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Vorinostat in Patients With Class 2 High Risk Uveal Melanoma

Primary Purpose

Uveal Melanoma

Status
Withdrawn
Phase
Early Phase 1
Locations
Study Type
Interventional
Intervention
Vorinostat
Sponsored by
University of Miami
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Uveal Melanoma focused on measuring Uveal Melanoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Uveal melanoma tumor determined by ophthalmic ultrasound or clinical assessment.
  2. Class 2 uveal melanoma
  3. No evidence of metastatic disease.
  4. Age ≥18 years.
  5. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
  6. Life expectancy of greater than 3 months.
  7. Able to swallow and retain orally-administered medication and does not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels
  8. Patients must have normal organ and marrow function as defined below:

    • Absolute neutrophil count (ANC) >1,500 cells/mm³
    • Platelet count >100,000/mm³
    • Hemoglobin >10.0g/dL
    • Aspartate transaminase (AST) and/or Alanine transaminase (ALT) < 3x upper limited of normal (ULN)
    • Total bilirubin < 2x ULN
    • Hemoglobin A1C ≤ 5.7%
    • Alkaline phosphatase < 3x ULN
    • Serum creatinine < 2x ULN or a creatinine clearance > 60 mL/min
    • Note: Patients with hyperbilirubinemia clinically consistent with an inherited disorder of bilirubin metabolism (e.g., Gilbert syndrome) will be eligible at the discretion of the treating physician and/or the principal investigator.
  9. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation until 4 months after completion of study drug administration. Women of child-bearing potential must have a negative serum or urine test at time of enrollment. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study therapy, and 4 months after completion of study drug administration.
  10. Willingness to comply with all the visits and procedures (including providing all biological specimens) as required by the protocol and the informed consent form (ICF).
  11. Ability to understand the investigational nature, potential risks and benefits of the research study and to provide valid written informed consent.

Exclusion Criteria:

  1. Definitive therapy of the primary uveal melanoma by either surgery or radiotherapy
  2. History of another malignancy except for those who have been disease-free for 3 years, or patients with a history of completely resected non-melanoma skin cancer and/or patients with indolent secondary malignancies not requiring active therapy, are eligible. Consult the study Principal Investigator if unsure whether second malignancies meet the requirements specified above.
  3. Any major surgery or extensive radiotherapy, chemotherapy with delayed toxicity, biologic therapy, or immunotherapy within 21 days prior to initiation of study therapy.
  4. History of prior vorinostat use.
  5. Use of other investigational drugs within 28 days
  6. Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to vorinostat (i.e. HDAC inhibitor hydroxamates such as panobinostat and belinostat).
  7. A QT interval corrected (QTc) for heart rate using the Bazett's formula (QTcB) ≥ 480 msec. Concurrent administration of vorinostat and agents that can cause QTc prolongation is not permitted.
  8. Concurrent administration of vorinostat and other HDAC inhibitors is not permitted due to the increased risk of thrombocytopenia and gastrointestinal bleeding.
  9. Patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with vorinostat.
  10. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infections, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with the study requirements.
  11. History of pulmonary embolism (PT) or deep-vein thrombosis (DVT)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Vorinostat

    Arm Description

    Vorinostat: 400 mg orally, once daily for 15 days.

    Outcomes

    Primary Outcome Measures

    Degree of transformation from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
    The investigators will analyze gene expression results from fine needle aspirate biopsies performed at baseline prior to vorinostat therapy and post-treatment (on Day 15, after the planned 15 days of vorinostat therapy).
    Proportion of patients whose tumors transformed from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
    Through gene expression analysis, the investigators will determine the proportion of patients whose tumors transformed from a Class 2 phenotype into a cell phenotype that resembles normal melanocytes.

