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E7080 (Lenvatinib) in Combination With Dacarbazine Versus Dacarbazine Alone as First Line Therapy in Patients With Stage IV Melanoma

Primary Purpose

Stage IV Melanoma

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Lenvatinib
Lenvatinib
Dacarbazine
Sponsored by
Eisai Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stage IV Melanoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients with histologically-confirmed metastatic melanoma (Stage IV, American Joint Committee on Cancer (AJCC)).
  2. No prior cytokine, chemotherapy, or targeted therapy for Stage IV melanoma.
  3. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
  4. Life expectancy greater than or equal to 3 months.
  5. At least 1 site of measurable disease by RECIST 1.1.
  6. Adequate hematologic, renal, liver, and coagulation system function as defined by laboratory values performed within 21 days prior to initiation of dosing.
  7. Blood pressure must be well-controlled (less than or equal to 140/90 mmHg at screening) with or without antihypertensive medication. Patients must have no history of hypertensive crisis or hypertensive encephalopathy.

Exclusion Criteria:

  1. Known central nervous system (CNS) lesions, except for asymptomatic, nonprogressive, treated brain metastases. Treatment for brain metastases must have been completed at least 4 weeks prior to Day 1 and may include whole brain radiotherapy (WBRT), radiosurgery [RS; Gamma Knife, linear accelerator (LINAC), or equivalent] or a combination as deemed appropriate by the treating physician. Dexamethasone must be discontinued at least 3 weeks prior to Day 1. Patients with CNS metastases treated by neurosurgical resection or brain biopsy performed within 3 months prior to Day 1 will be excluded.
  2. Lactate dehydrogenase greater than or equal to 2.0 x upper limit of normal (ULN).
  3. Subjects with proteinuria greater than 1+ on urine dipstick testing will undergo 24-hour urine collection for quantitative assessment of proteinuria. Subjects with 24-hour urine protein greater than or equal to 1 g/24 hours will be ineligible.
  4. Pregnant, breast-feeding, or refusing double barrier contraception, oral contraceptives or avoidance of pregnancy measures.
  5. Other active malignancy.
  6. History of or known carcinomatous meningitis.
  7. History of or known ocular melanoma.
  8. Are currently receiving any other treatment for the tumor (including palliative radiotherapy) aside from control of symptoms.
  9. Received treatment in another clinical study within the 30 days prior to commencing study treatment or patients who have not recovered from side effects of an investigational drug to grade less than or equal to 1, except for alopecia.
  10. Received radiotherapy within the 30 days prior to commencing study treatment or have not recovered from side effects of all radiation-related toxicities to grade less than or equal to 1, except for alopecia.
  11. Serious non-healing wound, ulcer, bone fracture, or have undergone a major surgical procedure, open biopsy, or significant traumatic injury within the 28 days prior to commencing study treatment. Minor surgery such as Portacath placement or skin biopsy is permitted if greater than or equal to 7 days have passed.
  12. History of bleeding diathesis or coagulopathy.
  13. Current use of anti-coagulants such as Vitamin K antagonists, unfractionated heparin, or low molecular weight heparin.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Lenvatinib + Dacarbazine (Phase 1b)

Lenvatinib + Dacarbazine (Phase 2)

Dacarbazine (Phase 2)

Arm Description

Participants received 16 mg, 20 mg or 22 mg lenvatinib once daily in combination with dacarbazine

Participants received lenvatinib per the maximum tolerated dose (MTD) as determined in the Phase Ib of the study in combination with dacarbazine

Participants received dacarbazine

Outcomes

Primary Outcome Measures

Dose Limiting Toxicity (DLT) of Lenvatinib Administered in Combination With Dacarbazine (for Phase 1b)
DLTs were defined as clinically significant adverse events (AEs) occurring less than or equal to 21 days after commencing study treatment and considered by the Investigator to be possibly or probably related to study treatment.
Number of Participants With Adverse Events/Serious Adverse Events (AEs/SAEs)
Safety assessments consisted of monitoring and recording all AEs, including all Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v. 4.0) grades, and SAEs; regular monitoring of hematology, blood chemistry, and urine values; periodic measurement of vital signs and electrocardiograms (ECGs); and performance of physical examinations. Details of AEs and SAEs are provided in the reported adverse event section.

Secondary Outcome Measures

Progression Free Survival (PFS) (for Phase 2)
PFS was defined as the time from the date of randomization of a participant until (1) the date of first documented progression of such participant's disease based on Investigator assessments according to Response Evaluation Criteria In Solid Tumors (RECIST v. 1.1) or (2) the date of such participant's death due to any cause. Progression was defined as at least a 20% increase or 5 mm increase in the sum of diameters of target lesions (taking as reference the smallest sum on study) recorded since the treatment started or the appearance of 1 or more new lesions, based on Investigator assessment according to RECIST 1.1. If missing assessments, imputed dates were used in the analysis.

