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AZD2171 in Treating Patients With Recurrent or Stage IV Melanoma

Primary Purpose

Acral Lentiginous Malignant Melanoma, Ciliary Body and Choroid Melanoma, Medium/Large Size, Ciliary Body and Choroid Melanoma, Small Size

Status
Completed
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
cediranib maleate
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acral Lentiginous Malignant Melanoma

Eligibility Criteria

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

Inclusion Criteria: Histologically/cytologically confirmed recurrent/metastatic malignant melanoma (stage IV acral lentiginous, lentigo maligna, superficial spreading or ocular malignant melanoma) Measurable disease- at least 1 lesion accurately measured in at least 1 dimension (longest diameter) as >=20mm with conventional techniques or >=10mm with spiral CT scan Previously irradiated lesions not considered measurable unless they demonstrated progression prior to study entry No prior chemotherapy (including regional therapy); prior adjuvant immunotherapy permitted if completed >3 months prior to study entry; patients may have received prior radiation therapy if completed >=4 weeks prior to study entry Previous surgery permissible if performed >=4 weeks prior to study entry Life expectancy >12 weeks ECOG performance status=< 2 (Karnofsky>=60%) Leukocytes>=3,000/mcL Absolute neutrophil count>=1,500/mcL Platelets>=100,000/mcL Hemoglobin>=8g/dL Total bilirubin<1.5x institutional ULN (IULN) AST/ALT=<3 x IULN (5xULN if liver metastases) Creatinine within IULN Creatinine within IULN OR Creatinine clearance>=60mL/min/m^2 if creatinine levels above IULN Baseline blood pressure <140/90mmHg; may be taking antihypertensive medications AZD2171 has shown to terminate fetal development in rat as expected for process dependent on VEGF signaling; women of childbearing potential must have negative pregnancy test prior to study entry; women of childbearing potential/men must agree to use adequate contraception (hormonal/barrier method of birth control; abstinence) prior to study entry and for duration of study Ability to understand/willingness to sign written informed consent Exclusion Criteria: Any previous chemotherapy or immunotherapy for recurrent/metastatic disease; patients who have had radiotherapy or major surgery within 4 weeks prior to entering study or those who have not recovered from AEs due to treatment received more than 4 weeks earlier May not be concurrently receiving other investigational agents nor have participated in an investigational trial of bio-, chemo- or immunotherapy agents Known brain metastases because of their poor prognosis and because patients often develop progressive neurologic dysfunction that would confound evaluation of neurologic and other AEs History of allergic reactions attributed to compounds of similar chemical/biologic composition to AZD2171 Mean QTc>470msec (Bazett's correction) in screening electrocardiogram or history of familial long QT syndrome >+1 proteinuria on 2 consecutive dipsticks taken no less than 1 week apart Uncontrolled intercurrent illness including but not limited to hypertension, ongoing/active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Pregnant women excluded from study because AZD2171 is a VEGF inhibitor with known abortifacient effects; breastfeeding should be discontinued if mother is treated with AZD2171 HIV-positive patients on combination antiretroviral therapy are ineligible because of potential for PK interactions with AZD2171; appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated Any significant abnormality noted in ECG within 14 days of treatment A NYHA classification of III or IV (NOTE: Patients classified as class II controlled with treatment may continue with increase monitoring) Conditions requiring concurrent use of drugs/biologics with proarrhythmic potential; these drugs are prohibited during studies with AZD2171

Sites / Locations

  • Princess Margaret Hospital Phase 2 Consortium

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (cediranib maleate)

Arm Description

Patients receive oral AZD2171 once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Objective Tumor Response (Partial or Complete Response) According to RECIST
Response and progression will be evaluated in this study using the new international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee [J Nat Cancer Inst 92(3):205-216, 2000]. Changes in only the largest diameter (unidimensional measurement) of the tumor lesions, assessed by CT or MRI; Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR."
Prolonged Stable Disease According to RECIST

Secondary Outcome Measures

Median Survival Time
Survival Rate
Response Duration
Stable Disease Duration
Highest Toxicity Grade Assessed by NCI CTCAE Version 3.0
Time to Disease Progression
Clinical Benefit Response
Changes in Levels of Soluble Angiogenic Factors
Change in Vessel Permeability and Blood Flow by DCE-MRI

