Comparison Between Fotemustin to Intensive Surveillance in Patients With High Risk Uveal Melanoma

NCT ID: NCT02843386

Last Updated: 2022-08-31

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 302 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2009-06-23
• Study Completion Date: 2020-06-12

Brief Summary

After the local treatment of the primary tumor (protonbeam-therapy, enucleation, external radiotherapy) patients with high risk of metastasis are randomized between:

• Adjuvant chemotherapy with Fotemustin.
• Observation

Both groups are followed during 3 years for Metastasis- Free Survival, safety and tolerance of Fotemustin, quality of life, and Overall Survival.

Detailed Description

High risk uveal melanoma is defined by :

• Clinical criteria: Largest Tumor Diameter ≥ 15 mm with extra scleral extension and/or retinal detachment or Largest Tumor Diameter ≥ 18 mm AND/ OR
• Genomic high risk signature (aCGH +/-LOH): Monosomy 3 or partial deletion of 3p associated with any 8 gain.

Treatment schedule :

• Induction: Fotemustin 100 mg/m², D1-D8-D15, 1 hour IV infusion, 1 cycle
• Maintenance : restart on D50, Fotemustine : 100 mg/m², 1 hour IV infusion, D1 D21, 5 cycles.

Both groups are followed during 3 years for Metastasis- Free Survival, safety and tolerance of Fotemustin, quality of life, and Overall Survival.

Note :Based on the second interim analysis showing futility, and no chance to observe any significant statistical difference at the end of the study, the Independent Data Monitoring Committee recommended to stop randomization and amend the protocol to propose an interventional surveillance to high-risk patients as per protocol (April 2016).

Conditions

Uveal Melanoma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

A : Chemotherapy

Adjuvant chemotherapy by Fotemustin 100mg/m²

Group Type: EXPERIMENTAL

Adjuvant chemotherapy by Fotemustin

Intervention Type: DRUG

Fotemustin is given for 6 cycles :

• One Induction cycle: Fotemustin 100 mg/m², 1 hour IV infusion, D1D8D15, 5 week rest period, restart on D50.
• Five Maintenance cycles: Fotemustin 100 mg/m², 1 hour IV infusion, D1-D21.

B : Surveillance

Intensive surveillance

Group Type: OTHER

Intensive surveillance

Intervention Type: OTHER

Intensive surveillance

• Total duration: 3 years.
• liver functional tests/3 months, - liver MRI or CT-scan/6 months, - whole body CT-scan/12 months.

Interventions

Adjuvant chemotherapy by Fotemustin

Fotemustin is given for 6 cycles :

• One Induction cycle: Fotemustin 100 mg/m², 1 hour IV infusion, D1D8D15, 5 week rest period, restart on D50.
• Five Maintenance cycles: Fotemustin 100 mg/m², 1 hour IV infusion, D1-D21.

Intervention Type: DRUG

Intensive surveillance

Intensive surveillance

• Total duration: 3 years.
• liver functional tests/3 months, - liver MRI or CT-scan/6 months, - whole body CT-scan/12 months.

Intervention Type: OTHER

Other Intervention Names

Fotemustin; Surveillance

Eligibility Criteria

Inclusion Criteria

1. High risk uveal melanoma, defined by :

• Clinical criteria: Largest Tumor Diameter ≥ 15 mm with extrascleral extension and/or retinal detachment or Largest Tumor Diameter ≥ 18 mm AND/OR
• Genomic high risk signature (cCGH +/- LOH) : Monosomy 3 or partial deletion of 3p and any 8 gain, from enucleation, transscleral or transvitreal samples

2. Age ≥ 18 years and ECOG Performance Status ≤ 2

3. No prior chemotherapy or history of invasive cancer < 5years

4. No metastases

5. Local treatment for the primary tumour (surgery and/or radiotherapy) achieved ≤ 30 days from randomization, chemotherapy to begin within 15 days.

6 - Contraception in women of child-bearing potential

7- Written informed consent

8- Patients with French Social Security in compliance with the French law relating to biomedical research.

1. Largest Tumor Diameter < 15 mm or Largest Tumor Diameter 15-18 mm without extrascleral extension and/or retinal detachment, in the absence of genomic alteration as defined per protocol or in the absence of Fine Needle Aspiration biopsy for genomic risk assessment.

2. Contraindication to Fotemustine administration

3. Hematological function : Hb < 10g/dL, absolute neutrophil count < 2,000/mm3, and platelets < 100,000/mm3

4. Biochemistry results :Total bilirubin and AST/ALT > 1,5 UNL (Upper Normal Limit)

5. Creatinine > 1,5 UNL (Upper Normal Limit)

6. Pregnant and/or breastfeeding women.

8 - Previous history of cancer excepting in situ cervical carcinoma or cutaneous basal carcinoma.

7- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, viral or other hepatitis or cirrhosis, or psychiatric illness/social situation that would interfere with the protocol or limit compliance with study requirements.

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

Sponsors

Servier

INDUSTRY

Sponsor Role: collaborator

UNICANCER

OTHER

Sponsor Role: collaborator

Institut Curie

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Sophie PIPERNO-NEUMANN, MD

Role: PRINCIPAL_INVESTIGATOR

Institut Curie

Locations

Centre Jean Perrin

Clermont-Ferrand, , France

Centre Léon Bérard

Lyon, , France

CHU Nice

Nice, , France

Centre Antoine Lacassagne

Nice, , France

Institut Curie

Paris, , France

Centre Hospitalier Universitaire Vaudois

Lausanne, , Switzerland

Countries

France; Switzerland

Other Identifiers

IC 2008-03

Identifier Type: -

Identifier Source: org_study_id