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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00626405
Other study ID # NCCTG-N0775
Secondary ID NCI-2009-00667CD
Status Completed
Phase Phase 2
First received
Last updated
Start date August 2008
Est. completion date November 2012

Study information

Verified date April 2018
Source Alliance for Clinical Trials in Oncology
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

RATIONALE: Drugs used in chemotherapy, such as temozolomide, paclitaxel albumin-stabilized nanoparticle formulation, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. It is not yet known whether bevacizumab is more effective when given together with temozolomide or paclitaxel albumin-stabilized nanoparticle formulation and carboplatin in killing malignant melanoma cells.

PURPOSE: This randomized phase II trial is studying the side effects of giving temozolomide together with bevacizumab and to see how well it works compared with giving bevacizumab together with paclitaxel albumin-stabilized nanoparticle formulation and carboplatin in treating patients with stage IV malignant melanoma that cannot be removed by surgery.


Description:

OBJECTIVES:

Primary

- To assess the anti-tumor activity, in terms of the percentage of patients who are treated with these regimens and who are progression-free at 6 months.

- To assess the safety profile of each treatment regimen.

Secondary

- To estimate the response rate in patients treated with these regimens.

- To estimate the distribution of progression-free survival time and overall survival time of patients treated with these regimens.

Tertiary

- To examine the impact of therapy on angiogenesis and immune homeostasis.

OUTLINE: Patients are stratified according to ECOG performance status (0 vs 1) and location of metastatic disease (M1a [skin or subcutaneous tissue or lymph node only] vs M1b [lung] vs M1c [other visceral sites]) and randomized to 1 of 2 treatment arms.

- Arm I: Patients receive oral temozolomide on days 1-5 and bevacizumab IV over 30-90 minutes on days 1 and 15. (closed to accrual 8/21/09)

- Arm II: Patients receive bevacizumab IV over 30-90 minutes on days 1 and 15, paclitaxel albumin-stabilized nanoparticle formulation IV over 30 minutes on days 1, 8, and 15, and carboplatin IV over 30 minutes on day 1.

In both arms, treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample collection periodically for VEGF plasma levels and analysis of changes in immune homeostasis.

Beginning at study entry, patients are followed up every 3 months for 2 years and then every 6 months for up to 3 years.


Recruitment information / eligibility

Status Completed
Enrollment 95
Est. completion date November 2012
Est. primary completion date July 2010
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility - Histologic confirmed diagnosis of malignant melanoma

- Stage IV disease

- Not amenable tosurgery

- Measurable disease with at least one lesion whose longest diameter canbe measured as = 20 mm by CT or MRI scans OR = 10 mm by spiral CT

- No disease that is measurable by physical examination only

- No brain metastases per MRI or CT

- No radiographically documented invasion of adjacent organs(duodenum, stomach, etc.) or tumor invading major blood vessels

- ECOG performance status 0-1

- Life expectancy = 4 months

- ANC = 1,500/mm³

- Platelet count = 100,000/mm³

- Hemoglobin = 9 g/dL (transfusion allowed)

- Creatinine = 1.5 times upper limit of normal (ULN)

- Total bilirubin = 1.5 mg/dL (unless Gilbert syndrome)

- AST = 2.5 times ULN

- Alkaline phosphatase = 2.5 times ULN

- Urine protein:creatinine ratio < 1.0 at screening ORproteinuria < 2+ by urine dipstick or protein = 1 g by 24-hour urine collection

- Negative serum pregnancy test

- Not pregnant or nursing

- Fertile patients must use effective contraception

- Active infection requiring parenteral antibiotics

- Poorly controlled high blood pressure (= 150 mm Hg systolic and/or100 mm Hg diastolic) despite treatment

- NYHA class II-IV congestive heart failure

- Serious cardiac arrhythmia requiring medication

- Myocardial infarction or unstable angina within the past 6 months

- Clinically significant peripheral vascular disease

- Deep venous thrombosis or pulmonary embolus within the past year

- Active bleeding or pathological conditions that carry high risk of bleeding (e.g., known esophageal varices)

- Serious, non-healing wound (including wounds healing by secondary intention), ulcer or bone fracture

- Abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within the past 6 months

- History of CNS disease (e.g., primary brain tumor, vascular abnormalities, etc.)

