Effect of Intravitreal Ranibizumab on Radiation Retinopathy Following Plaque Brachytherapy for Choroidal Melanoma

NCT ID: NCT00750399

Last Updated: 2012-04-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1
• Total Enrollment: 10 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2008-10-31
• Study Completion Date: 2011-09-30

Brief Summary

This is a Phase I clinical trial to test the safety and tolerability of intravitreal ranibizumab in the treatment of radiation retinopathy following plaque brachytherapy for patients with choroidal melanoma using the incidence and severity of events criteria.

The secondary objective is to assess the efficacy of intravitreal ranibizumab on regression of radiation retinopathy by ophthalmic examination, fundus photography, fluorescein angiography, and optical coherence tomography, as well as visual acuity.

Detailed Description

Following plaque brachytherapy as treatment for choroidal melanoma, patients may develop radiation retinopathy. Radiation retinopathy is a progressive condition that leads to blindness in over 50% of cases within 5 years of treatment.

Vascular endothelial growth factor (VEGF) protein is believed to play a critical role in angiogenesis and radiation retinopathy. It is one of the key contributors to physiological or pathological conditions that can stimulate both the formation of new blood vessels and normal vessel incompetence. Ranibizumab is a recently approved vascular endothelial growth factor (VEGF) inhibitor shown to be effective in treating exudative macular degeneration. Ranibizumab binds to and inhibits vascular endothelial growth factor A (VEGF-A), which has been shown to cause neovascularization and leakage in models of ocular angiogenesis.

This is an open label, non-randomized active treatment, Phase I trial to assess the safety and tolerability of intravitreal ranibizumab and its ability to reduce radiation retinopathy and potentially limit vision loss associated with this disease.

Conditions

Radiation Retinopathy; Choroidal Melanoma

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Intravitreal ranibizumab

Patients will receive intravitreal ranibizumab on a monthly basis depending on response to treatment

Group Type: EXPERIMENTAL

Ranibizumab

Intervention Type: DRUG

intravitreal ranibizumab monthly for 4 months, and then every month thereafter until month 12.

ranibizumab

Intervention Type: DRUG

intravitreal ranibizumab 0.5 mg

Interventions

Ranibizumab

intravitreal ranibizumab monthly for 4 months, and then every month thereafter until month 12.

Intervention Type: DRUG

ranibizumab

intravitreal ranibizumab 0.5 mg

Intervention Type: DRUG

Other Intervention Names

Lucentis; Lucentis

Eligibility Criteria

Inclusion Criteria

• Diagnosis of radiation retinopathy
• History of choroidal melanoma status post plaque brachytherapy
• Age > 21 years
• Ability to perform written consent and comply with study assessments for the full duration of the study

Exclusion Criteria

• Pregnancy or lactation, pre-menopausal women not using contraception
• Participation in another simultaneous medical investigation or trial
• Patient with significantly compromised visual acuity in the study eye due to concomitant ocular conditions.
• Patients who have undergone intraocular surgery within last 60 days.
• Patients who have had intravitreal anti-VEGF treatment within 45 days.
• Patients who have had intravitreal triamcinolone acetonide within 4 months.
• Patients who have had laser within 60 days.
• Inability to obtain photographs to document CNV (including difficulty with venous access).
• Patient has a history of any medical condition which would preclude scheduled visits or completion of study.
• Aphakia or absence of the posterior capsule in the study eye. Previous violation of the posterior capsule in the study eye is also excluded unless as a result of yttrium aluminum garnet (YAG) posterior capsulotomy in association with posterior chamber lens implantation..
• History of glaucoma filtering surgery in the study eye.
• Concurrent use of more than two therapies for glaucoma.
• Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated

• Minimum Eligible Age: 21 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Genentech, Inc.

INDUSTRY

Sponsor Role: collaborator

The New York Eye Cancer Center

OTHER

Sponsor Role: lead

Responsible Party

Paul T. Finger, MD

Director

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Paul T Finger, MD

Role: PRINCIPAL_INVESTIGATOR

The New York Eye Cancer Center

Locations

The New York Eye Cancer Center

New York, New York, United States

Countries

United States

References

Finger PT. Radiation retinopathy is treatable with anti-vascular endothelial growth factor bevacizumab (Avastin). Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):974-7. doi: 10.1016/j.ijrobp.2007.11.045.

Reference Type: BACKGROUND

PMID: 18313522 (View on PubMed)

Finger PT, Chin K. Anti-vascular endothelial growth factor bevacizumab (avastin) for radiation retinopathy. Arch Ophthalmol. 2007 Jun;125(6):751-6. doi: 10.1001/archopht.125.6.751.

Reference Type: BACKGROUND

PMID: 17562985 (View on PubMed)

Finger PT, Chin KJ. Intravitreous ranibizumab (lucentis) for radiation maculopathy. Arch Ophthalmol. 2010 Feb;128(2):249-52. doi: 10.1001/archophthalmol.2009.376. No abstract available.

Reference Type: RESULT

PMID: 20142553 (View on PubMed)

Other Identifiers

FVF4519s

Identifier Type: -

Identifier Source: org_study_id