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| Name | Class |
|---|---|
| The University of Texas Health Science Center at San Antonio | OTHER |
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The initial proposed clinical study will be conducted in adult head and neck cancer subjects. This will be an open-labeled, proof of concept trial to evaluate the efficacy, safety and tolerability of EISO in a form of oral rinse as adjunctive therapy to standard of care. Santalis believes that the proposed study is a prudent and appropriate approach to investigate the potential of their product to prevent or improve oral mucositis symptoms commonly seen in subjects undergoing radiotherapy with or without chemotherapy.
The objectives of this proof of concept trial are: to evaluate the efficacy, safety and tolerability of SAN005 when administered to adults for the prevention and treatment of radiation induced oral mucositis.
Subjects will be instructed on the administration of study medication thrice daily till oral mucositis resolves. Subjects will return to the clinic once a week while receiving radiation and then once every two weeks once their radiation has been completed and then until their mucositis has resolved for the Final Study Visit.
Preliminary Efficacy Evaluation will be the severity of pain rated by the Numeric Pain Rating Scale (NRPS) and mucositis grade by Radiation Therapy Oncology Group (RTOG) criteria at Visit 7 (Day 36). Additional secondary efficacy evaluations will include the severity of pain rated by the NRPS and mucositis grade by RTOG criteria at each study visit, frequency of the percutaneous endoscopic gastrostomy (PEG) tube for feeding during the duration of treatment and weight loss from baseline through Visit 5 and 7. The time of mucositis onset and duration will also be used in assessing efficacy. Additional secondary and exploratory endpoints will be outlined in the statistical analysis plan. The overall efficacy is determined by comparing the data to historical controls. Safety will be assessed by evaluating adverse events (AEs) with respect to severity, duration, and relationship to study drug. In addition, tolerability evaluations will be performed at each study visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 0.25% EISO Mouth Rinse | Experimental | A mouth rinse containing 0.25% East Indian sandalwood oil (EISO), a candidate botanical drug substance. The rinse will be used three times a day for up to ten weeks. The material will not be ingested but used to "swish, gargle and spit". |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 0.25% EISO mouth rinse | Drug | A mouth rinse to be used three times a day during the course of radiation and/or chemotherapy to prevent or minimize oral mucositis |
|
| Measure | Description | Time Frame |
|---|---|---|
| Patients Achieving Less Than or Equal to "2" RTOG Score At Visit 9 | The Radiation Therapy Oncology Group (RTOG) is the measure of anatomical changes associated with oral mucositis. Patients scores will be compared to historical data of patient progression. RTOG Scoring Criteria- Grade 0(none)- No change over baseline Grade 1(mild)- Irritation, may experience slight pain, not requiring analgesic Grade 2(moderate)- Patchy mucositis that may produce inflammatory serosanguinitis discharge; may experience moderate pain requiring analgesia Grade 3(severe) -Confluent, fibrinous mucositis, may include severe pain requiring narcotic Grade 4(life-threatening)-Ulceration, hemorrhage, or necrosis | Up to ten (10) weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Subject Self Reporting Burning or Irritation | Calculated by the number and percentage of subjects self reporting irritation of grade 1 (mild) or higher. | Up to ten (10) weeks |
| NRPS (Numerical Rating Pain Scale) |
| Measure | Description | Time Frame |
|---|---|---|
