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Phase II Topical Immunomodulatory Therapy With Imiquimod for the Chemoprevention of Recurrent and High-Grade Cervical Intraepithelial Neoplasia (CIN)


Phase 2
18 Years
N/A
Not Enrolling
Female
Cervical Cancer, Precancerous Condition

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Trial Information

Phase II Topical Immunomodulatory Therapy With Imiquimod for the Chemoprevention of Recurrent and High-Grade Cervical Intraepithelial Neoplasia (CIN)


OBJECTIVES:

- Compare the chemopreventive efficacy of topical imiquimod followed by local ablative or
excisional therapy vs ablative/excisional therapy alone in patients with recurrent or
high-grade cervical intraepithelial neoplasia.

- Compare the toxicity of these regimens in these patients.

- Compare the quality of life of patients treated with these regimens.

- Determine the safety and tolerability of imiquimod in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
participating center, disease (primary vs recurrent or persistent), severity of dysplasia
(grade I vs grade II vs grade III), current tobacco use (yes vs no), planned surgical
procedure (excisional vs laser vs cryotherapy vs other), and time since first abnormal Pap
smear, including pathology of ascus favor dysplasia (less than 1 year vs 1-3 years vs more
than 3 years). Patients are randomized to one of two treatment arms.

- Arm I: Patients undergo ablative or excisional therapy.

- Arm II: Patients have topical imiquimod applied to the cervix for 6-10 hours twice
weekly for a total of 5 doses. Within 3-4 weeks after the final application, patients
undergo ablative or excisional therapy.

Quality of life is assessed at baseline, after last dose of study drug (arm II only), 3-5
days after ablation or excisional therapy, at 3 months, and then annually thereafter.

Patients are followed every 3-4 months until 2 consecutive normal Pap smears or colposcopic
exams, every 6 months for 2 years, and then annually until 5 years after completion of study
therapy.

PROJECTED ACCRUAL: A total of 66-152 (33-76 per treatment arm) will be accrued for this
study within 18 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed primary grade II or III cervical intraepithelial neoplasia
(CIN) or persistent grade I-III CIN (dysplasia that is not new and requires
treatment)

- Squamous cell lesions not involving endocervix by colposcopy OR colposcopy with
negative cytobrush or endocervical curettage

- No untreated cervical or vaginal infection other than human papilloma virus

- No desire for hysterectomy as ablative therapy

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Performance status:

- Not specified

Life expectancy:

- At least 5 years

Hematopoietic:

- Not specified

Hepatic:

- Not specified

Renal:

- Not specified

Other:

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for 3 months after study

- HIV negative

- No AIDS

- No known hypersensitivity to imiquimod

- No latex allergy

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- Not specified

Endocrine therapy:

- Not specified

Radiotherapy:

- Not specified

Surgery:

- See Disease Characteristics

Other:

- No concurrent immunosuppressive therapy

Type of Study:

Interventional

Study Design:

Primary Purpose: Prevention

Principal Investigator

Bobbie S. Gostout, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Mayo Clinic

Authority:

United States: Federal Government

Study ID:

CDR0000069223

NCT ID:

NCT00031759

Start Date:

June 1999

Completion Date:

Related Keywords:

  • Cervical Cancer
  • Precancerous Condition
  • cervical cancer
  • cervical intraepithelial neoplasia grade 1
  • cervical intraepithelial neoplasia grade 2
  • cervical intraepithelial neoplasia grade 3
  • Neoplasms
  • Uterine Cervical Neoplasms
  • Precancerous Conditions
  • Cervical Intraepithelial Neoplasia
  • Carcinoma in Situ

Name

Location

Mayo Clinic Cancer CenterRochester, Minnesota  55905
MBCCOP - HawaiiHonolulu, Hawaii  96813
CCOP - WichitaWichita, Kansas  67214-3882
CCOP - Carle Cancer CenterUrbana, Illinois  61801
CCOP - Michigan Cancer Research ConsortiumAnn Arbor, Michigan  48106
CCOP - Sioux Community Cancer ConsortiumSioux Falls, South Dakota  57105-1080
Mayo ClinicJacksonville, Florida  32224
CCOP - Mayo Clinic Scottsdale Oncology ProgramScottsdale, Arizona  85259