Full Information

First Posted
May 21, 2010
Last Updated
August 16, 2016
Sponsor
Eisai Inc.
Collaborators
Quintiles, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01133977
Brief Title
E7080 (Lenvatinib) in Combination With Dacarbazine Versus Dacarbazine Alone as First Line Therapy in Patients With Stage IV Melanoma
Official Title
An Open-Label, Multicenter, Randomized, Phase Ib/II Study of E7080 (Lenvatinib) in Combination With Dacarbazine Versus Dacarbazine Alone as First Line Therapy in Patients With Stage IV Melanoma.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
April 2010 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eisai Inc.
Collaborators
Quintiles, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Primary: Phase Ib: To define the safety, tolerability and maximum tolerated dose (MTD) of lenvatinib administered in combination with dacarbazine. Phase II: To evaluate the safety and tolerability of lenvatinib administered in combination with dacarbazine, compared with dacarbazine alone. Secondary: -Phase II: To make a preliminary assessment of the efficacy of lenvatinib administered in combination with dacarbazine, compared with dacarbazine alone.
Detailed Description
Safety was assessed by monitoring and recording all treatment emergent adverse events (AEs) and serious adverse events (SAEs); regular monitoring of clinical laboratory parameters; periodic measurement of vital signs and electrocardiograms (ECGs); dose limiting toxicities; performance of physical examinations; concomitant medications and procedures.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage IV Melanoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
97 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lenvatinib + Dacarbazine (Phase 1b)
Arm Type
Experimental
Arm Description
Participants received 16 mg, 20 mg or 22 mg lenvatinib once daily in combination with dacarbazine
Arm Title
Lenvatinib + Dacarbazine (Phase 2)
Arm Type
Experimental
Arm Description
Participants received lenvatinib per the maximum tolerated dose (MTD) as determined in the Phase Ib of the study in combination with dacarbazine
Arm Title
Dacarbazine (Phase 2)
Arm Type
Active Comparator
Arm Description
Participants received dacarbazine
Intervention Type
Drug
Intervention Name(s)
Lenvatinib
Other Intervention Name(s)
E7080
Intervention Description
Lenvatinib tablets administered orally at doses of 16 mg, 20 mg, or 22 mg, once daily continuously over 3 weeks (21 days) during each 21-day cycle
Intervention Type
Drug
Intervention Name(s)
Lenvatinib
Other Intervention Name(s)
E7080
Intervention Description
Lenvatinib 20 mg (MTD/recommended Phase 2 dose as determined in Phase 1b of the study) administered once daily continuously over 3 weeks (21 days) during each 21-day cycle
Intervention Type
Drug
Intervention Name(s)
Dacarbazine
Other Intervention Name(s)
Dacarbazine (DTIC)-Dome
Intervention Description
Dacarbazine (1000 mg/m2) infusion over 60 minutes on Day 1 of each 21-day cycle.
Primary Outcome Measure Information:
Title
Dose Limiting Toxicity (DLT) of Lenvatinib Administered in Combination With Dacarbazine (for Phase 1b)
Description
DLTs were defined as clinically significant adverse events (AEs) occurring less than or equal to 21 days after commencing study treatment and considered by the Investigator to be possibly or probably related to study treatment.
Time Frame
From Day 1 through 21 days (one cycle)
Title
Number of Participants With Adverse Events/Serious Adverse Events (AEs/SAEs)
Description
Safety assessments consisted of monitoring and recording all AEs, including all Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v. 4.0) grades, and SAEs; regular monitoring of hematology, blood chemistry, and urine values; periodic measurement of vital signs and electrocardiograms (ECGs); and performance of physical examinations. Details of AEs and SAEs are provided in the reported adverse event section.
Time Frame
From signing of informed consent up to 30 days after the last dose, up to approximately 2 years
Secondary Outcome Measure Information:
Title
Progression Free Survival (PFS) (for Phase 2)
Description
PFS was defined as the time from the date of randomization of a participant until (1) the date of first documented progression of such participant's disease based on Investigator assessments according to Response Evaluation Criteria In Solid Tumors (RECIST v. 1.1) or (2) the date of such participant's death due to any cause. Progression was defined as at least a 20% increase or 5 mm increase in the sum of diameters of target lesions (taking as reference the smallest sum on study) recorded since the treatment started or the appearance of 1 or more new lesions, based on Investigator assessment according to RECIST 1.1. If missing assessments, imputed dates were used in the analysis.
Time Frame
From the date of randomization until the date of disease progression or death (whichever was earlier) or up to approximately 2 years
Other Pre-specified Outcome Measures:
Title
Time to Progression (TTP) (for Phase 2)
Description
TTP, defined as the time from the date of randomization until the date of progressive disease.
Time Frame
From the date of randomization until disease progression or death or up to approximately 2 years
Title
Overall Survival (OS) (for Phase 2)
Description