Full Information

First Posted
October 20, 2005
Last Updated
July 27, 2018
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00243061
Brief Title
AZD2171 in Treating Patients With Recurrent or Stage IV Melanoma
Official Title
A Phase II Study of AZD2171 in Previously Untreated Patients With Metastatic or Recurrent Malignant Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
January 2006 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
March 2012 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase II trial is studying how well AZD2171 works in treating patients with recurrent or stage IV melanoma. AZD2171 may stop the growth of tumor cells by blocking blood flow to the tumor and by blocking some of the enzymes needed for cell growth.
Detailed Description
PRIMARY OBJECTIVES: I. To assess the objective tumor response rate of AZD2171 administered to patients with recurrent or metastatic malignant melanoma. II. To assess the toxicity, median survival time, 1-year survival rate, response or stable disease duration, time to disease progression and clinical benefit response of AZD2171 administered to patients with recurrent or metastatic malignant melanoma. III. To measure baseline and post-treatment levels of angiogenic growth factors and receptors, as well as circulating endothelial cells, and to explore the relationship between these potential correlative endpoints and clinical outcome. IV. To assess changes in blood flow and vessel permeability using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pre- and post-treatment, and to explore the relationship between these potential imaging endpoints and clinical outcome. V. To look for polymorphisms of kdr/flk-1, and other genes in this pathway, by performing pharmacogenetic analysis of pbmc's, and correlate genotype with VEGF levels and response to therapy. OUTLINE: This is an open-label, multicenter study. Patients receive oral AZD2171 once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed for survival.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acral Lentiginous Malignant Melanoma, Ciliary Body and Choroid Melanoma, Medium/Large Size, Ciliary Body and Choroid Melanoma, Small Size, Extraocular Extension Melanoma, Intraocular Melanoma, Iris Melanoma, Lentigo Maligna Malignant Melanoma, Recurrent Melanoma, Stage, Intraocular Melanoma, Stage IV Melanoma, Superficial Spreading Malignant Melanoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment (cediranib maleate)
Arm Type
Experimental
Arm Description
Patients receive oral AZD2171 once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
cediranib maleate
Other Intervention Name(s)
AZD2171
Intervention Description
Given orally
Primary Outcome Measure Information:
Title
Objective Tumor Response (Partial or Complete Response) According to RECIST
Description
Response and progression will be evaluated in this study using the new international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee [J Nat Cancer Inst 92(3):205-216, 2000]. Changes in only the largest diameter (unidimensional measurement) of the tumor lesions, assessed by CT or MRI; Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR."
Time Frame
Up to 6 years
Title
Prolonged Stable Disease According to RECIST
Time Frame
Up to 6 months
Secondary Outcome Measure Information:
Title
Median Survival Time
Time Frame
Up to 6 years
Title
Survival Rate
Time Frame
At 1 year
Title
Response Duration
Time Frame
From the time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, assessed up to 6 years
Title
Stable Disease Duration
Time Frame
From the start of the treatment until the criteria for progression are met, assessed up to 6 years
Title
Highest Toxicity Grade Assessed by NCI CTCAE Version 3.0
Time Frame
Up to 6 years after completion of treatment
Title
Time to Disease Progression
Time Frame
Up to 6 years
Title
Clinical Benefit Response
Time Frame
Up to 6 years
Title
Changes in Levels of Soluble Angiogenic Factors
Time Frame
From baseline to up to 6 years
Title
Change in Vessel Permeability and Blood Flow by DCE-MRI
Time Frame
From baseline to up to 28 days after starting daily oral dosing

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically/cytologically confirmed recurrent/metastatic malignant melanoma (stage IV acral lentiginous, lentigo maligna, superficial spreading or ocular malignant melanoma) Measurable disease- at least 1 lesion accurately measured in at least 1 dimension (longest diameter) as >=20mm with conventional techniques or >=10mm with spiral CT scan Previously irradiated lesions not considered measurable unless they demonstrated progression prior to study entry No prior chemotherapy (including regional therapy); prior adjuvant immunotherapy permitted if completed >3 months prior to study entry; patients may have received prior radiation therapy if completed >=4 weeks prior to study entry Previous surgery permissible if performed >=4 weeks prior to study entry Life expectancy >12 weeks ECOG performance status=< 2 (Karnofsky>=60%) Leukocytes>=3,000/mcL Absolute neutrophil count>=1,500/mcL Platelets>=100,000/mcL Hemoglobin>=8g/dL Total bilirubin<1.5x institutional ULN (IULN) AST/ALT=<3 x IULN (5xULN if liver metastases) Creatinine within IULN Creatinine within IULN OR Creatinine clearance>=60mL/min/m^2 if creatinine levels above IULN Baseline blood pressure <140/90mmHg; may be taking antihypertensive medications AZD2171 has shown to terminate fetal development in rat as expected for process dependent on VEGF signaling; women of childbearing potential must have negative pregnancy test prior to study entry; women of childbearing potential/men must agree to use adequate contraception (hormonal/barrier method of birth control; abstinence) prior to study entry and for duration of study Ability to understand/willingness to sign written informed consent Exclusion Criteria: Any previous chemotherapy or immunotherapy for recurrent/metastatic disease; patients who have had radiotherapy or major surgery within 4 weeks prior to entering study or those who have not recovered from AEs due to treatment received more than 4 weeks earlier May not be concurrently receiving other investigational agents nor have participated in an investigational trial of bio-, chemo- or immunotherapy agents Known brain metastases because of their poor prognosis and because patients often develop progressive neurologic dysfunction that would confound evaluation of neurologic and other AEs History of allergic reactions attributed to compounds of similar chemical/biologic composition to AZD2171 Mean QTc>470msec (Bazett's correction) in screening electrocardiogram or history of familial long QT syndrome >+1 proteinuria on 2 consecutive dipsticks taken no less than 1 week apart Uncontrolled intercurrent illness including but not limited to hypertension, ongoing/active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Pregnant women excluded from study because AZD2171 is a VEGF inhibitor with known abortifacient effects; breastfeeding should be discontinued if mother is treated with AZD2171 HIV-positive patients on combination antiretroviral therapy are ineligible because of potential for PK interactions with AZD2171; appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated Any significant abnormality noted in ECG within 14 days of treatment A NYHA classification of III or IV (NOTE: Patients classified as class II controlled with treatment may continue with increase monitoring) Conditions requiring concurrent use of drugs/biologics with proarrhythmic potential; these drugs are prohibited during studies with AZD2171
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elaine McWhirter
Organizational Affiliation
Princess Margaret Hospital Phase 2 Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Hospital Phase 2 Consortium
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada

12. IPD Sharing Statement

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AZD2171 in Treating Patients With Recurrent or Stage IV Melanoma

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