Clinical Trial Results:
Double-Blind, Randomized, Vehicle-Controlled Proof of Concept Clinical Trial of Patidegib Gel 2%, 4%, and Vehicle to Decrease the Number of Surgically Eligible Basal Cell Carcinomas in Gorlin Syndrome Patients
Summary
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EudraCT number |
2015-004274-15 |
Trial protocol |
GB |
Global end of trial date |
24 Apr 2017
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Results information
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Results version number |
v2(current) |
This version publication date |
03 Jul 2020
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First version publication date |
11 May 2018
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Other versions |
v1 |
Version creation reason |
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Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
Pelle-926-201
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02762084 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
PellePharm, Inc.
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Sponsor organisation address |
275 Middlefield Rd., Suite 100, Menlo Park, United States, CA 94025
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Public contact |
Alix Alderman, PellePharm, Inc, +1 510-502-6144, aalderman@pellepharm.com
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Scientific contact |
Alix Alderman, PellePharm, Inc, +1 510-502-6144, aalderman@pellepharm.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
24 Apr 2017
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
24 Apr 2017
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Global end of trial reached? |
Yes
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Global end of trial date |
24 Apr 2017
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The primary objectives of the study were to evaluate the following:
1.The clinical efficacy of patidegib gel 2% or 4% compared to vehicle as defined by the percent decrease in greatest diameter of Baseline treatment targeted Surgically Eligible basal cell carcinomas (SEBs) after 26 weeks of treatment. [SEBs were defined as clinically diagnosed BCCs 5 mm or greater in diameter on the face excluding the nose and periorbital skin, and 9 mm or greater at sites other than the face].
2.The molecular efficacy of treatment as defined by reduction in the hedgehog (HH) signaling pathway target gene GLI1 after treatment with patidegib gel 2% or 4% or vehicle applied twice daily for 6 weeks to treatment-targeted SEBs.
3.The safety and tolerability of treatment with patidegib gel 2% or 4% or vehicle applied twice daily for 26 weeks.
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Protection of trial subjects |
The study was conducted in accordance with the ethical principles originating from the Declaration of Helsinki, ICH guidelines, GCP, and in compliance with local regulatory requirements pertinent to safety of trial subjects.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
06 Jun 2016
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
United Kingdom: 17
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Worldwide total number of subjects |
17
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EEA total number of subjects |
17
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
6
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From 65 to 84 years |
11
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85 years and over |
0
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Recruitment
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Recruitment details |
This study was conducted by 2 principal investigators at 2 clinical sites in the United Kingdom. A total of 17 subjects were randomized. | ||||||||||||||||||||||||
Pre-assignment
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Screening details |
- | ||||||||||||||||||||||||
Pre-assignment period milestones
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Number of subjects started |
17 | ||||||||||||||||||||||||
Number of subjects completed |
17 | ||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall trial (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||
Roles blinded |
Subject, Monitor, Investigator, Carer | ||||||||||||||||||||||||
Blinding implementation details |
The study drugs were packaged and labeled identically, and the study drug kits were numbered sequentially and dispensed randomly to the subjects entering the study within each investigational center. The Investigators, the site staff, PellePharm, and the Clinical Monitors were not aware of the treatment assigned to the individual study subjects. The treatment assignments for all enrolled subjects were unblinded only after the conclusion of the treatment phase of the study.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Patidegib Topical gel 2% | ||||||||||||||||||||||||
Arm description |
Patidegib gel 2% applied topically twice daily for 26 weeks | ||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||
Investigational medicinal product name |
Patidegib
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Gel
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Routes of administration |
Cutaneous use
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Dosage and administration details |
Patidegib 2% gel applied topically twice daily for 26 weeks.
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Arm title
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Patidegib Topical gel 4% | ||||||||||||||||||||||||
Arm description |
Patidegib gel 4% applied topically twice daily for 26 weeks | ||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||
Investigational medicinal product name |
Patidegib
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Gel
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Routes of administration |
Cutaneous use
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Dosage and administration details |
Patidegib 4% gel applied topically twice daily for 26 weeks.
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Arm title
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Vehicle gel | ||||||||||||||||||||||||
Arm description |
Vehicle gel applied topically twice daily for 26 weeks | ||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||
Investigational medicinal product name |
Vehicle
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Gel
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Routes of administration |
Cutaneous use
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Dosage and administration details |
Vehicle gel applied topically twice daily for 26 weeks.
