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Oral MucositisPhase 1NCT06669390

A Mouthwash Medicine for the Reduction or Prevention of Mouth Ulceration Caused by Radiotherapy for Head and Neck Cancer

A Phase 1 study testing NG11-2 in people with Oral Mucositis, run by VasoDynamics Ltd at 4 sites in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is looking at a new medication called NG11-2 to see if it can reduce a side effect called severe Radiation-induced Oral Mucositis (RIOM) that can happen to people getting radiation treatment for head and neck cancer. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Oral Mucositis
What is being tested?
NG11-2
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
4 sitesUnited Kingdom
Study dates
22 May 2023to 20 Aug 2024
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female head and neck cancer patients scheduled for radiotherapy, aged 18 or over on day of signing informed consent;
  • Histologically confirmed head and neck cancer with or without previous resective surgery, having not been previously treated with radiation therapy
  • Scheduled to receive a mean radiation dose of no less than 30 Gy on either (a) Extended Oral Cavity, or (b) Buccal Mucosa, or (c) Lips, according to CT-based delineation of Organ-At-Risk (OAR) Guideline, with or without concurrent chemotherapy (Section 13.8 for guidance);
  • Rendered dentally fit for radiotherapy;
  • Have a Performance Status >60 on the Karnofsky scale
  • No evidence of active systemic infections at the time of screening;
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  • No oral fungal infection by visual examination or swab test;
  • Body Mass Index >=18.5 kg/m²
  • Normalcy of diet evaluated with the Performance Status Scale for Head and Neck cancer patients (PSSHN) >=30;
  • Ability to retain and swill liquid inside the oral cavity for at least 90 seconds;
  • Female patients of childbearing potential must have a negative urine or serum pregnancy test during the 2 week Screening period
  • Provide written informed consent for the trial.
  • Consent to utilize medically acceptable methods of contraception throughout the study period if of child-bearing potential;
  • Be able to comply with protocol procedures (such as Oral Mucositis assessment and swish/spit) and study schedule

Who cannot join

  • Tumour of the larynx
  • Mentally or legally incapacitated, in the opinion of the PI, which could interfere with the ability of the patient to understand or adhere to the requirements of the study;
  • Open or unhealed non-cancerous wounds or ulcers in the oral cavity;
  • WHO Oral Mucositis grade of 2 or more
  • Uncontrolled Hypertension, defined as blood pressure in adults >150/100mm Hg at screening;
  • A known clinically significant abnormal ECG, such as arrhythmia and active ischemia,within 6 months prior to treatment;
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  • Xerostomia or hyposalivation;
  • Known allergy or intolerance to sympathomimetic drugs (e.g., pseudoephedrine, epinephrine), alcohol, or any NG11-2 excipient;
  • Receiving monoamine oxidase (MAO) inhibitors or antidepressants (triptyline or imipramine types); Use of MAO inhibitor in the 14 days prior to treatment, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine;
  • History or current evidence of clinically significant laboratory abnormality or any disease condition that might confound the results of the study, or interfere with the patient's participation for the full duration of the study
  • Current participation in any other oral mucositis studies or completion/ withdrawal from any other oral mucositis studies within the last 3 months
  • Patient is, at the time of signing informed consent, a regular user of any illicit drugs, which would interfere with cooperation with the requirements of the trial;
  • Patient is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the study;
  • Any other condition which, in the opinion of the Investigator, means that the patient is not a good candidate for study enrolment

Trial locations and contacts

4 sites in 1 country.

United Kingdom4 sites
  • Aberdeen Royal Infirmary

    Aberdeen, AB25 2ZN

  • Belfast City Hospital

    Belfast, BT9 7AB

  • Queen Elizabeth Hospital

    Birmingham, B15 2TH

  • Guy's & St Thomas' Hospital

    London, SE1 9RT

Other trials in United Kingdom

About this study

Official title: A Phase-1b Dose Escalation Study to Assess the Effect of NG11-2 on Radiation Induced Oral Mucositis in Patients With Head & Neck Cancer

This study is looking at a new medication called NG11-2 to see if it can reduce a side effect called severe Radiation-induced Oral Mucositis (RIOM) that can happen to people getting radiation treatment for head and neck cancer. Severe RIOM can make patients very sick and make it hard for them to finish their cancer treatment. Right now, there are no approved drugs that can prevent or treat severe RIOM. This study will test different doses of NG11-2 to find the best one, and then more patients will take that dose to see if it works. This study is being done at multiple hospitals in the UK.

Read the detailed description

The main objective of the trial is to see if the use of NG11-2, when administered as a mouthwash in head and neck cancer patients prior to their radiotherapy, is tolerable and can reduce or prevent the development of severe radiation induced oral mucositis. More specifically, the trial aims to identify an appropriate dose of NG11-2 IMP based on safety and activity/preliminary efficacy for subsequent assessment in follow-up clinical trials.

Although the primary objective of the trial is to evaluate the safety \& tolerability of NG11-2 mouthwash, the secondary objective is to obtain preliminary data on the activity/efficacy of NG11-2 mouthwash in the reduction of severe RIOM.

This is a Phase-1b unblinded, dose escalation, multi-centre study of NG11-2 for the reduction of severe RIOM in Head and Neck cancer patients undergoing radiotherapy, with or without concurrent chemotherapy.

The study design is a "2+4" Dose Escalation design with the following escalation schema (a) If 0 out of 2 enrolled patients have a Dose Limiting Toxicity (DLT) , then escalate to the next Dose Level and enroll 2 more patients (b) if 1 out of 2 patients has a DLT, then add 4 more patients at the same Dose Level (c) if 2 out of 2, or 2 or more out of 6 patients experience a DLT, then stop the dose escalation.

