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This phase I, open-label, single-arm, non-randomized clinical trial uses a "3+3" dose-escalation design to evaluate the safety, tolerability, and preliminary efficacy of intradermal delivery of complement factor H (CFH) fragment (human, 860-1231aa) via ice microneedles for the prevention of radiation-induced skin fibrosis in patients with head and neck squamous cell carcinoma (excluding nasopharyngeal carcinoma) receiving postoperative adjuvant radiotherapy. The main questions are: 1. The safety profile, including dose-limiting toxicities (DLTs) within 28 days after the first dose, adverse events, and tolerability. 2.Preliminary efficacy, assessed by changes in irradiated skin thickness, palpation of fibrotic area, CTCAE grade ≤2 fibrosis rate, and quality of life. Participants receive CFH ice microneedle patches twice weekly for a total of 8 doses (starting at 0.5 mg, escalating to 1.0 mg and 2.0 mg), applied to the skin area to be irradiated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Level 1: CFH Protein 0.5 mg via Ice Microneedles | Experimental | Participants receive intradermal delivery of CFH protein at a total dose of 0.5 mg per administration via ice microneedle patches, twice weekly for a total of 8 doses, starting on the first day of radiotherapy. |
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| Dose Level 2: CFH Protein 1.0 mg via Ice Microneedles | Experimental | Participants receive intradermal delivery of CFH protein at a total dose of 1.0 mg per administration via ice microneedle patches, twice weekly for a total of 8 doses, starting on the first day of radiotherapy. |
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| Dose Level 3: CFH Protein 2.0 mg via Ice Microneedles | Experimental | Participants receive intradermal delivery of CFH protein at a total dose of 2.0 mg per administration via ice microneedle patches, twice weekly for a total of 8 doses, starting on the first day of radiotherapy. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CFH Protein-loaded Ice Microneedles (0.5 mg) | Biological | Recombinant human CFH protein delivered intradermally via ice microneedle patches at a total dose of 0.5 mg per administration, twice weekly for a total of 8 doses, starting on the first day of radiotherapy. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Dose-Limiting Toxicities (DLTs) | Number of participants experiencing DLT within 28 days after the first dose of CFH protein delivered via ice microneedles. | First 28 days after the first study drug administration |
| Incidence and Severity of Adverse Events (AEs) | Number of participants with adverse events, graded according to NCI CTCAE v5.0. | Total study period up to approximately 6 months post-radiotherapy |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Irradiated Skin Thickness | Change in skin thickness of the irradiated area measured by ultrasound. | Baseline (pre-radiotherapy) to within 6 months after completion of radiotherapy |
| Change in Palpable Fibrotic Area (Surface Area and Volume) |
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Inclusion Criteria:
Male or female patients aged 18 to 75 years (inclusive) at screening.
Histologically confirmed head and neck squamous cell carcinoma (excluding nasopharyngeal carcinoma) scheduled to receive postoperative adjuvant radiotherapy.
Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2.
Adequate major organ function within 7 days before treatment, meeting the following criteria:
Hemoglobin ≥ 80 g/L; neutrophil count > 1.5 × 10⁹/L; platelet count ≥ 80 × 10⁹/L; Total bilirubin ≤ 1.5 × upper limit of normal (ULN); ALT or AST ≤ 2.5 × ULN (or ≤ 5 × ULN in the presence of liver metastases); Serum creatinine ≤ 1.5 × ULN or creatinine clearance (CrCl) ≥ 60 mL/min (Cockcroft-Gault formula); Prothrombin time (PT) and international normalized ratio (INR) ≤ 1.5 × ULN (unless on warfarin anticoagulation); Left ventricular ejection fraction (LVEF) ≥ 50%.