| Safety Will be Assessed Based on the Frequency and Severity of Adverse Events. | Adverse Events (AEs) will be assessed in accordance the Common Terminology Criteria for Adverse Events (CTCAE). The number of patients experiencing adverse events possibly, or probably related to the study product will be reported. Possibly related: A clinical event, including laboratory test abnormality (if applicable), with a reasonable time sequence to administration of the drug, but which could also be explained by concurrent disease or other drugs or chemicals. Probably related: A clinical event, including laboratory test abnormality (if applicable), with a reasonable time sequence to administration of the drug, unlikely to be attributed to concurrent disease or other drugs or chemicals, and which follows a clinically reasonable response on withdrawal. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Paul Castella, PhD | Santalis Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UTHSCSA Cancer Therapy and Research Center (CTRC) | San Antonio | Texas | 78229 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19028343 | Background | Rosenthal DI, Trotti A. Strategies for managing radiation-induced mucositis in head and neck cancer. Semin Radiat Oncol. 2009 Jan;19(1):29-34. doi: 10.1016/j.semradonc.2008.09.006. | |
| Background | Singh CU NJ, inventors. : Derivatives of sandalwood oil and santalols for treating cold sores and herpes. . US patent application publication US2008/0058413 A1. 06 2008 |
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| ID | Title | Description |
|---|---|---|
| FG000 | 0.25% EISO Mouth Rinse | A mouth rinse containing 0.25% East Indian sandalwood oil (EISO), a candidate botanical drug substance. The rinse will be used three times a day for up to ten weeks. The material will not be ingested but used to "swish, gargle and spit". 0.25% EISO mouth rinse: A mouth rinse to be used three times a day during the course of radiation and/or chemotherapy to prevent or minimize oral mucositis |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | 0.25% EISO Mouth Rinse | A mouth rinse containing 0.25% East Indian sandalwood oil (EISO), a candidate botanical drug substance. The rinse will be used three times a day for up to ten weeks. The material will not be ingested but used to "swish, gargle and spit". 0.25% EISO mouth rinse: A mouth rinse to be used three times a day during the course of radiation and/or chemotherapy to prevent or minimize oral mucositis |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Patients Achieving Less Than or Equal to "2" RTOG Score At Visit 9 | The Radiation Therapy Oncology Group (RTOG) is the measure of anatomical changes associated with oral mucositis. Patients scores will be compared to historical data of patient progression. RTOG Scoring Criteria- Grade 0(none)- No change over baseline Grade 1(mild)- Irritation, may experience slight pain, not requiring analgesic Grade 2(moderate)- Patchy mucositis that may produce inflammatory serosanguinitis discharge; may experience moderate pain requiring analgesia Grade 3(severe) -Confluent, fibrinous mucositis, may include severe pain requiring narcotic Grade 4(life-threatening)-Ulceration, hemorrhage, or necrosis | Not all subjects analyzed at visit 9 completed the trial. Therefore, the number of completed subjects (7) is less than the number of subjects analyzed for this endpoint. | Posted | Count of Participants | Participants | Up to ten (10) weeks |
|
Over the course of the treatment (up to 10 weeks), which was while the patients were undergoing radiotherapy and chemo.
Adverse events were solicited from subjects through clinic visits and captured on daily diaries
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 0.25% EISO Mouth Rinse | A mouth rinse containing 0.25% East Indian sandalwood oil (EISO), a candidate botanical drug substance. The rinse will be used three times a day for up to ten weeks. The material will not be ingested but used to "swish, gargle and spit". 0.25% EISO mouth rinse: A mouth rinse to be used three times a day during the course of radiation and/or chemotherapy to prevent or minimize oral mucositis |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Ying Li, M.D., Ph.D. | University of Texas Health Science Center at San Antonio | 210-450-1719 | liy8@uthscsa.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 27, 2015 | Apr 10, 2019 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Mar 15, 2017 | Apr 10, 2019 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D013280 | Stomatitis |
| D006258 | Head and Neck Neoplasms |
| ID | Term |
|---|---|
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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|
Severity of pain in the oral cavity/oropharynx was measured using the numerical rating pain scale (NRPS) at each study visit. The NRPS is an 11-point scale from 0-10:
0 = No pain 10 = The most intense pain imaginable.
