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A Trial Looking at Nilotinib to Treat Acral and Mucosal Melanoma Skin Cancer That Has Spread (NICAM)

Primary Purpose

Mucosal Lentiginous Melanoma, Acral Lentiginous Malignant Melanoma

Status
Completed
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
nilotinib
Sponsored by
Institute of Cancer Research, United Kingdom
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mucosal Lentiginous Melanoma focused on measuring c-KIT mutation, advanced disease, tyrosine kinase inhibitors

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients with c-KIT mutated histologically proven advanced mucosal or acral melanoma in which the mutation is not known to be associated with nilotinib resistance.
  2. Advanced mucosal and acral melanoma defined as unresectable locally advanced or metastatic disease
  3. The presence of one or more clinically or radiologically measurable lesions at least 10mm in size
  4. Age 18 or greater
  5. ECOG performance status 0, 1 or 2
  6. Life expectancy greater than 12 weeks
  7. At least 14 days since any major surgery
  8. The capacity to understand the patient information sheet and ability to provide written informed consent
  9. Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures
  10. Women must not be pregnant or lactating with no intention of pregnancy during study treatment. Women of child bearing potential must have a negative serum pregnancy test prior to study entry (even if surgically sterilised). Men and women of childbearing potential must use adequate birth control measures (e.g. abstinence, oral contraceptives, intrauterine device, barrier method with spermicide, implantable or injectable contraceptives or surgical sterilisation) for the duration of the study and should continue such precautions for 6 months after receiving the last study treatment
  11. Serum alanine transaminase (ALT) or serum aspartate aminotransferase ≤2.5 x upper limit of normal (ULN) and total serum bilirubin ≤1.5 x ULN
  12. Serum creatinine ≤1.5 x ULN
  13. Serum lipase and amylase <1.5 x ULN
  14. Haemoglobin ≥9.0 g/dL, absolute neutrophil count ≥1.5 x 109/L, platelets ≥100 x 109/L
  15. Prothrombin time (PT) ≤1.5 x ULN
  16. Able to swallow and retain oral medication.

Exclusion Criteria:

  1. Intracranial disease, unless there has been radiological evidence of stable intracranial disease > 6 months. In the case of a solitary brain metastasis, evidence of a disease-free interval of at least 3 months post surgery. All patients previously treated for brain metastases must be stable off corticosteroid therapy for at least 28 days
  2. Women who are pregnant, nursing, or planning to become pregnant during the course of the trial
  3. Men who plan to father a child during the course of the trial
  4. Use of any investigational drug within 30 days prior to screening (both cancer and non cancer treatments)
  5. Use of herbal or chinese medication
  6. Use of therapeutic coumarin derivatives (ie warfarin, acenocoumarol, phenprocoumon)
  7. Significant cardiac disease including patients who have or who are at significant risk of developing prolongation of QTc
  8. Severe and/or uncontrolled medical disease
  9. Known chronic liver disease
  10. Past medical history of chronic pancreatitis
  11. Known HIV infection
  12. Previous radiotherapy to 25% or more of the bone marrow
  13. Radiation therapy in the 4 weeks prior to study entry
  14. Prior exposure to a tyrosine kinase inhibitor
  15. Known lactose intolerance
  16. Any malabsorption syndrome (i.e. partial gastrectomy, small bowel resection, Crohn's disease or ulcerative colitis).

Sites / Locations

  • Royal Marsden NHS Foundation Trust

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

nilotinib

Arm Description

nilotinib 400mgs oral tablets

Outcomes

Primary Outcome Measures

Proportion of participants with the c-KIT mutation who remain progression free at 6 months.
Progression free survival times will be measured from the date of enrolment into the treatment phase until the first date (following start of treatment) of either death or confirmed progressive disease according to RECIST.

Secondary Outcome Measures

toxicity of treatment
Treatment related toxicity will be assessed at each clinic visit approximately every 4 weeks whilst the patient continues on study treatment. Study treatment will continue until the patient relapses or is withdrawn from study therapy (on average estimated to be between 4 and 52 weeks).
response at 12 weeks
Lesions must be measured and or evaluated at 12 weeks in accordance with the Response evaluation criteria in solid tumours (RECIST)
overall survival

Full Information

First Posted
April 13, 2011
Last Updated
June 7, 2017
Sponsor
Institute of Cancer Research, United Kingdom
Collaborators
Royal Marsden NHS Foundation Trust
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1. Study Identification

Unique Protocol Identification Number
NCT01395121
Brief Title
A Trial Looking at Nilotinib to Treat Acral and Mucosal Melanoma Skin Cancer That Has Spread
Acronym
NICAM
Official Title
A Phase II Trial of Nilotinib in the Treatment of Patients With c-KIT Mutated Advanced Acral and Mucosal Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
December 2009 (Actual)
Primary Completion Date
December 12, 2016 (Actual)
Study Completion Date
December 12, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institute of Cancer Research, United Kingdom
Collaborators
Royal Marsden NHS Foundation Trust