Ability to understand and voluntarily sign a written informed consent form prior to any study procedures.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Xingchen Peng, MD, PhD | Contact | +8618980606753 | pxx2014@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| West China Hospital, Sichuan University | Recruiting | Chengdu | Sichuan | 610000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29305301 | Background | Jozsi M, Schneider AE, Karpati E, Sandor N. Complement factor H family proteins in their non-canonical role as modulators of cellular functions. Semin Cell Dev Biol. 2019 Jan;85:122-131. doi: 10.1016/j.semcdb.2017.12.018. Epub 2018 Jan 5. | |
| 16260695 | Background | Delanian S, Porcher R, Rudant J, Lefaix JL. Kinetics of response to long-term treatment combining pentoxifylline and tocopherol in patients with superficial radiation-induced fibrosis. J Clin Oncol. 2005 Dec 1;23(34):8570-9. doi: 10.1200/JCO.2005.02.4729. Epub 2005 Oct 31. |
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| CFH Protein-loaded Ice Microneedles (1.0 mg) | Biological | Recombinant human CFH protein delivered intradermally via ice microneedle patches at a total dose of 1.0 mg per administration, twice weekly for a total of 8 doses, starting on the first day of radiotherapy. |
|
| CFH Protein-loaded Ice Microneedles (2.0 mg) | Biological | Recombinant human CFH protein delivered intradermally via ice microneedle patches at a total dose of 2.0 mg per administration, twice weekly for a total of 8 doses, starting on the first day of radiotherapy. |
|
Change in surface area (length × width) and volume (surface area × thickness) of palpable skin fibrosis in the irradiated area.
| Baseline (pre-radiotherapy) to within 6 months after completion of radiotherapy |
| Number of Participants with CTCAE Grade ≤2 Fibrosis | Number of participants who develop radiation-induced skin fibrosis of grade ≤2 according to NCI CTCAE v5.0. | Within 6 months after completion of radiotherapy |
| Change in Skindex Life Quality Index (SQLI) score-16 | Change in QoL scores assessed by SQLI-16 questionnaires. Minimum Value:0 Maximum Value:100 Higher Score Means:Worse outcome (higher score indicates greater impairment of quality of life) | Baseline (pre-radiotherapy) to within 6 months after completion of radiotherapy |
| Change in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) score | Change in QoL scores assessed by QLQ-C30 questionnaires. Minimum Value:0 Maximum Value:100 Higher Score Means:For Global Health Status / QoL scale:Better outcome | Baseline (pre-radiotherapy) to within 6 months after completion of radiotherapy |
| Change in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Cancer Module (EORTC QLQ-H&N35) score | Change in QoL scores assessed by QLQ-H&N35 questionnaires. Minimum Value:0 Maximum Value:100 Higher Score Means:Worse outcome (higher score indicates more severe symptoms/problems) | Baseline (pre-radiotherapy) to within 6 months after completion of radiotherapy |
| Change in Dermatology Life Quality Index (DLQI) score | Change in QoL scores assessed by DLQl questionnaires. Minimum Value:0 Maximum Value:30 Higher Score Means:Worse outcome (higher score indicates greater impairment of skin-related quality of life) | Baseline (pre-radiotherapy) to within 6 months after completion of radiotherapy |
| 15542159 | Background | Gothard L, Cornes P, Earl J, Hall E, MacLaren J, Mortimer P, Peacock J, Peckitt C, Woods M, Yarnold J. Double-blind placebo-controlled randomised trial of vitamin E and pentoxifylline in patients with chronic arm lymphoedema and fibrosis after surgery and radiotherapy for breast cancer. Radiother Oncol. 2004 Nov;73(2):133-9. doi: 10.1016/j.radonc.2004.09.013. |
| 38579363 | Background | Fijardo M, Kwan JYY, Bissey PA, Citrin DE, Yip KW, Liu FF. The clinical manifestations and molecular pathogenesis of radiation fibrosis. EBioMedicine. 2024 May;103:105089. doi: 10.1016/j.ebiom.2024.105089. Epub 2024 Apr 5. |
| 25910988 | Background | Straub JM, New J, Hamilton CD, Lominska C, Shnayder Y, Thomas SM. Radiation-induced fibrosis: mechanisms and implications for therapy. J Cancer Res Clin Oncol. 2015 Nov;141(11):1985-94. doi: 10.1007/s00432-015-1974-6. Epub 2015 Apr 25. |
| 28552214 | Background | Mayor S. WHO priority list of medical devices for cancer management. Lancet Oncol. 2017 Jul;18(7):856. doi: 10.1016/S1470-2045(17)30407-2. Epub 2017 May 25. No abstract available. |
| ID | Term |
|---|---|
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| 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 |
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