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The proposed study in patients with previously untreated locally advanced head and neck squamous cell carcinoma (HNSCC) is designed to evaluate the efficacy and safety of three different doses of MIT-001 compared to the placebo in prevention of oral mucositis (OM) in patients with HNSCC who are undergoing concurrent chemoradiotherapy (CCRT).
Oral mucositis associated with cancer therapy carries a significant morbidity. OM is a common complication in patients receiving CCRT used for treating HNSCC. Mucositis lesions can be painful, affect nutrition and quality of life (QoL), and have a significant economic impact. However, a definitive intervention regime has not been established. Therefore, it is essential to develop appropriate treatment.
MitoImmune Therapeutics Inc. (hereafter referred to as Sponsor) has developed MIT-001 which can scavenge abnormal levels of reactive oxygen species (ROS), enabling the cells to retain mitochondrial membrane permeability and mitochondrial function. This eventually inhibits additional ROS production, indicating that MIT-001 can prevent excessive inflammation caused by ROS. In addition, MIT-001 may possibly 1) block inflammatory cytokine production via inhibiting nuclear factor kappa B (NF kB) or inflammasome dependent pathways, 2) inhibit necrosis/necroptosis via blocking high mobility group box 1 (HMGB1) mediated cytokine production, and 3) balance regulation between T helper type 1/17 (Th1/17) and regulatory T cells.
Based on the pathophysiological progression of CCRT-associated OM, initiated by direct injury to basal epithelial cells which experience deoxyribonucleic acid (DNA) damage and increased ROS levels, Sponsor expects the prevention of OM in patients receiving CCRT of locally advanced HNSCC with MIT 001 by effectively scavenging increased ROS induced by CCRT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 20 mg | Experimental | MIT-001 20 mg |
|
| 40 mg | Experimental | MIT-001 40 mg |
|
| 60 mg | Experimental | MIT-001 60 mg |
|
| Placebo | Placebo Comparator | Matching placebo |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MIT-001 plus CCRT | Drug | MIT-001 IV-infusion plus CCRT |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of severe OM | severe OM (WHO criteria Grade 3 or higher) at a cumulative radiation dose of 60 Gy | From first treatment to 2 months of safety follow-up period after CCRT completion |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of OM | Incidence of OM of each Grade (WHO criteria) | From first treatment to 2 months of short-term safety follow-up period after CCRT completion |
| Time to onset of severe OM | Time to onset of severe OM, defined as Grade 3 or higher (WHO criteria) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jinsang Jung, M.Pharm | MitoImmune Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Banner MD Anderson Cancer Center | Gilbert | Arizona | 85234 | United States | ||
| Norris Comprehensive Cancer Center |
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The three active treatment groups will receive either 20, 40, and 60 mg/day of MIT-001 IV infusion for 30 minutes, two times per week for 5 to 7 continuous weeks until a cumulative radiation dose of between 60 and 72 Gy, with CCRT. Placebo group will receive placebo, manufactured with the same properties and appearance as MIT 001, at same treatment frequency as MIT-001 with CCRT.
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This study design will minimize bias and provide reference data (i.e., data from placebo treated subjects) which will aid in the interpretation of results. To limit the occurrence of conscious and unconscious bias in the conduct and interpretation of safety and efficacy results, the study is double blind where the subject, the Investigators/site staff, and the Sponsor staff remain unaware of the treatment assignment. The planned safety assessments that will be performed during the study are considered acceptable measures for ensuring the safety of subjects during a clinical study.
| From first treatment to 2 months of short-term safety follow-up period after CCRT completion |
| Mouth pain and discomfort | Patient-reported mucositis-related mouth pain and discomfort | From first treatment to 2 months of short-term safety follow-up period after CCRT completion |
| Analgesic use for OM | Frequency and Cumulative dose (in morphine mg equivalent) | From first treatment to 2 months of short-term safety follow-up period after CCRT completion |
| Los Angeles |
| California |
| 90033 |
| United States |
| Cancer Center of Kansas | Wichita | Kansas | 67208 | United States |
| James P. Wilmot Cancer Center | Rochester | New York | 14642 | United States |
| Wake Forest Baptist Health - Comprehensive Cancer Center | Winston-Salem | North Carolina | 27103 | United States |
| James Cancer Hospital Solove Research Institute | Columbus | Ohio | 43210 | United States |
| The Catholic University of Korea Saint Vincent's Hospital | Suwon | Gyeonggi-do | 16247 | South Korea |
| Jeonbuk National University Hospital | Jeonju | Jeollabuk-do | 54907 | South Korea |
| Keimyung University Dongsan Hospital | Daegu | South Korea |
| Chungnam National University Hospital | Daejeon | South Korea |
| National Cancer Center | Goyang-si | South Korea |
| Seoul National University Bundang Hospital | Gyeonggi-do | 13620 | South Korea |
| Inha University Hospital | Incheon | South Korea |
| Seoul National University Hospital | Seoul | 03082 | South Korea |
| Korea University Guro Hospital | Seoul | 08308 | South Korea |
| Hanyang University Seoul Hospital | Seoul | South Korea |
| ID | Term |
|---|---|
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| D013280 | Stomatitis |
| ID | Term |
|---|---|
| D002294 | Carcinoma, Squamous Cell |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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