Intervention: Cediranib
Trial phase: Phase 2
ATC code: L01EK02
SMILES: COc1cc2c(Oc3ccc4[nH]c(C)cc4c3F)ncnc2cc1OCCCN1CCCC1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 24
Group description: Patients receive oral AZD2171 once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

cediranib maleate: Given orally

laboratory biomarker analysis: Correlative studies

dynamic contrast-enhanced magnetic resonance imaging: Correlative studies
Eligibility criteria:
Inclusion Criteria:

Histologically/cytologically confirmed recurrent/metastatic malignant melanoma (stage IV acral lentiginous, lentigo maligna, superficial spreading or ocular malignant melanoma)

Measurable disease- at least 1 lesion accurately measured in at least 1 dimension (longest diameter) as >=20mm with conventional techniques or >=10mm with spiral CT scan

Previously irradiated lesions not considered measurable unless they demonstrated progression prior to study entry

No prior chemotherapy (including regional therapy); prior adjuvant immunotherapy permitted if completed >3 months prior to study entry; patients may have received prior radiation therapy if completed >=4 weeks prior to study entry

Previous surgery permissible if performed >=4 weeks prior to study entry
Life expectancy >12 weeks
ECOG performance status=< 2 (Karnofsky>=60%)
Leukocytes>=3,000/mcL
Absolute neutrophil count>=1,500/mcL
Platelets>=100,000/mcL
Hemoglobin>=8g/dL
Total bilirubin<1.5x institutional ULN (IULN)
AST/ALT=<3 x IULN (5xULN if liver metastases)
Creatinine within IULN
Creatinine within IULN OR
Creatinine clearance>=60mL/min/m^2 if creatinine levels above IULN
Baseline blood pressure <140/90mmHg; may be taking antihypertensive medications
AZD2171 has shown to terminate fetal development in rat as expected for process dependent on VEGF signaling; women of childbearing potential must have negative pregnancy test prior to study entry; women of childbearing potential/men must agree to use adequate contraception (hormonal/barrier method of birth control; abstinence) prior to study entry and for duration of study
Ability to understand/willingness to sign written informed consent

Exclusion Criteria:

Any previous chemotherapy or immunotherapy for recurrent/metastatic disease; patients who have had radiotherapy or major surgery within 4 weeks prior to entering study or those who have not recovered from AEs due to treatment received more than 4 weeks earlier
May not be concurrently receiving other investigational agents nor have participated in an investigational trial of bio-, chemo- or immunotherapy agents
Known brain metastases because of their poor prognosis and because patients often develop progressive neurologic dysfunction that would confound evaluation of neurologic and other AEs
History of allergic reactions attributed to compounds of similar chemical/biologic composition to AZD2171
Mean QTc>470msec (Bazett's correction) in screening electrocardiogram or history of familial long QT syndrome
>+1 proteinuria on 2 consecutive dipsticks taken no less than 1 week apart
Uncontrolled intercurrent illness including but not limited to hypertension, ongoing/active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Pregnant women excluded from study because AZD2171 is a VEGF inhibitor with known abortifacient effects; breastfeeding should be discontinued if mother is treated with AZD2171
HIV-positive patients on combination antiretroviral therapy are ineligible because of potential for PK interactions with AZD2171; appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated
Any significant abnormality noted in ECG within 14 days of treatment
A NYHA classification of III or IV (NOTE: Patients classified as class II controlled with treatment may continue with increase monitoring)
Conditions requiring concurrent use of drugs/biologics with proarrhythmic potential; these drugs are prohibited during studies with AZD2171