Clinical Trial Results:
A multi-center, randomized study on oral 8-methoxypsoralen plus UVA with or without maintenance therapy in mycosis fungoides EORTC/ISCL stage Ia to IIb.
Summary
|
|
EudraCT number |
2012-000212-28 |
Trial protocol |
AT |
Global end of trial date |
02 Jul 2018
|
Results information
|
|
Results version number |
v1(current) |
This version publication date |
04 Oct 2019
|
First version publication date |
04 Oct 2019
|
Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
|
|||
Trial identification
|
|||
Sponsor protocol code |
M-PUVA2012
|
||
Additional study identifiers
|
|||
ISRCTN number |
- | ||
US NCT number |
- | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
|
|||
Sponsor organisation name |
Medical University of Graz
|
||
Sponsor organisation address |
Auenbruggerplatz 8, Graz, Austria,
|
||
Public contact |
Information Klinische Studie, Medical University of Graz, 43 316385 12538, dermatologie@medunigraz.at
|
||
Scientific contact |
Information Klinische Studie, Medical University of Graz, 43 316385 12538, dermatologie@medunigraz.at
|
||
Paediatric regulatory details
|
|||
Is trial part of an agreed paediatric investigation plan (PIP) |
No
|
||
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
|
||
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
|
||
Results analysis stage
|
|||
Analysis stage |
Final
|
||
Date of interim/final analysis |
02 Jul 2018
|
||
Is this the analysis of the primary completion data? |
Yes
|
||
Primary completion date |
02 Jul 2018
|
||
Global end of trial reached? |
Yes
|
||
Global end of trial date |
02 Jul 2018
|
||
Was the trial ended prematurely? |
No
|
||
General information about the trial
|
|||
Main objective of the trial |
To determine whether PUVA maintenance therapy does prolong disease free survival after initial complete response.
|
||
Protection of trial subjects |
This study was conducted in conformance with Good Clinical Practice standards and applicable country regulations.
|
||
Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
01 Dec 2012
|
||
Long term follow-up planned |
No
|
||
Independent data monitoring committee (IDMC) involvement? |
No
|
||
Population of trial subjects
|
|||
Number of subjects enrolled per country |
|||
Country: Number of subjects enrolled |
Austria: 28
|
||
Worldwide total number of subjects |
28
|
||
EEA total number of subjects |
28
|
||
Number of subjects enrolled per age group |
|||
In utero |
0
|
||
Preterm newborn - gestational age < 37 wk |
0
|
||
Newborns (0-27 days) |
0
|
||
Infants and toddlers (28 days-23 months) |
0
|
||
Children (2-11 years) |
0
|
||
Adolescents (12-17 years) |
0
|
||
Adults (18-64 years) |
18
|
||
From 65 to 84 years |
10
|
||
85 years and over |
0
|
|
|||||||||||||||||
Recruitment
|
|||||||||||||||||
Recruitment details |
Recruitment started in April 2012. The last patient was enrolled in March 2016. Enrollment was closed in August 2016. | ||||||||||||||||
Pre-assignment
|
|||||||||||||||||
Screening details |
28 patients were assessed for eligibility. 1 patient was excluded due to an unconfirmed histologic diagnosis. 27 patients received induction treatment. Of these, 19....... patients reached complete remission and were randomised. | ||||||||||||||||
Period 1
|
|||||||||||||||||
Period 1 title |
Enrolment to randomisation
|
||||||||||||||||
Is this the baseline period? |
Yes | ||||||||||||||||
Allocation method |
Not applicable
|
||||||||||||||||
Blinding used |
Not blinded | ||||||||||||||||
Arms
|
|||||||||||||||||
Arm title
|
Initial treatment | ||||||||||||||||
Arm description |
- | ||||||||||||||||
Arm type |
Experimental | ||||||||||||||||
Investigational medicinal product name |
Oxsoralen
|
||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||
Other name |
|||||||||||||||||
Pharmaceutical forms |
Capsule, soft
|
||||||||||||||||
Routes of administration |
Oral use
|
||||||||||||||||
Dosage and administration details |
Initial treatment with a maximum duration of 24 weeks, depending on whether complete remission occurred
|
||||||||||||||||
|
|||||||||||||||||
Period 2
|
|||||||||||||||||
Period 2 title |
Randomisation to complete follow-up
|
||||||||||||||||
Is this the baseline period? |
No | ||||||||||||||||
Allocation method |
Randomised - controlled
|
||||||||||||||||
Blinding used |
Not blinded | ||||||||||||||||
Arms
|
|||||||||||||||||
Are arms mutually exclusive |
Yes
|
||||||||||||||||
Arm title
|
Maintenance group | ||||||||||||||||
Arm description |
Maintenance treatment was given once a week for one month (4 weeks), every 2 weeks for 2 months (8 weeks) and after three months once a month over 6 months. After 9 (10, 11, or 12) months of maintenance therapy (14 treatments) patients discontinued therapy. If PUVA treatment did lead to erythema during maintenance therapy, the dose for the next treatment was reduced by up to 30%. | ||||||||||||||||
Arm type |
Experimental | ||||||||||||||||
Investigational medicinal product name |
Oxsoralen
|
||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||
Other name |
|||||||||||||||||
Pharmaceutical forms |
Capsule, soft
|
||||||||||||||||
Routes of administration |
Oral use
|
||||||||||||||||
Dosage and administration details |
Maintenance treatment was given once a week for one month (4 weeks), every 2 weeks for 2 months (8 weeks) and after three months once a month over 6 months. After 9 (10, 11, or 12) months of maintenance therapy (14 treatments) patients discontinued therapy. If PUVA treatment didlead to erythema during maintenance therapy, the dose for the next treatment was reduced by up to 30%.
