Clinical trial NCT00026221: Bevacizumab With or Without Interferon Alfa in Treating Patients With Metastatic Malignant Melanoma
Official title: A Phase 2 Study of Bevacizumab and Interferon-Alpha-2b in Metastatic Malignant Melanoma
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Recurrent Melanoma
Stage IV Skin Melanoma
Lead sponsor: National Cancer Institute (NCI)
Sponsor class: NIH
First posted: 2003-01-27
Enrollment: 57
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This randomized phase II trial is studying giving bevacizumab together with interferon alpha to see how well it works compared to giving bevacizumab alone in treating patients with metastatic malignant melanoma. Monoclonal antibodies, such as bevacizumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or deliver cancer-killing substances to them. Interferon alpha may interfere with the growth of the cancer cells and slow the growth of the tumor. Combining bevacizumab with interferon alpha may kill more tumor cells.

Detailed description: OBJECTIVES:

I. Compare the objective response rate and progression-free survival in patients with metastatic malignant melanoma treated with bevacizumab with or without low- or high-dose interferon alpha.

OUTLINE: This is a randomized study. Patients are randomized to 1 of 3 treatment arms.

ARM I: Patients receive bevacizumab intravenously (IV) over 30-90 minutes on day 1. Patients also receive low-dose interferon alpha (IFN-alpha) subcutaneously (SC) on days 1-14.

ARM II: Patients receive bevacizumab as in arm I.

ARM III: Patients receive bevacizumab as in arm I. Patients also receive high-dose IFN-alpha SC on days 1, 3, 5, 8, 10, and 12. In all arms, treatment repeats every 14 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. Patients undergo restaging at the completion of course 12. Patients with stable disease or a clinical response may continue treatment according to their assigned treatment arm for up to 1 year. Patients with stable disease after 1 year of treatment with bevacizumab and IFN-alpha (arms I and III) may continue to receive bevacizumab alone every 21 days (as in arm II) in the absence of disease progression.

Patients are followed every 3 months for 2 years.

Eligibility criteria: Inclusion Criteria:

* Histologically or cytologically confirmed cutaneous malignant melanoma

  * Must meet one of the following criteria:

    * Clinical evidence of metastatic disease
    * Unresectable regional lymphatic disease
    * Extensive in transit recurrent disease
* Measurable disease

  * At least 20 mm by conventional techniques OR at least 10 mm by spiral computed tomography (CT) scan
* No known brain metastases
* No ocular melanoma
* Performance status - Eastern Cooperative Oncology Group (ECOG) 0-2
* Performance status - Karnofsky 60-100%
* More than 6 months
* White blood cells (WBC) at least 3,000/mm\^3
* Absolute neutrophil count at least 1,500/mm\^3
* Platelet count at least 100,000/mm\^3
* No clinical evidence of coagulopathy
* Bilirubin =\< 2.0 mg/dL (3.0 mg/dL for patients with Gilbert's disease provided patient is stable and asymptomatic)
* Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) no greater than 2.5 times upper limit of normal (ULN)
* Prothrombin time (PT)/International normalized ratio (INR) less than 1.5
* Creatinine =\< 1.5 mg/dL
* Creatinine clearance at least 60 mL/min
* Protein \< 1,000 mg on 24-hour urine collection for patients with proteinuria \>= 1+
* No symptomatic congestive heart failure
* No unstable angina pectoris
* No cardiac arrhythmia
* No history of thrombosis (e.g., deep vein thrombosis), unless the following criteria are met:

  * INR in normal range (usually 2-3) AND on a stable dose of warfarin or low molecular weight heparin
  * No active bleeding or pathologic condition that would confer a high risk of bleeding (e.g., known varices or tumor involving major vessels)
* No uncontrolled hypertension
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No prior allergic reactions to compounds of similar chemical or biologic composition to bevacizumab or interferon alfa
* No ongoing or active infection
* No other concurrent uncontrolled illness
* No psychiatric illness or social situation that would preclude study compliance
* Human immunodeficiency virus (HIV) allowed provided otherwise well
* At least 4 weeks since prior adjuvant interferon alfa
* No prior interferon alfa for metastatic disease
* No prior cytokine therapy for metastatic disease (e.g., high-dose interleukin-2 \[IL-2\])

  * Prior IL-2 allowed for patients randomized to arm III only
* No prior investigational antiangiogenic agents
* No more than 1 prior chemotherapy regimen for metastatic disease
* At least 4 weeks since prior chemotherapy and recovered
* At least 4 weeks since prior radiotherapy and recovered
* No other concurrent investigational agents

Primary outcomes:
measure: Objective Response Rate
timeFrame: Up to 2 years
measure: Progression-free Survival
timeFrame: Up to 2 years
Secondary outcomes:
measure: Comparison of Plasma Levels of VEGF Following Administration of Bevacizumab Alone or in Combination With IFN-alfa
timeFrame: At baseline
measure: New Vessel Formation in Patient Tumor Samples
timeFrame: Up to 2 years
Other outcomes:
measure: Toxicity
timeFrame: Continuously from the start of treatment to the end of study
Locations:
city: Cincinnati
country: United States
facility: University of Cincinnati
state: Ohio
city: Columbus
country: United States
facility: Ohio State University Comprehensive Cancer Center
state: Ohio
Study officials:
affiliation: Ohio State University Comprehensive Cancer Center
name: William Carson
role: PRINCIPAL_INVESTIGATOR
References: