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Azacitidine and Recombinant Interferon Alfa-2b in Treating Patients With Stage III or Stage IV Melanoma or Stage IV Kidney Cancer That Cannot Be Removed By Surgery

Primary Purpose

Recurrent Melanoma, Recurrent Renal Cell Cancer, Stage III Melanoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
recombinant interferon alfa-2b
amifostine/azacitidine
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

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

Inclusion Criteria: Histologically confirmed diagnosis of 1 of the following: Melanoma Unresectable stage III disease Stage IV disease Renal cell carcinoma Unresectable and/or stage IV disease Measurable disease No untreated brain metastases or leptomeningeal disease Patients with previously treated brain metastases are eligible provided they have no evidence of progression for ≥ 4 weeks following treatment and do not require steroids Performance status - ECOG 0-2 Performance status - Karnofsky 60-100% More than 3 months WBC ≥ 3,000/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 9.0 g/dL (may be transfused to this level) PT or PTT < 1.5 times upper limit of normal (ULN) Bilirubin ≤ 2.0 mg/mL AST and ALT ≤ 3 times ULN (5 times ULN for patients with liver metastases) Albumin ≥ 3.0 g/dL Creatinine ≤ 1.7 mg/dL Creatinine clearance ≥ 50 mL/min No symptomatic congestive heart failure No unstable angina pectoris No ventricular cardiac arrhythmia No myocardial infarction within the past 3 months No dyspnea at rest Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active gastrointestinal bleeding or ulcer disease No ongoing or active infection No psychiatric illness or social situation that would preclude study compliance No other uncontrolled illness No history of allergic reaction attributed to compounds of similar chemical or biologic composition to study agents At least 2 weeks since prior immunotherapy Prior adjuvant interferon alfa for metastatic disease or in the adjuvant setting allowed At least 3 weeks since prior cytotoxic agents (6 weeks for nitrosoureas or mitomycin) See Disease Characteristics At least 2 weeks since prior hormonal therapy At least 1 week since prior and no concurrent steroids At least 3 weeks since prior radiotherapy At least 2 weeks since prior minor surgery At least 3 weeks since prior major surgery Recovered from all prior therapy No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational agents No other concurrent anticancer therapy

Sites / Locations

  • Yale University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (chemotherapy, biological therapy)

Arm Description

Patients receive azacitidine SC once daily on days 1-4 and 15-17 and recombinant interferon alfa-2b SC on days 8, 10, 12, 15, 17, 19, 22, 24, and 26 during course 1. Beginning in course 2 and for all subsequent courses, patients receive azacitidine SC once daily on days 1-3 and 15-17 and interferon alfa-2b SC on days 1, 3, 5, 8, 10, 12, 15, 17, 19, 22, 24, and 26. Treatment repeats every 28 days for up to 12 total courses in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Adverse event profile of azacitidine and recombinant interferon alfa-2b in patients with unresectable or metastatic melanoma and renal cell carcinoma
Graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0.
Maximum tolerated dose of recombinant interferon alfa-2b when administered in combination with 5-azacitidine
Toxicity will be graded according to the NCI CTCAE version 3.0. The MTD is the highest dose level in which < 2 patients of 6 develop first cycle DLT.
Correlation of promoter methylation with the level of expression of the genes
Determined by Western blotting, immunohistochemistry, and/or RT-PCR. We will use Western blot analysis when antibodies are available and semi-quantitative RT-PCR in cases where antibodies are not available.

Secondary Outcome Measures

Response rate of giving recombinant interferon alfa-2b when administered in combination with 5-azacitidine in patients with metastatic melanoma and renal cell carcinoma
Evaluated using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee.

Full Information

First Posted
September 20, 2005
Last Updated
May 1, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00217542
Brief Title
Azacitidine and Recombinant Interferon Alfa-2b in Treating Patients With Stage III or Stage IV Melanoma or Stage IV Kidney Cancer That Cannot Be Removed By Surgery
Official Title
A Phase 1 Study of 5-azacitidine in Combination With Interferon-Alfa 2B in Unresectable or Metastatic Melanoma and Renal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2013
Overall Recruitment Status
Completed
Study Start Date
July 2005 (undefined)
Primary Completion Date
July 2008 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