|
||||||||||||||||
Arm title
|
Control | ||||||||||||||||
Arm description |
Patients received no therapy. Patients were followed up at the same intervals like patients in study arm A (maintenance). | ||||||||||||||||
Arm type |
No intervention | ||||||||||||||||
Investigational medicinal product name |
No investigational medicinal product assigned in this arm
|
||||||||||||||||
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||
Baseline characteristics reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Enrolment to randomisation
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
End points reporting groups
|
|||
Reporting group title |
Initial treatment
|
||
Reporting group description |
- | ||
Reporting group title |
Maintenance group
|
||
Reporting group description |
Maintenance treatment was given once a week for one month (4 weeks), every 2 weeks for 2 months (8 weeks) and after three months once a month over 6 months. After 9 (10, 11, or 12) months of maintenance therapy (14 treatments) patients discontinued therapy. If PUVA treatment did lead to erythema during maintenance therapy, the dose for the next treatment was reduced by up to 30%. | ||
Reporting group title |
Control
|
||
Reporting group description |
Patients received no therapy. Patients were followed up at the same intervals like patients in study arm A (maintenance). | ||
Subject analysis set title |
Mainentance group
|
||
Subject analysis set type |
Intention-to-treat | ||
Subject analysis set description |
Maintenance treatment was given once a week for one month (4 weeks), every 2 weeks for 2 months (8 weeks) and after three months once a month over 6 months. After 9 (10, 11, or 12) months of maintenance therapy (14 treatments) patients discontinued therapy.
|
||
Subject analysis set title |
Control group
|
||
Subject analysis set type |
Intention-to-treat | ||
Subject analysis set description |
Patients received no therapy
|
|
||||||||||
End point title |
median time to recurrence after complete remission | |||||||||
End point description |
The median duration of disease-free rremission was 15 months in patients with maintenance therapy compared with 4 months in those without it (p: 0.02)
|
|||||||||
End point type |
Primary
|
|||||||||
End point timeframe |
max. 12 months
|
|||||||||
|
||||||||||
Statistical analysis title |
Median duration of disease-free remission | |||||||||
Comparison groups |
Mainentance group v Control group
|
|||||||||
Number of subjects included in analysis |
18
|
|||||||||
Analysis specification |
Pre-specified
|
|||||||||
Analysis type |
superiority | |||||||||
P-value |
< 0.05 | |||||||||
Method |
Logrank | |||||||||
Confidence interval |
|
|||||||
End point title |
Expression of Treg-related molecules in lesional tissue | ||||||
End point description |
Expression of CD3 and CD4 mRNA was significantly lower than at baseline.
The expression of CTLA-4, Foxp3, GITR and TGF-ß was quantified to characterize Tregs in skin and their change throughout treatment.
In general, the expression of each of these markers was higher in lesional skin at baseline than in normal skin from donors. After 12 to 24 weeks, PUVA treatment significantly reduced the expression of these markers.
|
||||||
End point type |
Secondary
|
||||||
End point timeframe |
after 12 to 24 weeks of PUVA treatment
|
||||||
|
|||||||
No statistical analyses for this end point |
|
|||||||
End point title |
T-cell proliferative capacity | ||||||
End point description |
Analysis of T-cell proliferative capacity in cells from blood at baseline and throughout treatment showed that PUVA therapy reduced the response to CD3/CD28 stimulation, reaching statistical significance after 12 to 24 weeks of treatment.
|
||||||
End point type |
Secondary
|
||||||
End point timeframe |
Start of induction phase until end of induction phase (12 to 24 weeks)
|
||||||
|
|||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events information
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Timeframe for reporting adverse events |
From time of informed consent to end of follow-up
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
22.0
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Enrolled patients
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
||
30 Jan 2013 |
Addition of two study sites |
||
03 May 2013 |
Change of one principal investigator |
||
05 Aug 2013 |
Change of one principal investigator |
||
10 Mar 2014 |
Change of one principal investigator |
||
05 Jun 2014 |
Possible prolongation of initial treatment phase from 3 to max. 6 months
Change of one exclusion criterion
Addition of the observatory arm for patients who did not response completely after initial therapy after the maximum treatment period
Change of time period for taking of biopsies
Additional amount of blood taken |
||
Interruptions (globally) |
|||
Were there any global interruptions to the trial? No | |||
Limitations and caveats |
|||
Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |