A Phase I/II Study of Sunitinib and Dacarbazine

This study has been terminated.
(toxicities required dose reduction compromising effectiveness and PI left Moffitt)
Sponsor:
Collaborator:
Pfizer
Information provided by:
H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov Identifier:
NCT00496223
First received: July 3, 2007
Last updated: February 21, 2011
Last verified: February 2011
  Purpose

This is a combination Phase I/II design that explores the toxicity and activity of Sunitinib and Dacarbazine (DTIC) for metastatic melanoma. The initial Phase I part of this trial will consist of a dose escalation of sunitinib while keeping the DTIC dose constant. If no DLT is seen, this dose will be the suggested Phase II trial dose. If less than 2 disease responses are seen, patients will not be enrolled any further, and the study will be considered negative for activity. If a clinical response is seen, patients will continue to be enrolled.


Condition Intervention Phase
Melanoma
Drug: Sunitinib
Drug: Dacarbazine
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I/II Study of Sunitinib and Dacarbazine in Patients With Metastatic Melanoma

Resource links provided by NLM:


Further study details as provided by H. Lee Moffitt Cancer Center and Research Institute:

Primary Outcome Measures:
  • To determine the toxicity and safety of this combination and determine the recommended Phase II dose of this combination. [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  • To determine the overall response rate of the combination of sunitinib and DTIC as the first line treatment in stage IV malignant melanoma. [ Time Frame: 4 months ] [ Designated as safety issue: Yes ]
  • To determine the progression free survival (PFS) of disease of patients treated with the combination of sunitinib and DTIC. [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To determine Overall Survival of patients treated with this combination. [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]

Enrollment: 11
Study Start Date: September 2006
Study Completion Date: June 2007
Primary Completion Date: June 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1 Drug: Sunitinib
Sunitinib will be given PO once daily on days 1-14 of each 21 day cycle. The exact dose of sunitinib will be determined during the Phase I part of the trial.
Drug: Dacarbazine
Dacarbazine will be given at 1000 mg/m2 on day 1 of every 21 day cycle.
Other Name: DTIC

Detailed Description:

This is a combination Phase I/II design that explores the toxicity and activity of a combination of sunitinib and Dacarbazine (DTIC) for metastatic melanoma. Screening tests (pre-study) will consist of a history, physical, CBC, CMP, EKG, pregnancy test for women of childbearing age, amylase (blood test for diagnoses of pancreatitis or other pancreatic diseases), staging CT, and PK. Also, on day 1, these tests will be repeated - a history, physical, toxicity assessment, CBC, and amylase test. Re-staging tests will be performed after 2 complete cycles and follow up as indicated clinically.

The initial Phase I part of this trial will consist of a dose escalation of sunitinib while keeping the DTIC dose constant. Sunitinib will be given 2 weeks on and 1 week off with DTIC given once every 21 days for one cycle. If no DLT is seen, the maximum tolerated sunitinib dose will be the suggested as the Phase II trial dose.

Tumor response will be measured after 2 complete cycles. Subsequently, during Phase II the trial will enroll more patients; if less than 2 responses are seen, patients will not be enrolled any further, and the study will be considered negative for activity. But, if a clinical response is seen, more patients will be enrolled at the Phase II dose.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically or cytologically documented Stage IV or unresectable Stage III melanoma
  • Resolution of all acute toxic effects of prior radiotherapy or surgical procedures to NCI CTCAE Version 3.0 grade less than or equal to 1
  • Adequate organ function as defined by the following criteria:

    1. Serum aspartate transaminase (AST; serum glutamic oxaloacetic transaminase [SGOT]) and serum alanine transaminase (ALT; serum glutamic pyruvic transaminase [SGPT]) less than or equal to 2.5 x local laboratory upper limit of normal (ULN), or AST and ALT less than or equal to 5 x ULN if liver function abnormalities are due to underlying malignancy
    2. Total serum bilirubin less than or equal to 1.5 x ULN
    3. Absolute neutrophil count (ANC) greater than or equal to 1500/mcL
    4. Platelets greater than or equal to 100,000/mcL
    5. Hemoglobin greater than or equal to 9.0 g/dL
    6. Serum calcium less than or equal to 12.0 mg/dL
    7. Serum creatinine less than or equal to 1.5 x ULN
  • Patients with CNS metastasis must have had either:

    1. Resected CNS metastasis without evidence of recurrence for >12 weeks
    2. Brain metastasis treated by stereotactic radiosurgery without evidence of recurrence or progression for 12 weeks
    3. Multiple brain lesions treated with WBRT with stable disease off corticosteroids for at least 12 weeks prior to start of therapy
    4. Without any evidence of leptomeningeal disease
    5. Patients must be neurologically intact
  • May have previous adjuvant therapy with interferon, vaccines or therapy with IL-2 or GM-CSF
  • Measurable disease by RECIST criteria
  • In the phase I part of the trial patients with evaluable but not measurable disease may be allowed with the permission of the PI
  • ECOG PS 0-2

Exclusion Criteria:

  • Major surgery or radiation therapy within 4 weeks of starting the study treatment.
  • NCI CTCAE grade 3 hemorrhage within 4 weeks of starting the study treatment.
  • History of or known carcinomatous meningitis, or evidence of symptomatic leptomeningeal disease on screening CT or MRI scan.
  • Any of the following within the 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
  • Ongoing cardiac dysrhythmias of NCI CTCAE grade greater than or equal to 2.
  • QTc >470 msec on baseline EKG.
  • History of active CHF or LVEF<50% at screening echocardiogram.
  • Hypertension that cannot be controlled by medications (>150/100 mm Hg despite optimal medical therapy).
  • Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication.
  • Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)-related illness or other active infection.
  • Concurrent treatment on another clinical trial. Supportive care trials or non-treatment trials, e.g. QOL, are allowed.
  • Ongoing treatment with therapeutic doses of Coumadin (low dose Coumadin up to 2 mg po daily for thromboembolism prophylaxis is allowed).
  • Pregnancy or breastfeeding. Female subjects must be surgically sterile or be postmenopausal, or must agree to use effective contraception during the period of therapy. All female subjects with reproductive potential must have a negative pregnancy test (serum or urine) prior to enrollment. Male subjects must be surgically sterile or must agree to use effective contraception during the period of therapy. The definition of effective contraception will be based on the judgment of the principal investigator or a designated associate.
  • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the subject inappropriate for entry into this study.
  • Patients may not have had previous treatment with a DTIC or temozolomide based chemotherapy regimen. In the Phase II part of the trial patients may not have had treatment with any chemotherapy regimen.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00496223

Locations
United States, Florida
H. Lee Moffitt Cancer Center & Research Institute
Tampa, Florida, United States, 33612
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Pfizer
Investigators
Principal Investigator: Adil Daud, M.D. UCSF (formerly at H. Lee Moffitt Cancer Center & Research Institute)
  More Information

Additional Information:
No publications provided

Responsible Party: Adil Daud, M.D., UCSF (formerly at H. Lee Moffitt Cancer Center & Research Institute)
ClinicalTrials.gov Identifier: NCT00496223     History of Changes
Other Study ID Numbers: MCC-14743
Study First Received: July 3, 2007
Last Updated: February 21, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
Sunitinib
Dacarbazine
Melanoma

Additional relevant MeSH terms:
Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas
Dacarbazine
Sunitinib
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Antineoplastic Agents
Therapeutic Uses
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors

ClinicalTrials.gov processed this record on July 22, 2014