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Baseline characteristics reporting groups
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Reporting group title |
Overall trial
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Patidegib Topical gel 2%
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Reporting group description |
Patidegib gel 2% applied topically twice daily for 26 weeks | ||
Reporting group title |
Patidegib Topical gel 4%
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Reporting group description |
Patidegib gel 4% applied topically twice daily for 26 weeks | ||
Reporting group title |
Vehicle gel
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Reporting group description |
Vehicle gel applied topically twice daily for 26 weeks | ||
Subject analysis set title |
Patidegib gel
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Patidegib: 2% or 4% gel applied topically twice daily for 26 weeks
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End point title |
Clinical efficacy : Percentage change in tumor size from baseline | ||||||||||||||||
End point description |
Percent change in tumor size of Treatment-targeted Surgically Eligible Basal Cell Carcinomas (SEBs) Tumor Size from Baseline.
SEBs were defined as clinically diagnosed basal cell carcinoma (BCC) 5 millimeters (mm) or greater in diameter on the face, excluding the nose and periorbital skin, and 9-millimeter (mm) or greater at sites other than the face. The percent change in greatest diameters of treatment-targeted surgically eligible basal cell carcinomas (SEBs) from Baseline to Week 26 was calculated as follows: (sum [Baseline] - sum [Week 26] / sum [Baseline] * 100), where sum = the greatest diameters of Baseline treatment-targeted SEBs, positive Numbers to represent decrease in tumor size and negative Numbers to represent increases in tumor size. Missing values were imputed using Last-Observation Carried Forward (LOCF).
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End point type |
Primary
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End point timeframe |
Baseline and Week 26
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Statistical analysis title |
Statistical analysis 1 for Clinical Efficacy | ||||||||||||||||
Statistical analysis description |
Percent Decrease in Baseline Treatment-targeted Surgically Eligible Basal Cell Carcinomas (SEBs) Tumor Size from Baseline
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Comparison groups |
Patidegib Topical gel 2% v Vehicle gel
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Number of subjects included in analysis |
11
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Analysis specification |
Pre-specified
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Analysis type |
other [1] | ||||||||||||||||
P-value |
= 0.909 | ||||||||||||||||
Method |
ANCOVA | ||||||||||||||||
Confidence interval |
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Notes [1] - Pairwise comparison ANCOVA with treatment group as a factor and Baseline value as a covariate |
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Statistical analysis title |
Statistical analysis 2 for Clinical Efficacy | ||||||||||||||||
Statistical analysis description |
Percent Decrease in Baseline Treatment-targeted Surgically Eligible Basal Cell Carcinomas (SEBs) Tumor Size from baseline
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Comparison groups |
Patidegib Topical gel 4% v Vehicle gel
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Number of subjects included in analysis |
11
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Analysis specification |
Pre-specified
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Analysis type |
other [2] | ||||||||||||||||
P-value |
= 0.648 | ||||||||||||||||
Method |
ANCOVA | ||||||||||||||||
Confidence interval |
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Notes [2] - Pairwise comparison ANCOVA with treatment group as a factor and Baseline value as a covariate |
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End point title |
Molecular efficacy: Percent Change in GLI1 mRNA levels | ||||||||||||||||
End point description |
Percent change in the Hedgehog (HH) Signaling Pathway Target Gene Glioma-associated Oncogene Homolog 1 (GLI1) Messenger Ribonucleic Acid (mRNA) Levels from Baseline.
SEBs were defined as clinically diagnosed BCC 5 mm or greater in diameter on the face, excluding the nose and periorbital skin, and 9-mm or greater at sites other than the face. A single baseline SEB designated as a treatment targeted tumor at Baseline was biopsied first at Baseline and again following 6 weeks of treatment. This was used to assess percent decrease in GLI1 mRNA levels as follows: (Baseline - Week 6) / Baseline * 100, where positive numbers to represent decrease in GL1 mRNA level, and negative Numbers to represent increase in GL1 mRNA level. Any missing values are not imputed; all available data is summarized.
