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An Expanded Cohort Trial of Bortezomib and Sorafenib in Advanced Malignant Melanoma

Primary Purpose

Melanoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
bortezomib
sorafenib
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring bortezomib, sorafenib, advanced melanoma

Eligibility Criteria

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

Inclusion Criteria:

  • Histological or cytological confirmation of malignant melanoma that is metastatic or unresectable
  • Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension as 10mm or greater with spiral CT scan
  • Patients may have received up to 4 prior treatments for their disease including immunotherapies such as high-dose interleukin 2 and antibodies directed against the human cytotoxic T-lymphocyte antigen 4
  • 18 years of age or older
  • Life expectancy of greater than three months
  • ECOG Performance status of 0 or 1
  • Adequate organ and marrow function as outlined in the protocol
  • Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment
  • INT < 1.5 or a PT/PTT within normal limits. Patients receiving anti-coagulation treatment wih an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be measured prior to initiation of sorafenib and monitored at least weekly, or as defined by the local standard of care, until INR is stable
  • Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation.

Exclusion Criteria:

  • Chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events dur to agents administered more than 4 weeks earlier
  • Participants may not be receiving any other study agents
  • Known, active CNS disease, including primary brain tumor, seizures not controlled with standard medical therapy, any unstable or untreated brain metastasis, or history of stroke within the past 12 months
  • Prior therapy with bortezomib, sorafenib, or other proteasome inhibitor
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to sorafenib and bortezomib
  • Participants receiving any medications or substances that are inducers of CYP3A4
  • Known cardiac disease including congestive heart failure > class II NHYA, unstable angina or new onset angina, myocardial infarction within the past 6 months, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening has to be documented by the investigator as not medically relevant
  • Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
  • Uncontrolled intercurrent illness
  • Pregnant women
  • Individuals with a history of a different malignancy are ineligible except for the circumstances outlined in the protocol
  • HIV-positive individuals on combination antiretroviral therapy
  • Uncontrolled hypertension despite optimal medical management
  • Thrombolic or embolic events
  • Pulmonary hemorrhage/bleeding event CTCAE Grade 2 or greater within 4 weeks of first dose of study drug
  • Any other hemorrhage/bleeding event CTCAE Grade 3 or greater within 4 weeks of first dose of study drug
  • Serious non-healing wound, ulcer or bone fracture
  • Evidence or history of bleeding diathesis or coagulopathy
  • Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study drug
  • Any condition that impairs patient's ability to swallow whole pills
  • Any malabsorption problem
  • Known hypersensitivity to boron or mannitol
  • Grade 2 or greater peripheral neuropathy within 14 days before enrollment

Sites / Locations

  • Massachusetts General Hospital
  • Dana-Farber Cancer Institute
  • Beth Israel Deaconess Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dose Escalation

Arm Description

Outcomes

Primary Outcome Measures

Maximally tolerated dose
To determine the maximally tolerated dose of weekly bortezomib in combination with 400mg twice daily sorafenib.
Document and summarize toxicities
To document and summarize the toxicities of weekly bortezomib in combination with 400mg twice daily sorafenib

Secondary Outcome Measures

Anti-tumor activity
To document the anti-tumor activity of weekly bortezomib in combination with sorafenib by describing the six-month progression free survival, one-year progression-free survival, and objective response rate.

