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Study on the Effects of Topical Sirolimus for Lingual Microcystic Lymphatic Malformations in Children and Adults

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What is this trial about?

A plain-language summary of the goals, design and what participants do

This clinical trial is focused on studying a rare condition known as lingual microcystic lymphatic malformations (LMLMs). These are unusual vascular malformations that appear as clusters of cysts filled with lymph fluid or blood. They can cause significant issues, even if the lesions are small, such as oozing, bleeding, infections, and difficulties with speech, chewing, or breathing. Pain and cosmetic concerns are also common. The treatment being tested in this study is a solution called sirolimus, which is applied topically, meaning it is put directly on the affected area.

The purpose of the study is to evaluate how effective and safe the 1 mg/mL sirolimus solution is when applied once daily to the front part of the tongue affected by LMLMs in both children and adults. Participants will be observed over a period of 24 weeks, with assessments at various intervals: 4, 8, 12, 16, 20, and 24 weeks. During the study, the effects of the sirolimus solution will be compared to usual care, which involves no treatment. The study aims to see if there is an improvement in the condition of the LMLMs and to monitor any side effects that may occur.

Throughout the study, participants will have their condition evaluated by experts using photographs and will also provide their own assessments of symptoms like oozing, bleeding, and discomfort. The study will also look at the overall quality of life and any changes in the size of the lesions. Safety is a key focus, with regular checks for any adverse effects and monitoring of sirolimus levels in the blood. This trial seeks to provide valuable information on whether topical sirolimus can be a beneficial treatment for those with LMLMs.

The research process

The trial runs in 6 steps – from screening to follow-up. Each step says what happens and what the team monitors.

  1. Step 1

    Joining the study

    Upon joining the study, eligibility is confirmed. Participants must be at least 5 years old and have a lingual microcystic lymphatic malformation, confirmed by clinical examination and MRI imaging.

    Participants must have social security coverage and provide written informed consent. Compliance with the French mandatory immunization program is required.

  2. Step 2

    Treatment initiation

    The treatment involves the application of a 1 mg/mL sirolimus solution once daily on the affected area of the tongue.

    The treatment is administered as an oral solution and is applied topically to the anterior part of the lingual microcystic lymphatic malformation.

  3. Step 3

    Treatment duration and assessment

    The treatment is evaluated over a period of 24 weeks, with assessments at weeks 4, 8, 12, 16, 20, and 24.

    The primary goal is to assess the change in the severity of the condition using a Physical Global Assessment (PGA) score, which ranges from 0 to 5.

  4. Step 4

    Patient self-assessment

    Participants will assess the severity of symptoms such as oozing, bleeding, and pain using a numeric scale from 0 to 10 at specified intervals.

    Participants will also evaluate their overall quality of life and the global evolution of their condition compared to the baseline.

  5. Step 5

    Safety monitoring

    Safety assessments include monitoring for local and general adverse events at each visit.

    Blood tests will be conducted to measure sirolimus levels and assess biological safety at weeks 8, 16, and 24.

  6. Step 6

    Final evaluation

    At the end of the 24-week period, a final evaluation of the treatment's efficacy and safety is conducted.

    The results are compared to the baseline to determine the overall impact of the treatment.

Who can join the trial?

6 criteria

  • Participants must be **5 years of age or older**.
  • Participants must have a **lingual microcystic lymphatic malformation**. This is a condition where there are small clusters of cysts on the tongue filled with lymph fluid or blood. It can cause problems like bleeding, infections, or difficulty with speech, chewing, or breathing.
  • Participants must be **covered by or have rights to social security**.
  • Participants must provide **written informed consent**. If the participant is under 18, their legal representative must also give consent. This means they agree to participate in the study after being informed about it.
  • Participants must be able to **comply with the requirements of the study**. This means they can follow the study's rules and procedures.
  • Participants must be **compliant with the French mandatory immunization program**. This means they have received the required vaccinations according to French health regulations.

Who cannot join the trial?

7 criteria

  • Patients who have any other serious health conditions that could interfere with the study.
  • Patients who are currently taking medications that might interact with the study treatment.
  • Patients who have allergies to the study medication or its ingredients.
  • Patients who are pregnant or breastfeeding.
  • Patients who have participated in another clinical trial recently.
  • Patients who have a history of not following medical advice or treatment plans.
  • Patients who have any condition that the study doctors believe would make it unsafe for them to participate.
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Investigated drugs

Sirolimus: This medication is used in the trial as a topical solution. It is applied once daily to the affected area on the tongue. The purpose of using sirolimus in this study is to see if it can effectively reduce the size or symptoms of microcystic lymphatic malformations on the tongue. The trial aims to assess both the effectiveness and safety of this treatment over a period of several weeks.

What is already known about the treatment

Sirolimus – This medication is administered topically as a 1mg/mL solution applied once daily. It is currently being studied in clinical trials for its effectiveness and safety in treating lingual microcystic lymphatic malformations, which are rare congenital vascular malformations. The main therapeutic indication is to reduce symptoms such as oozing, bleeding, and infections, as well as to improve speech, chewing, and breathing. Sirolimus works by inhibiting a specific protein that regulates cell growth and proliferation, thereby reducing the size and symptoms of the malformations. It is classified as an immunosuppressant and is being evaluated for its potential benefits in this specific condition.

Investigated diseases

Lingual Microcystic Lymphatic Malformations – These are rare congenital vascular malformations that appear as clusters of cysts filled with lymph fluid or blood. They can cause significant issues even when the lesions are small and well-defined, due to problems like oozing, bleeding, and infections. Additionally, they may lead to difficulties with speech, chewing, or breathing. Pain and aesthetic concerns are also commonly associated with these malformations. The condition can be burdensome, affecting daily activities and quality of life.
Trial detailsLast updated 2 Oct 2026
Age18+ yearsPhasePhase IITrial ID2024-515955-39-01Protocol codeTOPGUNEstimated enrolment12 patientsSponsorCentre Hospitalier Regional Universitaire De Tours

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