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End point type |
Primary
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End point timeframe |
Baseline and Week 6
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Statistical analysis title |
Statistical analysis 1 for molecular efficacy | ||||||||||||||||
Statistical analysis description |
Percent Decrease in the Hedgehog (HH) Signaling Pathway Target Gene Glioma-associated Oncogene Homolog 1 (GLI1) Messenger Ribonucleic Acid (mRNA) Levels from Baseline
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Comparison groups |
Patidegib Topical gel 2% v Vehicle gel
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Number of subjects included in analysis |
8
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Analysis specification |
Pre-specified
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Analysis type |
other [3] | ||||||||||||||||
P-value |
= 0.5 | ||||||||||||||||
Method |
ANCOVA | ||||||||||||||||
Confidence interval |
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Notes [3] - Pairwise comparison With a factor of treatment group and using Baseline value as a covariate |
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Statistical analysis title |
Statistical analysis 2 for molecular efficacy | ||||||||||||||||
Statistical analysis description |
Percent Decrease in the Hedgehog (HH) Signaling Pathway Target Gene Glioma-associated Oncogene Homolog 1 (GLI1) Messenger Ribonucleic Acid (mRNA) Levels from Baseline
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Comparison groups |
Patidegib Topical gel 4% v Vehicle gel
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Number of subjects included in analysis |
8
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Analysis specification |
Pre-specified
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Analysis type |
other [4] | ||||||||||||||||
P-value |
= 0.681 | ||||||||||||||||
Method |
ANCOVA | ||||||||||||||||
Confidence interval |
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Notes [4] - Pairwise comparison With a factor of treatment group and using Baseline value as a covariate |
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End point title |
Safety and Tolerability Assessment of Treatment With Patidegib Gel: Number of Participants With a Treatment-emergent Adverse Event Causally Related to Study Drug [5] | ||||||||||||
End point description |
All serious adverse events (SAEs) and all other non-serious adverse events (AEs) regardless of causality are located in the Reported AE Module. AEs considered as related where categorized by the Investigator as either definitely related, probably related, or possibly related. Treatment-emergent AEs are those with an onset after use of study drug.
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End point type |
Primary
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End point timeframe |
Baseline through Week 26
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Notes [5] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: Additional statistical analysis is not applicable to this endpoint. |
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No statistical analyses for this end point |
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End point title |
Safety and Tolerability Assessment of Treatment With Patidegib Gel: Number of Participants With Treatment-emergent Administrative Site Skin Condition AEs Causally Related to Study Drug [6] | ||||||||||||||||||||||||||||||||
End point description |
All SAEs and all other non-serious AEs, regardless of causality, are located in the Reported AE Module. The number of participants reporting administrative-site, skin condition treatment-emergent AEs considered related to study drug by the Investigator are presented below. Treatment-emergent AEs are those with an onset after use of study drug.
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End point type |
Primary
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End point timeframe |
Baseline through Week 26
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Notes [6] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: Additional statistical analysis is not applicable to this endpoint. |
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No statistical analyses for this end point |
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End point title |
The Number of Participants Reporting New SEBs on the Face From Baseline for the Combined Patidegib Treatment Groups [7] | |||||||||
End point description |
Facial SEBs were defined as clinically diagnosed BCC 5 mm or greater in diameter on the face, excluding the nose and periorbital skin. A new facial SEB was defined as an SEB first noted on the face after Week 2 that developed at a site where there was no visible BCC of any size at Baseline or Week 2. New facial SEBs were investigated for participants on vehicle gel versus participants on patidegib 2% and 4% gel. Missing values were imputed using LOCF.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26
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Notes [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: New facial SEBs were investigated for participants on vehicle gel versus participants on patidegib 2% and 4% gel combined. |
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No statistical analyses for this end point |
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End point title |
The Mean number of new SEBs on the face for the Combined Patidegib Treatment groups [8] | ||||||||||||
End point description |
Facial SEBs were defined as clinically diagnosed BCC 5 mm or greater in diameter on the face, excluding the nose and periorbital skin. A new facial SEB was defined as an SEB first noted on the face after Week 2 that developed at a site where there was no visible BCC of any size at Baseline or Week 2. New facial SEBs were investigated for participants on vehicle gel versus participants on patidegib 2% and 4% gel. Missing values were imputed using LOCF. The mean number of new SEBs (number per participant) are presented. No measure of dispersion/precision was calculated.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26
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Notes [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: New facial SEBs were investigated for participants on vehicle gel versus participants on patidegib 2% and 4% gel combined. |
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No statistical analyses for this end point |
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End point title |
The Mean Number of New SEBs on the Face for the Combined Patidegib Treatment Groups by Tumor Population [9] | ||||||||||||
End point description |
Facial SEBs were defined as clinically diagnosed BCC 5 mm or greater in diameter on the face, excluding the nose and periorbital skin. A new facial SEB was defined as an SEB first noted on the face after Week 2 that developed at a site where there was no visible BCC of any size at Baseline or Week 2. New facial SEBs were investigated for participants on vehicle gel versus participants on patidegib 2% and 4% gel. Missing values were imputed using LOCF. The mean number of new SEBs (number per participant) are presented. No measure of dispersion/precision was calculated.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26
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Notes [9] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: New facial SEBs were investigated for participants on vehicle gel versus participants on patidegib 2% and 4% gel combined. |
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No statistical analyses for this end point |
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End point title |
Percent Change in Baseline Treatment-targeted SEBs Tumor Size From Baseline | ||||||||||||||||||||||||||||||||||||
End point description |
SEBs were defined as clinically diagnosed BCC 5 mm or greater in diameter on the face, excluding the nose and periorbital skin, and 9 mm or greater at sites other than the face. The percent change in greatest diameters of Baseline treatment-targeted SEBs from Baseline to Week x (Week 6, 10, 14, 18, or 22) was calculated as follows: (sum [Baseline] - sum [Week x] / sum [Baseline] * 100), where sum = the greatest diameters of Baseline treatment-targeted SEBs, and positive numbers to represent decrease in tumor size and negative numbers to represent increase in tumor size. Missing values were imputed using LOCF.
