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Imatinib Mesylate and Bevacizumab in Treating Patients With Advanced Melanoma or Other Advanced Cancers

Primary Purpose

Recurrent Melanoma, Stage III Melanoma, Stage IV Melanoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
imatinib mesylate
bevacizumab
pharmacological study
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Melanoma

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically or cytologically confirmed diagnosis of 1 of the following: Metastatic or unresectable malignancy for which standard curative or palliative measures do not exist or are no longer effective (phase I) (phase I study closed to accrual as of 8/23/04) Melanoma (phase I and II) Measurable disease (phase II) No history or clinical evidence of CNS disease, including primary brain tumor or brain metastases Performance status - ECOG 0-1 More than 3 months WBC at least 3,000/mm^3 Absolute granulocyte count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 No history of bleeding diathesis or coagulopathy Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST and ALT no greater than 2.5 times ULN INR no greater than 1.5 APTT normal Creatinine no greater than 2.0 times ULN Creatinine clearance at least 40 mL/min No proteinuria Urinary protein less than 500 mg/24 hours No history of stroke No uncontrolled hypertension within the past 6 months Blood pressure less than 150/100 mm Hg on a stable antihypertensive regimen None of the following within the past 6 months: Myocardial infarction Unstable angina New York Heart Association class II-IV congestive heart failure Serious cardiac arrhythmia requiring medication Grade II or greater peripheral vascular disease Transient ischemic attack Cerebrovascular accident Other arterial thromboembolic event Other clinically significant cardiovascular disease Not pregnant or nursing Negative pregnancy test Fertile patients must use effective barrier contraception during and for at least 3 months after study participation No seizures not controlled with standard medical therapy No prior allergic reactions attributed to Chinese hamster ovary cell products, other recombinant human antibodies, or compounds of similar chemical or biological composition to imatinib mesylate No serious, nonhealing wound, ulcer, or bone fracture No ongoing or active infection requiring parenteral antibiotics No significant traumatic injury within the past 28 days No psychiatric illness or social situation that would preclude study compliance No other concurrent uncontrolled illness More than 4 weeks since prior immunotherapy More than 8 weeks since prior monoclonal antibody therapy No concurrent prophylactic granulocyte or platelet colony-stimulating factors More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) No more than 1 prior cytotoxic chemotherapy regimen for advanced disease (phase II) More than 4 weeks since prior radiotherapy More than 28 days since prior major surgical procedure or open biopsy Recovered from prior therapy No concurrent chronic daily aspirin (greater than 325 mg/day) or nonsteroidal anti-inflammatory drugs known to inhibit platelet function No recent or concurrent full-dose anticoagulants (except as required to maintain patency of preexisting permanent indwelling IV catheters) or thrombolytic agent No concurrent grapefruit juice No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, or phenobarbital) No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational or commercial agents or therapies directed at the malignancy No other concurrent investigational agents

Sites / Locations

  • Abramson Cancer Center of The University of Pennsylvania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm I

Arm Description

Patients receive oral imatinib mesylate once or twice daily on days 1-28 and bevacizumab IV over 30-90 minutes on days 1 and 14. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

MTD, Defined as One Dose Level Below the Dose That Induced DLT in at Least One Third of Patients at a Dose Level, Graded According to NCI CTCAE Version 3.0 (Phase I)
Progression-free Survival at 16 Weeks (Phase II)
Progression Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.

Secondary Outcome Measures

Response Rate at 8 Weeks, Evaluated Using RECIST (Phase II)
Response and progression was evaluated in this study using Response Evaluation Criteria in Solid Tumors (RECIST). Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.
Overall Survival (Phase II)
Kaplan-Meier estimates of overall survival and 95% confidence intervals will be calculated.

Full Information

First Posted
December 10, 2003
Last Updated
May 23, 2018
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00074308
Brief Title
Imatinib Mesylate and Bevacizumab in Treating Patients With Advanced Melanoma or Other Advanced Cancers
Official Title
A Phase I/II Study Of Imatinib Mesylate And Bevacizumab In Patients With Advanced Melanoma And Other Advanced Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
October 2003 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
July 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Phase II trial to study the effectiveness of combining imatinib mesylate with bevacizumab in treating patients who have advanced melanoma or other metastatic or unresectable cancer. Imatinib mesylate may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Bevacizumab may stop the growth of tumor cells by stopping blood flow to the tumor. Combining imatinib mesylate with bevacizumab may kill more tumor cells
Detailed Description
OBJECTIVES: I. Determine the tolerability, maximum tolerated dose, and lowest biologically active dose of imatinib mesylate and bevacizumab in patients with advanced melanoma or other advanced cancers. II. Determine the response rate, time to progression, and survival of patients treated with this regimen. III. Correlate clinical activity with inhibition of platelet-derived growth factor receptor beta, vascular endothelial growth factor receptor, flt-1, and markers of angiogenesis in patients treated with this regimen. IV. Correlate clinical activity with alterations in tumor perfusion as assessed by dynamic contrast-enhanced MRI and Doppler ultrasound in patients treated with this regimen. V. Correlate toxicity, clinical activity, and correlative endpoints with the steady-stage plasma concentration of imatinib mesylate in patients treated with this regimen. OUTLINE: This is a dose-escalation, open-label study. PHASE I (closed to accrual as of 8/23/04): Patients receive oral imatinib mesylate once or twice daily on days 1-28 and bevacizumab IV over 30-90 minutes on days 1 and 14. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of imatinib mesylate and bevacizumab until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. PHASE II: Patients receive imatinib mesylate and bevacizumab as in phase I at the MTD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Melanoma, Stage III Melanoma, Stage IV Melanoma, Unspecified Adult Solid Tumor, Protocol Specific

