Vorinostat in Patients With Class 2 High Risk Uveal Melanoma
Primary Purpose
Uveal Melanoma
Status
Withdrawn
Phase
Early Phase 1
Locations
Study Type
Interventional
Intervention
Vorinostat
Sponsored by
About this trial
This is an interventional treatment trial for Uveal Melanoma focused on measuring Uveal Melanoma
Eligibility Criteria
Inclusion Criteria:
- Uveal melanoma tumor determined by ophthalmic ultrasound or clinical assessment.
- Class 2 uveal melanoma
- No evidence of metastatic disease.
- Age ≥18 years.
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
- Life expectancy of greater than 3 months.
- Able to swallow and retain orally-administered medication and does not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels
Patients must have normal organ and marrow function as defined below:
- Absolute neutrophil count (ANC) >1,500 cells/mm³
- Platelet count >100,000/mm³
- Hemoglobin >10.0g/dL
- Aspartate transaminase (AST) and/or Alanine transaminase (ALT) < 3x upper limited of normal (ULN)
- Total bilirubin < 2x ULN
- Hemoglobin A1C ≤ 5.7%
- Alkaline phosphatase < 3x ULN
- Serum creatinine < 2x ULN or a creatinine clearance > 60 mL/min
- Note: Patients with hyperbilirubinemia clinically consistent with an inherited disorder of bilirubin metabolism (e.g., Gilbert syndrome) will be eligible at the discretion of the treating physician and/or the principal investigator.
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation until 4 months after completion of study drug administration. Women of child-bearing potential must have a negative serum or urine test at time of enrollment. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study therapy, and 4 months after completion of study drug administration.
- Willingness to comply with all the visits and procedures (including providing all biological specimens) as required by the protocol and the informed consent form (ICF).
- Ability to understand the investigational nature, potential risks and benefits of the research study and to provide valid written informed consent.
Exclusion Criteria:
- Definitive therapy of the primary uveal melanoma by either surgery or radiotherapy
- History of another malignancy except for those who have been disease-free for 3 years, or patients with a history of completely resected non-melanoma skin cancer and/or patients with indolent secondary malignancies not requiring active therapy, are eligible. Consult the study Principal Investigator if unsure whether second malignancies meet the requirements specified above.
- Any major surgery or extensive radiotherapy, chemotherapy with delayed toxicity, biologic therapy, or immunotherapy within 21 days prior to initiation of study therapy.
- History of prior vorinostat use.
- Use of other investigational drugs within 28 days
- Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to vorinostat (i.e. HDAC inhibitor hydroxamates such as panobinostat and belinostat).
- A QT interval corrected (QTc) for heart rate using the Bazett's formula (QTcB) ≥ 480 msec. Concurrent administration of vorinostat and agents that can cause QTc prolongation is not permitted.
- Concurrent administration of vorinostat and other HDAC inhibitors is not permitted due to the increased risk of thrombocytopenia and gastrointestinal bleeding.
- Patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with vorinostat.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infections, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with the study requirements.
- History of pulmonary embolism (PT) or deep-vein thrombosis (DVT)
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Vorinostat
Arm Description
Vorinostat: 400 mg orally, once daily for 15 days.
Outcomes
Primary Outcome Measures
Degree of transformation from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
The investigators will analyze gene expression results from fine needle aspirate biopsies performed at baseline prior to vorinostat therapy and post-treatment (on Day 15, after the planned 15 days of vorinostat therapy).
Proportion of patients whose tumors transformed from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
Through gene expression analysis, the investigators will determine the proportion of patients whose tumors transformed from a Class 2 phenotype into a cell phenotype that resembles normal melanocytes.
Secondary Outcome Measures
Toxicity During Protocol Therapy
Rate of adverse events (AEs) and serious adverse events (SAEs) experienced by study participants during Vorinostat therapy and up to one month after Vorinostat treatment completion.
Tumor size before and after Vorinostat therapy
Tumor size will be determined before and after Vorinostat therapy by B-Scan ultrasonography.