- Clinically significant stroke or TIA within the past 6 months

- Seizures not controlled with standardmedical therapy

- Peripheral neuropathy = grade 2

- History of other malignancy within the past 5 years except basal cell or squamous cell carcinoma of the skin treatable with local resection only or carcinoma in situ of the cervix

- Significant traumatic injury within the past 4 weeks

- History of hypertensive crisis or hypertensive encephalopathy

- Active or recent (= 30 days) history of hemoptysis (= ½ teaspoon of bright red blood per episode)

- Known hypersensitivity to any of the components of bevacizumab

- Known to be HIV positive

- Current or known history of hepatitis

- Prior adjuvant chemotherapy and/or immunotherapy for this cancer allowed

- No prior treatment with agents disrupting VEGF activity (i.e., bevacizumab,VEGF-trap, anti-VEGFR Mab)

- No ongoing need for full-dose oral or parenteral anticoagulation

- No ongoing anti-platelet treatment other than low-dose aspirin(i.e., aspirin 81 mg daily)

- No other investigational agents within the past 4 weeks

- No major surgical procedure or open biopsy within the past 4 weeks

- No fine needle aspirations or core biopsies within the past 7 days

- No prior chemotherapy in the metastatic setting

- No prior treatment with sunitinib malate or sorafenib

- No prior treatment with any taxane-based chemotherapy

- Patients who have had > 25% of their functional bone marrow irradiated are not eligible for this trial

- No adjuvant radiation therapy within the past 4 weeks

- More than 2 weeks since prior and no concurrent palliative radiation therapy

- No concurrent major surgical procedure

- No concurrent participation in another clinical study for procedures or agents that treat the same primary study malignancy

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
bevacizumab
Given IV over 30-90 minutes
Drug:
carboplatin
Given IV over 30 minutes
paclitaxel albumin-stabilized nanoparticle formulation
Given IV over 30 minutes
temozolomide
Oral temozolomide on days 1-5

