Metastatic Cancer Clinical Trial
Official title:
Dose Finding Study of Aerosolized GM-CSF in the Treatment of Metastatic Melanoma to the Lung
RATIONALE: Inhaling sargramostim may interfere with the growth of tumor cells and may be an
effective treatment for melanoma that has spread to the lung.
PURPOSE: This phase I trial is studying the side effects and best dose of inhaled
sargramostim in treating patients with melanoma that is metastatic to the lung.
OBJECTIVES:
- Determine immunomodulatory effects of aerosolized sargramostim (GM-CSF) in patients
with metastatic melanoma to the lung (part A).
- Determine toxicity profile of this therapy, in terms of pulmonary and hematologic
toxicity, in these patients.
- Determine, preliminarily, the therapeutic effects of this therapy, in terms of
progression-free survival, overall survival, and objective response rate, in these
patients.
- Determine the maximum tolerated dose of GM-CSF in these patients (part B).
OUTLINE: This is a dose-escalation, multicenter study.
Patients receive aerosolized sargramostim (GM-CSF) twice a day on days 1-7 and 15-21.
Treatment repeats every 28 days for 2 courses. Patients with no disease progression after
completion of course 2 may continue on treatment until disease progression. Patients are
grouped to 1 of 2 dose-escalation regimens (part A vs B).
- Part A: Cohorts of 5-10 patients receive escalating doses of GM-CSF until the optimal
immunostimulatory dose (ISD) is determined. The optimal ISD is defined as the dose at
which at least 7 of 10 patients experience immunostimulation. Once the optimal ISD is
determined, 10 patients receive aerosolized GM-CSF at a dose halfway between the
optimal ISD and the preceding dose. Dose escalation is discontinued if at least 2 of 5
or at least 4 of 10 patients on a particular dose level experience dose-limiting
toxicity.
- Part B: Cohorts of 3-6 patients receive escalating doses of GM-CSF until the maximum
tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at
which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. At least 6 patients
are treated at the MTD.
After completion of study therapy, patients are followed at 3 months, every 2 months for 1
year, and then every 3-4 months for 5 years.
PROJECTED ACCRUAL: A total of 85 patients will be accrued for this study.
;
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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