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Evaluation of Pathway Modulation by Raf, MEK, & Kinase Inhibitors

Primary Purpose

Metastatic Cancer, Melanoma, Colon Cancer

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Solar Simulator
Sponsored by
University of Arizona
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Metastatic Cancer focused on measuring metastatic, melanoma, cancer, colon, thyroid, Differentiated, Hepatocellular Carcinoma, HCC, RCC, Renal Cell Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects who have not yet initiated but plan to undergo dosing with a Tyrosine Kinase inhibitor (TKI) or Raf inhibitor, either alone or with a MEK inhibitor, for treatment of metastatic melanoma, colon cancer, hepatic cell carcinoma, or thyroid cancer.
  • Individuals with normal skin and Fitzpatrick skin type II, III or IV.
  • Individuals who are willing to limit sun exposure to the body during the study period, and who agree to wear protective clothing and SPF 50 broad spectrum sunscreen or sunblock on exposed skin when they are outdoors.
  • Individuals who have the ability to understand and willingness to sign an informed consent before initiation of study procedures, after the nature of the study is explained to them and they have asked any questions.
  • Individuals with a Karnofsky Performance Status of at least 80%.

Exclusion Criteria:

  • Individuals with any inflammation or irritation of the skin at the test area (buttocks), or any skin conditions felt by the study physician to contraindicate enrollment.
  • Individuals with a history of any skin cancer, melanocytic lesions, actinic keratoses or actinic damage in the test area are ineligible. History of such conditions at a body site other than the test area is not exclusionary if in the opinion of the study physician it will not pose a risk to the subject.
  • Individuals who are immunosuppressed by virtue of medication or disease, as determined by the examining study physician. This includes AIDS patients and subjects taking oral steroids.
  • Individuals with active infection, psychiatric illness, or other situations that in the opinion of the study physician limit compliance or interfere with the study regimen.
  • Individuals with a history of photosensitive diseases including, but not limited to, Lupus Erythematosus, pseudoporphyria, or other diseases that in the opinion of the study physician would pose a risk to the subject or interfere with the study.
  • Individuals who have used photosensitizing drugs within the last 30 days prior to study enrollment, or who will be using a photosensitizing drug during the time of the study.
  • Individuals who have used any topical medication other than emollients on the test area within 30 days prior to study enrollment.
  • Individuals who have used retinoids, steroids, 5-fluorouracil, Levulan, Vaniqua (eflornithine), Solaraze, or Imiquimod (Aldara®) anywhere on the body within 30 days prior to enrollment.
  • Individuals must not take mega-doses of vitamins. Mega-doses are defined as more than 5 capsules of standard multivitamins daily or more than the Tolerable Upper Intake Levels of Vitamins, as defined by the Institute of Medicine, National Academy of Sciences. Such vitamin therapy must be discontinued at least 30 days prior to study entry.
  • Individuals with a history of natural or artificial sun exposure to the buttocks within 30 days of study participation.
  • Individuals with Fitzpatrick skin type I
  • Individuals with Fitzpatrick skin type V or VI
  • Individuals enrolled in or who plan to enroll in a clinical intervention trial. There must be a 30-day period between completing a previous study and enrolling in this study. The Principal Investigator will have the option to consider an exception for patients on drugs of interest for the purpose of this study.
  • Individuals with a known allergy to lidocaine.

Sites / Locations

  • University of Arizona Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

No Intervention

Arm Label

ArmA: With Solar Simulated Light Exposure

ArmB: With Solar Simulated Light Exposure (Vemurafenib/Dabraf)

ArmC: Without Solar Simulated Light Exposure

Arm Description

Subjects in this study arm undergo the same procedures as Arm A, with the addition of a blood test for the presence of porphyrins

Outcomes

Primary Outcome Measures

Modulatory effect of systemic Raf inhibition in the MEK/Erk and PI3 /AKT/mTOR pathways in patients undergoing targeted therapy for metastatic disease
The primary endpoint of the study is to evaluate the modulatory effect of systemic Raf inhibition in the MEK/Erk and PI3 /AKT/mTOR pathways in patients undergoing targeted therapy for metastatic disease. Changes in relevant proteins will be evaluated using a combined protein expression methodology that in includes immunohistochemistry (IHC) and reverse phase protein microarray (RPPA) technology. The primary endpoint of this study will be assessed in normal skin and skin acutely exposed to solar simulated light.

