinoids (such as etretinate, isotretinoin, tazarotene, tretinoin, adapalene) systemically or topically, or \> 5% of an alphahydroxy acid (such as glycolic acid, lactic acid), photodynamic therapy (PDT), or 5-fluorouracil or imiquimod (except as topical treatment to discrete BCCs) systemically or topically to the skin during the six months prior to entry.
• Systemic chemotherapy within one year prior to screening. (Note: field therapy with topically applied treatments can be done as long as they are not applied within 5 cm of a treatment-targeted tumor).
• Known inhibitors of the HH signaling pathway (such as vismodegib, patidegib, sonidegib, and itraconazole) topically or systemically within 6 months of entry into the study.
• The participant has a history of hypersensitivity to any of the ingredients in the study medication formulation.
• The participant is unable or unwilling to make a good faith effort to be present for all follow-up visits and tests.
• The participant is a woman who is currently nursing.
• The participant has any systemic disease that in the Investigator's opinion would interfere with the subject's ability to participate.
• The participant has a clinically significant history of liver disease, including viral hepatitis, current alcohol abuse, or cirrhosis, that in the investigator's opinion would interfere with the participant's ability to participate.
• The participant has any condition or situation which in the Investigator's opinion may put the subject at significant risk, could confound the study results, or could interfere significantly with the participant's participation in the study. This includes history of other skin conditions or diseases, metabolic dysfunction, physical examination findings, or clinical laboratory findings giving reasonable suspicion of a disease or condition that contraindicates use of this investigational drug or that might affect interpretation of the results of the study or render the participant at high risk from treatment complications.
• The participant has a history of invasive cancer within the past five years excluding non-melanoma skin cancer, Stage I cervical cancer, ductal carcinoma in situ of breast, or chronic lymphocytic lymphoma (CLL) (Stage 0).
• The participant is currently participating in an experimental drug study (within 4 weeks of Baseline visit) or plans to participate in an experimental drug study while enrolled in this study.
• The participant is on a concomitant medication that is a strong CYP3A4 inhibitor. These include, but are not limited to: larithromycin, telithromycin, nefazodone, itraconazole, ketoconazole, atazanavir, darunavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, and tipranavir.

Sponsors & Collaborators

• PellePharm, Inc.: lead

Study Sites (1)

12121 Bluff Creek Drive Suite 100

Los Angeles, California, 90094, United States

Location

MeSH Terms

Conditions

Carcinoma, Basal Cell; Basal Cell Nevus Syndrome

Interventions

IPI-926; Drug Evaluation

Condition Hierarchy (Ancestors)

Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Basal Cell; Odontogenic Cysts; Jaw Cysts; Bone Cysts; Cysts; Neoplastic Syndromes, Hereditary; Bone Diseases, Developmental; Bone Diseases; Musculoskeletal Diseases; Jaw Diseases; Stomatognathic Diseases; Abnormalities, Multiple; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Genetic Diseases, Inborn

Intervention Hierarchy (Ancestors)

Drug Development; Investigative Techniques; Evaluation Studies as Topic

Results Point of Contact

• Title: Chief Medical Officer
• Organization: PellePharm, Inc.

clinical@pellepharm.com

(510) 502-6144

Study Officials

• Ervin Epstein, MD

  PellePharm, Inc.

  STUDY DIRECTOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 1, 2016
• First Posted: July 11, 2016
• Study Start: November 11, 2016
• Primary Completion: November 9, 2017
• Study Completion: November 9, 2017
• Last Updated: January 8, 2019
• Results First Posted: January 4, 2019

Record last verified: 2019-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)