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Dasatinib in Treating Patient...

Dasatinib in Treating Patients With Locally Advanced or Metastatic Mucosal Melanoma, Acral Melanoma, or Vulvovaginal Melanoma That Cannot Be Removed By Surgery

Last Updated: 2023-07-03

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

81 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-07-02

Study Completion Date

2020-12-28

Brief Summary

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RATIONALE: Dasatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase II trial is studying how well dasatinib works in treating patients with locally advanced or metastatic mucosal melanoma or acral melanoma.

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Detailed Description

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OBJECTIVES:

Primary

* To estimate the objective tumor response rate in patients with KIT-positive, unresectable, locally advanced or metastatic acral or mucosal melanoma treated with dasatinib monotherapy.

Secondary

* To estimate the response duration in patients treated with this drug.
* To estimate the progression-free survival of patients treated with this drug.
* To evaluate the safety profile of this drug in these patients.
* To evaluate the PDGFR expression and activation of Src family kinases in tumor samples and correlate these parameters with response to treatment.

OUTLINE: This is a multicenter study.

Patients receive oral dasatinib twice daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Tissue samples may be collected from some patients for correlative studies.

After completion of study therapy, patients are followed up periodically for up to 5 years.

Conditions

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Melanoma (Skin)

Study Design

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Allocation Method

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dasatinib

Patients receive oral dasatinib at 70 mg twice daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

dasatinib

Intervention Type DRUG

Patients receive oral dasatinib at 70 mg twice daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Interventions

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dasatinib

Patients receive oral dasatinib at 70 mg twice daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Intervention Type DRUG

Other Intervention Names

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Sprycel BMS-354825

Eligibility Criteria

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Inclusion Criteria

* Histologically or cytologically confirmed melanoma of 1 of the following subtypes:

* Acral melanoma (defined as occurring on the palms, soles, or subungual sites)
* Melanoma arising from the vagina and/or vulva
* Melanoma arising on other mucosal surface (not vagina or vulva)
* Unresectable locally advanced or metastatic disease
* c-KIT mutation identified by polymerase chain reaction (PCR) and sequencing meeting 1 of the following criteria:

* At least 1 mutation in exon 9, 11, 13, 17, or 18
* At least 1 mutation in an exon not listed above and approved by central reviewer
* Metastatic tumor blocks are required for the evaluation of KIT mutations or amplifications
* Prior radiotherapy to a measurable lesion allowed provided there is radiographic evidence of progression of that lesion
* No other concurrent malignancies except basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, ductal or lobular carcinoma in situ of the breast, or other malignancies from which the patient has been continuously disease-free for ≥ 5 years
* ECOG performance status 0-1

* Meeting the eligibility criteria for pre-registration (Step 0)
* The melanoma must harbor a c-KIT mutation determined by PCR and sequencing as defined in the protocol either by local assessment or Massachusetts General Hospital (MGH)
* Measurable disease, defined as at least one measurable lesion by Response Evaluation Criteria in Solid Tumors (RECIST) criteria
* At least 4 weeks since prior chemotherapy, radiotherapy or immunotherapy and the beginning of protocol therapy and the patient must have recovered from toxicity due to the previous therapy
* History or clinical evidence of brain metastasis allowed provided the following criteria are met:

* Completed radiotherapy or surgical treatment of brain lesions and there is no evidence of central nervous system (CNS) progression for ≥ 8 weeks
* Must not require corticosteroids for treatment of cerebral edema from brain metastases
* Negative pregnancy test
* Fertile patients must use effective contraception
* Patients must have the following within 4 weeks of registration:

* computed tomography (CT) chest with intravenous (IV) and oral agent
* CT pelvis/abdomen with IV and oral agent
* MRI brain with gadolinium
* Baseline bone scan required for patients with known bone metastases, elevated alkaline phosphatase, or symptoms raising suspicion of bone metastases
* White blood count (WBC) ≥ 3,000/mm³
* Absolute granulocyte count (AGC) ≥ 1,500/mm³
* Platelet count ≥ 100,000/mm³
* Creatinine ≤ 2.0 times upper limit of normal (ULN) OR creatinine clearance (CrCl) ≥ 40 mL/min
* Total bilirubin ≤ 1.5 times ULN (\< 3.0 times ULN in the presence of Gilbert disease)
* Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times ULN (≤ 5.0 times ULN in the presence of liver metastases)
* Serum potassium and magnesium normal (repletion allowed)
* Total serum calcium or ionized calcium ≥ institutional lower limit of normal
* International normalized ratio (INR) ≤ 1.5 and partial thromboplastin time (PTT) wtihin normal limits

* Therapeutic anticoagulation with warfarin allowed provided INR ≤ 1.5 or PTT normal prior to initiating anticoagulation therapy

Exclusion Criteria

* Prior treatment with targeted therapies directed to c-KIT/PDGFR (e.g., imatinib or sunitinib)
* Ocular melanoma
* Evidence of bleeding diathesis
* Clinically significant psychiatric illness or social situations that would limit compliance with study requirements
* Clinically significant cardiovascular disease including the following:

* Myocardial infarction or ventricular tachyarrhythmia within 6 months
* Prolonged QTc \>480 msec (Fridericia correction)
* Ejection fraction less than institutional normal
* Major conduction abnormality (unless a cardiac pacemaker is present)
* Patients with any cardiopulmonary symptoms of unknown cause (e.g., shortness of breath, chest pain, etc.) are to be evaluated by a baseline echocardiogram with or without stress test as needed in addition to electrocardiogram (EKG) to rule out QTc prolongation
* Patients with underlying cardiopulmonary dysfunction are excluded from the study

* Pregnant or nursing
* Concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (i.e., phenytoin, carbamazepine, or phenobarbital), rifampin, or Hypericum perforatum (St. John wort)
* Uncontrolled hypertension, defined as systolic blood pressure ≥ 150 mm Hg or diastolic blood pressure ≥ 90 mm Hg

* Hypertension that is adequately controlled with medication allowed
* QTc prolongation, defined as a QTc interval ≥ 450 msecs
* Serious intercurrent illness including, but not limited to, ongoing or active infection requiring parenteral antibiotics

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Donald P. Lawrence, MD

Role: STUDY_CHAIR

Massachusetts General Hospital

Kevin Kalinsky, MD

Role: PRINCIPAL_INVESTIGATOR

Tufts Medical Center Cancer Center

Locations

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Arkansas Cancer Research Center at University of Arkansas for Medical Sciences

Little Rock, Arkansas, United States

Site Status

Stanford Cancer Center

Stanford, California, United States

Site Status

Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital

Fort Lauderdale, Florida, United States

Site Status

Baptist Cancer Institute - Jacksonville

Jacksonville, Florida, United States

Site Status

Ella Milbank Foshay Cancer Center at Jupiter Medical Center

Jupiter, Florida, United States

Site Status

CCOP - Mount Sinai Medical Center

Miami Beach, Florida, United States

Site Status

Florida Hospital Cancer Institute at Florida Hospital Orlando

Orlando, Florida, United States

Site Status