Secondary Outcome Measures

Downstream modulation of direct Ras and MEK inhibition in human keratinocytes and melanocytes following acute solar simulated light exposure in the presence of metastatic disease treatment with Tyrosine kinase and MEK inhibitors.
The modulatory effect will be evaluated using IHC and RPPA technology.
Modulatory effect of systemic Raf inhibition in the MEK/Erk and PI3 /AKT/mTOR pathways in eligible melanocytic nevi.
Correlate the type and severity of cutaneous squamous cell carcinoma development in patients treated with BRaf inhibitors and the modulatory profile identified in the proposed primary endpoint.
Safety of performing solar simulated light studies in patients undergoing Ras inhibition for metastatic disease.
Modulatory effect of Ras inhibition in Epidermal Growth Factor Receptor (EGFR) and Activating Protein-1 (AP1) signaling pathways (IHC and RPPA).

Full Information

First Posted
June 1, 2017
Last Updated
January 3, 2019
Sponsor
University of Arizona
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1. Study Identification

Unique Protocol Identification Number
NCT03176485
Brief Title
Evaluation of Pathway Modulation by Raf, MEK, & Kinase Inhibitors
Official Title
Pilot Study to Evaluate the Signaling Pathway Modulation Demonstrated by Raf, MEK, and Kinase Inhibitors In Human Skin With or Without Solar Simulated Light
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
October 17, 2014 (Actual)
Primary Completion Date
November 1, 2018 (Actual)
Study Completion Date
November 1, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Arizona

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a pilot study designed to evaluate the cutaneous effect of systemic inhibition of the tyrosine kinase pathway in the presence or absence of solar simulated light exposure. A maximum of 45 subjects will be accrued into the overall study we anticipate approximately 25 patients in the Raf inhibitor group and 10 patients each into the Tyrosine Kinase and MEK inhibitor arms of the study.
Detailed Description
The study will evaluate the modulatory effect of systemic Raf inhibition in the MEK/ERK and PI3 /Akt/mTOR pathways in patients undergoing targeted therapy for metastatic disease. Changes in relevant proteins will be evaluated using a combined protein expression methodology that in includes immunohistochemistry (IHC) and reverse phase protein microarray (RPPA) technology. The primary endpoint of this study will be assessed in normal skin and skin acutely exposed to solar simulated light

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Cancer, Melanoma, Colon Cancer, Differentiated Thyroid Cancer, Hepatocellular Carcinoma, Renal Cell Carcinoma, Metastatic Melanoma, HCC, Metastatic Colon Cancer
Keywords
metastatic, melanoma, cancer, colon, thyroid, Differentiated, Hepatocellular Carcinoma, HCC, RCC, Renal Cell Carcinoma

