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High-Dose Interferon Alfa in Treating Patients With Stage II or Stage III Melanoma

This study has been terminated.
(The third interim analysis showed that there was no evidence of benefit from treatment with interferon.)
Sponsor:
Collaborators:
National Cancer Institute (NCI)
Southwest Oncology Group
Cancer and Leukemia Group B
NCIC Clinical Trials Group
Children's Oncology Group
Information provided by (Responsible Party):
Eastern Cooperative Oncology Group ( ECOG-ACRIN Cancer Research Group )
ClinicalTrials.gov Identifier:
NCT00003641
First received: November 1, 1999
Last updated: March 31, 2016
Last verified: March 2016
  Purpose

RATIONALE: Interferon alfa may interfere with the growth of cancer cells. It is not yet known whether treatment with interferon alfa is more effective than observation alone for stage II or stage III melanoma that has been completely removed surgically.

PURPOSE: This randomized phase III trial is studying high dose interferon alfa to see how well it works compared to observation only in treating patients with stage II or stage III melanoma that has been completely removed by surgery.


Condition Intervention Phase
Melanoma (Skin)
Biological: interferon alfa-2b
Other: observation
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase III Randomized Study of Four Weeks of High Dose Interferon Alfa-2b in Stage T2bN0, T3a-bN0, T4a-bN0, and T1-4, N1a,2a (Microscopic) Melanoma

Resource links provided by NLM:


Further study details as provided by Eastern Cooperative Oncology Group:

Primary Outcome Measures:
  • 5-year Relapse-free Survival Rate [ Time Frame: assessed every 3 months for 2 years, every 6 months for 3 years ] [ Designated as safety issue: No ]
    Relapse-free survival (RFS) was defined as time from randomization to disease relapse or death from any cause, whichever occurred first. Patients without disease relapse were censored at last disease assessment date known of free of relapse. Kaplan-Meier method was used to estimate 5-year RFS rate in the intent-to-treat (ITT) patients.


Secondary Outcome Measures:
  • 5-year Overall Survival Rate [ Time Frame: assessed every 3 months for 2 years, every 6 months for 3 years ] [ Designated as safety issue: No ]
    Overall survival (OS) was defined as time from randomization to death from any cause. Patients still alive were censored at last known alive date. Kaplan-Meier method was used to estimate 5-year OS rate in the ITT patients.


Enrollment: 1150
Study Start Date: December 1998
Estimated Study Completion Date: October 2025
Primary Completion Date: January 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Observation
Patients undergo observation for 4 weeks.
Other: observation
Patients undergo observation for 4 weeks.
Other Name: clinical observation
Experimental: Interferon Alfa-2b
Patients receive high-dose interferon alfa-2b IV over 20 minutes daily for 5 consecutive days. Treatment repeats weekly for 4 weeks in the absence of unacceptable toxicity.
Biological: interferon alfa-2b
Given IV
Other Names:
  • recombinant interferon alfa
  • Intron-A
  • IFN-α 2b
  • NSC # 377523

Detailed Description:

OBJECTIVES:

Primary Objective:

  • Compare the effect of high-dose interferon alfa-2b treatment on the relapse-free survival of patients with stage II or III resected malignant melanoma.

Secondary Objectives:

  • Compare the effect of this treatment regimen on overall survival of these patients.
  • Assess the toxicity of this treatment in these patients.
  • Compare the effect of treatment on quality of life.

OUTLINE: This is a randomized study. Patients are stratified by pathologic lymph node status (known vs unknown),lymph node staging procedures(sentinel lymph node procedure vs. elective lymph node dissection vs. no lymphadenectomy), Breslow depth (<= 1.0 mm vs. 1.01-2.0 mm vs. 2.01-4.0 mm vs > 4.0 mm), ulceration of the primary lesion (yes vs. no vs. unknown), and disease stage (lymph node positive [N1, N2a] vs. lymph node negative [N0]). Patients are randomized into one of two treatment arms in a 1:1 ratio.

  • Arm I (observation): Patients undergo observation for 4 weeks.
  • Arm II (Interferon Alfa-2b): Patients receive high-dose interferon alfa-2b intravenously (IV) over 20 minutes daily for 5 consecutive days. Treatment repeats weekly for 4 weeks in the absence of unacceptable toxicity.

Quality of life is assessed before treatment, at day 22, every 3 months for 2 years, and then every 6 months for 3 years.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter until 15 years after randomization.

PROJECTED ACCRUAL: A total of 1,420 patients will be accrued for this study over 5 years.

