This study evaluates the efficacy of Lymfactin® in patients with secondary lymphedema associated with the treatment of breast cancer by comparing the effects of active study treatment Lymfactin® to placebo. The study product will be administered in combination with a surgical lymph node transfer operation. In addition, the safety and tolerability of the Lymfactin® treatment will be evaluated.
This is a Phase II, double-blind, placebo-controlled, multi-centre clinical study, in which 40 patients with breast cancer associated secondary lymphedema will be randomized 1:1 either to Lymfactin® (1 x 10E11 viral particles, vp) or placebo (0.9% physiological saline) group. The study product (Lymfactin® or placebo solution) will be administered as a single dose in a volume of two (2) mL, by ex vivo perinodal injection into the fat pad of a flap of tissue containing lymph nodes from the patient's own abdominal wall or the groin area. This flap of tissue will then be surgically implanted into the axillary region of the affected arm. This treatment with the study product is performed in combination with a surgical lymph node transfer, in conjunction with or without breast reconstruction surgery. Patients will be followed-up for efficacy and safety according to a specified schedule up to 5 years post-treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
39
Lymfactin® will be administered as a single dose via perinodal injection in a volume of 2 mL.
Placebo will be administered as a single dose via perinodal injection in a volume of 2 mL.
Töölö Hospital, Department of Plastic Surgery
Helsinki, Finland
Tampere University Hospital, Department of Plastic Surgery
Tampere, Finland
Turku University Hospital, Department of Plastic Surgery
Turku, Finland
Karolinska University Hospital, Department of Reconstructive Plastic Surgery
Stockholm, Sweden
Measurement of the volume of the arms
Changes in the volume of the affected arm and comparison to the unaffected arm.
Time frame: 24 Months
Measurement of the lymphatic flow of the affected arm by quantitative lymphoscintigraphy (99Tc-nanocolloid clearance rate with calculation of transport index).
Assessment of the changes in the lymphatic flow.
Time frame: 24 Months
Questionnaire according to the Lymphedema Quality of Life Inventory (LQOLI)
Assessment of changes in the quality of life using Lymphedema Quality of Life Inventory (LQOLI) in which the patients assess how their lymphedema is affecting the activities of daily living. LQOLI consists of three dimensions: Physical, psychosocial and practical, which are reported separately as the mean score of that part. Each part of the LQOLI is scored from 0 to 3, where score 0 means "no impact", 1 means "a little bit impact", 2 means "somewhat impact" and score 3 means "significant impact" on the quality of life of the patient, the smaller score thus being the better.
Time frame: 24 Months
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Adverse Events as assessed by CTCAE v4.0 to evaluate the safety profile after administration of Lymfactin.
Time frame: 24 Months
CT scan of chest and abdomen
Changes in CT scans of chest and abdomen in order to detect malignancies.
Time frame: 60 Months
Lymfactin genome copy number in blood
Changes in Lymfactin genome copy number in blood.
Time frame: 30 Days
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Uppsala University Hospital, Department of Plastic Surgery
Uppsala, Sweden
Lymfactin genome copy number in wound secretion
Changes in Lymfactin genome copy number in wound secretion.
Time frame: 7 Days
Formation of anti-Lymfactin antibodies
Changes in anti-Lymfactin antibody titer in blood.
Time frame: 12 Months
Systemic concentration of vascular endothelial growth factor C (VEGF-C)
Changes in the VEGF-C concentration in blood.
Time frame: 30 Days