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ArmA: With Solar Simulated Light Exposure
Arm Type
Experimental
Arm Title
ArmB: With Solar Simulated Light Exposure (Vemurafenib/Dabraf)
Arm Type
Experimental
Arm Description
Subjects in this study arm undergo the same procedures as Arm A, with the addition of a blood test for the presence of porphyrins
Arm Title
ArmC: Without Solar Simulated Light Exposure
Arm Type
No Intervention
Intervention Type
Other
Intervention Name(s)
Solar Simulator
Other Intervention Name(s)
Multiport UV Solar Simulator Model 60
Intervention Description
A Multiport UV Solar Simulator Model 600 (Solar Light Co., Inc., Philadelphia, PA) will be used to administer Solar Simulated Light (SSL) exposures to formerly unexposed buttock skin.The device is equipped with six 8mm liquid light guides (LLG), allowing for 6 simultaneously conducted exposures.A large 3x2 endplate places the LLGs several centimeters apart and is specifically designed for Sun Protection Factor (SPF) and photo patch testing. The dose of emission from each LLG can be precisely regulated and the spectrum of emission can be limited to UVA (320-390 nm) or UVB+UVA (290-390 nm). The operator can select between UVA only and a combined Ultraviolet-A (UVA)/ Ultraviolet-B (UVB) spectrum by placement of an optical filter. The spectral output (indicated below) follows the distribution of sunlight from 290 to 390 nm.
Primary Outcome Measure Information:
Title
Modulatory effect of systemic Raf inhibition in the MEK/Erk and PI3 /AKT/mTOR pathways in patients undergoing targeted therapy for metastatic disease
Description
The primary endpoint of the study is to evaluate the modulatory effect of systemic Raf inhibition in the MEK/Erk and PI3 /AKT/mTOR pathways in patients undergoing targeted therapy for metastatic disease. Changes in relevant proteins will be evaluated using a combined protein expression methodology that in includes immunohistochemistry (IHC) and reverse phase protein microarray (RPPA) technology. The primary endpoint of this study will be assessed in normal skin and skin acutely exposed to solar simulated light.
Time Frame
2 months
Secondary Outcome Measure Information:
Title
Downstream modulation of direct Ras and MEK inhibition in human keratinocytes and melanocytes following acute solar simulated light exposure in the presence of metastatic disease treatment with Tyrosine kinase and MEK inhibitors.
Description
The modulatory effect will be evaluated using IHC and RPPA technology.
Time Frame
2 months
Title
Modulatory effect of systemic Raf inhibition in the MEK/Erk and PI3 /AKT/mTOR pathways in eligible melanocytic nevi.
Time Frame
2 months
Title
Correlate the type and severity of cutaneous squamous cell carcinoma development in patients treated with BRaf inhibitors and the modulatory profile identified in the proposed primary endpoint.
Time Frame
2 months
Title
Safety of performing solar simulated light studies in patients undergoing Ras inhibition for metastatic disease.
Time Frame
2 months
Title
Modulatory effect of Ras inhibition in Epidermal Growth Factor Receptor (EGFR) and Activating Protein-1 (AP1) signaling pathways (IHC and RPPA).
Time Frame
2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who have not yet initiated but plan to undergo dosing with a Tyrosine Kinase inhibitor (TKI) or Raf inhibitor, either alone or with a MEK inhibitor, for treatment of metastatic melanoma, colon cancer, hepatic cell carcinoma, or thyroid cancer. Individuals with normal skin and Fitzpatrick skin type II, III or IV. Individuals who are willing to limit sun exposure to the body during the study period, and who agree to wear protective clothing and SPF 50 broad spectrum sunscreen or sunblock on exposed skin when they are outdoors. Individuals who have the ability to understand and willingness to sign an informed consent before initiation of study procedures, after the nature of the study is explained to them and they have asked any questions. Individuals with a Karnofsky Performance Status of at least 80%. Exclusion Criteria: Individuals with any inflammation or irritation of the skin at the test area (buttocks), or any skin conditions felt by the study physician to contraindicate enrollment. Individuals with a history of any skin cancer, melanocytic lesions, actinic keratoses or actinic damage in the test area are ineligible. History of such conditions at a body site other than the test area is not exclusionary if in the opinion of the study physician it will not pose a risk to the subject. Individuals who are immunosuppressed by virtue of medication or disease, as determined by the examining study physician. This includes AIDS patients and subjects taking oral steroids. Individuals with active infection, psychiatric illness, or other situations that in the opinion of the study physician limit compliance or interfere with the study regimen. Individuals with a history of photosensitive diseases including, but not limited to, Lupus Erythematosus, pseudoporphyria, or other diseases that in the opinion of the study physician would pose a risk to the subject or interfere with the study. Individuals who have used photosensitizing drugs within the last 30 days prior to study enrollment, or who will be using a photosensitizing drug during the time of the study. Individuals who have used any topical medication other than emollients on the test area within 30 days prior to study enrollment. Individuals who have used retinoids, steroids, 5-fluorouracil, Levulan, Vaniqua (eflornithine), Solaraze, or Imiquimod (Aldara®) anywhere on the body within 30 days prior to enrollment. Individuals must not take mega-doses of vitamins. Mega-doses are defined as more than 5 capsules of standard multivitamins daily or more than the Tolerable Upper Intake Levels of Vitamins, as defined by the Institute of Medicine, National Academy of Sciences. Such vitamin therapy must be discontinued at least 30 days prior to study entry. Individuals with a history of natural or artificial sun exposure to the buttocks within 30 days of study participation. Individuals with Fitzpatrick skin type I Individuals with Fitzpatrick skin type V or VI Individuals enrolled in or who plan to enroll in a clinical intervention trial. There must be a 30-day period between completing a previous study and enrolling in this study. The Principal Investigator will have the option to consider an exception for patients on drugs of interest for the purpose of this study. Individuals with a known allergy to lidocaine.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clara Curiel-Lewandroski
Organizational Affiliation
University of Arizona
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Arizona Cancer Center
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Evaluation of Pathway Modulation by Raf, MEK, & Kinase Inhibitors

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