Locations

Country Name City State
United States Hickman Cancer Center at Bixby Medical Center Adrian Michigan
United States Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown Pennsylvania
United States McFarland Clinic, PC Ames Iowa
United States Providence Cancer Center Anchorage Alaska
United States AnMed Cancer Center Anderson South Carolina
United States CCOP - Michigan Cancer Research Consortium Ann Arbor Michigan
United States Saint Joseph Mercy Cancer Center Ann Arbor Michigan
United States Hospital District Sixth of Harper County Anthony Kansas
United States Aurora Presbyterian Hospital Aurora Colorado
United States Battle Creek Health System Cancer Care Center Battle Creek Michigan
United States St. Francis Hospital and Health Centers - Beech Grove Campus Beech Grove Indiana
United States Mary Rutan Hospital Bellefontaine Ohio
United States MeritCare Bemidji Bemidji Minnesota
United States Mecosta County Medical Center Big Rapids Michigan
United States Billings Clinic - Downtown Billings Montana
United States CCOP - Montana Cancer Consortium Billings Montana
United States Hematology-Oncology Centers of the Northern Rockies - Billings Billings Montana
United States Northern Rockies Radiation Oncology Center Billings Montana
United States St. Vincent Healthcare Cancer Care Services Billings Montana
United States Bismarck Cancer Center Bismarck North Dakota
United States Medcenter One Hospital Cancer Care Center Bismarck North Dakota
United States Mid Dakota Clinic, PC Bismarck North Dakota
United States St. Alexius Medical Center Cancer Center Bismarck North Dakota
United States Illinois CancerCare - Bloomington Bloomington Illinois
United States St. Joseph Medical Center Bloomington Illinois
United States Boulder Community Hospital Boulder Colorado
United States Wood County Oncology Center Bowling Green Ohio
United States Bozeman Deaconess Cancer Center Bozeman Montana
United States Fairview Ridges Hospital Burnsville Minnesota
United States St. James Healthcare Cancer Care Butte Montana
United States Graham Hospital Canton Illinois
United States Illinois CancerCare - Canton Canton Illinois
United States Illinois CancerCare - Carthage Carthage Illinois
United States Rocky Mountain Oncology Casper Wyoming
United States Cedar Rapids Oncology Associates Cedar Rapids Iowa
United States Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids Iowa
United States Cancer Center of Kansas, PA - Chanute Chanute Kansas
United States Adena Regional Medical Center Chillicothe Ohio
United States Medical Oncology and Hematology Associates - West Des Moines Clive Iowa
United States North Coast Cancer Care - Clyde Clyde Ohio
United States Penrose Cancer Center at Penrose Hospital Colorado Springs Colorado
United States CCOP - Columbus Columbus Ohio
United States Doctors Hospital at Ohio Health Columbus Ohio
United States Grant Medical Center Cancer Care Columbus Ohio
United States Mount Carmel Health - West Hospital Columbus Ohio
United States Riverside Methodist Hospital Cancer Care Columbus Ohio
United States Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids Minnesota
United States Geisinger Cancer Institute at Geisinger Health Danville Pennsylvania
United States CCOP - Dayton Dayton Ohio
United States David L. Rike Cancer Center at Miami Valley Hospital Dayton Ohio
United States Good Samaritan Hospital Dayton Ohio
United States Grandview Hospital Dayton Ohio
United States Samaritan North Cancer Care Center Dayton Ohio
United States Oakwood Cancer Center at Oakwood Hospital and Medical Center Dearborn Michigan
United States Grady Memorial Hospital Delaware Ohio
United States CCOP - Colorado Cancer Research Program Denver Colorado
United States Porter Adventist Hospital Denver Colorado
United States Presbyterian - St. Luke's Medical Center Denver Colorado
United States Rose Medical Center Denver Colorado
United States St. Anthony Central Hospital Denver Colorado
United States St. Joseph Hospital Denver Colorado
United States CCOP - Iowa Oncology Research Association Des Moines Iowa
United States John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines Iowa
United States John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines Iowa
United States Medical Oncology and Hematology Associates at John Stoddard Cancer Center Des Moines Iowa
United States Medical Oncology and Hematology Associates at Mercy Cancer Center Des Moines Iowa
United States Mercy Cancer Center at Mercy Medical Center - Des Moines Des Moines Iowa
United States Mercy Capitol Hospital Des Moines Iowa
United States Cancer Center of Kansas, PA - Dodge City Dodge City Kansas
United States CCOP - Duluth Duluth Minnesota
United States Duluth Clinic Cancer Center - Duluth Duluth Minnesota
United States Miller - Dwan Medical Center Duluth Minnesota
United States Fairview Southdale Hospital Edina Minnesota
United States Cancer Center of Kansas, PA - El Dorado El Dorado Kansas
United States Elkhart General Hospital Elkhart Indiana
United States Hematology Oncology Center Elyria Ohio
United States Swedish Medical Center Englewood Colorado
United States Green Bay Oncology, Limited - Escanaba Escanaba Michigan
United States Eureka Community Hospital Eureka Illinois
United States Illinois CancerCare - Eureka Eureka Illinois
United States CCOP - MeritCare Hospital Fargo North Dakota
United States MeritCare Broadway Fargo North Dakota
United States Blanchard Valley Medical Associates Findlay Ohio
United States Genesys Hurley Cancer Institute Flint Michigan
United States Hurley Medical Center Flint Michigan
United States Front Range Cancer Specialists Fort Collins Colorado
United States Cancer Center of Kansas - Fort Scott Fort Scott Kansas
