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Merkel Positron Emission Tomography (PET) Protocol (MP3)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01013779
Recruitment Status : Active, not recruiting
First Posted : November 16, 2009
Last Update Posted : March 13, 2020
Information provided by (Responsible Party):
Trans-Tasman Radiation Oncology Group (TROG)

Brief Summary:
A Phase II Study designed to evaluate the efficacy of Chemo-Radiotherapy in achieving loco-regional control in patients with Merkel Cell Carcinoma (MCC) of the skin. Patients will undergo PET scans to assist in staging and planning the patient's treatment as well as assessing response at the conclusion of treatment.

Condition or disease Intervention/treatment Phase
Merkel Cell Carcinoma Drug: Carboplatin Drug: Etoposide Radiation: Radiotherapy Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 43 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Efficacy Study of Chemo-Radiotherapy in PET Stage II and III Merkel Cell Carcinoma of the Skin
Study Start Date : December 2009
Estimated Primary Completion Date : December 2020
Estimated Study Completion Date : December 2020

Arm Intervention/treatment
Experimental: Arm A
Conventional radical radiotherapy in this trial means that those patients with microscopic disease receive a dose of 50Gy using daily incremental fractions of 2Gy over 25 fractions and those with macroscopic disease receive 54Gy in 27 fractions.
Drug: Carboplatin

During radiotherapy: Carboplatin (AUC2) commences on day 1 of radiation and is repeated at weekly intervals on days 8, 15, 22 and 29 (of radiation).

After radiotherapy: 3 weeks after completing radiotherapy, 3 cycles of 3 weekly carboplatin (AUC4.5) intravenously on day 1.

Drug: Etoposide
After Radiotherapy: 3 weeks after completing the radiation therapy, 3 cycles of 3 weekly etoposide (80mg/M2/day) intravenously days 1-3

Radiation: Radiotherapy

Microscopic Disease: 50Gy delivered in 2Gy doses over 25 fractions

Macroscopic Disease: 54Gy delivered in 2Gy doses over 27 fractions

Other Names:
  • RT
  • Radiation Therapy

Primary Outcome Measures :
  1. Time to loco-regional failure curve [ Time Frame: Minimum of 18 months follow up ]
  2. Incidence of grade 3 and 4 toxicity and incidence of febrile neutropenia [ Time Frame: Duration of Radiotherapy treatment ]

Secondary Outcome Measures :
  1. Overall survival and time to distant failure curves [ Time Frame: 3 year acturarial curves ]
  2. Proportion of patients for which PET can influence management. [ Time Frame: 12 weeks post Radiotherapy ]
  3. Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of PET. [ Time Frame: 12 weeks post Radiotherapy ]
  4. Post-treatment PET complete response rate for patients with unresected disease [ Time Frame: 12 weeks post Radiotherapy ]

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria for Trial Registration:

Patients may be registered on the trial only if they meet all of the following criteria:

  • Age 18 years or older
  • Written informed consent to participate in the study
  • Able to undergo 18-FDG PET scan (no uncontrolled diabetes mellitus or severe claustrophobia).
  • Available for follow-up.
  • Using adequate contraception if capable of child bearing
  • Any Merkel Cell carcinoma confined to the primary and/or nodal sites
  • ECOG 0-2.
  • Full Blood Count (FBC) should be satisfactory ( Haemoglobin > or equal to 10g/dl, neutrophils > or equal to 2.0 x 109 /l and platelets > or equal to 100 x 109 /l) and renal function (GFR > or equal to 50 ml/min) and hepatic function ( ALT < 5 X upper limit normal, bilirubin < 1.5 X upper limit normal)
  • Patients must be able to tolerate protocol treatment

Exclusion Criteria for Registration:

  • Previous chemotherapy in the past 5 years or prior radiotherapy to the area of concern
  • Unable to comply with treatment protocol eg dementia
  • Other malignancy in the past 5 years other than non-melanoma skin cancer.
  • Women who are pregnant or lactating.
  • Clinical evidence of metastatic disease.
  • Immunosuppression from long term steroid use or immunosuppressive drugs.
  • Any serious illness or medical condition that precludes the safe administration of the chemotherapy including:

    1. Active infection
    2. Uncontrolled or unstable cardiac disease including unstable angina, myocardial infarction within the last 3 months, and recurrent ventricular arrhythmias

Inclusion Criteria for Treatment Registration:

Patients may proceed to protocol treatment if they meet the following criteria:

  • High risk disease with no evidence of distant spread: Biopsy proven MCC with a primary that is > 2cm (T2N0M0= Stage II) and/or regional nodes (any T, N1M0= Stage III); OR Recurrent MCC not previously treated with radiation treatment; Dermal or in-transit metastasis with or without nodes; Occult primary with involved nodes
  • Patients who have no metastases on CT or PET scan OR If CT is suggestive of metastases, they must be PET negative

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01013779

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Australia, New South Wales
Campbelltown, New South Wales, Australia
Liverpool Hospital
Liverpool, New South Wales, Australia
Royal Prince Alfred
Sydney, New South Wales, Australia
Calvary Mater Newcastle
Waratah, New South Wales, Australia, 2298
Westmead Hospital
Westmead, New South Wales, Australia, 2145
Australia, Queensland
Radiation Oncology Services - Mater Centre
Brisbane, Queensland, Australia, 4101
Princess Alexandra Hospital Radiation Oncology
Brisbane, Queensland, Australia
Royal Brisbane Hospital
Herston, Queensland, Australia, 4029
Oncology Research Australia
Toowoomba, Queensland, Australia, 4350
Genesis Cancer Care (previously Premion)
Tugun, Queensland, Australia, 4224
Australia, Victoria
Geelong Hospital
Geelong, Victoria, Australia
Peter MacCallum Cancer Centre
Melbourne, Victoria, Australia, 3000
Australia, Western Australia
Sir Charles Gairdner
Nedlands, Western Australia, Australia, 6009
Sponsors and Collaborators
Trans-Tasman Radiation Oncology Group (TROG)
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Study Chair: Michael Poulsen Trans-Tasman Radiation Oncology Group (TROG)
Additional Information:
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Responsible Party: Trans-Tasman Radiation Oncology Group (TROG) Identifier: NCT01013779    
Other Study ID Numbers: TROG 09.03
ACTRN12610000480088 ( Registry Identifier: ANZCTR )
First Posted: November 16, 2009    Key Record Dates
Last Update Posted: March 13, 2020
Last Verified: March 2020
Keywords provided by Trans-Tasman Radiation Oncology Group (TROG):
Merkel Cell Cancer
PET scanning
Additional relevant MeSH terms:
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Carcinoma, Merkel Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Polyomavirus Infections
DNA Virus Infections
Virus Diseases
Tumor Virus Infections
Carcinoma, Neuroendocrine
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action