    Secondary Outcome Measures

    Toxicity During Protocol Therapy
    Rate of adverse events (AEs) and serious adverse events (SAEs) experienced by study participants during Vorinostat therapy and up to one month after Vorinostat treatment completion.
    Tumor size before and after Vorinostat therapy
    Tumor size will be determined before and after Vorinostat therapy by B-Scan ultrasonography.
    Recurrence-free survival (RFS)
    Recurrence-Free Survival (RFS) in Study Participants. RFS is defined as the duration of time from start of treatment to time of disease recurrence or death, whichever occurs first.
    Overall survival (OS)
    Overall Survival (OS) in Study Participants. OS is defined as the length of time from date of start of Vorinostat treatment to death.
    Disease Specific Survival (DSS)
    Disease Specific Survival (DSS) in Study Participants. DSS is defined as the time from start of Vorinostat treatment to death due to disease.

    Full Information

    First Posted
    December 21, 2016
    Last Updated
    February 4, 2020
    Sponsor
    University of Miami
    Collaborators
    University of Miami Sylvester Comprehensive Cancer Center
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03022565
    Brief Title
    Vorinostat in Patients With Class 2 High Risk Uveal Melanoma
    Official Title
    Proof of Concept Study of Vorinostat, A Histone Deacetylase Inhibitor, in Patients With Class 2 High Risk Uveal Melanoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2020
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Investigator Decision
    Study Start Date
    January 2020 (Anticipated)
    Primary Completion Date
    January 29, 2020 (Actual)
    Study Completion Date
    January 29, 2020 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of Miami
    Collaborators
    University of Miami Sylvester Comprehensive Cancer Center

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This proof-of-concept study will evaluate the ability of vorinostat to induce the transformation of Class 2 uveal melanoma cells into a cell phenotype that resembles normal melanocytes.
    Detailed Description
    This is a proof of concept, single-center, open-label study of an FDA-approved drug, vorinostat, a Histone deacetylase (HDAC) inhibitor, for patients with Class 2, high-risk uveal melanoma with localized eye tumors. The primary aim is to test if vorinostat can transform aggressive class 2 uveal melanoma cells into cells that look more like normal melanocytes as observed in the laboratory. Uveal melanoma patients that meet the inclusion criteria outlined in this protocol will be consented and asked to provide a fine needle aspiration (FNA) biopsy of their uveal melanoma primary tumor. This biopsy will be submitted for gene expression analysis to determine the phenotype of the tumor. A total of 10 patients who meet the criteria of Class 2 uveal melanoma and no radiologic evidence of metastases will be treated with 400 mg of vorinostat daily for 15 days. On Day 15, patients will be asked to provide a second FNA biopsy prior to receiving the standard of care local definitive therapy either plaque radiotherapy or enucleation.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Uveal Melanoma
    Keywords
    Uveal Melanoma

