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Recruiting

NCT Number: NCT07215988

Studying Off Label Insurance Coverage for Patients With Cutaneous Cancers a "Filter" Observational Study

This study evaluates the time spent on obtaining insurance approval and drugs, means of insurance coverage, out-of-pocket costs for patients, and the surgical outcomes after neoadjuvant treatment is completed in skin cancer patients receiving "off label" and "on label" neoadjuvant treatment. "Neoadjuvant therapy" means cancer treatment given before surgery. However, in many instances, neoadjuvant therapy is used as an "off-label" approach for several types of skin cancers. "Off-label" means that the FDA has not yet approved its use for that type of cancer. Therefore, insurance approval of these "off-label" treatments could be delayed compared to label use, and "off-label" treatments may require several weeks of pre-authorization. There is evidence that the delayed start of cancer treatment can lead to poorer outcomes.

Recruiting

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210, United States

Location status: Recruiting

Location contact

Claire F. Verschraegen, MD

CONTACT

[email protected]

614-366-5068

Claire F. Verschraegen, MD

PRINCIPAL_INVESTIGATOR

About this study

PRIMARY OBJECTIVE:

I. To assess in real-life clinical practice, the timing, cost, and surgical outcomes of patients who have resectable various skin cancers that are locally advanced or have a high risk of recurrence.

OUTLINE: This is an observational study.

Patients complete a survey and have their medical records reviewed on study.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • * MERKEL CELL CARCINOMA
  • Signed informed consent
  • Pathology report confirming Merkel at the time of screening
  • Stage II, III or IV resectable (criteria based on Merkel Cell carcinoma TNM pathologic staging AJCC UICC 8th edition) or unresectable cancers amenable to surgery if a response is elicited with neoadjuvant therapy
  • ≥ 18 years of age
  • Genomics of the cancer attempted
  • Description of planned surgical resection by surgeon
  • Planned treatment with immunotherapy. Possible Beacon plan entitled OP NIVOLUMAB IPILIMUMAB NEUROENDOCRINE (PRL 8149)
  • 2 cycles will be given prior to surgery (=12 weeks).
  • MUCOSAL MELANOMA
  • Signed informed consent
  • Pathology report confirming mucosal melanoma at the time of screening
  • Stage III or IV resectable (TNM pathologic staging AJCC UICC 8th edition) or unresectable cancers amenable to surgery if a response is elicited with neoadjuvant therapy
  • ≥ 18 years of age
  • Genomics of the cancer attempted
  • Description of planned surgical resection by surgeon
  • SOC (standard of care) treatment planned with immunotherapy Possible Beacon plan entitled OP NIVOLUMAB IPILIMUMAB -> NIVOLUMAB Q4 WEEK MAINTENANCE MELANOMA 4 cycles will be given prior to surgery (=12 weeks)
  • BASAL CELL CARCINOMA
  • Signed informed consent
  • Pathology report confirming basal cell carcinoma with subtype at the time of screening
  • Resectable tumor of any stage, or unresectable tumor that could be amenable to surgery if there is a good response.
  • ≥ 18 years of age
  • Genomics of the cancer attempted
  • Description of planned surgical resection by surgeon
  • SOC treatment planned with possible Beacon plan entitled OP SONIDEGIB BASAL CELL CARCINOMA 3 months will be given prior to surgery (= 12 weeks) (Vismodegib may be substituted if current national shortage of sonidegib persists)
  • RARE CUTANEOUS CANCERS
  • Signed informed consent
  • Pathology report confirming squamous cell carcinoma at the time of screening
  • Stage II, III, or IV resectable or (TNM pathologic staging AJCC UICC 8th edition) or unresectable cancers amenable to surgery if a response is elicited with neoadjuvant therapy
  • ≥ 18 years of age
  • Genomics of the cancer attempted
  • Description of planned surgical resection by surgeon
  • Planned SOC treatment with possible Beacon plan entitled OP WEEKLY CARBOPLATIN PACLITAXEL + PEMBROLIZUMAB Q3 WEEKS HEAD AND NECK
  • 4 cycles will be given prior to surgery (= 12 weeks)

Exclusion criteria

  • * MERKEL CELL CARCINOMA
  • Metastatic disease not amenable to complete resection
  • Prior immunotherapy, chemotherapy, or radiation therapy for treatment of MCC within the past year
  • Any clinically significant medical condition, which in the judgment of the attending physician would contraindicate immunotherapy
  • Is pregnant or breast feeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of SOC treatment.
  • MUCOSAL MELANOMA
  • Metastatic disease not amenable to complete resection
  • Prior immunotherapy, chemotherapy, or radiation therapy for treatment of this mucosal melanoma within the past year
  • Any clinically significant medical condition, which in the judgment of the attending physician would contraindicate immunotherapy
  • Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of SOC treatment.
  • BASAL CELL CARCINOMA
  • Metastatic disease not amenable to complete resection
  • Prior immunotherapy, chemotherapy, or radiation therapy for treatment of this basal cell carcinoma within the past year
  • Any clinically significant medical condition, which in the judgment of the attending physician would contraindicate immunotherapy
  • Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of SOC treatment.
  • RARE CUTANEOUS CANCERS
  • Metastatic disease not amenable to complete resection
  • Prior immunotherapy, chemotherapy, or radiation therapy for treatment of this mucosal melanoma within the past year
  • Any clinically significant medical condition, which in the judgment of the attending physician would contraindicate immunotherapy
  • Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of SOC treatment.

Treatment and study plan

Non-Interventional Study

Other

Non-interventional study

Other names: Non-Interventional Observational Study, Noninterventional (Observational) Study

Primary outcomes

  1. Time spent obtaining approval and drugs

    Time frame: Up to study completion, up to 17 weeks

    Start and end times for obtaining approval for drugs will be based on date the initial request is submitted by the provider and the date the drugs are obtained. Confidence intervals will provide precision for estimating the mean time spent on obtaining approval and drugs and out-of-pocket expenses for patients.

  2. Means of coverage

    Time frame: Up to study completion, up to 17 weeks

    Descriptive statistics will summarize the conditions of off label coverage among patients, with mean, median, interquartile range, min, and max for continuous variables and frequencies / percentages for categorical variables.

  3. Out of pocket expenses for patients

    Time frame: Up to study completion, up to 17 weeks

    Descriptive statistics will summarize the conditions of off label coverage among patients, with mean, median, interquartile range, min, and max for continuous variables and frequencies / percentages for categorical variables.

  4. Extent of surgical resection

    Time frame: Up to study completion, up to 17 weeks

    Planned vs empirical extent of surgical resection will be calculated and compared within each cohort, with Clopper-Pearson exact binomial 95% confidence intervals for the percent of patients receiving lesser extent of surgery.

Study contacts

Contact information is provided by the study sponsor or research team.

The Ohio State University Comprehensive Cancer Center

CONTACT

[email protected]

800-293-5066

Sponsors and collaborators

Lead sponsor

Ohio State University Comprehensive Cancer Center

Other

Registry information

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Oct 14, 2025
Registry last updated
Jun 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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