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Oral Epithelial Dysplasia (OED)p53 RCTNCT07090070

Evaluating Treatment Strategies for p53 Mutant Oral Cancer and Oral Cancer Precursors

A study testing Cohort 1 Intervention group, Cohort 2 severe/CIS margins clear and Cohort 2 p53 and severe/CIS margins clear in people with Oral Epithelial Dysplasia (OED) and Oral Squamous Cell Carcinoma (SCC), run by University of British Columbia at 1 site in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to optimize treatment strategies for patients with p53-mutant oral epithelial dysplasia (OED) and early-stage oral squamous cell carcinoma (OSCC). The main question it aims to answer is what the most optimal treatment is at each diagnostic stage. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Cohort 1 Intervention group, Cohort 2 severe/CIS margins clear and Cohort 2 p53 and severe/CIS margins clear
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
636 participants
Where
1 siteCanada
Study dates
8 Jul 2026to Sep 2032
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults age 18 or over
  • No history of head and neck radiation
  • p53-abnormal IHC patterns (surrogate marker for TP53 mutation)
  • Cohort 1:
  • Biopsy-confirmed mild/moderate dysplasia
  • Cohort 2:
Show all 10Show fewer
  • Biopsy-confirmed severe dysplasia or CIS
  • Cohort 3:
  • T1 SCC with depth of Invasion (DOI) <4mm
  • Clinically and radiologically node-negative (confirmed by contrast-enhanced CT)

Who cannot join

  • Immunocompromised status
  • Lesions greater than 3 cm
  • Presence of Proliferative Verrucous Leukoplakia
  • Cohort 1:
  • Had prior treatment for oral premalignant lesions
  • Cohort 2:
Show all 10Show fewer
  • Presence of invasive SCC on initial biopsy
  • Cohort 3:
  • Positive nodes on contrast-enhanced CT
  • DOI >= 4mm

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Canada1 site, 1 recruiting
  • Vancouver General Hospital

    Vancouver, British Columbia

    Eitan Prisman, 6048754126, eitan.prisman@ubc.ca

    Recruiting

Other trials in Canada

About this study

Official title: Evaluating Treatment Strategies for p53 Mutant Oral Epithelial Dysplasia and SCC Study

The goal of this clinical trial is to optimize treatment strategies for patients with p53-mutant oral epithelial dysplasia (OED) and early-stage oral squamous cell carcinoma (OSCC). The main question it aims to answer is what the most optimal treatment is at each diagnostic stage. It is hypothesized that lesions with p53-abnormal low-grade dysplasia (LGD) without surgical intervention will progress to high-grade dysplasia (HGD) or SCC in 4 years. It is also predicted that a clear p53 and severe/CIS excision margins in patients with p53-abnormal HGD will reduce the progression to invasive SCC, compared to clear severe/CIS margins, within 4 years. Finally, it is thought that patients with p53-abnormal cT1N0 and DOI<4mm receiving an END will have improved disease free and overall survival. This research will elucidate whether or not these hypotheses are correct.

Participants in each diagnostic cohort will be assigned to one of two different treatment options, listed below:

Read more

Cohort 1:

  1. No intervention, observation only B) Surgical excision with clear margins

Cohort 2:

  1. Surgical excision with clear severe/CIS margins B) Surgical excision with clear severe/CIS and p53 margins

Cohort 3:

  1. Surgical excision and elective neck dissection (END) B) Surgical excision and close follow-up, only salvage ND if development of nodal disease
Being tested
Cohort 1 Intervention group, Cohort 2 severe/CIS margins clear, Cohort 2 p53 and severe/CIS margins clear, Cohort 3 Excision and END, Cohort 3 Excision and Close follow up
Keywords
p53 mutant, SCC, oral epithelial dysplasia
Medical subject headings
Squamous Cell Carcinoma of Head and Neck

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cohort 1 Intervention groupProcedure or surgery

    Clear margin excision of the lesion under local anesthetic, with re-excision for p53-positive margins.