United States Middletown Regional Hospital Franklin Ohio
United States Fredericksburg Oncology, Incorporated Fredericksburg Virginia
United States Mercy and Unity Cancer Center at Unity Hospital Fridley Minnesota
United States Galesburg Clinic, PC Galesburg Illinois
United States Galesburg Cottage Hospital Galesburg Illinois
United States Altru Cancer Center at Altru Hospital Grand Forks North Dakota
United States St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center Grand Junction Colorado
United States Butterworth Hospital at Spectrum Health Grand Rapids Michigan
United States CCOP - Grand Rapids Grand Rapids Michigan
United States Lacks Cancer Center at Saint Mary's Health Care Grand Rapids Michigan
United States Great Falls Clinic - Main Facility Great Falls Montana
United States North Colorado Medical Center Greeley Colorado
United States Green Bay Oncology, Limited at St. Mary's Hospital Green Bay Wisconsin
United States Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center Green Bay Wisconsin
United States St. Mary's Hospital Medical Center - Green Bay Green Bay Wisconsin
United States St. Vincent Hospital Regional Cancer Center Green Bay Wisconsin
United States Wayne Hospital Greenville Ohio
United States Van Elslander Cancer Center at St. John Hospital and Medical Center Grosse Pointe Woods Michigan
United States Illinois CancerCare - Havana Havana Illinois
United States Mason District Hospital Havana Illinois
United States Northern Montana Hospital Havre Montana
United States Geisinger Hazleton Cancer Center Hazleton Pennsylvania
United States St. Peter's Hospital Helena Montana
United States Hutchinson Area Health Care Hutchinson Minnesota
United States Cancer Center of Kansas-Independence Independence Kansas
United States Dickinson County Healthcare System Iron Mountain Michigan
United States Foote Memorial Hospital Jackson Michigan
United States Mayo Clinic - Jacksonville Jacksonville Florida
United States Glacier Oncology, PLLC Kalispell Montana
United States Kalispell Medical Oncology at KRMC Kalispell Montana
United States Kalispell Regional Medical Center Kalispell Montana
United States Charles F. Kettering Memorial Hospital Kettering Ohio
United States Illinois CancerCare - Kewanee Clinic Kewanee Illinois
United States Cancer Center of Kansas, PA - Kingman Kingman Kansas
United States Howard Community Hospital Kokomo Indiana
United States Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte Indiana
United States Haematology-Oncology Associates of Ohio and Michigan, PC Lambertville Michigan
United States Fairfield Medical Center Lancaster Ohio
United States Sparrow Regional Cancer Center Lansing Michigan
United States Lawrence Memorial Hospital Lawrence Kansas
United States Southwest Medical Center Liberal Kansas
United States Lima Memorial Hospital Lima Ohio
United States Cancer Resource Center - Lincoln Lincoln Nebraska
United States St. Mary Mercy Hospital Livonia Michigan
United States Sky Ridge Medical Center Lone Tree Colorado
United States Hope Cancer Care Center at Longmont United Hospital Longmont Colorado
United States McKee Medical Center Loveland Colorado
United States Illinois CancerCare - Macomb Macomb Illinois
United States McDonough District Hospital Macomb Illinois
United States HealthEast Cancer Care at St. John's Hospital Maplewood Minnesota
United States Minnesota Oncology Hematology, PA - Maplewood Maplewood Minnesota
United States Strecker Cancer Center at Marietta Memorial Hospital Marietta Ohio
United States Bay Area Cancer Care Center at Bay Area Medical Center Marinette Wisconsin
United States Mercy Cancer Center at Mercy Medical Center - North Iowa Mason City Iowa
United States Northwest Ohio Oncology Center Maumee Ohio
United States St. Luke's Hospital Maumee Ohio
United States Hennepin County Medical Center - Minneapolis Minneapolis Minnesota
United States Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis Minnesota
United States Community Medical Center Missoula Montana
United States Guardian Oncology and Center for Wellness Missoula Montana
United States Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula Montana
United States Montana Cancer Specialists at Montana Cancer Center Missoula Montana
United States Trinity Cancer Center at Trinity Medical Center - 7th Street Campus Moline Illinois
United States Illinois CancerCare - Monmouth Monmouth Illinois
United States OSF Holy Family Medical Center Monmouth Illinois
United States Community Cancer Center of Monroe Monroe Michigan
United States Mercy Memorial Hospital - Monroe Monroe Michigan
United States Mercy General Health Partners Muskegon Michigan
United States Licking Memorial Cancer Care Program at Licking Memorial Hospital Newark Ohio
United States Cancer Center of Kansas, PA - Newton Newton Kansas
United States BroMenn Regional Medical Center Normal Illinois
United States Community Cancer Center Normal Illinois
United States Illinois CancerCare - Community Cancer Center Normal Illinois
United States Green Bay Oncology, Limited - Oconto Falls Oconto Falls Wisconsin
United States Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha Nebraska
United States CCOP - Missouri Valley Cancer Consortium Omaha Nebraska
United States Creighton University Medical Center Omaha Nebraska
United States Immanuel Medical Center Omaha Nebraska
United States St. Charles Mercy Hospital Oregon Ohio
United States Toledo Clinic - Oregon Oregon Ohio
United States Community Hospital of Ottawa Ottawa Illinois
United States Oncology Hematology Associates of Central Illinois, PC - Ottawa Ottawa Illinois
United States McCreery Cancer Center at Ottumwa Regional Ottumwa Iowa
United States Cancer Center of Kansas, PA - Parsons Parsons Kansas
