Title

Safety and Efficacy of Nitrogen Mustard in Treatment of Mycosis Fungoides
A Phase II Pivotal Trial to Evaluate the Safety and Efficacy of Nitrogen Mustard (NM) 0.02% Ointment Formulations in Patients With Stage I or IIA Mycosis Fungoides (MF)
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    mechlorethamine ...
  • Study Participants

    260
This study will evaluate the efficacy, tolerability and safety of the topical application of mechlorethamine (MCH) formulations in patients with stage I or IIA mycosis fungoides (MF).
The successful use of mechlorethamine (MCH) as a topical agent in the treatment of mycosis fungoides, a form of cutaneous T-cell lymphoma, was first reported in the late 1950s, and provided a rationale for skin-directed chemotherapy that minimized systemic toxicity. Since then, multiple investigators have demonstrated the safety and efficacy of topically applied MCH in the treatment of mycosis fungoides. This study will evaluate the efficacy (non-inferiority), tolerability and safety of topical application of MCH proprietary gel versus a compounded ointment formulation in Aquaphor in patients with stage I or IIA MF.
Study Started
May 31
2006
Primary Completion
Aug 31
2010
Study Completion
Aug 31
2011
Results Posted
Oct 31
2012
Estimate
Last Update
Oct 31
2012
Estimate

Drug mechlorethamine-MCH (nitrogen mustard)

All affected areas (lesions) are to be treated once daily for twelve months with mechlorethamine-MCH (nitrogen mustard) 0.02% PG or NM 0.02% AP ointment

  • Other names: mechlorethamine, nitrogen mustard

1 (PG - NM (MCH) 0.02%) Active Comparator

PG - mechlorethamine-MCH (nitrogen mustard) 0.02% gel To evaluate the tolerability and safety of topical mechlorethamine-MCH (nitrogen mustard) 0.02% ointment formulations in patients with stage I or IIA MF

2 (AP - MCH(NM) 0.02%) Active Comparator

AP - mechlorethamine-MCH (nitrogen mustard) 0.02% compounded in Aquaphor To evaluate the tolerability and safety of mechlorethamine-MCH (nitrogen mustard)0.02% ointment formulations in patients with stage I or IIA MF

Criteria

Inclusion Criteria:

Patients with mycosis fungoides confirmed by a skin biopsy
Stage I or IIA patients must have been treated previously with prior topical therapies including PUVA, UVB, topical steroids, but not NM within the past 2 years, or topical carmustine (BCNU)
Patients must be otherwise healthy with acceptable organ function.
Prior to initiating study therapy, patients must not have had topical therapy within four weeks
Lab values within normal range
Willing/able to give consent
Must use effective means of contraception if of childbearing potential

Exclusion Criteria:

Newly diagnosed mycosis fungoides with no prior therapy
A prior history of treatment with topical NM within the past 2 years or topical carmustine (BCNU)
Use of topical or systemic therapies for MF within four (4) weeks of entry in the study
Patients with a diagnosis of stage IIB-IV MF
Serious known concurrent medical illness or infection, which could potentially present a safety risk and/or prevent compliance with the requirements of the treatment program
Pregnant or nursing females, or males and females of childbearing potential, not using an effective means of contraception
Patients who have had radiation therapy within one year of study start
Patients who have a history of a higher T score than T2 or a higher N score than N1
Patients who do not agree to do all labs at one site

Summary

PG -Mechlorethamine-MCH (Nitrogen Mustard) 0.02% PG Gel

AP- Mechlorethamine-MCH (NM) 0.02% Compounded in Aquaphor

All Events

Event Type Organ System Event Term PG -Mechlorethamine-MCH (Nitrogen Mustard) 0.02% PG Gel AP- Mechlorethamine-MCH (NM) 0.02% Compounded in Aquaphor

Ratio of Response Rates Based on CAILS

The ratio of the response rate of the patients treated with the PG formulation to the response rate of the patients treated with the AP formulation. Skin response determined by at least a 50% reduction from baseline in the Composite Assessment of Index Lesion Severity (CAILS) following up to 12 months of treatment

PG- Mechlorethamine-MCH (Nitrogen Mustard) 0.02% Gel

76.0
percentage of participants

AP- Aquaphor Formulation Mechlorethamine-MCH (NM) 0.02%

62.0
percentage of participants

Severity-weighted Assessment Tool (SWAT) Within up to 12 Months by 2 or More Consecutive Observations Over at Least 4 Weeks

Outcome Measure Data Not Reported

Percent of Participants Achieving at Least 50% Improvement of Severity Weighted Assessment Tool (SWAT)

Assessment of lesion distribution and severity. A responder analysis was performed on whether subject achieved at least 50% improvement on scale. This had to be confirmed on at least one visit at least 4 weeks apart.

PG -Mechlorethamine-MCH (Nitrogen Mustard) 0.02% PG Gel

61.0
Percent of participants

AP- Mechlorethamine-MCH (NM) 0.02% Compounded in Aquaphor

60.0
Percent of participants

Total

260
Participants

Age Continuous

55.7
years (Mean)
Standard Deviation: 14.28

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

PG -Mechlorethamine (Nitrogen Mustard) 0.02% PG Gel

AP- Mechlorethamine 0.02% Compounded in Aquaphor

Drop/Withdrawal Reasons

PG -Mechlorethamine (Nitrogen Mustard) 0.02% PG Gel

AP- Mechlorethamine 0.02% Compounded in Aquaphor