  • Cohort 2 severe/CIS margins clearProcedure or surgery

    Clear margin excision of the lesion under local anesthetic, with re-excision until severe/CIS margins are clear

  • Cohort 2 p53 and severe/CIS margins clearProcedure or surgery

    Excision of the lesion ensuring final negative p53 and severe/CIS margins

  • Cohort 3 Excision and ENDProcedure or surgery

    Excision of primary lesion and immediate elective neck dissection

  • Cohort 3 Excision and Close follow upProcedure or surgery

    Excision of primary lesion and close follow up with salvage neck dissection if development of nodal disease

Study groups in NCT07090070
Study groupRoleWhat they receive
Cohort 1: p53 mutant mild/moderate dysplasia observational groupNo interventionObservation only
Cohort 1: p53 mutant mild/moderate dysplasia excision groupExperimentalClear margin excision of the lesion under local anesthetic, with re-excision for p53-positive margins
Receives: Procedure: Cohort 1 Intervention group
Cohort 2: p53 mutant Severe/CIS dysplasia clear severe/CIS margin groupActive comparatorClear margin excision of the lesion under local anesthetic, with re-excision until severe/CIS margins are clear
Receives: Procedure: Cohort 2 severe/CIS margins clear
Cohort 2: p53 mutant Severe/CIS dysplasia negative p53 and severe/CIS margin groupExperimentalExcision of the lesion ensuring final negative p53 and severe/CIS margins
Receives: Procedure: Cohort 2 p53 and severe/CIS margins clear
Cohort 3: p53 mutant T1 SCC (DOI <4mm) excision and END groupActive comparatorExcision of primary lesion and immediate elective neck dissection (END)
Receives: Procedure: Cohort 3 Excision and END
Cohort 3: p53 mutant T1 SCC (DOI <4mm) excision and follow up groupExperimentalExcision of primary lesion and close follow up with salvage neck dissection if development of nodal disease
Receives: Procedure: Cohort 3 Excision and Close follow up

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression of Disease

    Study 1: Whether diagnosis progressed from low-grade dysplasia (mild/moderate OED) to high-grade (severe/CIS) dysplasia or OSCC.

    Study 2: Whether diagnosis progressed from high-grade (severe/CIS) dysplasia to OSCC.

    Measured: 4 years

  2. Time of Disease Progression

    Study 1: Time for disease to progress from low-grade dysplasia (mild/moderate OED) to high-grade (severe/CIS) dysplasia or OSCC.

    Study 2: Time for disease to progress from high-grade (severe/CIS) dysplasia to OSCC.

    Measured: 4 years

  3. Recurrence of Disease

    Study 1: Whether recurrence of low-grade dysplasia is present. Study 2: Whether recurrence of high-grade dysplasia is present. Study 3: Whether recurrence of OSCC is present, and if recurrence pattern is local recurrence or nodal metastasis.

    All: Time for disease to recur.

    Measured: Study 1 and 2: 4 years, Study 3: 3 years

  4. Disease-free Survival

    Study 3: If survival is achieved disease-free following treatment.

    Measured: 3 years

Secondary outcomes (2)
  1. Overall survival

    Overall survival is measured as survival for 4 years following diagnosis and treatment. Cause of death will be included, if applicable.

    Measured: Study 1 and 2: 4 years, Study 3: 3 years

  2. Patient Reported Outcomes - Quality of Life and Functional Measurements

    Patient quality of life:

    1. Oral Health Impact Profile-14 (OHIP) - 14 questions on a 5 point Likert scale (0-4), total ranging from 0-56, with higher scores indicating worse quality of life.
    2. Hospital Anxiety and Depression Scale (HADS) - 14 questions on a 4 point Likert scale (0-3), total ranging from 0-21, with higher scores indicating increased severity or probability of depression and anxiety.

    Functional measurement:

    1. MD Anderson Dysphagia Inventory (MDADI) - 20 questions on a 5 point Likert scale (1-5), score total ranging from 20-100, with lower scores indicating more severe limitations.

    Measured: Study 1 and 2: 4 years, Study 3: 3 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jul 2025
  2. Study start8 Jul 2026
  3. Primary completionJan 2032 (estimated)
  4. Study completionSep 2032 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
636 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07090070
Sponsor's protocol ID
H25-01056
Acronym
p53 RCT
Status last verified
Sep 2026
First submitted
22 Jul 2025
Last updated
8 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • D'Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R, Agarwal JP, Pantvaidya G, Chaukar D, Deshmukh A, Kane S, Arya S, Ghosh-Laskar S, Chaturvedi P, Pai P, Nair S, Nair D, Badwe R; Head and Neck Disease Management Group. Elective versus Therapeutic Neck Dissection in Node-Negative Oral Cancer. N Engl J Med. 2015 Aug 6;373(6):521-9. doi: 10.1056/NEJMoa1506007. Epub 2015 May 31.