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End point type |
Secondary
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End point timeframe |
Baseline and Weeks 6, 10, 14, 18, and 22
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No statistical analyses for this end point |
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End point title |
Percent Change in Central Facial SEBs From Baseline | ||||||||||||||||||||||||||||||||||||||||
End point description |
Central facial SEBs were defined as those located on the nose or periorbital area (eyelids) which were 3 mm or greater at Baseline. The percent change from Baseline to Week x (Week x = Weeks 6, 10, 14, 18, 22, or 26) in central facial SEBs was calculated as follows: [sum (Baseline) - sum (Week x)] / [sum (Baseline)] * 100 where sum = the greatest diameters of Baseline treatment-targeted SEBs where positive numbers to represent decrease in tumor size and negative numbers to represent increase in tumor size. Missing values were imputed using LOCF. The data presented as "99999" indicates that the standard deviation was not calculated because there was only 1 participant in the analysis population.
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End point type |
Secondary
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End point timeframe |
Baseline and Weeks 6, 10, 14, 18, 22, and 26
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No statistical analyses for this end point |
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End point title |
Proportion of Non-central Facial BCCs Increasing to ≥ 5 mm From Baseline | ||||||||||||||||||||||||||||||||||||||||
End point description |
The proportion of non-central facial BCCs that at Baseline measured a greatest diameter of < 5 mm and increased to a diameter of ≥ 5 mm by Week x (Week x = Weeks 6, 10, 14, 18, 22, or 26) were calculated for each participant as follows: (Number of non−central facial BCCs with greatest diameter ≥ 5 mm at Week x) / (Number of non−central facial BCCs with greatest diameter < 5 mm at Baseline). Missing values were imputed using LOCF.
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End point type |
Secondary
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End point timeframe |
Baseline and Weeks 6, 10, 14, 18, 22, and 26
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No statistical analyses for this end point |
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End point title |
Proportion of Treatment-Targeted SEBs No Longer Classified as SEBs After 26 Weeks | ||||||||||||||||||||||||||||||||||||||||
End point description |
SEBs were defined as clinically diagnosed BCC 5 mm or greater in diameter on the face, excluding the nose and periorbital skin, and 9 mm or greater at sites other than the face. The proportion of Baseline treatment-targeted SEBs that at the end of 26 weeks of treatment were no longer large enough to be classified as SEBs (that is, the proportion of Baseline treatment targeted SEBs on the face that became < 5 mm in greatest diameter and non-facial Baseline treatment targeted SEBs that became < 9 mm in greatest diameter) were calculated for each participant as follows:
(Number of Baseline treatment-targeted facial SEBs with greatest diameter < 5 mm) + (Baseline treatment targeted non-facial SEBs with greatest diameter < 9 mm) / Number of baseline treatment targeted SEBs.
Missing values were imputed using LOCF.