Recurrence-free survival (RFS)
Recurrence-Free Survival (RFS) in Study Participants. RFS is defined as the duration of time from start of treatment to time of disease recurrence or death, whichever occurs first.
Overall survival (OS)
Overall Survival (OS) in Study Participants. OS is defined as the length of time from date of start of Vorinostat treatment to death.
Disease Specific Survival (DSS)
Disease Specific Survival (DSS) in Study Participants. DSS is defined as the time from start of Vorinostat treatment to death due to disease.
Full Information
NCT ID
NCT03022565
First Posted
December 21, 2016
Last Updated
February 4, 2020
Sponsor
University of Miami
Collaborators
University of Miami Sylvester Comprehensive Cancer Center
1. Study Identification
Unique Protocol Identification Number
NCT03022565
Brief Title
Vorinostat in Patients With Class 2 High Risk Uveal Melanoma
Official Title
Proof of Concept Study of Vorinostat, A Histone Deacetylase Inhibitor, in Patients With Class 2 High Risk Uveal Melanoma
Study Type
Interventional
2. Study Status
Record Verification Date
February 2020
Overall Recruitment Status
Withdrawn
Why Stopped
Investigator Decision
Study Start Date
January 2020 (Anticipated)
Primary Completion Date
January 29, 2020 (Actual)
Study Completion Date
January 29, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Miami
Collaborators
University of Miami Sylvester Comprehensive Cancer Center
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This proof-of-concept study will evaluate the ability of vorinostat to induce the transformation of Class 2 uveal melanoma cells into a cell phenotype that resembles normal melanocytes.
Detailed Description
This is a proof of concept, single-center, open-label study of an FDA-approved drug, vorinostat, a Histone deacetylase (HDAC) inhibitor, for patients with Class 2, high-risk uveal melanoma with localized eye tumors. The primary aim is to test if vorinostat can transform aggressive class 2 uveal melanoma cells into cells that look more like normal melanocytes as observed in the laboratory. Uveal melanoma patients that meet the inclusion criteria outlined in this protocol will be consented and asked to provide a fine needle aspiration (FNA) biopsy of their uveal melanoma primary tumor. This biopsy will be submitted for gene expression analysis to determine the phenotype of the tumor. A total of 10 patients who meet the criteria of Class 2 uveal melanoma and no radiologic evidence of metastases will be treated with 400 mg of vorinostat daily for 15 days. On Day 15, patients will be asked to provide a second FNA biopsy prior to receiving the standard of care local definitive therapy either plaque radiotherapy or enucleation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Uveal Melanoma
Keywords
Uveal Melanoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Vorinostat
Arm Type
Experimental
Arm Description
Vorinostat:
400 mg orally, once daily for 15 days.
Intervention Type
Drug
Intervention Name(s)
Vorinostat
Other Intervention Name(s)
Zolinza
Intervention Description
Study participants who meet the criteria of Class 2 uveal melanoma and no radiologic evidence of metastases will be treated with 400 mg of Vorinostat daily for 15 days.
Primary Outcome Measure Information:
Title
Degree of transformation from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
Description
The investigators will analyze gene expression results from fine needle aspirate biopsies performed at baseline prior to vorinostat therapy and post-treatment (on Day 15, after the planned 15 days of vorinostat therapy).
Time Frame
From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks
Title
Proportion of patients whose tumors transformed from a class 2 phenotype into a cell phenotype that resembles normal melanocytes.
Description
Through gene expression analysis, the investigators will determine the proportion of patients whose tumors transformed from a Class 2 phenotype into a cell phenotype that resembles normal melanocytes.
Time Frame
From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks
Secondary Outcome Measure Information:
Title
Toxicity During Protocol Therapy
Description
Rate of adverse events (AEs) and serious adverse events (SAEs) experienced by study participants during Vorinostat therapy and up to one month after Vorinostat treatment completion.
Time Frame
Up to 1 Month Post-Treatment Completion
Title
Tumor size before and after Vorinostat therapy
Description
Tumor size will be determined before and after Vorinostat therapy by B-Scan ultrasonography.
