Sorafenib With Either Temsirolimus or Tipifarnib in Treating Patients With Stage IV Malignant Melanoma That Cannot Be Removed By Surgery
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Purpose
This randomized phase II trial is studying how well giving sorafenib together with either temsirolimus or tipifarnib works in treating patients with stage IV melanoma that cannot be removed by surgery. Sorafenib, temsirolimus, and tipifarnib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Sorafenib and tipifarnib may also stop the growth of tumor by blocking blood flow to the tumor. It is not yet known whether sorafenib is more effective when given together with temsirolimus or tipifarnib in treating patients with malignant melanoma.
| Condition | Intervention | Phase |
|---|---|---|
|
Recurrent Melanoma Stage IV Melanoma |
Drug: sorafenib tosylate Drug: tipifarnib Drug: temsirolimus |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized Phase II Trial of BAY 43-9006 (Sorafenib; NSC-724772) With Either CCI-779 (Temsirolimus; NSC-683864) or R115777 (Tipifarnib; NSC-702818) in Metastatic Melanoma |
- Response Rate (Complete and Partial) [ Time Frame: Every 8 weeks until progression ] [ Designated as safety issue: No ]Complete response corresponds to complete disappearance of all measurable and non-measurable lesions with no new lesions. Partial response corresponds to greater than or equal to 30fi decrease of sum of longest diameter of all target measurable lesions with no new lesion and non unequivocal progression of non-measurable disease.
- 4-month Progression-free Survival [ Time Frame: 4 months after registration ] [ Designated as safety issue: No ]Progression was defined as one or more of the following: 20% increase in the sum of longest diameters of target measurable lesions over smallest sum observed, unequivocal progression of non-measurable disease, appearance of any new lesions, death due to disease without prior documentation of progression and without symptomatic deterioration.
- One-year Overall Survival [ Time Frame: One year after registration ] [ Designated as safety issue: No ]
- Toxicity [ Time Frame: Weekly during first cycle, every two weeks during the second cycle, and once a cycle further cycles (one cycle = 4 weeks). ] [ Designated as safety issue: Yes ]Number of patients with Grade 3-5 adverse events that are related to study drug by given type of adverse event
| Enrollment: | 120 |
| Study Start Date: | August 2007 |
| Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I (sorafenib, temsirolimus)
Patients receive oral sorafenib twice daily on days 1-28 and temsirolimus IV over 30 minutes on days 1, 8, 15, and 22.
|
Drug: sorafenib tosylate
Given orally
Other Names:
Drug: temsirolimus
Given IV
Other Names:
|
|
Experimental: Arm II (sorafenib, tipifarnib)
Patients receive oral sorafenib as in arm I and oral tipifarnib twice daily on days 1-21
|
Drug: sorafenib tosylate
Given orally
Other Names:
Drug: tipifarnib
Given orally
Other Names:
|
Detailed Description:
PRIMARY OBJECTIVES:
I. Compare the response rate (confirmed and unconfirmed and complete and partial) in patients with unresectable stage IV malignant melanoma treated with sorafenib in combination with either temsirolimus or tipifarnib.
II. Compare the 4-month progression-free survival rate of patients treated with these regimens.
III. Compare the safety and tolerability of these regimens, with an emphasis on long-term side effects and toxic effects, in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to metastatic (M) stage (M1a/b vs M1c). Patients are randomized to 1 of 2 treatment arms.
ARM I (reopened to accrual as of 8/15/2009): Patients receive oral sorafenib twice daily on days 1-28 and temsirolimus IV over 30 minutes on days 1, 8, 15, and 22.
ARM II (closed to accrual as of 8/15/2009): Patients receive oral sorafenib as in arm I and oral tipifarnib twice daily on days 1-21.
In both arms, courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed periodically for up to 3 years.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria:
- Histologically confirmed malignant melanoma of cutaneous origin
- Patients with unknown primary allowed
- Stage IV disease
- Measurable disease by physical examination, CT scan, MRI or plain x-ray
- Unresectable disease
- Residual or recurrent disease after prior surgery for stage IV disease allowed
- Residual tumor at the site of incomplete resection may be included only as nonmeasurable disease
- Must have serum lactate dehydrogenase (LDH) levels measured
- Must have tissue specimens available
- Negative brain CT scan or MRI within the past 42 days
- Creatinine =< 1.5 times ULN
- Absolute neutrophil count >= 1,000/mm^3
- Platelet count >= 100,000/mm^3
- Hemoglobin >= 9.0 g/dL
- Fasting cholesterol =< 350 mg/dL (lipid-lowering agents allowed)
- Triglycerides =< 300 mg/dL (lipid-lowering agents allowed)
- No symptomatic sensory neuropathy >= grade 2
- No evidence of bleeding diathesis or coagulopathy
- No congestive heart failure
- No myocardial infarction within the past 2 months
- No New York Heart Association class III or IV heart disease
- No condition that impairs the ability to swallow pills (e.g., gastrointestinal tract disease resulting in an inability to take oral medication, requirement for IV alimentation, prior surgical procedure affecting absorption, or active peptic ulcer disease)
- No known allergy to imidazoles (e.g. clotrimazole, ketoconazole, miconazole, or econazole)
- No history of allergic reaction to compounds of similar chemical or biologic composition as tipifarnib
- No hypertension with systolic blood pressure (BP) > 140 mm Hg or diastolic BP > 90 mm Hg
- Patients with well-controlled hypertension allowed
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No uncontrolled diabetes
- No uncontrolled diabetes
- No active uncontrolled infection
- No other severe or uncontrolled medical disease
- No psychologic or medical condition that would preclude study treatment or compliance
- No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, adequately treated stage I or II cancer that is in complete remission, or carcinoma in situ of the cervix
- At least 90 days since prior adjuvant therapy, including cytotoxic agents
- At least 28 days since prior radiotherapy
- At least 28 days since prior surgery to remove the tumor
- No prior systemic therapy for stage IV melanoma
- No prior therapy with agents targeting farnesyl transferase, the MAP kinase pathway, or vascular endothelial growth factors (VEGF) or receptors (VEFGR), including drugs such as sorafenib, temsirolimus, or tipifarnib
- Concurrent lipid-lowering agents allowed
- Not requiring full-dose anticoagulation for recent thrombotic event
- No concurrent highly active antiretroviral therapy (HAART) in HIV-positive patients
- No concurrent use of any of the following: dilantin; carbamazepine; Phenobarbital; rifampin; hypericum perforatum (St. John's wort); ketoconazole; itraconazole; ritonavir; cyclosporine; phenytoin; grapefruit juice
- Bilirubin =< 1.5 times upper limit of normal (ULN)
- SGOT or SGPT =< 2.5 times ULN (5 times ULN if hepatic metastases)
- No history of brain metastases
- Zubrod performance status 0-1
Contacts and Locations
Show 173 Study Locations| Principal Investigator: | Kim Margolin | Southwest Oncology Group |
More Information
No publications provided
| Responsible Party: | National Cancer Institute (NCI) |
| ClinicalTrials.gov Identifier: | NCT00281957 History of Changes |
| Other Study ID Numbers: | NCI-2009-00774, S0438, CDR0000454925, U10CA032102 |
| Study First Received: | January 24, 2006 |
| Results First Received: | June 5, 2012 |
| Last Updated: | April 1, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Melanoma Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms, Nerve Tissue Nevi and Melanomas Sirolimus Everolimus Tipifarnib Sorafenib Antibiotics, Antineoplastic |
Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Antifungal Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Anti-Bacterial Agents Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 22, 2013