Recurrent Melanoma Clinical Trial
Official title:
A Phase II, Pharmacokinetic (PK), Pharmacodynamic (PD) and Biological Correlative Study of the Efficacy and Safety of Dual Antiangiogenic Inhibition Using Bevacizumab and Sorafenib in Patients With Advanced Malignant Melanoma
This phase II trial is studying how well giving bevacizumab together with sorafenib works in treating patients with unresectable stage III or stage IV malignant melanoma. 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. Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Bevacizumab and sorafenib may also stop the growth of melanoma by blocking blood flow to the tumor. Giving bevacizumab together with sorafenib may kill more tumor cells.
PRIMARY OBJECTIVES:
I. Determine the clinical biologic activity of sorafenib tosylate and bevacizumab, defined as
the sum of complete response, partial response, and prolonged stable disease for ≥ 16 weeks,
in patients with unresectable stage III or stage IV malignant melanoma previously treated
with at least 2 regimens of immunotherapy, cytokines, biologic therapy, or vaccine therapy or
in previously untreated patients who are not appropriate candidates to receive
aldesleukin-based treatment.
SECONDARY OBJECTIVES:
I. Evaluate the safety and tolerability of sorafenib tosylate and bevacizumab in these
patients.
II. Evaluate the biologic activity of this regimen, in terms of time to progression,
progression-free survival at 6 months, and overall survival, in these patients.
III. Describe significant pharmacokinetic interactions between bevacizumab and sorafenib
tosylate.
IV. Characterize the pharmacodynamic relationships between the plasma concentration of
sorafenib tosylate and bevacizumab and the effects of treatment on normal organ function and
tumor tissue in these patients.
V. Identify predictive biomarkers of response to this regimen in these patients.
VI. Correlate changes in biological measurements with patient outcomes.
OUTLINE: This is an open-label, multicenter study.
Patients receive oral sorafenib tosylate on days 1-5, 8-12, 15-19, and 22-26 and bevacizumab
IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days in the absence of
unacceptable toxicity or disease progression. Blood samples and tumor biopsies are obtained
periodically for pharmacokinetic and pharmacodynamic studies. Samples are examined by liquid
chromatography, mass spectrometry, immunohistochemistry, gene expression analysis, DNA
mutation analysis, and genomic analysis for biological markers.
After completion of study treatment, patients are followed for 4 weeks.
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