United States Cancer Treatment Center at Pekin Hospital Pekin Illinois
United States Illinois CancerCare - Pekin Pekin Illinois
United States CCOP - Illinois Oncology Research Association Peoria Illinois
United States Methodist Medical Center of Illinois Peoria Illinois
United States Oncology Hematology Associates of Central Illinois, PC - Peoria Peoria Illinois
United States OSF St. Francis Medical Center Peoria Illinois
United States Proctor Hospital Peoria Illinois
United States Illinois CancerCare - Peru Peru Illinois
United States Illinois Valley Community Hospital Peru Illinois
United States St. Joseph Mercy Oakland Pontiac Michigan
United States Mercy Regional Cancer Center at Mercy Hospital Port Huron Michigan
United States Cancer Center of Kansas, PA - Pratt Pratt Kansas
United States Illinois CancerCare - Princeton Princeton Illinois
United States Perry Memorial Hospital Princeton Illinois
United States St. Mary - Corwin Regional Medical Center Pueblo Colorado
United States Rapid City Regional Hospital Rapid City South Dakota
United States Reid Hospital & Health Care Services Richmond Indiana
United States Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale Minnesota
United States Mayo Clinic Cancer Center Rochester Minnesota
United States Rutherford Hospital Rutherfordton North Carolina
United States Seton Cancer Institute at Saint Mary's - Saginaw Saginaw Michigan
United States CentraCare Clinic - River Campus Saint Cloud Minnesota
United States Coborn Cancer Center Saint Cloud Minnesota
United States Lakeland Regional Cancer Care Center - St. Joseph Saint Joseph Michigan
United States Arch Medical Services, Incorporated at Center for Cancer Care and Research Saint Louis Missouri
United States Missouri Baptist Cancer Center Saint Louis Missouri
United States CCOP - Metro-Minnesota Saint Louis Park Minnesota
United States Park Nicollet Cancer Center Saint Louis Park Minnesota
United States Regions Hospital Cancer Care Center Saint Paul Minnesota
United States United Hospital Saint Paul Minnesota
United States Cancer Center of Kansas, PA - Salina Salina Kansas
United States North Coast Cancer Care, Incorporated Sandusky Ohio
United States Mayo Clinic Scottsdale Scottsdale Arizona
United States St. Francis Cancer Center at St. Francis Medical Center Shakopee Minnesota
United States Welch Cancer Center at Sheridan Memorial Hospital Sheridan Wyoming
United States Mercy Medical Center - Sioux City Sioux City Iowa
United States Siouxland Hematology-Oncology Associates, LLP Sioux City Iowa
United States St. Luke's Regional Medical Center Sioux City Iowa
United States Medical X-Ray Center, PC Sioux Falls South Dakota
United States Sanford Cancer Center at Sanford USD Medical Center Sioux Falls South Dakota
United States CCOP - Northern Indiana CR Consortium South Bend Indiana
United States Memorial Hospital of South Bend South Bend Indiana
United States Saint Joseph Regional Medical Center South Bend Indiana
United States South Bend Clinic South Bend Indiana
United States CCOP - Upstate Carolina Spartanburg South Carolina
United States Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Spartanburg South Carolina
United States Illinois CancerCare - Spring Valley Spring Valley Illinois
United States St. Margaret's Hospital Spring Valley Illinois
United States CCOP - Cancer Research for the Ozarks Springfield Missouri
United States Community Hospital of Springfield and Clark County Springfield Ohio
United States Hulston Cancer Center at Cox Medical Center South Springfield Missouri
United States Mercy Medical Center Springfield Ohio
United States St. John's Regional Health Center Springfield Missouri
United States Geisinger Medical Group - Scenery Park State College Pennsylvania
United States Green Bay Oncology, Limited - Sturgeon Bay Sturgeon Bay Wisconsin
United States Flower Hospital Cancer Center Sylvania Ohio
United States North Suburban Medical Center Thornton Colorado
United States Mercy Hospital of Tiffin Tiffin Ohio
United States CCOP - Toledo Community Hospital Toledo Ohio
United States Medical University of Ohio Cancer Center Toledo Ohio
United States St. Anne Mercy Hospital Toledo Ohio
United States St. Vincent Mercy Medical Center Toledo Ohio
United States Toledo Clinic, Incorporated - Main Clinic Toledo Ohio
United States Toledo Hospital Toledo Ohio
United States Munson Medical Center Traverse City Michigan
United States UVMC Cancer Care Center at Upper Valley Medical Center Troy Ohio
United States Ridgeview Medical Center Waconia Minnesota
United States St. John Macomb Hospital Warren Michigan
United States Fulton County Health Center Wauseon Ohio
United States Cancer Center of Kansas, PA - Wellington Wellington Kansas
United States Mount Carmel St. Ann's Cancer Center Westerville Ohio
United States Exempla Lutheran Medical Center Wheat Ridge Colorado
United States Associates in Womens Health, PA - North Review Wichita Kansas
United States Cancer Center of Kansas, PA - Medical Arts Tower Wichita Kansas
United States Cancer Center of Kansas, PA - Wichita Wichita Kansas
United States CCOP - Wichita Wichita Kansas
United States Via Christi Cancer Center at Via Christi Regional Medical Center Wichita Kansas
United States Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center Wilkes-Barre Pennsylvania
United States Clinton Memorial Hospital Wilmington Ohio
United States Cancer Center of Kansas, PA - Winfield Winfield Kansas
United States Minnesota Oncology Hematology, PA - Woodbury Woodbury Minnesota
United States Metro Health Hospital Wyoming Michigan
United States Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia Ohio
United States Genesis - Good Samaritan Hospital Zanesville Ohio