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End point type |
Secondary
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End point timeframe |
Baseline and Weeks 6, 10, 14, 18, 22, and 26
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No statistical analyses for this end point |
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End point title |
Percentage of Treatment-targeted SEBs Achieving Clear or Almost Clear on the 5-point Investigator Static Global Tumor Assessment (ISGTA) Scale | ||||||||||||||||||||||||||||||||||||||||
End point description |
The ISGTA is a scale with scores ranging from 0 (clear), 1 (almost clear), 2 (minimal residual tumor), to 3 (clearly visible tumor). The Investigator assessed each Baseline treatment-targeted SEB at Weeks 6, 10, 14, 18, 22, and 26. SEBs were defined as clinically diagnosed BCC 5 mm or greater in diameter on the face, excluding the nose and periorbital skin, and 9 mm or greater at sites other than the face. The percentage of Baseline treatment-targeted SEBs evaluated as being clear or almost clear at Week x (Week x = Week 6, 10, 14, 18, 22 or 26) based on the ISGTA scale was calculated as follows: (Number of baseline treatment-targeted SEBs with ISGTA score of 0 or 1 at Week x) / (Number of Baseline treatment-targeted SEBs) * 100. Missing data were imputed using LOCF. The percentage of responders achieving clear (0) or almost clear (1) on the ISGTA scale are presented by Week.
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End point type |
Secondary
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End point timeframe |
Baseline and Weeks 6, 10, 14, 18, 22, and 26
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
26 weeks
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Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.0
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Reporting groups
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Reporting group title |
Patidegib gel 2%
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Reporting group description |
Patidegib gel 2% applied topically twice daily for 26 weeks | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Patidegib gel 4%
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Reporting group description |
Patidegib gel 4% applied topically twice daily for 26 weeks | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Vehicle gel
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Reporting group description |
Vehicle gel applied topically twice daily for 26 weeks | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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27 Jan 2016 |
•Section 6.1 Overall Study Design and Plan was edited to provide a rationale for the dose level and frequency of the topical gel, based on nonclinical data and the known characteristics of the oral formulation. Patidegib 2% and 4% gel applied twice daily was predicted to be effective while providing a large safety margin for both dermal and systemic safety.
•Table 2 Schedule of Assessments footnote e was expanded to specify that the following clinical laboratory tests would be performed: chemistry (AST, total bilirubin, BUN, calcium, carbon dioxide, chloride, creatinine, glucose, potassium, protein, sodium), hematology (WBC, RBC, hemoglobin, hematocrit, MCV, MCH, MCHC, Red Cell Distribution Width, Platelets, Mean Platelet Volumes, Absolute/Percent Neutrophil Count, Absolute/Percent Lymphocyte count, Absolute/Percent Monocyte count, Absolute/Percent Eosinophil Count, Absolute/Percent Basophil Count), and urinalysis (including reflex microscopic examination).
•Appendix 16.4 Safety Laboratory Tests was newly added to provide a detailed list of clinical laboratory assessments to be collected.
•Section 8.3 Unblinding was edited to clarify that, in the case of a medical emergency, the Investigator could break the blind for the subject involved without first discussing the situation with the Medical Monitor.
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02 Mar 2016 |
.
•Section 1 Synopsis and Section 7.1 Subject Inclusion Criteria were edited per feedback from the MHRA to specify 2 acceptable methods of contraception:
1) barrier method in association with bilateral tubal ligation, combined oral contraceptives, or implanted or injectable contraceptives with a stable dose for at least 1 month prior to Baseline; or
2) hormonal intrauterine device inserted at least 1 month prior to Baseline.
•Section 10.1.1 Screening Visit and Section 10.1.5 Week 26 were edited. Previously, subject height assessment was erroneously included at these visits; it was removed.
•Section 10.1.2 Baseline Visit (Day 1) was edited. Height and weight assessments were erroneously included in item 4; they were removed as they already were present in item 5.
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18 Aug 2016 |
•Synopsis/Section 7.1 Inclusion Criteria
8-Female subjects must have a negative serum pregnancy test at Screening.
9-If the subject is a male with a female sexual partner who is of childbearing potential the couple 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. A female of childbearing potential is a sexually mature woman who has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months), must agree to use two effective methods of contraception for the duration of the study and at least 1 month after the last study drug application. 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.
•Synopsis/Section 7.2 Exclusion Criteria
1-The subject is a woman of childbearing potential. (based on the key role of the HH pathway in embryogenesis, the known preclinical teratogenic effects of systemic cyclopamine, a naturally occurring inhibitor of SMO, and the unknown level of systemic exposure following topical application of patidegib in humans) A female of childbearing potential is a sexually mature woman who has not undergone a hysterectomy or bilateral oophorectomy or has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months.