    PubMed 26027881
  • Liu KY, Durham JS, Wu J, Anderson DW, Prisman E, Poh CF. Nodal Disease Burden for Early-Stage Oral Cancer. JAMA Otolaryngol Head Neck Surg. 2016 Nov 1;142(11):1111-1119. doi: 10.1001/jamaoto.2016.2241.

    PubMed 27560665
  • Durham JS, Brasher P, Anderson DW, Yoo J, Hart R, Dort JC, Seikaly H, Kerr P, Rosin MP, Poh CF. Effect of Fluorescence Visualization-Guided Surgery on Local Recurrence of Oral Squamous Cell Carcinoma: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2020 Dec 1;146(12):1149-1155. doi: 10.1001/jamaoto.2020.3147.

    PubMed 33034628
  • Hyodo T, Kuribayashi N, Fukumoto C, Komiyama Y, Shiraishi R, Kamimura R, Sawatani Y, Yaguchi E, Hasegawa T, Izumi S, Wakui T, Nakashiro KI, Uchida D, Kawamata H. The mutational spectrum in whole exon of p53 in oral squamous cell carcinoma and its clinical implications. Sci Rep. 2022 Dec 15;12(1):21695. doi: 10.1038/s41598-022-25744-8.

    PubMed 36522371
  • Lin TY, Liu KYP, Novack R, Mattu PS, Ng TL, Hoang LN, Prisman E, Poh CF, Ko YCK. Abnormal p53 Immunohistochemical Patterns Are Associated with Regional Lymph Node Metastasis in Oral Cavity Squamous Cell Carcinoma at Time of Surgery. Mod Pathol. 2024 Dec;37(12):100614. doi: 10.1016/j.modpat.2024.100614. Epub 2024 Sep 10.

    PubMed 39265952
  • Gleber-Netto FO, Neskey D, Costa AFM, Kataria P, Rao X, Wang J, Kowalski LP, Pickering CR, Dias-Neto E, Myers JN. Functionally impactful TP53 mutations are associated with increased risk of extranodal extension in clinically advanced oral squamous cell carcinoma. Cancer. 2020 Oct 15;126(20):4498-4510. doi: 10.1002/cncr.33101. Epub 2020 Aug 14.

    PubMed 32797678
  • Liu KYP, Zhu SY, Harrison A, Chen ZY, Guillaud M, Poh CF. Quantitative nuclear phenotype signatures predict nodal disease in oral squamous cell carcinoma. PLoS One. 2021 Nov 4;16(11):e0259529. doi: 10.1371/journal.pone.0259529. eCollection 2021.

    PubMed 34735529
  • Novack R, Zhang L, Hoang LN, Kadhim M, Ng TL, Poh CF, Kevin Ko YC. Abnormal p53 Immunohistochemical Patterns Shed Light on the Aggressiveness of Oral Epithelial Dysplasia. Mod Pathol. 2023 Jul;36(7):100153. doi: 10.1016/j.modpat.2023.100153. Epub 2023 Mar 9.

    PubMed 36906072
  • Ko YCK, Liu KYP, Chen E, Zhu SY, Poh CF. p53 Abnormal Oral Epithelial Dysplasias are Associated With High Risks of Progression and Local Recurrence-A Retrospective Study in a Longitudinal Cohort. Mod Pathol. 2024 Dec;37(12):100613. doi: 10.1016/j.modpat.2024.100613. Epub 2024 Sep 10.

    PubMed 39265950

Questions about this trial

What is this clinical trial studying?

A study testing Cohort 1 Intervention group, Cohort 2 severe/CIS margins clear and Cohort 2 p53 and severe/CIS margins clear in people with Oral Epithelial Dysplasia (OED) and Oral Squamous Cell Carcinoma (SCC), run by University of British Columbia at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 8 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Eitan Prisman (6048754126, prisman.eitan@vch.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression of Disease (time frame: 4 years). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07090070, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Sep 2026.

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