Stage IV Melanoma Clinical Trial
Official title:
Phase I Evaluation of Sodium Stibogluconate in Combination With Interferon α-2b Followed by Cisplatin, Vinblastine and Dacarbazine for Patients With Melanoma or Malignancies Potentially Responsive to SSG and/or Interferons
RATIONALE: Sodium stibogluconate may stop the growth of tumor cells by blocking some of the
enzymes needed for cell growth. Interferon alfa-2b may interfere with the growth of tumor
cells and slow the growth of melanoma and other cancers. Drugs used in chemotherapy, such as
cisplatin, vinblastine, and dacarbazine, work in different ways to stop the growth of tumor
cells, either by killing the cells or by stopping them from dividing. Giving sodium
stibogluconate and interferon alfa-2b together with combination chemotherapy may kill more
tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of sodium
stibogluconate when given together with interferon alfa-2b, cisplatin, vinblastine, and
dacarbazine in treating patients with advanced melanoma or other cancer.
OBJECTIVES:
Primary
- To determine the safety of the combination of sodium stibogluconate and interferon
alfa-2b with chemotherapy.
- To confirm the activity of sodium stibogluconate in augmenting cytokine effects.
Secondary
- To quantify the effects of sodium stibogluconate on interferon alfa-2b induced gene
modulation and signal transduction pathways by measuring the serum soluble gene
products.
- To define the effectiveness of sodium stibogluconate in inhibiting the protein tyrosine
phosphatases SHP-1 and SHP-2 assayed from peripheral blood leukocytes of patients
receiving sodium stibogluconate in combination with interferon alfa-2b.
- To define the pharmacokinetics of sodium stibogluconate in serum at escalating doses.
- To assess clinical response to the combination of sodium stibogluconate and interferon
alfa-2b as priming for combination chemotherapy.
OUTLINE:
- Course 1: Patients receive sodium stibogluconate IV over 15 minutes on day 1 and days
15-18; interferon alfa-2b subcutaneously (SC) on days 8-12 and 15-18; cisplatin IV over
30-60 minutes and vinblastine IV on days 19 and 20; and dacarbazine. After a 2-week rest
period, patients proceed to course 2.
- Course 2 and all subsequent courses: Patients receive sodium stibogluconate IV over 15
minutes and interferon alfa-2b SC on days 1-4; cisplatin IV over 30-60 minutes and
vinblastine IV on days 5 and 6; dacarbazine. Courses repeat every 4 weeks in the absence
of disease progression or unacceptable toxicity.* NOTE: *Patients with stage IV disease
who have no evidence of disease [NED} receive only 4 courses of therapy.
Cohorts of 6 patients receive escalating doses of sodium stibogluconate until the maximum
tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which
dose-limiting toxicity occurs (i.e., no more than 1 patient at a given dose experiences DLT).
Patients undergo blood sample collection periodically for immunological and pharmacokinetic
studies. Samples are analyzed for serum soluble gene products and protein tyrosine
phosphatase inhibition.
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