OS, defined as the time from the date of randomization until the date of death. Few events of deaths (9 events in the Lenvatinib + Dacarbazine arm and 4 events in the Dacarbazine arm) were reported to calculate the median OS or to draw conclusions regarding the OS.
Time Frame
From the date of randomization until death or up to approximately 2 years
Title
Overall Response Rate (ORR) (for Phase 2)
Description
ORR, defined as percentage of participants with best confirmed response (complete response [CR] or partial response [PR]). A confirmatory scan was required after no less than 4 weeks and no later than 8 weeks, starting on the date that the response was first recorded.
Time Frame
From the date of randomization until disease progression or death or up to approximately 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with histologically-confirmed metastatic melanoma (Stage IV, American Joint Committee on Cancer (AJCC)). No prior cytokine, chemotherapy, or targeted therapy for Stage IV melanoma. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1. Life expectancy greater than or equal to 3 months. At least 1 site of measurable disease by RECIST 1.1. Adequate hematologic, renal, liver, and coagulation system function as defined by laboratory values performed within 21 days prior to initiation of dosing. Blood pressure must be well-controlled (less than or equal to 140/90 mmHg at screening) with or without antihypertensive medication. Patients must have no history of hypertensive crisis or hypertensive encephalopathy. Exclusion Criteria: Known central nervous system (CNS) lesions, except for asymptomatic, nonprogressive, treated brain metastases. Treatment for brain metastases must have been completed at least 4 weeks prior to Day 1 and may include whole brain radiotherapy (WBRT), radiosurgery [RS; Gamma Knife, linear accelerator (LINAC), or equivalent] or a combination as deemed appropriate by the treating physician. Dexamethasone must be discontinued at least 3 weeks prior to Day 1. Patients with CNS metastases treated by neurosurgical resection or brain biopsy performed within 3 months prior to Day 1 will be excluded. Lactate dehydrogenase greater than or equal to 2.0 x upper limit of normal (ULN). Subjects with proteinuria greater than 1+ on urine dipstick testing will undergo 24-hour urine collection for quantitative assessment of proteinuria. Subjects with 24-hour urine protein greater than or equal to 1 g/24 hours will be ineligible. Pregnant, breast-feeding, or refusing double barrier contraception, oral contraceptives or avoidance of pregnancy measures. Other active malignancy. History of or known carcinomatous meningitis. History of or known ocular melanoma. Are currently receiving any other treatment for the tumor (including palliative radiotherapy) aside from control of symptoms. Received treatment in another clinical study within the 30 days prior to commencing study treatment or patients who have not recovered from side effects of an investigational drug to grade less than or equal to 1, except for alopecia. Received radiotherapy within the 30 days prior to commencing study treatment or have not recovered from side effects of all radiation-related toxicities to grade less than or equal to 1, except for alopecia. Serious non-healing wound, ulcer, bone fracture, or have undergone a major surgical procedure, open biopsy, or significant traumatic injury within the 28 days prior to commencing study treatment. Minor surgery such as Portacath placement or skin biopsy is permitted if greater than or equal to 7 days have passed. History of bleeding diathesis or coagulopathy. Current use of anti-coagulants such as Vitamin K antagonists, unfractionated heparin, or low molecular weight heparin.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dave Harish
Organizational Affiliation
Quintiles, Inc.
Official's Role
Study Director
Facility Information:
City
Hagerstown
State/Province
Maryland
Country
United States
City
Albany
State/Province
New York
Country
United States
City
Greenville
State/Province
South Carolina
Country
United States
City
Dallas
State/Province
Texas
Country
United States
City
Norfolk
State/Province
Virginia
Country
United States
City
Berlin
ZIP/Postal Code
10249
Country
Germany
City
Berlin
ZIP/Postal Code
12351
Country
Germany
City
Berlin
ZIP/Postal Code
13585
Country
Germany
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
City
Muenchen
ZIP/Postal Code
81675
Country
Germany
City
Bari
ZIP/Postal Code
70126
Country
Italy
City
Milan
ZIP/Postal Code
20133
Country
Italy
City
Milian
ZIP/Postal Code
20141
Country
Italy
City
Napoli
ZIP/Postal Code
80131
Country
Italy
City
Siena
ZIP/Postal Code
53100
Country
Italy
City
Barcelona
Country
Spain
City
Madrid
ZIP/Postal Code
28033
Country
Spain
City
Madrid
ZIP/Postal Code
28034
Country
Spain
City
Madrid
ZIP/Postal Code
28050
Country
Spain
City
Valenica
ZIP/Postal Code
46014
Country
Spain
City
Dorset
Country
United Kingdom
City
Glasgow
Country
United Kingdom
City
Manchester
Country
United Kingdom
City
Middlesex
Country
United Kingdom
City
Oxford
Country
United Kingdom
City
Southampton
Country
United Kingdom
City
Wirral
Country
United Kingdom

12. IPD Sharing Statement

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E7080 (Lenvatinib) in Combination With Dacarbazine Versus Dacarbazine Alone as First Line Therapy in Patients With Stage IV Melanoma

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