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Vorinostat
    Arm Type
    Experimental
    Arm Description
    Vorinostat: 400 mg orally, once daily for 15 days.
    Intervention Type
    Drug
    Intervention Name(s)
    Vorinostat
    Other Intervention Name(s)
    Zolinza
    Intervention Description
    Study participants who meet the criteria of Class 2 uveal melanoma and no radiologic evidence of metastases will be treated with 400 mg of Vorinostat daily for 15 days.
    Primary Outcome Measure Information:
    Title
    Degree of transformation from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
    Description
    The investigators will analyze gene expression results from fine needle aspirate biopsies performed at baseline prior to vorinostat therapy and post-treatment (on Day 15, after the planned 15 days of vorinostat therapy).
    Time Frame
    From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks
    Title
    Proportion of patients whose tumors transformed from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
    Description
    Through gene expression analysis, the investigators will determine the proportion of patients whose tumors transformed from a Class 2 phenotype into a cell phenotype that resembles normal melanocytes.
    Time Frame
    From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks
    Secondary Outcome Measure Information:
    Title
    Toxicity During Protocol Therapy
    Description
    Rate of adverse events (AEs) and serious adverse events (SAEs) experienced by study participants during Vorinostat therapy and up to one month after Vorinostat treatment completion.
    Time Frame
    Up to 1 Month Post-Treatment Completion
    Title
    Tumor size before and after Vorinostat therapy
    Description
    Tumor size will be determined before and after Vorinostat therapy by B-Scan ultrasonography.
    Time Frame
    From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks
    Title
    Recurrence-free survival (RFS)
    Description
    Recurrence-Free Survival (RFS) in Study Participants. RFS is defined as the duration of time from start of treatment to time of disease recurrence or death, whichever occurs first.
    Time Frame
    Up to 5 Years Post-Treatment Completion
    Title
    Overall survival (OS)
    Description
    Overall Survival (OS) in Study Participants. OS is defined as the length of time from date of start of Vorinostat treatment to death.
    Time Frame
    Up to 5 Years Post-Treatment Completion
    Title
    Disease Specific Survival (DSS)
    Description
    Disease Specific Survival (DSS) in Study Participants. DSS is defined as the time from start of Vorinostat treatment to death due to disease.
    Time Frame
    Up to 5 Years Post-Treatment Completion
    Other Pre-specified Outcome Measures:
    Title
    Global histone acetylation levels in peripheral blood mononuclear cells (PBMCs) before and after Vorinostat therapy.
    Description
    Global histone acetylation levels in peripheral blood mononuclear cells (PBMCs) will be measured at baseline (Day 1, before Vorinostat treatment) and post-treatment (day 15 after completion of Vorinostat therapy).
    Time Frame
    From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Uveal melanoma tumor determined by ophthalmic ultrasound or clinical assessment. Class 2 uveal melanoma No evidence of metastatic disease. Age ≥18 years. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 Life expectancy of greater than 3 months. Able to swallow and retain orally-administered medication and does not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels Patients must have normal organ and marrow function as defined below: Absolute neutrophil count (ANC) >1,500 cells/mm³ Platelet count >100,000/mm³ Hemoglobin >10.0g/dL Aspartate transaminase (AST) and/or Alanine transaminase (ALT) < 3x upper limited of normal (ULN) Total bilirubin < 2x ULN Hemoglobin A1C ≤ 5.7% Alkaline phosphatase < 3x ULN Serum creatinine < 2x ULN or a creatinine clearance > 60 mL/min Note: Patients with hyperbilirubinemia clinically consistent with an inherited disorder of bilirubin metabolism (e.g., Gilbert syndrome) will be eligible at the discretion of the treating physician and/or the principal investigator. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation until 4 months after completion of study drug administration. Women of child-bearing potential must have a negative serum or urine test at time of enrollment. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study therapy, and 4 months after completion of study drug administration. Willingness to comply with all the visits and procedures (including providing all biological specimens) as required by the protocol and the informed consent form (ICF). Ability to understand the investigational nature, potential risks and benefits of the research study and to provide valid written informed consent. Exclusion Criteria: Definitive therapy of the primary uveal melanoma by either surgery or radiotherapy History of another malignancy except for those who have been disease-free for 3 years, or patients with a history of completely resected non-melanoma skin cancer and/or patients with indolent secondary malignancies not requiring active therapy, are eligible. Consult the study Principal Investigator if unsure whether second malignancies meet the requirements specified above. Any major surgery or extensive radiotherapy, chemotherapy with delayed toxicity, biologic therapy, or immunotherapy within 21 days prior to initiation of study therapy. History of prior vorinostat use. Use of other investigational drugs within 28 days Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to vorinostat (i.e. HDAC inhibitor hydroxamates such as panobinostat and belinostat). A QT interval corrected (QTc) for heart rate using the Bazett's formula (QTcB) ≥ 480 msec. Concurrent administration of vorinostat and agents that can cause QTc prolongation is not permitted. Concurrent administration of vorinostat and other HDAC inhibitors is not permitted due to the increased risk of thrombocytopenia and gastrointestinal bleeding. Patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with vorinostat. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infections, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with the study requirements. History of pulmonary embolism (PT) or deep-vein thrombosis (DVT)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    J. William Harbour, MD
    Organizational Affiliation
    University of Miami
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Vorinostat in Patients With Class 2 High Risk Uveal Melanoma

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