Time Frame
From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks
Title
Recurrence-free survival (RFS)
Description
Recurrence-Free Survival (RFS) in Study Participants. RFS is defined as the duration of time from start of treatment to time of disease recurrence or death, whichever occurs first.
Time Frame
Up to 5 Years Post-Treatment Completion
Title
Overall survival (OS)
Description
Overall Survival (OS) in Study Participants. OS is defined as the length of time from date of start of Vorinostat treatment to death.
Time Frame
Up to 5 Years Post-Treatment Completion
Title
Disease Specific Survival (DSS)
Description
Disease Specific Survival (DSS) in Study Participants. DSS is defined as the time from start of Vorinostat treatment to death due to disease.
Time Frame
Up to 5 Years Post-Treatment Completion
Other Pre-specified Outcome Measures:
Title
Global histone acetylation levels in peripheral blood mononuclear cells (PBMCs) before and after Vorinostat therapy.
Description
Global histone acetylation levels in peripheral blood mononuclear cells (PBMCs) will be measured at baseline (Day 1, before Vorinostat treatment) and post-treatment (day 15 after completion of Vorinostat therapy).
Time Frame
From Baseline to 15 Days of Protocol Therapy, Up to 4 Weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Uveal melanoma tumor determined by ophthalmic ultrasound or clinical assessment.
Class 2 uveal melanoma
No evidence of metastatic disease.
Age ≥18 years.
Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
Life expectancy of greater than 3 months.
Able to swallow and retain orally-administered medication and does not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels
Patients must have normal organ and marrow function as defined below:
Absolute neutrophil count (ANC) >1,500 cells/mm³
Platelet count >100,000/mm³
Hemoglobin >10.0g/dL
Aspartate transaminase (AST) and/or Alanine transaminase (ALT) < 3x upper limited of normal (ULN)
Total bilirubin < 2x ULN
Hemoglobin A1C ≤ 5.7%
Alkaline phosphatase < 3x ULN
Serum creatinine < 2x ULN or a creatinine clearance > 60 mL/min
Note: Patients with hyperbilirubinemia clinically consistent with an inherited disorder of bilirubin metabolism (e.g., Gilbert syndrome) will be eligible at the discretion of the treating physician and/or the principal investigator.
Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation until 4 months after completion of study drug administration. Women of child-bearing potential must have a negative serum or urine test at time of enrollment. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study therapy, and 4 months after completion of study drug administration.
Willingness to comply with all the visits and procedures (including providing all biological specimens) as required by the protocol and the informed consent form (ICF).
Ability to understand the investigational nature, potential risks and benefits of the research study and to provide valid written informed consent.
Exclusion Criteria:
Definitive therapy of the primary uveal melanoma by either surgery or radiotherapy
History of another malignancy except for those who have been disease-free for 3 years, or patients with a history of completely resected non-melanoma skin cancer and/or patients with indolent secondary malignancies not requiring active therapy, are eligible. Consult the study Principal Investigator if unsure whether second malignancies meet the requirements specified above.
Any major surgery or extensive radiotherapy, chemotherapy with delayed toxicity, biologic therapy, or immunotherapy within 21 days prior to initiation of study therapy.
History of prior vorinostat use.
Use of other investigational drugs within 28 days
Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to vorinostat (i.e. HDAC inhibitor hydroxamates such as panobinostat and belinostat).
A QT interval corrected (QTc) for heart rate using the Bazett's formula (QTcB) ≥ 480 msec. Concurrent administration of vorinostat and agents that can cause QTc prolongation is not permitted.
Concurrent administration of vorinostat and other HDAC inhibitors is not permitted due to the increased risk of thrombocytopenia and gastrointestinal bleeding.
Patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with vorinostat.
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infections, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with the study requirements.
History of pulmonary embolism (PT) or deep-vein thrombosis (DVT)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
J. William Harbour, MD
Organizational Affiliation
University of Miami
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Vorinostat in Patients With Class 2 High Risk Uveal Melanoma
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