Full Information

First Posted
March 1, 2010
Last Updated
June 7, 2016
Sponsor
Massachusetts General Hospital
Collaborators
Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Bayer, Millennium Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01078961
Brief Title
An Expanded Cohort Trial of Bortezomib and Sorafenib in Advanced Malignant Melanoma
Official Title
A Phase I Expanded Cohort Trial of Bortezomib and Sorafenib in Advanced Malignant Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
September 2010 (undefined)
Primary Completion Date
February 2013 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital
Collaborators
Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Bayer, Millennium Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study involves the use of two investigational drugs: sorafenib and bortezomib. Sorafenib is designed to stop the growth of cells caused by changes associated with cancer. Bortezomib is designed to stop cancer cells from getting rid of waste products. This causes the cells to build up toxic levels of waste that leads to cell death. In the laboratory, the combination of sorafenib and bortezomib has been shown to fight cancer cells better than either drug alone. We are looking to determine if the combination of sorafenib and bortezomib is a safe treatment for patients with advanced melanoma. The effectiveness of this combination will also be assessed.
Detailed Description
Since we are looking for the highest dose of the study drug that can be administered safely without severe or unmanageable side effects in participants that have melanoma, not everyone who participates will receive the same dose of the study drug. The dose participants will get will depend upon the number of participants who have been enrolled in the study before and how well they tolerated their doses. Each treatment cycle lasts 28 days. Participants will take sorafenib orally twice a day and will receive bortezomib as an out-patient intravenous injection on Days 1, 8 and 15 of every cycle. At the end of each treatment cycle, participants will be examined to determine whether their disease has worsened, improved or stayed the same, and to see if they are experiencing any side effects of treatment. The following tests will be done at these visits: physical examination, vital signs, blood tests and scans (repeated every 2 months). Once the maximum tolerated dose of sorafenib and bortezomib have been determined, an additional 12 participants will be enrolled in this study. This is called the expansion cohort of this study. Participants enrolled in this cohort will be required to undergo a biopsy of the tumor lesion before they start study treatment and an additional biopsy after you start study treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma
Keywords
bortezomib, sorafenib, advanced melanoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
bortezomib
Intervention Description
Given intravenously on days 1, 8 and 15 of each 28 day cycle
Intervention Type
Drug
Intervention Name(s)
sorafenib
Intervention Description
400mg taken orally twice a day
Primary Outcome Measure Information:
Title
Maximally tolerated dose
Description
To determine the maximally tolerated dose of weekly bortezomib in combination with 400mg twice daily sorafenib.
Time Frame
2 years
Title
Document and summarize toxicities
Description
To document and summarize the toxicities of weekly bortezomib in combination with 400mg twice daily sorafenib
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Anti-tumor activity
Description
To document the anti-tumor activity of weekly bortezomib in combination with sorafenib by describing the six-month progression free survival, one-year progression-free survival, and objective response rate.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histological or cytological confirmation of malignant melanoma that is metastatic or unresectable Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension as 10mm or greater with spiral CT scan Patients may have received up to 4 prior treatments for their disease including immunotherapies such as high-dose interleukin 2 and antibodies directed against the human cytotoxic T-lymphocyte antigen 4 18 years of age or older Life expectancy of greater than three months ECOG Performance status of 0 or 1 Adequate organ and marrow function as outlined in the protocol Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment INT < 1.5 or a PT/PTT within normal limits. Patients receiving anti-coagulation treatment wih an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be measured prior to initiation of sorafenib and monitored at least weekly, or as defined by the local standard of care, until INR is stable Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation. Exclusion Criteria: Chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events dur to agents administered more than 4 weeks earlier Participants may not be receiving any other study agents Known, active CNS disease, including primary brain tumor, seizures not controlled with standard medical therapy, any unstable or untreated brain metastasis, or history of stroke within the past 12 months Prior therapy with bortezomib, sorafenib, or other proteasome inhibitor History of allergic reactions attributed to compounds of similar chemical or biologic composition to sorafenib and bortezomib Participants receiving any medications or substances that are inducers of CYP3A4 Known cardiac disease including congestive heart failure > class II NHYA, unstable angina or new onset angina, myocardial infarction within the past 6 months, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening has to be documented by the investigator as not medically relevant Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy Uncontrolled intercurrent illness Pregnant women Individuals with a history of a different malignancy are ineligible except for the circumstances outlined in the protocol HIV-positive individuals on combination antiretroviral therapy Uncontrolled hypertension despite optimal medical management Thrombolic or embolic events Pulmonary hemorrhage/bleeding event CTCAE Grade 2 or greater within 4 weeks of first dose of study drug Any other hemorrhage/bleeding event CTCAE Grade 3 or greater within 4 weeks of first dose of study drug Serious non-healing wound, ulcer or bone fracture Evidence or history of bleeding diathesis or coagulopathy Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study drug Any condition that impairs patient's ability to swallow whole pills Any malabsorption problem Known hypersensitivity to boron or mannitol Grade 2 or greater peripheral neuropathy within 14 days before enrollment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ryan J. Sullivan, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25986244
Citation
Sullivan RJ, Ibrahim N, Lawrence DP, Aldridge J, Giobbie-Hurder A, Hodi FS, Flaherty KT, Conley C, Mier JW, Atkins MB, McDermott DF. A Phase I Trial of Bortezomib and Sorafenib in Advanced Malignant Melanoma. Oncologist. 2015 Jun;20(6):617-8. doi: 10.1634/theoncologist.2015-0105. Epub 2015 May 18.
Results Reference
result

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An Expanded Cohort Trial of Bortezomib and Sorafenib in Advanced Malignant Melanoma

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