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Comparison Between Fotemustin to Intensive Surveillance in Patients With High Risk Uveal Melanoma (FOTEADJ)

Primary Purpose

Uveal Melanoma

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Adjuvant chemotherapy by Fotemustin
Intensive surveillance
Sponsored by
Institut Curie
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Uveal Melanoma focused on measuring Uveal melanoma, High risk of metastasis, Genomic high risk signature, Adjuvant chemotherapy

Eligibility Criteria

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

Inclusion Criteria:

  1. High risk uveal melanoma, defined by :

    • Clinical criteria: Largest Tumor Diameter ≥ 15 mm with extrascleral extension and/or retinal detachment or Largest Tumor Diameter ≥ 18 mm AND/OR
    • Genomic high risk signature (cCGH +/- LOH) : Monosomy 3 or partial deletion of 3p and any 8 gain, from enucleation, transscleral or transvitreal samples
  2. Age ≥ 18 years and ECOG Performance Status ≤ 2
  3. No prior chemotherapy or history of invasive cancer < 5years
  4. No metastases
  5. Local treatment for the primary tumour (surgery and/or radiotherapy) achieved ≤ 30 days from randomization, chemotherapy to begin within 15 days.

6 - Contraception in women of child-bearing potential

7- Written informed consent

8- Patients with French Social Security in compliance with the French law relating to biomedical research.

Non-Inclusion Criteria:

  1. Largest Tumor Diameter < 15 mm or Largest Tumor Diameter 15-18 mm without extrascleral extension and/or retinal detachment, in the absence of genomic alteration as defined per protocol or in the absence of Fine Needle Aspiration biopsy for genomic risk assessment.
  2. Contraindication to Fotemustine administration
  3. Hematological function : Hb < 10g/dL, absolute neutrophil count < 2,000/mm3, and platelets < 100,000/mm3
  4. Biochemistry results :Total bilirubin and AST/ALT > 1,5 UNL (Upper Normal Limit)
  5. Creatinine > 1,5 UNL (Upper Normal Limit)
  6. Pregnant and/or breastfeeding women.

8 - Previous history of cancer excepting in situ cervical carcinoma or cutaneous basal carcinoma.

7- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, viral or other hepatitis or cirrhosis, or psychiatric illness/social situation that would interfere with the protocol or limit compliance with study requirements.

Sites / Locations

  • Centre Jean Perrin
  • Centre Léon Bérard
  • CHU Nice
  • Centre Antoine Lacassagne
  • Institut Curie
  • Centre Hospitalier Universitaire Vaudois

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

A : Chemotherapy

B : Surveillance

Arm Description

Adjuvant chemotherapy by Fotemustin 100mg/m²

Intensive surveillance

Outcomes

Primary Outcome Measures

Metastasis-Free survival
Time between patient randomization and metastases occurrence or death

Secondary Outcome Measures

Overall Survival
Time between patient randomization and death
Safety : incidence of Adverse Events and Serious Adverse Events and laboratory abnormalities
using National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) V3
Quality of life assessment
Using QLQ-C30 questionary.

Full Information

First Posted
July 21, 2016
Last Updated
August 30, 2022
Sponsor
Institut Curie
Collaborators
Servier, UNICANCER
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1. Study Identification

Unique Protocol Identification Number
NCT02843386
Brief Title
Comparison Between Fotemustin to Intensive Surveillance in Patients With High Risk Uveal Melanoma
Acronym
FOTEADJ
Official Title
Randomized Phase III Study Comparing an Adjuvant Chemotherapy With Fotemustin to Intensive Surveillance in Patients With High Risk Uveal Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
June 23, 2009 (Actual)
Primary Completion Date
June 12, 2020 (Actual)
Study Completion Date
June 12, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut Curie
Collaborators
Servier, UNICANCER

