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RANDOMIZED PHASE II STUDY COMPARING TWO SCHEDULES OF TEMOZOLOMIDE IN COMBINATION WITH BAY43-9006 IN PATIENTS WITH ADVANCED MELANOMA


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Melanoma (Skin)

Thank you

Trial Information

RANDOMIZED PHASE II STUDY COMPARING TWO SCHEDULES OF TEMOZOLOMIDE IN COMBINATION WITH BAY43-9006 IN PATIENTS WITH ADVANCED MELANOMA


OBJECTIVES:

Primary

- To measure the progression-free survival of patients with metastatic or unresectable
melanoma with no brain metastasis or no prior treatment with temozolomide (TMZ) treated
with sorafenib tosylate in combination with two different schedules (extended daily
dosing vs standard dosing) of TMZ.

- To measure the progression-free survival of patients with or without brain metastasis
and prior treatment with TMZ treated with sorafenib in combination with extended daily
dosing of TMZ.

- To measure the progression-free survival of patients with brain metastasis and no prior
treatment with TMZ treated with sorafenib in combination with standard dosing TMZ.

- To estimate the median time to progression in all patients.

- To quantify the number and percent of patients who have stable disease after 6 months
of treatment (failure to progress).

- To choose the optimal combination dosing regimen for further study.

Secondary

- To estimate and define the objective response rate in these patients.

- To characterize the duration of objective responses in these patients.

- To estimate the incidence of new symptomatic brain metastasis in these patients.

- To measure overall survival of these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to prior brain
metastases (yes vs no) and prior treatment with temozolomide (TMZ) (yes vs no). Patients
with no prior brain metastases who did not receive prior treatment with TMZ are randomized
to 1 of 2 treatment arms. These patients are further stratified according to prior treatment
with sorafenib tosylate (yes vs no). Patients with or without prior brain metastases who
received prior treatment with TMZ are assigned to arm I. Patients with prior brain
metastases who did not receive prior treatment with TMZ are assigned to arm II.

- Arm I: Patients receive oral sorafenib tosylate twice daily on days -7 to 56 of course
1 and on days 1-56 of all subsequent courses. Patients also receive oral TMZ once daily
on days 1-42.

- Arm II: Patients receive sorafenib tosylate as in arm I and oral TMZ once daily on days
1-5 and 29-33.

In both arms, courses repeat every 8 weeks in the absence of disease progression or
unacceptable toxicity.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed melanoma

- Metastatic or unresectable disease

- Measurable disease by RECIST criteria

- Cutaneous lesions measuring at least 1 cm will be considered measurable disease

- Brain metastases allowed provided patient completed radiotherapy, if radiotherapy was
clinically indicated at the time of diagnosis, AND discontinued steroids prior to
study enrollment

PATIENT CHARACTERISTICS:

- ECOG performance status 0-1

- WBC ≥ 3,000/mm³

- Absolute granulocyte count ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Serum creatinine ≤ 2.0 times upper limit of normal (ULN)

- Total bilirubin ≤ 1.5 times ULN (< 3.0 times ULN if Gilbert's disease is present)

- AST or ALT ≤ 2.5 times ULN (≤ 5.0 times ULN if liver metastases are present)

- INR ≤ 1.5 (if on anticoagulation, baseline INR must be < 1.5 before starting
anticoagulation)

- PTT normal

- No other concurrent malignancies, except basal cell or squamous cell skin cancer,
carcinoma in situ of the cervix, or ductal or lobular carcinoma in situ of the breast

- No concurrent serious illness including, but not limited to, any of the following:

- Ongoing or active infection requiring parenteral antibiotics

- Clinically significant cardiovascular disease (e.g., uncontrolled hypertension,
myocardial infarction, unstable angina)

- New York Heart Association class II-IV congestive heart failure

- Serious cardiac arrhythmia requiring medication

- Peripheral vascular disease ≥ grade II within the past year

- Psychiatric illness/social situation that would limit compliance with study
requirements

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No HIV positivity

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- Recovered from all prior therapy

- Prior radiotherapy allowed

- If radiotherapy has been administered to a lesion, there must be radiographic
evidence of progression of that lesion for that lesion to constitute measurable
disease or to be included in the measured target lesions

- Prior temozolomide or sorafenib tosylate allowed

- At least 4 weeks since prior chemotherapy

- At least 4 weeks since prior active immunotherapy (aldesleukin, interferon,
sargramostim [GM-CSF], or CTLA-4)

- At least 4 weeks since prior and no other concurrent investigational anticancer
therapy (except vaccines)

- No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin,
carbamazepine, or phenobarbital), rifampin, or Hypericum perforatum (St. John's wort)

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression-free survival

Safety Issue:

No

Principal Investigator

Amy Kramer, RN, MPA

Investigator Affiliation:

Abramson Cancer Center of the University of Pennsylvania

Authority:

United States: Food and Drug Administration

Study ID:

CDR0000580808

NCT ID:

NCT00602576

Start Date:

January 2005

Completion Date:

Related Keywords:

  • Melanoma (Skin)
  • recurrent melanoma
  • stage III melanoma
  • stage IV melanoma
  • Melanoma

Name

Location

Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283