  Eligibility

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically confirmed primary melanoma of cutaneous origin

    • Stage II (T3 N0 M0 1.5-4.0 mm Breslow depth)

      • Clinically negative regional lymph node pathologic status unknown OR
      • Histologically negative regional lymph nodes
    • Stage III (T4 N0 M0)

      • Greater than 4.0 mm Breslow depth OR
    • Stage III (T1-4 N1)

      • One lymph node positive microscopically
  • Patients must meet at least 1 of the following criteria:

    • T2b N0 - primary melanoma 1.01-2.0 mm with ulceration, node negative
    • T3a-b N0 - primary melanoma 2.01-4.0 mm with and without ulceration, node negative
    • T4a-b N0 - primary melanoma > 4.0 mm with or without ulceration, node negative
    • T1a N1a-2a (microscopic) - primary melanoma of any thickness with microscopically positive lymph node (any number)
  • Patients with a positive sentinel node should undergo complete lymphadenectomy of the nodal basin prior to study
  • Must complete all primary therapy (wide excision with or without lymphadenectomy) and be randomized in this study within 84 days of wide excision
  • Must have undergone an adequate wide excision of the primary lesion
  • Age 18 and over (For ECOG patients only, patients must be >=10 years)
  • Eastern Cooperative Oncology Group (ECOG) Performance status of 0-1
  • Adequate hematopoietic, hepatic, and renal function based on the following tests:

    • White blood cell (WBC) cout at least 3,000/mm^3
    • Platelet count at least 125,000/mm^3
    • Hematocrit at least 30%
    • Bilirubin no greater than 2 times upper limit of normal (ULN)
    • Aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and alkaline phosphatase no greater than 2 times ULN
    • If lactate dehydrogenase or alkaline phosphatase is above normal, a contrast-enhanced computed tomography (CT) scan or Magnetic resonance imaging (MRI) of the liver is required to document the absence of tumor
    • Blood urea nitrogen (BUN) no greater than 33 mg/dL OR Creatinine no greater than 1.8 mg/dL
  • No other concurrent or prior malignancies within the past 5 years except:

    • Cancer in situ
    • Lobular carcinoma in situ of the breast
    • Carcinoma in situ of the cervix
    • Atypical melanocytic hyperplasia or Clark 1 melanoma in situ
    • Basal or squamous cell skin cancer
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after study

Exclusion Criteria:

  • Clinical, radiological/laboratory, or pathological evidence of incompletely resected melanoma or any distant metastatic disease
  • Clinically palpable lymphadenopathy
  • Evidence of organic brain syndrome or significant impairment of basal cognitive function or any psychiatric disorder that would preclude study participation
  • Other significant medical or surgical condition, or any medication or treatment regimens, that would interfere with study participation
  • Pregnant or nursing
  • Other history of invasive melanoma
  • Autoimmune disorders or conditions of immunosuppression
  • History of active ischemic heart disease
  • Cerebrovascular disease
  • Congestive heart failure (New York Heart Association class III or IV heart disease)
  • Prior or concurrent chemotherapy
  • Prior immunotherapy including tumor vaccines, interferon, interleukins, levamisole, or other biologic response modifiers for melanoma
  • Concurrent systemic corticosteroids including oral steroids (i.e., prednisone, dexamethasone), topical steroid creams or ointments, or any steroid-containing inhalers
  • Prior or concurrent radiotherapy
  • Other concurrent immunosuppressive medications
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00003641

  Show 533 Study Locations
Sponsors and Collaborators
ECOG-ACRIN Cancer Research Group
National Cancer Institute (NCI)
Southwest Oncology Group
Cancer and Leukemia Group B
NCIC Clinical Trials Group
Children's Oncology Group
Investigators
Study Chair: Sanjiv S. Agarwala, MD St. Luke's Cancer Network at St. Luke's Hospital
Study Chair: John M. Kirkwood, MD UPMC Cancer Center at UPMC Presbyterian
Study Chair: Lawrence E. Flaherty, MD Barbara Ann Karmanos Cancer Institute
Study Chair: William E. Carson, MD Ohio State University Comprehensive Cancer Center
Study Chair: Michael Smylie, MD, MB, ChB Cross Cancer Institute at University of Alberta
Principal Investigator: Alberto S. Pappo, MD Texas Children's Cancer Center
  More Information

Responsible Party: ECOG-ACRIN Cancer Research Group
ClinicalTrials.gov Identifier: NCT00003641     History of Changes
Other Study ID Numbers: E1697  E1697  U10CA023318  CDR0000066727 
Study First Received: November 1, 1999
Results First Received: February 2, 2016
Last Updated: March 31, 2016
Health Authority: United States: Federal Government
United States: Food and Drug Administration
Individual Participant Data  
Plan to Share IPD: Yes
Plan Description: Individual participant data may be made available upon request as per the ECOG-ACRIN Data Sharing Policy

Keywords provided by Eastern Cooperative Oncology Group:
stage II melanoma
stage III melanoma

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
Interferons
Interferon-alpha
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Immunologic Factors
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on December 08, 2016