Assessment of the Effectiveness of TA Versus LEEP for Cervical Cancer Risk Reduction in WLHIV in Mozambique
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: Thermal ablation, LOOP ELECTROSURGICAL EXCISION PROCEDURE.
- Who it may be relevant to
- Registry conditions: HIV Infections, HPV Infection, CIN 2/3. Basic parameters: 25 years — 49 years · Female.
- 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
- Mozambique
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
A Randomized Clinical Trial to Assess the Effectiveness of Thermal Ablation Versus Loop Electrosurgical Excision Procedure for Cervical Cancer Risk Reduction in Women Living With Human Immunodeficiency Virus in Mozambique
Overview
Given that WLWH are more likely to develop persistent HPV infection and CC, effective screening and the management and treatment of pre-cancerous cervical abnormalities is critical to decrease the global burden of cervical cancer. The vast majority of WLWH live in SSA, where resources are more constrained. Therefore, simple, affordable, and effective tools are needed for the prevention of cervical cancer in SSA. In this setting, the best method for treatment of screen-positive WLWH has not been determined. The proposed study will compare the effectiveness of TA vs. LEEP, for treating precursor lesions (CIN 2/3) and HPV infection in WLWH, identify the determinants of treatment failure, and develop a strategy to predict patients in whom treatment is likely to fail so that alternative treatments can be provided. Moreover, local evidence of the optimal method of treatments is necessary to inform health policy and promote adherence.
Detailed description
A. General purpose:
The goal of this study is to compare TA, an ablative cervical treatment modality, and LEEP, an excisional cervical treatment modality, in screen-positive WLWH patients, for eradication of hrHPV and effectiveness of treating biopsy-confirmed CIN 2/3.
B. Specific purposes
Primary Objectives:
1. Compare the effectiveness of treating biopsy-confirmed CIN 2/3 by TA versus LEEP 2. Compare the effectiveness of treating hrHPV infection by TA versus LEEP 3. Assess pain and side effects/adverse events due to TA versus LEEP
Secondary Objectives:
1. Identify the determinants of treatment failures 2. Develop a deep learning-based automated visual evaluation tool that predicts treatment failure
Interventions
- Device Thermal ablation
Thermal ablative uses heat (100°C to 120°C) to cause localized tissue damage at the cervical transformation zone and destroy the abnormal epithelium. - Procedure LOOP ELECTROSURGICAL EXCISION PROCEDURE
Cervical tissue excision
Primary outcome measures
- Comparison of treatment success rates for biopsy-confirmed CIN 2/3: Thermoablation (TA) vs. Loop Electrosurgical Excision Procedure (LEEP) [Time frame: 12 months]
Eligibility criteria
Inclusion criteria
- ages 25-49 years;
- confirmed HIV infection;
- physically and mentally willing and able to participate in the study, and provide informed consent.
Exclusion criteria
- currently pregnant or <6 weeks post-partum;
- had a hysterectomy and no longer have a cervix;
- a history of cervical cancer or treatment for cervical abnormalities; and
- any medical, psychiatric, or other condition that would interfere with protocol adherence, assessment of safety, and/or ability/competence to provide informed consent.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Mozambique · 1 center
- INSMozambique — Maputo
Publications
- Fallah PN, Salcedo MP, Nhacule E, Utui Y, Massinga MM, Osman NB, Tivir GG, Carrilho C, Monteiro E, Rangeiro R, Neves A, Changule D, Mariano A, Machaze A, Castiano CE, Baker E, Jeronimo J, Chiao EY, Munsell MF, Varon ML, Milan J, Thomas JP, Richards-Kortum R, Lorenzoni C, Omar Viegas EN, Castle PE, Schmeler KM. A randomized clinical trial to assess the effectiveness of thermal ablation versus loop PMID 40399211
Identifiers
NCT: NCT06326294 · 727/CNBS/23