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A Randomized Phase III Trial of Hyperthermic Isolated Limb Perfusion With Melphalan, Tumor Necrosis Factor, and Interferon-Gamma in Patients With Locally Advanced Extremity Melanoma

Primary Purpose

Melanoma

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
melphalan
tumor necrosis factor
interferon-gamma
hyperthermic isolated limb perfusion
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring Interferon-Gamma, Isolated Limb Perfusion, Melanoma, Melphalan, TNF

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Biopsy-proven Stage IIIA or IIIAB melanoma (M.D. Anderson staging system) of an extremity, as follows: Advanced local disease indicated by 2 or more satellite or in-transit metastases. Lower limb regional metastases must be distal to the apex of the femoral triangle except inguinal lymph node metastases. Upper limb regional metastases must be distal to the deltoid insertion except axillary lymph node metastases. No evidence of systemic disease outside the involved extremity. Recurrent disease subsequent to prior successful limb perfusion allowed. Bidimensional directly measurable dermal or subcutaneous lesion required. PRIOR/CONCURRENT THERAPY: No prior isolated limb perfusion. Biologic Therapy: At least 1 month since Biologic Therapy. At least 3 months since regional therapy of the extremity. Chemotherapy: At least 1 month since chemotherap.y At least 3 months since regional therapy of the extremity. Endocrine Therapy: Not specified. Radiotherapy: At least 1 month since radiotherapy. Surgery: Not specified. PATIENT CHARACTERISTICS: Age: 18 and over. Performance status: ECOG 0 or 1. Hematopoietic: Platelets greater than 150,000. Hepatic: Bilirubin less than 1.5 mg/dl; Coagulation profile normal. Renal: Creatinine less than 2.0 mg/dl. Cardiovascular: No evidence of peripheral vascular disease, e.g.: No history of claudication. OTHER: HIV negative. No pregnant or nursing women.

Sites / Locations

  • National Cancer Institute (NCI)

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 3, 1999
Last Updated
March 3, 2008
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00001296
Brief Title
A Randomized Phase III Trial of Hyperthermic Isolated Limb Perfusion With Melphalan, Tumor Necrosis Factor, and Interferon-Gamma in Patients With Locally Advanced Extremity Melanoma
Official Title
A Randomized Phase III Trial of Hyperthermic Isolated Limb Perfusion With Melphalan, Tumor Necrosis Factor, and Interferon-Gamma in Patients With Locally Advanced Extremity Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
November 1999
Overall Recruitment Status
Completed
Study Start Date
February 1992 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 2000 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Randomized study. Initially, 3 patients will be entered on Arm I as a pilot feasibility study and to standardize the technical aspects of the study. Subsequently, all patients are randomized to Arms I and II. Arm I: Regional Hyperthermia plus Regional Single-Agent Chemotherapy. Hyperthermic intravenous limb perfusion, HILP; plus Melphalan, L-PAM, NSC-8806. Arm II: Regional Hyperthermia plus Regional Single-Agent Chemotherapy and Biological Response Modifier Therapy. HILP as in Arm I; plus L-PAM; and Tumor Necrosis Factor (Knoll), TNF, NSC-635257; Interferon gamma (Genentech), IFN-G, NSC-600662.
Detailed Description
Patients with locally advanced melanoma confined to an extremity (Stage IIIA or Stage IIIAB) will be treated in a randomized Phase III study with hyperthermic isolated limb perfusion. One arm of the study will be a standard 60 minute perfusion with melphalan as a single agent. The second arm of the study will combine melphalan, tumor necrosis factor, and interferon-gamma in the isolated limb perfusion reproducing a regimen shown to have 100% response rates in a Phase II European trial. Patients will be followed for local response rates, duration of response, treatment toxicity, and disease-free survival.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma
Keywords
Interferon-Gamma, Isolated Limb Perfusion, Melanoma, Melphalan, TNF

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Enrollment
122 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
melphalan
Intervention Type
Drug
Intervention Name(s)
tumor necrosis factor
Intervention Type
Drug
Intervention Name(s)
interferon-gamma
Intervention Type
Procedure
Intervention Name(s)
hyperthermic isolated limb perfusion

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Biopsy-proven Stage IIIA or IIIAB melanoma (M.D. Anderson staging system) of an extremity, as follows: Advanced local disease indicated by 2 or more satellite or in-transit metastases. Lower limb regional metastases must be distal to the apex of the femoral triangle except inguinal lymph node metastases. Upper limb regional metastases must be distal to the deltoid insertion except axillary lymph node metastases. No evidence of systemic disease outside the involved extremity. Recurrent disease subsequent to prior successful limb perfusion allowed. Bidimensional directly measurable dermal or subcutaneous lesion required. PRIOR/CONCURRENT THERAPY: No prior isolated limb perfusion. Biologic Therapy: At least 1 month since Biologic Therapy. At least 3 months since regional therapy of the extremity. Chemotherapy: At least 1 month since chemotherap.y At least 3 months since regional therapy of the extremity. Endocrine Therapy: Not specified. Radiotherapy: At least 1 month since radiotherapy. Surgery: Not specified. PATIENT CHARACTERISTICS: Age: 18 and over. Performance status: ECOG 0 or 1. Hematopoietic: Platelets greater than 150,000. Hepatic: Bilirubin less than 1.5 mg/dl; Coagulation profile normal. Renal: Creatinine less than 2.0 mg/dl. Cardiovascular: No evidence of peripheral vascular disease, e.g.: No history of claudication. OTHER: HIV negative. No pregnant or nursing women.
Facility Information:
Facility Name
National Cancer Institute (NCI)
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
7350699
Citation
Karakousis CP, Choe KJ, Holyoke ED. Biologic behavior and treatment of intransit metastasis of melanoma. Surg Gynecol Obstet. 1980 Jan;150(1):29-32.
Results Reference
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A Randomized Phase III Trial of Hyperthermic Isolated Limb Perfusion With Melphalan, Tumor Necrosis Factor, and Interferon-Gamma in Patients With Locally Advanced Extremity Melanoma

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