A Phase 2 interventional study of 5-Amino Levulinic Acid in Oral Cancer, Oral Cavity Cancer and Oral Leukoplakia, sponsored by University of Massachusetts, Boston. Not yet recruiting at 2 sites in India. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-03-19.
Sponsored by University of Massachusetts, Boston · Phase 2, Interventional, and Treatment
The primary goal of this study is to see if photodynamic therapy (PDT) is effective for treatment of lesions in the oral cavity which have high risk of becoming oral cancer. PDT treatment uses a drug, called a photosensitizer, which makes the diseased cells become light-sensitive such that they are destroyed when laser light is delivered to the target lesion. In this study a new handheld device, called SITOS (a "Screen, Image and Treat Optical System), is used. The ability of this device to simultaneously visualize the inside of the mouth and deliver laser light to the target site will be evaluated. The main questions this study seeks to answer are:
This study seeks to evaluate the efficacy of photodynamic therapy (PDT) using aminolevulinic acid (ALA) photosensitization for treatment of oral potentially malignant lesions (OPML) or early stage oral cancer. Eligible participants will have histopathologically confirmed high-grade dysplasia/HGD (severe/moderate dysplasia) or early stage cancer (carcinoma-in-situ, CIS) in the oral cavity. While PDT using ALA photosensitization has already been shown to be safe and effective for other indications it is not yet approved for use in treatment of oral lesions. Preliminary clinical studies have indicated that PDT is well tolerated and can achieve complete clearance of lesions with excellent healing of the oral mucosa. This study specifically seeks to evaluate the use of a new handheld optical device called the Screen, Image, and Treat Optical System (SITOS) which combines imaging and PDT light delivery. This device, which is similar in size and shape to a standard dental camera, contains integrated optics for imaging the characteristic fluorescence signal which results from ALA-induced protoporpohpryin IX photosensitization. This will be used for imaging-based guidance of light delivery for PDT, which uses a red diode laser that is also integrated into the device.
Potential study participants will be identified in screening sessions at the participating clinical sites or through referral. Those with potentially qualifying lesions and who consent to participate undergo will undergo pre-treatment investigation, including clinical information on the oral lesion, risk profile and baseline toxicity profile, and preliminary imaging.
For those who qualify for PDT treatment, photosensitization will use 5-ALA (20 mg/kg body weight 5-ALA-HCl, Gleolan) administered orally 2 to 4 hours before treatment. After administration of 5-ALA, exposure of eyes and skin to strong light sources (e.g., operating illumination, direct sunlight, or brightly focused indoor light) must be avoided for 24 hours. The lesion area to be treated will be anesthetized locally with 2% xylocaine with 1:100,000 adrenalin. If the patient or the investigator desires, he/she may undergo the procedure under general anesthesia or IV sedation. Following administration of 5-ALA, the participant will undergo image-guided SITOS-based PDT treatment. SITOS will be used in the imaging mode to establish background fluorescence before 5-ALA administration, and again after ALA photosensitization to provide visualization of the photosensitized lesion. For photoactivation, a total light dose of 100 J/cm\^2 will require \~30 minutes, depending on the final irradiance generated by SITOS. This may be given in 10-minute fractions with brief breaks for comfort. At light delivery time, SITOS will be used for real-time visualization of light applicator positioning to ensure centering of the beam spot and margins around the lesion. The SITOS probe also has a snap-on collar to control spacing and beam spot size which is fixed in place. A bitewing is clipped on for stable positioning with a hygienic sleeve over the whole probe. SITOS will monitor photobleaching (the decrease in fluorescence due to photosensitizer degradation during PDT) in real time, switching to image mode with brief interruptions in light delivery (approximately \~ 1 sec). Once per minute, measurement of bleaching relative to pre-irradiation will be performed. Participants will be kept in a room without direct sunlight exposure. The patients will be discharged after 48 hours of monitoring and toxicity profile evaluation.
The lesion response will be evaluated three weeks after PDT treatment. If complete response is not observed PDT may be repeated for a maximum of three sessions total. The clinical responses will be defined as complete, partial, and not responding as per the modified RECIST criteria. The final response will be determined in three weeks after the last PDT treatment (maximum of three sessions). If the patients show complete clinical response in less than three sessions of PDT, the PDT will be stopped, and the patients will be followed up every 3 months for one year. Punch biopsy will be performed to confirm histologic response a minimum of three months after the last PDT administration. Any lesions showing histologic evidence of dysplasia are considered a persistent disease and recommended to undergo surgical excision.
Subject Inclusion Criteria
The subjects meeting the following laboratory eligibility criteria during a time not older than 2 months before accrual
Exclusion criteria:
The participants will take 5-ALA in oral solution (20 mg/kg BW 5-ALA HCl) 2 to 4 hours prior to undergoing image guided SITOS based PDT treatment. PDT treatment will use a total light dose of 100 J/cm\^2 of 635 nm light (red light) delivered from a laser at an irradiance of approximately 50 mW/cm\^2 at the tissue surface. Participants will be admitted for 48 hours to monitor toxicity profile evaluation. The lesion response will be evaluated and the PDT treatment will be repeated, if required, once in every 3 weeks with a maximum of up to three sessions. The clinical responses will be evaluated during the clinical visits. If the patient shows complete clinical response in less than three sessions of PDT, the PDT will be stopped and the patients will be followed up every 3 months, for one year. If there is lack of complete response or relapse of the lesions during the follow up, the patients will be advised to undergo surgical excision.
Drug: 5-Amino Levulinic Acid
5-ALA (Gleolan) orally (20 mg/kg BW 5-ALA HCl) 2 to 4 hours prior to undergoing image-guided SITOS-based PDT treatment
Also known as: Gleolan
Efficacy of 5-ALA based PDT to treat HGD-OPML
The response will be clinically evaluated three weeks after PDT treatment. It will be defined as complete, partial, stable or progressive disease by modified RECIST criteria.
Time frame: 3 weeks after PDT treatment
Plan to share: Yes — Only de-identified clinical data which underlie published results will be available for sharing as per requirements of the journal in which study results are reported.
Supporting information: Study protocol, Icf, Csr
This study is not yet recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
University of Massachusetts, Boston