Clinical Trials /

Safety and Efficacy Study of Vemurafenib and High-dose Interferon Alfa-2b in Melanoma

NCT01943422

Description:

This is a dose-seeking and efficacy study of combined BRAF Inhibitor Vemurafenib and High-dose Interferon alfa-2b for therapy of advanced melanoma.

Related Conditions:
  • Melanoma
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Safety and Efficacy Study of Vemurafenib and High-dose Interferon Alfa-2b in Melanoma
  • Official Title: Dose-seeking and Efficacy Study of the Combination of the BRAF Inhibitor Vemurafenib and High-dose Interferon Alfa-2b for Therapy of Advanced Melanoma

Clinical Trial IDs

  • ORG STUDY ID: 12-107
  • NCT ID: NCT01943422

Conditions

  • Melanoma

Interventions

DrugSynonymsArms
High-dose Interferon alfa-2bIFNα-2b (HDI)Vemurafenib + IFNα-2b (10 MU/m2/d)
VemurafenibZelborafVemurafenib + IFNα-2b (10 MU/m2/d)

Purpose

This is a dose-seeking and efficacy study of combined BRAF Inhibitor Vemurafenib and High-dose Interferon alfa-2b for therapy of advanced melanoma.

Detailed Description

      -  Dose-selection and dose-expansion study of combination therapy with high-dose interferon
           alfa-2b and vemurafenib.

        -  Vemurafenib at standard dosing with a 2 week lead-in period to exploit potential
           immunomodulatory effects. Concurrent HDI following this (week 2 onwards) at standard
           induction (4 weeks) and maintenance (48 weeks) doses.

        -  Modified Storer's "up and down" dose escalation schema using 3 fixed dose levels for HDI
           and a fixed sample size that allows efficient identification of recommended phase II
           dose.

        -  36-63 patients will be enrolled depending on toxicity parameters. oIn the dose-selection
           portion, 3 patients will be enrolled per dose level, starting from the lowest dose
           level. Enrollment will occur serially allowing for the observation of toxicity during
           the observation period.

      oIterative enrollment of up to 3 subjects per cohort will be continued until a total of 30
      evaluable subjects have been enrolled.

      oThe dose level at which the RLT rate is the closest to 1/3 will be considered as RP2D.

      oDuring the dose-expansion portion of the trial, depending on the number of patients treated
      at RP2D during the dose-selection portion, additional patients may be enrolled - the accrual
      target is 36 patients treated at RP2D.
    

Trial Arms

NameTypeDescriptionInterventions
Vemurafenib + IFNα-2b (10 MU/m2/d)ExperimentalVemurafenib + High-dose Interferon alfa-2b (10 MU/m2/d) IFNα-2b will be administered intravenously for 5 consecutive days (Monday through Friday) every week for 4 weeks (induction) Vemurafenib will be dosed continuously at the standard Food and Drug Administration (FDA) approved dose of 960mg twice a day orally without dose interruption except for toxicities attributable to this agent.
  • High-dose Interferon alfa-2b
  • Vemurafenib
Vemurafenib + IFNα-2b(15 MU/m2/d)ExperimentalVemurafenib + High-dose Interferon alfa-2b (15 MU/m2/d) IFNα-2b will be administered intravenously for 5 consecutive days (Monday through Friday) every week for 4 weeks (induction) Vemurafenib will be dosed continuously at the standard Food and Drug Administration (FDA) approved dose of 960mg twice a day orally without dose interruption except for toxicities attributable to this agent.
  • High-dose Interferon alfa-2b
  • Vemurafenib
Vemurafenib + IFNα-2b (20 MU/m2/d)ExperimentalVemurafenib + High-dose Interferon alfa-2b (20 MU/m2/d) IFNα-2b will be administered intravenously for 5 consecutive days (Monday through Friday) every week for 4 weeks (induction) Vemurafenib will be dosed continuously at the standard Food and Drug Administration (FDA) approved dose of 960mg twice a day orally without dose interruption except for toxicities attributable to this agent.
  • High-dose Interferon alfa-2b
  • Vemurafenib

Eligibility Criteria

        Inclusion Criteria:

          -  Patients must have a written informed consent.

          -  18 years of age.

