AZD2171 in Treating Patients With Recurrent or Stage IV Melanoma
Condition: Acral Lentiginous Malignant Melanoma; Ciliary Body and Choroid Melanoma, Medium/Large Size; Ciliary Body and Choroid Melanoma, Small Size; Extraocular Extension Melanoma; Intraocular Melanoma; Iris Melanoma; Lentigo Maligna Malignant Melanoma; Recurrent Melanoma; Stage, Intraocular Melanoma; Stage IV Melanoma; Superficial Spreading Malignant Melanoma
MeSH terms: Melanoma; Uveal Neoplasms; Hutchinson's Melanotic Freckle; Lentigo; Recurrence
Intervention: cediranib maleate
Intervention description: Given orally
Intervention MeSH terms: Cediranib
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 24.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      This phase II trial is studying how well AZD2171 works in treating patients with recurrent or
      stage IV melanoma. AZD2171 may stop the growth of tumor cells by blocking blood flow to the
      tumor and by blocking some of the enzymes needed for cell growth.
    

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