Study of the Anti-Angiogenesis Agent Axitinib in Patients With Stage III Malignant Melanoma

NCT ID: NCT01321437

Last Updated: 2021-01-20

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 11 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-12-31
• Study Completion Date: 2016-12-31

Brief Summary

The purpose of this research study is to determine the efficacy of Axitinib in treating individuals with Stage III melanoma.

Detailed Description

The American Cancer Society estimates that there will be about 68,720 new cases of melanoma (29,900 in men and 25,200 in women) annually in the United States, and about 8,650 people will die from this cancer. The systemic therapy of advanced disease remains palliative until new agents are found that might improve the survival of patients with stage III melanoma.

Melanomas are often vascular, and a decrease in the number of blood vessels that supply the tumor may starve it of needed nutrients. An approach to blocking the growth of blood vessels that supply the tumor is to inhibit the vascular endothelial growth factor receptor tyrosine kinase (VEGFR TK) signaling pathway. Axitinib (AG 013736) is a VEGFR TK inhibitor.

Because of the poor prognosis of patients with stage III melanoma and indications that anti-angiogenesis compounds might have clinically meaningful activity in this disease, a Phase 2 trial of the vascular endothelial growth factor receptor tyrosine kinase (VEGFR TK) inhibitor Axitinib (AG 013736) is warranted.

Conditions

Melanoma; Malignant Melanoma; Stage IIIA Melanoma; Stage IIIB Melanoma; Stage IIIC Melanoma

Study Design

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

Study Groups

Axitinib

Patients receive axitinib PO BID on days 1-28. Treatment repeats every 4 weeks for 2 courses in the absence of disease progression or unacceptable toxicity. Patients then undergo surgery within 14-21 days after completion of treatment. Beginning 28-56 days after surgery, patients receive axitinib PO BID on days 1-28. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity

Group Type: EXPERIMENTAL

therapeutic conventional surgery

Intervention Type: PROCEDURE

Undergo surgery

laboratory biomarker analysis

Intervention Type: OTHER

Correlative studies

Axitinib

Intervention Type: DRUG

Axitinib will be administered 5 mg orally twice each day (BID) continuously. Dose adjustments will be based on adverse events.

pharmacological study

Intervention Type: OTHER

Correlative studies

Interventions

therapeutic conventional surgery

Undergo surgery

Intervention Type: PROCEDURE

laboratory biomarker analysis

Correlative studies

Intervention Type: OTHER

Axitinib

Axitinib will be administered 5 mg orally twice each day (BID) continuously. Dose adjustments will be based on adverse events.

Intervention Type: DRUG

pharmacological study

Correlative studies

Intervention Type: OTHER

Other Intervention Names

AG-013736; Inlyta

Eligibility Criteria

Inclusion Criteria

• Histologically documented melanoma with local lymph node stage III metastases.
• No prior systemic therapy. Prior adjuvant therapy with interferon does not count.
• No expectation of further effects of prior anticancer therapy.
• At least 1 target lesion, as defined by RECIST, that has not been irradiated. New lesions that have developed in a previously irradiated field may be used as sites of measurable disease assuming all other criteria are met. All target lesions must have a unidimensional diameter of at least 1 cm for spiral CT scans if the reconstruction algorithm is 0.5 cm), or an standard uptake value (SUV) value ≥ 2.5. Baseline measurements/evaluations must be completed within 4 weeks prior to treatment.
• Adequate bone marrow, hepatic, and renal function documented within 14 days prior to treatment as documented by:

• absolute neutrophil count (ANC, calculated as the absolute number of neutrophils and bands) ≥1.5 x 10^9 cells/L
• platelets ≥100 x 10^9 cells /L
• aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 x upper limit of normal (ULN), unless there are liver metastases in which case AST and ALT ≤5.0 x ULN
• total bilirubin ≤1.5 x ULN
• serum creatinine ≤1.5 x ULN or calculated creatinine clearance ≥60 mL/min
• urinary protein <2+ by urine dipstick. If dipstick is ≥2+ then a 24-hour urine collection can be done and the patient may enter only if urinary protein is <2 g per 24 hours
• Age ≥18 years.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• No evidence of preexisting uncontrolled hypertension as documented by 2 baseline blood pressure readings taken at least 1 hour apart. The baseline systolic blood pressure readings must be ≤140, and the baseline diastolic blood pressure readings must be ≤90. Patients whose hypertension is controlled by antihypertensive therapies are eligible.
• Women of childbearing potential must have a negative serum or urine pregnancy test within 7 days prior to treatment.
• Written and voluntary informed consent

Exclusion Criteria

• Stage IV disease
• History of hemoptysis
• Gastrointestinal abnormalities including:

• inability to take oral medication
• requirement for intravenous alimentation
• prior surgical procedures affecting absorption including gastric resection
• treatment for active peptic ulcer disease in the past 6 months
• active gastrointestinal bleeding, unrelated to cancer, as evidenced by hematemesis, hematochezia or melena in the past 3 months without evidence of resolution documented by endoscopy or colonoscopy.
• malabsorption syndromes.
• Previous treatment with anti-angiogenesis agents including thalidomide, or inhibitors of epidermoid growth factor (EGF), platelet derived growth factor (PDGF), or fibroblast growth factors (FGF) receptors.
• Current use or anticipated inability to avoid use of drugs that are known potent cytochrome P450 3A4 (CYP3A4) inhibitors (ie, grapefruit juice, verapamil, ketoconazole, miconazole, itraconazole, erythromycin, clarithromycin, ergot derivatives, indinavir, saquinavir, ritonavir, nelfinavir, lopinavir, and delavirdine).
• Current use or anticipated inability to avoid use of drugs that are known CYP3A4 or Cytochrome P450 1A2 (CYP1A2) inducers (ie, carbamazepine, dexamethasone, felbamate, omeprazole, phenobarbital, phenytoin, primidone, rifabutin, rifampin, and St. John's wort).
• Active seizure disorder or evidence of brain metastases. (Appropriate imaging should be done to rule out brain metastases.)
• A serious uncontrolled medical disorder or active infection that would impair their ability to receive study treatment.
• History of a malignancy (other than melanoma) except those treated with curative intent for skin cancer (other than melanoma) or in situ breast or cervical cancer or those treated with curative intent for any other cancer with no evidence of disease for 5 years.
• 10. Major surgical procedure or any radiation therapy within 4 weeks of treatment, minimum rest period is 28 days post surgery; maximum rest period 56 days post surgery.
• Dementia or significantly altered mental status that would prohibit the understanding or rendering of informed consent and compliance with the requirements of this protocol.
• Patients (male and female) having procreative potential who are not using adequate contraception or practicing abstinence.
• Women who are pregnant or breast-feeding.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Pfizer

INDUSTRY

Sponsor Role: collaborator

University of California, Irvine

OTHER

Sponsor Role: lead

Responsible Party

John P. Fruehauf

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

John P. Fruehauf, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Chao Family Comprehensive Cancer Center

Locations

Chao Family Comprehensive Cancer Center

Orange, California, United States

Countries

United States

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

2011-8282

Identifier Type: OTHER

Identifier Source: secondary_id

WS830279

Identifier Type: OTHER

Identifier Source: secondary_id

NCI-2012-02173

Identifier Type: OTHER

Identifier Source: secondary_id

UCI 10-55 [HS# 2011-8282]

Identifier Type: -

Identifier Source: org_study_id