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
After the local treatment of the primary tumor (protonbeam-therapy, enucleation, external radiotherapy) patients with high risk of metastasis are randomized between: Adjuvant chemotherapy with Fotemustin. Observation Both groups are followed during 3 years for Metastasis- Free Survival, safety and tolerance of Fotemustin, quality of life, and Overall Survival.
Detailed Description
High risk uveal melanoma is defined by : Clinical criteria: Largest Tumor Diameter ≥ 15 mm with extra scleral extension and/or retinal detachment or Largest Tumor Diameter ≥ 18 mm AND/ OR Genomic high risk signature (aCGH +/-LOH): Monosomy 3 or partial deletion of 3p associated with any 8 gain. Treatment schedule : Induction: Fotemustin 100 mg/m², D1-D8-D15, 1 hour IV infusion, 1 cycle Maintenance : restart on D50, Fotemustine : 100 mg/m², 1 hour IV infusion, D1 D21, 5 cycles. Both groups are followed during 3 years for Metastasis- Free Survival, safety and tolerance of Fotemustin, quality of life, and Overall Survival. Note :Based on the second interim analysis showing futility, and no chance to observe any significant statistical difference at the end of the study, the Independent Data Monitoring Committee recommended to stop randomization and amend the protocol to propose an interventional surveillance to high-risk patients as per protocol (April 2016).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Uveal Melanoma
Keywords
Uveal melanoma, High risk of metastasis, Genomic high risk signature, Adjuvant chemotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
302 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A : Chemotherapy
Arm Type
Experimental
Arm Description
Adjuvant chemotherapy by Fotemustin 100mg/m²
Arm Title
B : Surveillance
Arm Type
Other
Arm Description
Intensive surveillance
Intervention Type
Drug
Intervention Name(s)
Adjuvant chemotherapy by Fotemustin
Other Intervention Name(s)
Fotemustin
Intervention Description
Fotemustin is given for 6 cycles : One Induction cycle: Fotemustin 100 mg/m², 1 hour IV infusion, D1D8D15, 5 week rest period, restart on D50. Five Maintenance cycles: Fotemustin 100 mg/m², 1 hour IV infusion, D1-D21.
Intervention Type
Other
Intervention Name(s)
Intensive surveillance
Other Intervention Name(s)
Surveillance
Intervention Description
Intensive surveillance Total duration: 3 years. liver functional tests/3 months, - liver MRI or CT-scan/6 months, - whole body CT-scan/12 months.
Primary Outcome Measure Information:
Title
Metastasis-Free survival
Description
Time between patient randomization and metastases occurrence or death
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Overall Survival
Description
Time between patient randomization and death
Time Frame
3 years
Title
Safety : incidence of Adverse Events and Serious Adverse Events and laboratory abnormalities
Description
using National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) V3
Time Frame
3 years
Title
Quality of life assessment
Description
Using QLQ-C30 questionary.
Time Frame
Baseline, 6 months and 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: High risk uveal melanoma, defined by : Clinical criteria: Largest Tumor Diameter ≥ 15 mm with extrascleral extension and/or retinal detachment or Largest Tumor Diameter ≥ 18 mm AND/OR Genomic high risk signature (cCGH +/- LOH) : Monosomy 3 or partial deletion of 3p and any 8 gain, from enucleation, transscleral or transvitreal samples Age ≥ 18 years and ECOG Performance Status ≤ 2 No prior chemotherapy or history of invasive cancer < 5years No metastases Local treatment for the primary tumour (surgery and/or radiotherapy) achieved ≤ 30 days from randomization, chemotherapy to begin within 15 days. 6 - Contraception in women of child-bearing potential 7- Written informed consent 8- Patients with French Social Security in compliance with the French law relating to biomedical research. Non-Inclusion Criteria: Largest Tumor Diameter < 15 mm or Largest Tumor Diameter 15-18 mm without extrascleral extension and/or retinal detachment, in the absence of genomic alteration as defined per protocol or in the absence of Fine Needle Aspiration biopsy for genomic risk assessment. Contraindication to Fotemustine administration Hematological function : Hb < 10g/dL, absolute neutrophil count < 2,000/mm3, and platelets < 100,000/mm3 Biochemistry results :Total bilirubin and AST/ALT > 1,5 UNL (Upper Normal Limit) Creatinine > 1,5 UNL (Upper Normal Limit) Pregnant and/or breastfeeding women. 8 - Previous history of cancer excepting in situ cervical carcinoma or cutaneous basal carcinoma. 7- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, viral or other hepatitis or cirrhosis, or psychiatric illness/social situation that would interfere with the protocol or limit compliance with study requirements.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sophie PIPERNO-NEUMANN, MD
Organizational Affiliation
Institut Curie
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centre Jean Perrin
City
Clermont-ferrand
ZIP/Postal Code
63011
Country
France
Facility Name
Centre Léon Bérard
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
CHU Nice
City
Nice
ZIP/Postal Code
06003
Country
France
Facility Name
Centre Antoine Lacassagne
City
Nice
ZIP/Postal Code
06189
Country
France
Facility Name
Institut Curie
City
Paris
ZIP/Postal Code
75005
Country
France
Facility Name
Centre Hospitalier Universitaire Vaudois
City
Lausanne
ZIP/Postal Code
1011
Country
Switzerland

12. IPD Sharing Statement

Plan to Share IPD
No

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Comparison Between Fotemustin to Intensive Surveillance in Patients With High Risk Uveal Melanoma

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