Iris Melanoma Clinical Trial
Official title:
Randomized Phase II Trial of Temozolomide Versus Hyd-Sulfate AZD6244 [NSC 748727] in Patients With Metastatic Uveal Melanoma
This randomized phase II trial studies temozolomide to see how well it works compared to selumetinib in treating patients with melanoma of the eye that has spread to other places in the body. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Selumetinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether temozolomide is more effective than selumetinib in treating melanoma of the eye.
PRIMARY OBJECTIVES:
I. To assess the progression-free survival (PFS) in three separate patient populations with
uveal melanoma: Patients on COHORT 1 (guanine nucleotide binding protein [G protein], q
polypeptide [Gnaq]/G protein, alpha 11 [Gna11] mutant uveal melanoma; temozolomide
[TMZ]/dacarbazine [DTIC] naive) treated with AZD6244 (selumetinib) or TMZ (or DTIC);
patients on both COHORT 1 and COHORT 2 (Gnaq/Gna11 mutant and Gnaq/Gna11 wild-type uveal
melanoma; TMZ/DTIC naive) treated with AZD6244 or TMZ (or DTIC); and patients on COHORT 3
(Gnaq/Gna11 mutant or wild-type uveal melanoma; previously treated with TMZ/DTIC) treated
with AZD6244.
SECONDARY OBJECTIVES:
I. Overall survival (OS). II. Overall response rate (RR). III. To determine the tolerability
of AZD6244 in patients with advanced uveal melanoma.
IV. To correlate PFS, OS, and overall RR with Gnaq and Gna11 mutational status.
TERTIARY OBJECTIVES:
I. To correlate clinical outcome with baseline phosphorylated (p)-extracellular
signal-regulated kinases (ERK), p-v-akt murine thymoma viral oncogene homolog 1 (AKT), and
phosphatase and tensin homolog (PTEN) expression by immunohistochemistry.
II. To correlate clinical outcome with changes in p-ERK, p-AKT, and PTEN expression by
immunohistochemistry.
III. To correlate clinical outcome with changes in Ki67 and cleaved caspase 3. IV. To
explore the overall quality of life (QoL) of the treatment groups as measured by the
Functional Assessment of Cancer Therapy-Melanoma (FACT-M) questionnaire.
V. To explore the radiographic effects of treatment with AZD6244 as assessed by 18F
fluorothymidine (FLT)-positron emission tomography (PET) imaging.
OUTLINE: Patients in groups 1 and 2 are randomized to 1 of 2 treatment arms. Patients in
group 3 are assigned to arm II.
ARM I: Patients receive temozolomide orally (PO) once daily (QD) on days 1-5. Courses repeat
every 28 days in the absence of disease progression or unacceptable toxicity. Patients who
are unable to be treated with temozolomide may be treated with dacarbazine intravenously
(IV) every 3 weeks (with approval from the Principal Investigator). Patients who experience
disease progression may crossover to arm II.
ARM II: Patients receive selumetinib PO twice daily (BID) on days 1-28. Courses repeat every
28 days in the absence of disease progression or unacceptable toxicity.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment
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