Melanoma (Skin) Clinical Trial
Official title:
A Randomized Phase II Trial of Temozolomide (TMZ) and Bevacizumab or ABI-007 (ABX)/Carboplatin (CBDCA) and Bevacizumab in Patients With Unresectable Stage IV Malignant Melanoma
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.
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.
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