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive oral imatinib mesylate once or twice daily on days 1-28 and bevacizumab IV over 30-90 minutes on days 1 and 14. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
imatinib mesylate
Other Intervention Name(s)
CGP 57148, Gleevec, Glivec
Intervention Description
Given orally
Intervention Type
Biological
Intervention Name(s)
bevacizumab
Other Intervention Name(s)
anti-VEGF humanized monoclonal antibody, anti-VEGF monoclonal antibody, Avastin, rhuMAb VEGF
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
MTD, Defined as One Dose Level Below the Dose That Induced DLT in at Least One Third of Patients at a Dose Level, Graded According to NCI CTCAE Version 3.0 (Phase I)
Time Frame
Up to 28 days
Title
Progression-free Survival at 16 Weeks (Phase II)
Description
Progression Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
Response Rate at 8 Weeks, Evaluated Using RECIST (Phase II)
Description
Response and progression was evaluated in this study using Response Evaluation Criteria in Solid Tumors (RECIST). Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.
Time Frame
8 weeks
Title
Overall Survival (Phase II)
Description
Kaplan-Meier estimates of overall survival and 95% confidence intervals will be calculated.
Time Frame
Up to 6 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed diagnosis of 1 of the following: Metastatic or unresectable malignancy for which standard curative or palliative measures do not exist or are no longer effective (phase I) (phase I study closed to accrual as of 8/23/04) Melanoma (phase I and II) Measurable disease (phase II) No history or clinical evidence of CNS disease, including primary brain tumor or brain metastases Performance status - ECOG 0-1 More than 3 months WBC at least 3,000/mm^3 Absolute granulocyte count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 No history of bleeding diathesis or coagulopathy Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST and ALT no greater than 2.5 times ULN INR no greater than 1.5 APTT normal Creatinine no greater than 2.0 times ULN Creatinine clearance at least 40 mL/min No proteinuria Urinary protein less than 500 mg/24 hours No history of stroke No uncontrolled hypertension within the past 6 months Blood pressure less than 150/100 mm Hg on a stable antihypertensive regimen None of the following within the past 6 months: Myocardial infarction Unstable angina New York Heart Association class II-IV congestive heart failure Serious cardiac arrhythmia requiring medication Grade II or greater peripheral vascular disease Transient ischemic attack Cerebrovascular accident Other arterial thromboembolic event Other clinically significant cardiovascular disease Not pregnant or nursing Negative pregnancy test Fertile patients must use effective barrier contraception during and for at least 3 months after study participation No seizures not controlled with standard medical therapy No prior allergic reactions attributed to Chinese hamster ovary cell products, other recombinant human antibodies, or compounds of similar chemical or biological composition to imatinib mesylate No serious, nonhealing wound, ulcer, or bone fracture No ongoing or active infection requiring parenteral antibiotics No significant traumatic injury within the past 28 days No psychiatric illness or social situation that would preclude study compliance No other concurrent uncontrolled illness More than 4 weeks since prior immunotherapy More than 8 weeks since prior monoclonal antibody therapy No concurrent prophylactic granulocyte or platelet colony-stimulating factors More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) No more than 1 prior cytotoxic chemotherapy regimen for advanced disease (phase II) More than 4 weeks since prior radiotherapy More than 28 days since prior major surgical procedure or open biopsy Recovered from prior therapy No concurrent chronic daily aspirin (greater than 325 mg/day) or nonsteroidal anti-inflammatory drugs known to inhibit platelet function No recent or concurrent full-dose anticoagulants (except as required to maintain patency of preexisting permanent indwelling IV catheters) or thrombolytic agent No concurrent grapefruit juice No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, or phenobarbital) No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational or commercial agents or therapies directed at the malignancy No other concurrent investigational agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Keith Flaherty
Organizational Affiliation
Abramson Cancer Center at Penn Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Abramson Cancer Center of The University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

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Imatinib Mesylate and Bevacizumab in Treating Patients With Advanced Melanoma or Other Advanced Cancers

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