Sponsors (2)

Lead Sponsor Collaborator
Alliance for Clinical Trials in Oncology National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

References & Publications (1)

Kottschade LA, Suman VJ, Perez DG, McWilliams RR, Kaur JS, Amatruda TT 3rd, Geoffroy FJ, Gross HM, Cohen PA, Jaslowski AJ, Kosel ML, Markovic SN. A randomized phase 2 study of temozolomide and bevacizumab or nab-paclitaxel, carboplatin, and bevacizumab in — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Progression-free Survival at 6 Months The primary endpoint is the 6 month post registration Progression-free survival (PFS) rate. Progression-free survival time is defined as the time from registration to documentation of disease progression using the RECIST criteria. Patients who died without documentation of disease progression will be considered to have progressed at death unless there is sufficient documented evidence to conclude no progression occurred prior to death. All patients, who meet the eligibility criteria, sign a consent form, and start treatment will be included in the evaluation of the 6 month PFS rate. at 6 months
Secondary Tumor Response Rate, Calculated as a Percentage Along With it's 95% Confidence Interval A confirmed tumor response is defined to be a Complete Response or Partial Response noted
> as the objective status on 2 consecutive evaluations at least 8
> weeks apart. The proportion of tumor responses will be
> estimated by the number of confirmed tumor responses divided
> by the total number of evaluable patients.
> Complete Response (CR): Disappearance of all target lesions
> Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions taking as reference the baseline sum LD.
> Progression (PD): At least a 20% increase in the sum of target lesions taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
> Stable Disease (SD): Neither sufficient shrinkage to Qualify for PR nor sufficient increase to Qualify for PD taking as reference the smallest sum LD. responses will be calculated assuming that the number of
> confirmed tumor responses follows a binomial distribution.
Up to 5 years
Secondary Overall Survival Overall survival time is defined as the time from registration to death due to any cause. The distribution of survival time will be estimated using the method of Kaplan-Meier. Up to 5 years
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