This research study is studying the effect of different drugs as possible treatments for squamous cell carcinoma (SCC).
The pilot study will determine the feasibility of using an in situ microdevice to measure local intratumoral response to several cancer treatments in patients with cutaneous lesions of squamous cell carcinoma. This research study is a Pilot Study, which is the first-time investigators are examining this study device in SCC. The treatment received will be the normal standard-of-care treatment for SCC However, the placement and removal of the microdevice is being tested for the first time in this type of cancer. This research study involves drugs that are released by a small implantable microdevice (IMD) as small as the tip of a needle, that is inserted into the tumor and is then removed 3-5 days later. The microdevice can hold up to 20 drugs in very small concentrations that are able to access the cancer through small pores in the device. When the device is removed along with the cancer 3-5 days later, it will be evaluated to understand which drug(s) may be effective to treat these cancers. The U.S. Food and Drug Administration (FDA) has not approved the microdevice a treatment for any disease. AACRF, a research foundation, is supporting this research study by providing funding for the research study, the study drugs and study procedures
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
25
Device: Microdevices The microdevice is an investigational miniaturized implantable nanodose drug delivery device. It was developed as a tool with the ultimate goal to help screen several existing and investigational drugs directly within a patient's tumor to identify what drugs are the most effective for treating a patient's cancer. The microdevice releases nanodoses of several approved drugs into the tumor, and is then excised minimally invasively several days later. Other: Standard of care therapy Participant to receive standard of care therapy as previously determined by participant's treating oncologist and/or dermatologist, which may include a skin-directed or systemic therapy
Feasibility of analysis
For the feasibility endpoint, a "successful" procedure will be defined as the ability to retrieve the device (by either skin punch biopsy tool or surgical excision) without damaging tumor tissue surrounding the microdevice, and with a rim of tissue of at least 500um thickness surrounding the microdevice, to allow for downstream immunohistochemistry analysis. At least 80% of the device reservoirs need to be surrounded by tissue in order to be considered successful. For purposes of this endpoint, feasibility will be assessed on a per-device basis rather than a per-patient basis, with each device considered relatively independent in terms of placement, retrieval, and analysis.
Time frame: through study completion, an average of 1 year
Cell death index measurement
To identify which microdosed targeted or chemotherapeutic cancer agents, delivered by an implantable microdevice in cutaneous lesions of squamous cell carcinoma in the expansion cohort, induce a cell death index value of at least 30% based on quantitative histopathologic assessment. To identify which microdosed targeted or chemotherapeutic cancer agents, delivered by an implantable microdevice in cutaneous lesions of squamous cell carcinoma in the expansion cohort, induce a cell death index value of at least 30% based on quantitative histopathologic assessment. To identify which microdosed targeted or chemotherapeutic cancer agents, delivered by an implantable microdevice in cutaneous lesions of squamous cell carcinoma in the expansion cohort, induce a cell death index value of at least 30% based on quantitative histopathologic assessment.
Time frame: through study completion, an average of 1 year
Safety
To evaluate the safety of microdevice placement and removal based on assessment of adverse events.
Time frame: through study completion, an average of 1 year
Correlation between tumor-drug response on microdevice and clinical response to systemic treatment
We will perform a preliminary assessment of the statistical correlation between the extent of tumor response to drug with the microdevice (measured using immunohistochemical analysis of drug-exposed tumor tissue for markers of apoptosis and cell proliferation) and the clinical responses to systemic therapy (via disease measurements including clinical and/or radiographic evidence of disease response).
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Time frame: through study completion, an average of 1 year
Additional biomarker identification
Immune infiltrates in the local tumor tissue exposed to microdevice delivered drugs.
Time frame: through study completion, an average of 1 year
Intralesional heterogeneity assessment
To assess intralesional heterogeneity in drug response by comparing the extent of tumor response to drug among different locations in a single tumor with multiple microdevices.
Time frame: through study completion, an average of 1 year