NAM-Trial: Multiferon in Malignant Melanoma

Study Overview
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Brief Summary
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The current clinical trial shall clarify the efficacy, safety and biologic effects of neoadjuvant treatment with natural interferon-α (Multiferon) in patients with locoregional metastases of melanoma in stage IIIB/C.

Detailed Description
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The study is an open label, multicenter phase IIa clinical trial which is designed as a pilot project in order to establish the efficacy and tolerability of Multiferon as a neoadjuvant treatment of locoregional metastases. Patients will be treated subsequently in cohorts characterized by different doses (3 - 9 - 18 MIU) to analyze dosage dependent effects.

Official Title
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Neoadjuvant Treatment of Locoregional Metastases in Malignant Melanoma (AJCC Stage IIIB/C) With Multiferon: a Phase IIa DeCOG Trial

Conditions
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Locoregional Metastases in Malignant Melanoma Stages IIIB/C

Intervention / Treatment
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* Drug: human interferon-α


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically proven cutaneous melanoma Clinical stage IIIB or IIIC (AJCC 2010) ≥ 18 years of age Presence of at least two metastases, not more than 10 metastases, and completely resectable Measurable disease (at least one lesion that can be accurately measured in two perpendicular diameters, with both dimensions at least 10 mm x 10 mm for spiral CT and 5 mm x 5 mm for locoregional metastases assessed by ultrasound or digital photography) ECOG performance status of 0/1 Patients with previous adjuvant recombinant interferon-α treatment of any dose are eligible if (i) treatment was stopped at least 1 month before start of treatment and (ii) no progression occurred during interferon-α treatment. No childbearing potential or negative pregnancy test within 14 days before inclusion in women with child bearing potential Women with childbearing potential must be using an effective method of contraception (Pearl-Index < 1, e.g. oral contraceptives, other hormonal contraceptives [vaginal products, skin patches, or implanted or injectable products], or mechanical products such as an intrauterine device or barrier methods [diaphragm, spermicides]) throughout the study and for up to 3 months after the last dose of investigational product, in such a manner that the risk of pregnancy is minimized. No men of fathering potential or men of fathering potential must be using an effective method of contraception to avoid conception throughout the study and for up to 3 months after the last dose of investigational product, in such a manner that the risk of pregnancy is minimized. Signed and dated informed consent informed consent before the start of specific protocol procedures Exclusion Criteria: Mucous membrane or ocular melanoma Any evidence of distant metastasis (e.g. whole body CT-scan including brain scan within 4 weeks before inclusion) Patients with severe cardiac disease (e.g. NYHA Functional Class III or IV, myocardial infarction within 6 months before inclusion, ventricular tachyarrhythmia requiring ongoing treatment, unstable angina pectoris). ALAT or ASAT > 2 x ULN Total bilirubin > 2 x ULN Creatinine > 2 x ULN Evidence or history of depression. If this condition can not be ruled out, the patient should be transferred to a psychiatrist for consultation and further assessment before inclusion. Patients with seizure disorders requiring anticonvulsant therapy Any of the following abnormal baseline hematologic/laboratory values: Hb < 10g/dl WBC < 3.0x109 /l Platelets < 100x109 /l Presence of active autoimmune disease Concurrent systemic glucocorticoids or any other systemic immunosuppressive therapy Unwilling or unable to comply with the requirements of the protocol Known infection with HBV, HCV, HIV Pregnant or lactating women Unwillingness or inability to employ an effective barrier method of birth control throughout the study and for up to 3 months after end of treatment in female or male patients Known or suspected allergy to human interferon alpha or any ingredient of the IMP. Any thyroid dysfunctions not responsive to therapy Presence of chronic hepatitis with decompensated liver cirrhosis Immunosuppression in patients with transplantation Evidence or history of bleeding diathesis or coagulopathy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental arm<br> | Drug: human interferon-α<br>* Neoadjuvant treatment: Multiferon is given as flat dosages (3 - 9 - 18 MIU) 5 days per week, subcutaneously for 4 weeks<br>* Other names: Multiferon;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall response rate | Overall response rate (clinical and radiological) after 4 weeks of treatment (CR + PR) according to immune-related response criteria (irRC) | after 4 weeks of treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disease control rate | Disease control rate (CR + PR +SD) according to irRC | after 4 weeks of treatment | 
| Rate of histopathological complete responses | Rate of histopathological complete responses | after 4 weeks of treatment | 
| Tolerability | Assessment of numbers of adverse events | after 4 weeks of treatment | 
| Differences in gene expression in metastatic tissue before/after treatment |  | after 4 weeks of treatment | 
| Dose dependency of effects |  | after 4 weeks of treatment | 
| Changes of serum markers and PBMC subsets before/after treatment (optional translational side studies) |  | after 4 weeks of treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Malignatn Melanoma