          -  Patients must have histologically confirmed recurrent stage III or stage IV melanoma
             (AJCC 7th edition classification).

          -  BRAF V600E and V600K mutated

          -  Cutaneous squamous cell carcinomas (SCC) lesions identified at baseline must be
             excised. Adequate wound healing is required prior to study entry.

          -  Patients must have measurable disease as defined by the Response Evaluation Criteria
             in Solid Tumors v1.1.

          -  Patients must have adequate hematologic, renal, and liver function:

               -  WBC ≥ 3,000/mm3

               -  ANC ≥ 1500

               -  Hb ≥ 9g/dL (women) or ≥ 11g/dL (men) (supportive transfusions will be allowed
                  during induction and maintenance phases to maintain these levels)

               -  Platelets ≥ 100,000/mm3 (supportive transfusions will be allowed during induction
                  and maintenance phases to maintain these levels)

               -  Serum Creatinine ≤ 1.5 x upper limit of normal (ULN)

               -  Serum Bilirubin ≤ 1.5 x ULN

               -  Serum AST/ALT ≤ 2.5 x ULN

          -  EKG documenting normal intervals.

          -  Fully recovered from any effects of major surgery, and be free of significant
             detectable infection.

          -  ECOG performance status of 0 or 1.

          -  Free of active brain metastases by contrast-enhanced CT/MRI scans within 4 weeks prior
             to starting the study drugs.

          -  Female patients of child bearing potential must have a negative pregnancy test (within
             7 days from the time of randomization).

        Exclusion Criteria:

          -  Serious illnesses, such as: cardiovascular disease (uncontrolled congestive heart
             failure, uncontrolled hypertension, cardiac ischemia, myocardial infarction, and
             severe cardiac arrhythmia), bleeding disorders, symptomatic autoimmune diseases,
             severe obstructive or restrictive pulmonary diseases, uncontrolled endocrine disorders
             (hypothyroidism, hyperthyroidism and diabetes mellitus), retinopathy, active systemic
             infections, and inflammatory bowel disorders. This includes known HIV or AIDS-related
             illness, or active HBV and HCV.

          -  Prior therapy (except for adjuvant immunotherapy) with a BRAF and/or MEK and/or ERK
             inhibitors.

          -  Refractory nausea, vomiting, small bowel resection or any other gastrointestinal
             ailment that would preclude study drug absorption.

          -  Cardiac abnormalities

               -  Mean QTc interval ≥ 480 msec at screening.

               -  Recent ACS/AMI - defined as within 24 weeks prior to screening.

               -  Recent PCI/PTCA - defined as within 24 weeks prior to screening.

               -  Recent malignant cardiac arrhythmias - all except sinus arrhythmia within 24
                  weeks prior to screening.

               -  Symptomatic heart failure - NYHA Class ≥ II symptoms.

          -  Active infection or antibiotics within one-week prior to study, including unexplained
             fever Any significant psychiatric disease, medical intervention, or other condition,
             which in the opinion of the principal investigator, could prevent adequate informed
             consent or compromise participation in the clinical trial.

          -  Systemic steroid or other immunosuppressive therapy within 4 weeks of starting the
             study.

          -  Lactating females or pregnant females.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of Participants with Adverse Events to determine Ph II dose
Time Frame:12-24 months from study start
Safety Issue:
Description:At each dose level, the number of patients experiencing Adverse Events over their course of treatment will be characterized by type of Adverse Event and grade using NCI CTCAE (v4.0), and by time of onset in relation to the first day of therapy.

Secondary Outcome Measures

Measure:Progression Free and overall survival (Efficacy)
Time Frame:48 months
Safety Issue:
Description:•Progression Free Survival will be evaluated at 6 months using the Kaplan-Meier method. Overall Survival will be measured from the initial date of treatment to the recorded date of death, and analyzed similarly to Progression Free Survival. Overall Survival will also be analyzed with the Kaplan-Meier method. The complete response rate and partial response rate will be estimated by the proportion of patients with a best response respectively by RECIST criteria.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:John Kirkwood

Trial Keywords

  • advanced
  • melanoma
  • Vemurafenib
  • High-dose Interferon alfa-2b

Last Updated

April 3, 2018