Patient case: 86-year-old female with melanoma; genetic feature: high tumor mutational burden

Clinical trial: Interferon Beta in Treating Patients With Metastatic Cutaneous Melanoma or Ocular Melanoma

Summary: RATIONALE: Interferon beta may interfere with the growth of tumor cells.
  PURPOSE: This phase II trial is studying how well interferon beta works in treating patients with metastatic cutaneous (skin) melanoma or ocular (eye) melanoma.

Detailed description: OBJECTIVES:
  -  Determine the objective clinical response rate in patients with metastatic cutaneous or ocular melanoma treated with interferon beta.
  -  Determine the frequency and degree of apoptosis induction in patients treated with this drug.
  -  Determine the safety and tolerability of this drug in these patients.
  OUTLINE: This is an open-label study. Patients are stratified according to type of melanoma (ocular vs cutaneous).
  Patients receive interferon beta subcutaneously once daily in the absence of disease progression or unacceptable toxicity.
  Patients are followed within 3 days after completion of study treatment and then for survival.
  PROJECTED ACCRUAL: A total of 28-56 patients (14-28 per stratum) will be accrued for this study.

Eligibility: DISEASE CHARACTERISTICS:
  -  Histologically confirmed metastatic melanoma
  -  Cutaneous or ocular disease
  -  Measurable disease
  -  No active unstable CNS metastases by neurologic exam AND CT scan or MRI
  -  Irradiated and/or resected CNS lesions allowed if there is no evidence of disease by head MRI or CT scan for > 6 months after surgery and/or radiotherapy
  -  Patients with cutaneous metastases and previously irradiated and/or resected CNS metastases are eligible if the CNS metastases are controlled and do not require dexamethasone
  PATIENT CHARACTERISTICS:
  Age
  -  18 and over
  Performance status
  -  ECOG 0-1 (0-2 for patients with cutaneous metastases)
  Life expectancy
  -  At least 3 months
  Hematopoietic
  -  Absolute neutrophil count ≥ 1,200/mm^3
  -  Platelet count ≥ 100,000/mm^3
  -  Hemoglobin ≥ 9.5 g/dL
  Hepatic
  -  Bilirubin ≤ 1.5 mg/dL
  -  AST ≤ 3.0 times normal
  -  Alkaline phosphatase ≤ 2.5 times normal (10 times normal if due to bone metastases)
  -  Hepatitis B surface antigen negative
  Renal
  -  Creatinine ≤ 1.5 mg/dL
  Cardiovascular
  -  No serious cardiac arrhythmia requiring treatment
  -  No congestive heart failure
  -  No angina pectoris
  -  No New York Heart Association class II-IV heart disease
  -  No other severe cardiovascular disease
  Other
  -  HIV negative
  -  No other malignancy within the past 3 years except basal cell or squamous cell skin cancer or carcinoma in situ of the uterine cervix
  -  No history of seizure disorder
  -  No severe psychiatric disorder
  -  Not pregnant or nursing
  -  Negative pregnancy test
  -  Fertile patients must use effective contraception
  PRIOR CONCURRENT THERAPY:
  Biologic therapy
  -  More than 12 months since prior adjuvant interferon alfa-2 (IFNα-2) therapy
  -  More than 30 days since prior IFNα-2 therapy for metastatic disease (6 months for patients with cutaneous metastases)
  -  No more than 1 prior systemic regimen (chemotherapy or biologic) for metastatic disease (3 regimens for patients with cutaneous metastases)
  Chemotherapy
  -  See Biologic therapy
  -  No concurrent chemotherapy
  Endocrine therapy
  -  See Disease Characteristics
  -  Concurrent replacement therapy with physiologic doses of corticosteroids allowed
  -  No concurrent dexamethasone or other steroidal antiemetics or anti-inflammatories
  -  No other concurrent hormonal agents except steroids administered for preexisting adrenal failure or hormones administered for non-disease-related conditions (e.g., insulin for diabetes)
  Radiotherapy
  -  See Disease Characteristics
  -  More than 28 days since prior radiotherapy and recovered
  -  No concurrent palliative radiotherapy
  Surgery
  -  See Disease Characteristics
  -  No prior organ allograft
  -  More than 28 days since prior major surgery requiring general anesthesia
  Other
  -  More than 28 days since prior antibiotics for local or systemic infection
  -  No concurrent aspirin
  -  No concurrent barbiturates
  -  No other concurrent investigational agents

Relevance to patient case: not relevant