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The aim of this study is to see if a drug called nilotinib (Tasigna®) is effective in the treatment of patients with a rare group of acral and mucosal melanomas that have a change (mutation) in a protein called cKIT. Nilotinib interferes with signalling inside cells with this mutation and it is believed that this may lead to shrinkage of tumours. Acral melanomas are found on the palms and soles and mucosal melanomas start inside body cavities rather than on the skin.
Detailed Description
NICAM has a two step consent process. Patients diagnosed with advanced acral or mucosal melanoma first consent for study registration and undergo screening tests including testing samples of melanoma tissue for the c-KIT mutation. Following confirmation of the c-KIT mutation, patients are asked to consent to study entry with continuation of screening. Eligible patients then enter the study and commence taking nilotinib tablets twice a day for as long as clinical benefit is maintained.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mucosal Lentiginous Melanoma, Acral Lentiginous Malignant Melanoma
Keywords
c-KIT mutation, advanced disease, tyrosine kinase inhibitors

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
nilotinib
Arm Type
Experimental
Arm Description
nilotinib 400mgs oral tablets
Intervention Type
Drug
Intervention Name(s)
nilotinib
Other Intervention Name(s)
Tasigna
Intervention Description
nilotinib 400 mgs orally twice daily until disease progression or withdrawal from treatment
Primary Outcome Measure Information:
Title
Proportion of participants with the c-KIT mutation who remain progression free at 6 months.
Description
Progression free survival times will be measured from the date of enrolment into the treatment phase until the first date (following start of treatment) of either death or confirmed progressive disease according to RECIST.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
toxicity of treatment
Description
Treatment related toxicity will be assessed at each clinic visit approximately every 4 weeks whilst the patient continues on study treatment. Study treatment will continue until the patient relapses or is withdrawn from study therapy (on average estimated to be between 4 and 52 weeks).
Time Frame
evaluated every 4 weeks whilst the patient is on treatment (on average estimated to be between 4 and 52 weeks)
Title
response at 12 weeks
Description
Lesions must be measured and or evaluated at 12 weeks in accordance with the Response evaluation criteria in solid tumours (RECIST)
Time Frame
tumours measured at 12 weeks from start of treatment
Title
overall survival
Time Frame
Expected to be 6 - 12 months (Measured from commencement of treatment until time of death)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with c-KIT mutated histologically proven advanced mucosal or acral melanoma in which the mutation is not known to be associated with nilotinib resistance. Advanced mucosal and acral melanoma defined as unresectable locally advanced or metastatic disease The presence of one or more clinically or radiologically measurable lesions at least 10mm in size Age 18 or greater ECOG performance status 0, 1 or 2 Life expectancy greater than 12 weeks At least 14 days since any major surgery The capacity to understand the patient information sheet and ability to provide written informed consent Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures Women must not be pregnant or lactating with no intention of pregnancy during study treatment. Women of child bearing potential must have a negative serum pregnancy test prior to study entry (even if surgically sterilised). Men and women of childbearing potential must use adequate birth control measures (e.g. abstinence, oral contraceptives, intrauterine device, barrier method with spermicide, implantable or injectable contraceptives or surgical sterilisation) for the duration of the study and should continue such precautions for 6 months after receiving the last study treatment Serum alanine transaminase (ALT) or serum aspartate aminotransferase ≤2.5 x upper limit of normal (ULN) and total serum bilirubin ≤1.5 x ULN Serum creatinine ≤1.5 x ULN Serum lipase and amylase <1.5 x ULN Haemoglobin ≥9.0 g/dL, absolute neutrophil count ≥1.5 x 109/L, platelets ≥100 x 109/L Prothrombin time (PT) ≤1.5 x ULN Able to swallow and retain oral medication. Exclusion Criteria: Intracranial disease, unless there has been radiological evidence of stable intracranial disease > 6 months. In the case of a solitary brain metastasis, evidence of a disease-free interval of at least 3 months post surgery. All patients previously treated for brain metastases must be stable off corticosteroid therapy for at least 28 days Women who are pregnant, nursing, or planning to become pregnant during the course of the trial Men who plan to father a child during the course of the trial Use of any investigational drug within 30 days prior to screening (both cancer and non cancer treatments) Use of herbal or chinese medication Use of therapeutic coumarin derivatives (ie warfarin, acenocoumarol, phenprocoumon) Significant cardiac disease including patients who have or who are at significant risk of developing prolongation of QTc Severe and/or uncontrolled medical disease Known chronic liver disease Past medical history of chronic pancreatitis Known HIV infection Previous radiotherapy to 25% or more of the bone marrow Radiation therapy in the 4 weeks prior to study entry Prior exposure to a tyrosine kinase inhibitor Known lactose intolerance Any malabsorption syndrome (i.e. partial gastrectomy, small bowel resection, Crohn's disease or ulcerative colitis).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Larkin, MA BM BCh MRCP PhD
Organizational Affiliation
Royal Marsden NHS Foundation
Official's Role
Principal Investigator
Facility Information:
Facility Name
Royal Marsden NHS Foundation Trust
City
London
ZIP/Postal Code
SW3 6JJ
Country
United Kingdom

12. IPD Sharing Statement

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A Trial Looking at Nilotinib to Treat Acral and Mucosal Melanoma Skin Cancer That Has Spread

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