The Maximum Tolerated Dose (MTD) is one dose level below the level at which 2/2 or 2+/6 patients experienced a DLT.

On completion of the Dose Escalation, the Safety Committee will review the available data and a small cohort of patients will be treated at the dose(s) selected by the Safety Committee..

Dosing will start at the 0.92mg/mL (5mM) Dose Level with patients being treated with NG11-2 prior to Radiotherapy on days 1-5 each week for up to 7 weeks.

The proposed patient population for this study includes male and female patients, aged 18 or older with histologically confirmed Head and Neck cancer (preferring oral cavity, oropharyngeal, nasopharyngeal cancer), undergoing primary radical chemoradiotherapy/radiotherapy or adjuvant chemoradiotherapy/radiotherapy with either (a) Extended Oral Cavity, or (b) Buccal Mucosa, or (c) Lips receiving a mean radiation dose of at least 30Gy.

Safety assessments will include evaluation of adverse events (AEs) using NCI CTCAE v5), clinical laboratory assessments (biochemistry, haematology), vital sign measurements (blood pressure, heart rate), 12-lead electrocardiogram (ECG) measurements, and physical examination.

An inspection of the Oral Mucosa will take place every day prior to NG11-2 treatment, except on those days where the Oral Mucositis Scoring Assessment has already occurred, to inspect the condition of the oral mucosa.

The severity of Oral Mucositis (OM) will be scored by trained site staff using WHO, RTOG and NCI-CTCAE v5 scales twice weekly (assessments 72hrs apart) from enrolment to the last study drug treatment, then at weeks 1, 2, 4 and 6 post RT. The WHO scale is the primary scoring scale and the RTOG \& NCI-CTCAE v5 scales are exploratory scoring scales.

Additionally, a Patient Reported Outcome Measure - Oral Mucositis (PROM-OM) questionnaire will be performed at each Oral Mucositis Scoring Assessment.

Conditions
Oral Mucositis
Being tested
NG11-2
Keywords
Oral Mucositis, RIOM, Severe Oral Mucositis
Medical subject headings
Stomatitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NG11-2Drug

    NG11-2 dose level will vary from 0.92 mg/mL to 5.5 mg/mL during the dose escalation process. The NG11-2 is given as an oral rinse.

    Throughout the radiotherapy regimen, no more than 60 minutes prior to the completion of radiotherapy, on each weekday the patient will rinse their mouth with 12.5 ml of NG11-2 for between 90 \& 120 seconds duration, gargling twice for approximately three seconds each if possible during this period then expectorate the solution.

Study groups in NCT06669390
Study groupRoleWhat they receive
NG11-2 TreatmentExperimentalPatients will undergo daily treatment with NG11-2 immediately prior to radiotherapy for 5 days/week (Mon-Fri) for up to 7 weeks.
Receives: Drug: NG11-2

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Occurence of Dose Limiting Toxicities (DLT)

    Measured: Dose Limiting Toxicities will be evaluated throughout the study from time of patient consent until 42 days after last IMP dose

  2. Occurence of Serious Adverse Events (SAE)

    Measured: Serious Adverse Events will be evaluated throughout the study from time of patient consent until 42 days after last IMP dose

Secondary outcomes (10)
  1. Duration of severe Radiation-Induced Oral Mucositis (World Health Organisation Grade 0-4, higher = worse)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  2. Duration of severe Radiation-Induced Oral Mucositis (Radiation Therapy Oncology Group Grade 0-4, higher = worse)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  3. Duration of severe Radiation-Induced Oral Mucositis (National Cancer Institute - Common Toxicity Criteria for Adverse Events V5 Grade 1-5, higher = worse)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  4. Incidence of severe Radiation-Induced Oral Mucositis (World Health Organisation Grade 0-4, higher = worse

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  5. Incidence of severe Radiation-Induced Oral Mucositis (Radiation Therapy Oncology Group Grade 0-4, higher = worse)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  6. Incidence of severe Radiation-Induced Oral Mucositis (National Cancer Institute - Common Toxicity Criteria for Adverse Events V5 Grade 1-5, higher = worse)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  7. Time to onset of severe Radiation-Induced Oral Mucositis (World Health Organisation Grade 0-4, higher = worse

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  8. Time to onset of severe Radiation-Induced Oral Mucositis (Radiation Therapy Oncology Group Grade 0-4, higher = worse)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  9. Time to Onset of severe Radiation-Induced Oral Mucositis (National Cancer Institute - Common Toxicity Criteria for Adverse Events V5 Grade 1-5, higher = worse)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

  10. Impact of Oral Mucositis on patient's oral pain and ability to eat and drink

    Patient Reported Outcome Measure - Oral Mucositis (PROM-OM)

    Measured: From screening and twice weekly in each week of study treatment and then at up to 42 days post end of Radiotherapy, in the follow-up period.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Nov 2024
  2. Study start22 May 2023
  3. Primary completion20 Aug 2024
  4. Study completion20 Aug 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Model description
This is an unblinded, single-arm study
Masking
None (open label)
Enrolment
15 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06669390
Sponsor's protocol ID
NG11-2-P1b
Other IDs
2022-002409-99, 87831050
Status last verified
Oct 2024
First submitted
25 Oct 2024
Last updated
1 Nov 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing NG11-2 in people with Oral Mucositis, run by VasoDynamics Ltd at 4 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Occurence of Dose Limiting Toxicities (DLT) (time frame: Dose Limiting Toxicities will be evaluated throughout the study from time of patient consent until 42 days after last IMP dose). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Nov 2024.

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