| Up to ten (10) weeks |
| [ Time Frame: Up to ten (10) weeks ] |
| Participants |
|
| Age, Continuous | Mean | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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A mouth rinse containing 0.25% East Indian sandalwood oil (EISO), a candidate botanical drug substance. The rinse will be used three times a day for up to ten weeks. The material will not be ingested but used to "swish, gargle and spit". 0.25% EISO mouth rinse: A mouth rinse to be used three times a day during the course of radiation and/or chemotherapy to prevent or minimize oral mucositis |
|
|
| Secondary | Subject Self Reporting Burning or Irritation | Calculated by the number and percentage of subjects self reporting irritation of grade 1 (mild) or higher. | All subjects who reported tolerability at any point during the study were analyzed | Posted | Count of Participants | Participants | Up to ten (10) weeks |
|
|
|
| Secondary | NRPS (Numerical Rating Pain Scale) | Severity of pain in the oral cavity/oropharynx was measured using the numerical rating pain scale (NRPS) at each study visit. The NRPS is an 11-point scale from 0-10: 0 = No pain 10 = The most intense pain imaginable. | ITT (Intention-to-treat) | Posted | Mean | Standard Deviation | score on a scale | Up to ten (10) weeks |
|
|
|
| Other Pre-specified | Safety Will be Assessed Based on the Frequency and Severity of Adverse Events. | Adverse Events (AEs) will be assessed in accordance the Common Terminology Criteria for Adverse Events (CTCAE). The number of patients experiencing adverse events possibly, or probably related to the study product will be reported. Possibly related: A clinical event, including laboratory test abnormality (if applicable), with a reasonable time sequence to administration of the drug, but which could also be explained by concurrent disease or other drugs or chemicals. Probably related: A clinical event, including laboratory test abnormality (if applicable), with a reasonable time sequence to administration of the drug, unlikely to be attributed to concurrent disease or other drugs or chemicals, and which follows a clinically reasonable response on withdrawal. | Only 4 patients reported adverse events possibly or probably related to the study product. | Posted | Number | participants | [ Time Frame: Up to ten (10) weeks ] |
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| 0 |
| 13 |
| 0 |
| 13 |
| 10 |
| 13 |
| Vomiting Grade 1 | Gastrointestinal disorders | Non-systematic Assessment |
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| Dysgeusia | General disorders | Non-systematic Assessment |
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| Dry Mouth | General disorders | Non-systematic Assessment |
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| Fatigue | General disorders | Non-systematic Assessment |
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| Dermatitis Radiation | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Weight Loss | General disorders | Non-systematic Assessment |
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| Dysphagia | General disorders | Non-systematic Assessment |
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| Insomnia | General disorders | Non-systematic Assessment |
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| Mucositis | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Anemia | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Cough | General disorders | Non-systematic Assessment |
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| Creatinine Increased | Renal and urinary disorders | Non-systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | Non-systematic Assessment |
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| Ear Pain | Ear and labyrinth disorders | Non-systematic Assessment |
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| Hypoalbuminemia | General disorders | Non-systematic Assessment |
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| Hypocalcemia | Renal and urinary disorders | Non-systematic Assessment |
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| Hypomagnesemia | General disorders | Non-systematic Assessment |
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| Hyponatremia | General disorders | Non-systematic Assessment |
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| Lymphocyte count decreased | Immune system disorders | Non-systematic Assessment |
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| Mucosal Infection | Immune system disorders | Non-systematic Assessment |
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| Oral Pain | General disorders | Non-systematic Assessment |
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| Sore Throat | General disorders | Non-systematic Assessment |
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| White Blood Cell Decreased | Immune system disorders | Non-systematic Assessment |
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| Chills | General disorders | Non-systematic Assessment |
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| Constipation | General disorders | Non-systematic Assessment |
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| Dizziness | General disorders | Non-systematic Assessment |
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| Epistaxis | General disorders | Non-systematic Assessment |
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| Hyperpigmentation | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Hypokalemia | General disorders | Non-systematic Assessment |
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| Memory Impairment | Psychiatric disorders | Non-systematic Assessment |
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| Neutrophil Count Decreased | Immune system disorders | Non-systematic Assessment |
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| Otitis Externa | Eye disorders | Non-systematic Assessment |
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| Otitis Media | Eye disorders | Non-systematic Assessment |
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| Platelet Count Decreased | Immune system disorders | Non-systematic Assessment |
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| Tumor Pain | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment |
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| Severe |
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