Melanoma (Skin) Clinical Trial
Official title:
Phase III Trial of High Dose Interferon Alfa 2-b Versus Cisplatin, Vinblastine, DTIC Plus IL-2 and Interferon in Patients With High Risk Melanoma
RATIONALE: Interferon alfa may interfere with the growth of cancer cells. Drugs used in
chemotherapy use different ways to stop tumor cells from dividing so they stop growing or
die. Interleukin-2 may stimulate a person's white blood cells to kill melanoma cells. It is
not yet known whether interferon alfa is more effective with or without combination
chemotherapy and interleukin-2 for melanoma.
PURPOSE: Randomized phase III trial to compare the effectiveness of interferon alfa with or
without combination chemotherapy consisting of cisplatin, vinblastine, and dacarbazine, plus
interleukin-2, in treating patients who have melanoma.
OBJECTIVES:
- Compare the overall survival and disease-free survival of patients with high-risk
melanoma treated with interferon alfa vs cisplatin, vinblastine, and dacarbazine plus
interferon alfa and interleukin-2.
- Compare the toxic effects of these treatment regimens in these patients.
- Determine the relationship between minimal residual disease (MRD) status at 12 weeks
and 52 weeks and overall survival of patients treated with these regimens.
- Compare the effects of these treatment regimens on the MRD status of these patients.
- Determine the relationship between clinical characteristics (number of involved lymph
nodes, ulcerated primary, and extracapsular extension) and MRD in patients treated with
these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to nodal
status (N1 or N2 vs N3), degree of lymph node involvement (micrometastases only vs any
macrometastases, including satellite/in-transit metastases), and ulceration of the primary
tumor (yes vs no vs unknown primary). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive interferon alfa IV on days 1-5 of weeks 1-4 followed by
interferon alfa subcutaneously (SC) on days 1, 3, and 5 of weeks 5-52 in the absence of
disease progression or unacceptable toxicity.
- Arm II: Patients receive cisplatin IV over 30 minutes followed by vinblastine IV on
days 1-4. Patients also receive dacarbazine IV over 1 hour on day 1, interleukin-2 IV
over 96 hours on days 1-4, and interferon alfa SC on days 1-5, 8, 10, and 12. In
addition, patients receive filgrastim (G-CSF) SC on days 6-15. Treatment repeats every
3 weeks for 3 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then
annually for 5 years.
PROJECTED ACCRUAL: A total of 410 patients (205 per treatment arm) will be accrued for this
study within 3 years.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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