Menu
Recruiting NCT05334004

Lopinavir/Ritonavir in PLWH With High-Grade AIN

Phase I Interventional High-Grade Anal Intraepithelial Neoplasia

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Lopinavir / Ritonavir.
Who it may be relevant to
Registry conditions: High-Grade Anal Intraepithelial Neoplasia. Basic parameters: from 18 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
United States
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

A Phase I Study of Intra-anally Administered Lopinavir/Ritonavir in People Living With HIV (PLWH) With High-Grade Anal Intraepithelial Neoplasia (AIN 2/3)

Overview

This study is being done to assess the safety of lopinavir/ritonavir in patients with PLWH with AIN. 30 participants will be recruited and can expect to be on active study for approximately 3 months and long term follow up for 40 weeks.

Detailed description

This is a Phase I modified 3 + 3 design, in which the maximum tolerated dose (MTD) will be identified. The 3 + 3 dose escalation will consist of 6 dose levels (18 participants; planned escalation described in arms below) in combination with variation in dosing schedules of the drug lopinavir/ritonavir. This design also allows for some possible intermediate doses to be examined if dose-limiting toxicities (DLTs) occur and de-escalation is needed.

An expansion cohort of 12 participants will occur at the MTD. Once the MTD is determined, then secondary outcomes will be evaluated.

Primary Objective

* To evaluate the safety and tolerability of intra-anal administration of lopinavir/ritonavir, administered via suppository with 3 different schedules, in PLWH with high-grade anal intraepithelial neoplasia (HGAIN) (AIN 2/3).

Secondary Objectives

* To measure the effect of intra-anal topical lopinavir/ritonavir administration * To evaluate clearance of human papillomavirus (HPV) * To elucidate the mechanism of action of protease inhibitors

Interventions

  • Drug Lopinavir / Ritonavir
    Human Immunodeficiency Virus (HIV) antiviral, given via suppository

Primary outcome measures

  • Maximum Tolerated Dose (MTD) as determined by the number of participants at each dose level in the escalation cohorts who experienced a dose-limiting toxicity (DLT) [Time frame: up to 5 weeks]
  • Rate of Grade 3 or above Toxicities in any Organ System in the Escalation Cohorts [Time frame: up to 5 weeks]
Secondary outcome measures (7)
  • Number of Participants in the Expansion Cohort Who Experience Regression of AIN2/3 Determined by Pathology [Time frame: week 12, week 40]
  • Number of Participants in the Expansion Cohort Determined clear of HPV by PCR test [Time frame: week 12, week 40]
  • Number of Tissue Samples with evidence of apoptosis measured by presence of Activated Caspase 3 [Time frame: week 12, week 40]
  • Number of Tissue Samples with evidence of autophagy measured by presence of LC3β and p62 [Time frame: week 12, week 40]
  • Number of Tissue Samples with evidence of cellular proliferation measured by presence of Ki-67 [Time frame: week 12, week 40]
  • Number of Tissue Samples with evidence of HPV positivity measured by presence of p16 [Time frame: week 12, week 40]
  • Number of Tissue Samples with p53 expression [Time frame: week 12, week 40]

Eligibility criteria

Inclusion criteria

  • willing to provide informed consent
  • greater than or equal to 18 years of age
  • Diagnosis of biopsy-confirmed HGAIN
  • willing to comply with all study procedures

Exclusion criteria

  • Diagnosis of low-grade anal dysplasia (AIN, low-grade squamous intraepithelial lesion (LSIL)) by HRA.
  • CD4 count less than 200 cells/mm\^3 at the time of consideration for entry into the study
  • unable to provide informed consent
  • Pregnant or breastfeeding female
  • Currently receiving systemic chemotherapy or radiation therapy for another cancer.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Non-randomized
Model
Sequential
Masking
Open label
Primary purpose
Prevention

Study locations

United States · 1 center
  • UW Digestive Health Center Anoscopy Clinic — Madison

Identifiers

NCT: NCT05334004 · 2023-0052 · SMPH/SURGERY/COLON RECT · Protocol Version 2/24/2026 · 2022-0468 [former] · UW22123

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