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

4. Oversight

5. Study Description

Brief Summary
This phase I trial is studying the side effects and best dose of recombinant interferon alfa-2b when given together with azacitidine in treating patients with stage III or stage IV melanoma or stage IV kidney cancer that cannot be removed by surgery. Drugs used in chemotherapy, such as azacitidine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Recombinant interferon alfa-2b may interfere with the growth of tumor cells. Giving azacitidine together with recombinant interferon alfa-2b may kill more tumor cells.
Detailed Description
OBJECTIVES: I. Determine the adverse event profile and maximum tolerated dose of interferon alfa-2b when combined with azacitidine in patients with unresectable stage III or IV melanoma or unresectable stage IV renal cell carcinoma. II. Determine the feasibility of this regimen for future phase II trials. OUTLINE: This is a dose-escalation, multicenter study. Patients receive azacitidine subcutaneously (SC) once daily on days 1-4 and 15-17 and recombinant interferon alfa-2b SC on days 8, 10, 12, 15, 17, 19, 22, 24, and 26 during course 1. Beginning in course 2 and for all subsequent courses, patients receive azacitidine SC once daily on days 1-3 and 15-17 and interferon alfa-2b SC on days 1, 3, 5, 8, 10, 12, 15, 17, 19, 22, 24, and 26. Treatment repeats every 28 days for up to 12 total courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of interferon alfa-2b until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. After completion of study treatment, patients are followed every 2-4 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Melanoma, Recurrent Renal Cell Cancer, Stage III Melanoma, Stage IV Melanoma, Stage IV Renal Cell Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment (chemotherapy, biological therapy)
Arm Type
Experimental
Arm Description
Patients receive azacitidine SC once daily on days 1-4 and 15-17 and recombinant interferon alfa-2b SC on days 8, 10, 12, 15, 17, 19, 22, 24, and 26 during course 1. Beginning in course 2 and for all subsequent courses, patients receive azacitidine SC once daily on days 1-3 and 15-17 and interferon alfa-2b SC on days 1, 3, 5, 8, 10, 12, 15, 17, 19, 22, 24, and 26. Treatment repeats every 28 days for up to 12 total courses in the absence of disease progression or unacceptable toxicity.
Intervention Type
Biological
Intervention Name(s)
recombinant interferon alfa-2b
Other Intervention Name(s)
Alfatronol, Glucoferon, Heberon Alfa, IFN alpha-2B, Intron A
Intervention Description
Given SC
Intervention Type
Drug
Intervention Name(s)
amifostine/azacitidine
Intervention Description
Given SC
Primary Outcome Measure Information:
Title
Adverse event profile of azacitidine and recombinant interferon alfa-2b in patients with unresectable or metastatic melanoma and renal cell carcinoma
Description
Graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0.
Time Frame
Continuously throughout study
Title
Maximum tolerated dose of recombinant interferon alfa-2b when administered in combination with 5-azacitidine
Description
Toxicity will be graded according to the NCI CTCAE version 3.0. The MTD is the highest dose level in which < 2 patients of 6 develop first cycle DLT.
Time Frame
Course 1 (4 weeks)
Title
Correlation of promoter methylation with the level of expression of the genes
Description
Determined by Western blotting, immunohistochemistry, and/or RT-PCR. We will use Western blot analysis when antibodies are available and semi-quantitative RT-PCR in cases where antibodies are not available.
Time Frame
Day 5 or 8 and 24 or 26 of course 1
Secondary Outcome Measure Information:
Title
Response rate of giving recombinant interferon alfa-2b when administered in combination with 5-azacitidine in patients with metastatic melanoma and renal cell carcinoma
Description
Evaluated using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee.
Time Frame
Every 8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed diagnosis of 1 of the following: Melanoma Unresectable stage III disease Stage IV disease Renal cell carcinoma Unresectable and/or stage IV disease Measurable disease No untreated brain metastases or leptomeningeal disease Patients with previously treated brain metastases are eligible provided they have no evidence of progression for ≥ 4 weeks following treatment and do not require steroids Performance status - ECOG 0-2 Performance status - Karnofsky 60-100% More than 3 months WBC ≥ 3,000/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 9.0 g/dL (may be transfused to this level) PT or PTT < 1.5 times upper limit of normal (ULN) Bilirubin ≤ 2.0 mg/mL AST and ALT ≤ 3 times ULN (5 times ULN for patients with liver metastases) Albumin ≥ 3.0 g/dL Creatinine ≤ 1.7 mg/dL Creatinine clearance ≥ 50 mL/min No symptomatic congestive heart failure No unstable angina pectoris No ventricular cardiac arrhythmia No myocardial infarction within the past 3 months No dyspnea at rest Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active gastrointestinal bleeding or ulcer disease No ongoing or active infection No psychiatric illness or social situation that would preclude study compliance No other uncontrolled illness No history of allergic reaction attributed to compounds of similar chemical or biologic composition to study agents At least 2 weeks since prior immunotherapy Prior adjuvant interferon alfa for metastatic disease or in the adjuvant setting allowed At least 3 weeks since prior cytotoxic agents (6 weeks for nitrosoureas or mitomycin) See Disease Characteristics At least 2 weeks since prior hormonal therapy At least 1 week since prior and no concurrent steroids At least 3 weeks since prior radiotherapy At least 2 weeks since prior minor surgery At least 3 weeks since prior major surgery Recovered from all prior therapy No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational agents No other concurrent anticancer therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mario Sznol
Organizational Affiliation
Yale University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520-8032
Country
United States

12. IPD Sharing Statement

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Azacitidine and Recombinant Interferon Alfa-2b in Treating Patients With Stage III or Stage IV Melanoma or Stage IV Kidney Cancer That Cannot Be Removed By Surgery

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