10-Female sexual partner(s) of male subjects unwilling/unable to comply with pregnancy prevention measures. |
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18 Aug 2016 |
•Synopsis Safety Measurements /Section 10.3.1 Dermal Safety and Tolerability were amended to specify that safety and tolerability would be evaluated, and that each of the 5 baseline treatment-targeted tumor sites, as well as the face in general, would be evaluated separately for these signs and symptoms of application site reactions. Scales for assessing local skin reactions were clarified to specify that the subjects should rate the symptoms experienced at the application site(s).
•Synopsis Statistical Methods /Section 11 Statistics were edited to add that if determined appropriate by the Sponsor, limited efficacy analysis on tumor shrinkage and biomarkers might have been performed after the last subject completed 14 weeks of treatment.
•Table 2 Schedule of Assessments was edited to indicate that at Baseline and Week 6, a BCC was to be identified for biopsy, and that visible BCCs were to be measured at Baseline and at Weeks 2, 6, 10, 14, 18, 22, and 26/ET. Footnote f was added:
Tumors to be measured and mapped included the 5 baseline treatment-targeted tumors as well as all other facial tumors including those on the eyelids and the nose. In addition, up to 10 non treatment-targeted non-facial tumors also were measured and mapped.
•Section 10 Study Procedures and Evaluations was edited to indicate that a physician must identify the treatment targeted tumor to be biopsied.
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18 Aug 2016 |
•Section 10.1.2 Baseline Visit (Day 1) was edited to clarify the following procedures:
7. The Investigator will perform the clinical evaluation to identify BCCs including the 5 baseline treatment-targeted tumors, as well as, all other facial tumors (including those on the eyelids and the nose). In addition, up to 10 non treatment-targeted non facial tumors will also be clinically classified as superficial, nodular, infiltrative, morpheic or sclerosing, pigmented, or micronodular/morpheaform, circle each tumor in ink, photographed, measured, and recorded on a body diagram. The 5 baseline treatment-targeted tumors will also be evaluated based on the ISGTA.
8. Obtain 2 mm punch biopsy from the baseline treatment targeted SEB that has been designated for biomarker evaluation. The 2 mm punch biopsies can be performed by the Investigator or designee as allowed by the clinical site's normal policies and procedures.
9. The Investigator or designee will assess each of the areas to be treated by observations and questioning the subjects as necessary for the signs and symptoms of irritation including pain/burning, pruritus, erythema, edema, and scabbing/crusting. Each of the 5 treatment targeted-tumors, as well as the face in general, will be evaluated separately.
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18 Aug 2016 |
•Section 10.1.3 Weeks 2, 10, 18, and 22; Section 10.1.4 Weeks 6, 14, and 26; and Section 10.1.5 Week 26 (Day 183 ± 3 Days) / Early Termination were edited to clarify the following procedures:
-The Investigator will perform the clinical evaluation of the 5 baseline treatment targeted tumors, as well as, all other facial tumors (including those on the eyelids and the nose). In addition, up to 10 non treatment-targeted non-facial tumors will be circled in ink, photographed, measured, and recorded on a body diagram. The 5 baseline treatment-targeted tumors will be evaluated based on the ISGTA.
-The Investigator or designee will assess each of the treated areas by observations and questioning the subjects as necessary for the signs and symptoms of irritation including pain/burning, pruritus, erythema, edema, and scabbing/crusting. Each of the 5 treatment-targeted tumors, as well as the face in general, will be evaluated separately.
Section 10.1.4 Weeks 6, 14, and 26 was edited to clarify the following procedure:
-Obtain a biopsy with a 2 mm punch at Week 6 from the single SEB designated as the biomarker treatment targeted tumor and previously biopsied at baseline. The 2 mm punch biopsies can be performed by the Investigator or designee as allowed by the clinical site's normal policies and procedures.
•Section 10.1.5 Week 26 (Day 183 ± 3 Days) / Early Termination was edited to remove the 2 mm punch biopsy of non-responding tumors for subjects considered to be non responders.
•Section 10.2 (Evaluation of Efficacy) renamed, “Evaluation of Tumors.”
•Section 11 Statistics and Section 11.6 Interim Analyses were edited to remove the sentence, “No interim analyses are planned.” Text was added to Section 11.6: “If determined appropriate by the Sponsor, limited efficacy analysis on tumor shrinkage and biomarkers may be performed after the last subject completes 14 weeks of treatment.”
•Section 13 (Data Monitoring Committee) was renamed, “Data Safety Monitoring Committee.” |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |