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VEGF Trap in Treating Patients With Recurrent Stage III or Stage IV Melanoma That Cannot Be Removed by Surgery

A Phase 2 Study Evaluating the Efficacy of VEGF Trap in Patients With Recurrent Inoperable Stage III or Stage IV Melanoma

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00450255
Enrollment
41
Registered
2007-03-22
Start date
2007-06-30
Completion date
2011-01-31
Last updated
2018-05-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Ciliary Body and Choroid Melanoma, Medium/Large Size, Extraocular Extension Melanoma, Iris Melanoma, Metastatic Intraocular Melanoma, Recurrent Intraocular Melanoma, Recurrent Melanoma, Stage III Melanoma, Stage IV Melanoma

Brief summary

This phase II trial is studying how well VEGF Trap works in treating patients with recurrent stage III or stage IV melanoma that cannot be removed by surgery. Combinations of biological substances in VEGF Trap may be able to carry tumor-killing substances directly to melanoma cells. It may also stop the growth of melanoma by blocking blood flow to the tumor.

Detailed description

PRIMARY OBJECTIVES: I. Determine the antitumor response rate (complete and partial response) in patients with recurrent inoperable stage III or IV melanoma treated with VEGF Trap. II. Compare the progression-free survival of patients treated with this regimen vs historical controls. SECONDARY OBJECTIVES: I. Determine the overall survival of patients treated with this regimen. II. Determine the toxicity and tolerability of this regimen in these patients. III. Determine the impact of this regimen on laboratory correlates including anti-VEGF Trap antibody testing and pharmacokinetics in these patients. OUTLINE: This is a multicenter study. Patients receive VEGF Trap IV over 1 hour on day 1. Treatment repeats every 14 days for at least 6 courses in the absence of disease progression or unacceptable toxicity. Blood samples are collected at baseline, prior to course 2, and 60 days after completion of study treatment for pharmacokinetic and pharmacodynamic studies. Samples are analyzed by enzyme-linked immunosorbent assay. After completion of study treatment, patients are followed periodically for 5 years.

Interventions

BIOLOGICALziv-aflibercept

Given IV

OTHERpharmacological study

Correlative studies

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 120 Years
Healthy volunteers
No

Inclusion criteria

* Histologically confirmed stage III or IV melanoma * Cutaneous, ocular, or mucosal melanoma allowed * Recurrent, inoperable disease * Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan * No evidence of CNS disease, including primary brain tumor or brain metastases * No brain metastases by MRI or CT scan within the past 4 weeks * ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100% * Life expectancy \> 3 months * WBC ≥ 3,000/mm³ * Absolute neutrophil count ≥ 1,500/mm³ * Platelet count ≥ 75,000/mm³ * Bilirubin \< 1.5 times upper limit of normal (ULN) * AST and ALT ≤ 2.5 times ULN * Creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min * Urine protein:creatinine ratio \< 1 OR urine protein \< 500 mg by 24-hour urine collection * PT INR ≤ 1.5 unless on full-dose warfarin * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for ≥ 6 months after completion of study treatment * No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies * No history of allergic reactions attributed to compounds of similar chemical or biological composition to agents used in the study * No serious or nonhealing wound, ulcer, or bone fracture * No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days * No significant traumatic injury within the past 28 days * No clinically significant cardiovascular disease, including any of the following: * Cerebrovascular accident within the past 6 months * Uncontrolled hypertension, defined as blood pressure (BP) \> 150/100 mm Hg or systolic BP \> 180 mm Hg if diastolic BP \< 90 mm Hg within the past 3 months * Myocardial infarction, coronary artery bypass graft, or unstable angina within the past 6 months * New York Heart Association class III-IV congestive heart failure * Serious cardiac arrhythmia requiring medication * Unstable angina pectoris within the past 6 months * Clinically significant peripheral vascular disease within the past 6 months * Pulmonary embolism, deep vein thrombosis, or other thromboembolic event within the past 6 months * No evidence of bleeding diathesis or coagulopathy * No concurrent uncontrolled illness, including, but not limited to any of the following: * Ongoing or active infection * Psychiatric illness or social situation that would preclude study compliance * Recovered from all prior therapy and major surgery * No prior chemotherapy or hormonal therapy * More than 7 days since prior core visceral organ biopsy * More than 4 weeks since prior biologic therapy or radiotherapy * More than 28 days since prior major surgery or open biopsy * No concurrent major surgery * No other concurrent investigational agents * No concurrent combination antiretroviral therapy for HIV-positive patients * Concurrent full-dose warfarin with PT INR \> 1.5 allowed provided the following criteria are met: * INR in range (2-3) on a stable dose of oral anticoagulant or low molecular weight heparin * No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices)

Design outcomes

Primary

MeasureTime frameDescription
Objective Response Rate (CR + PR)Start of treatment to disease progression/recurrence, up to 5 yearsUsing the RECIST v1.0 criteria for target lesions assessed by CT or MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Objective Response = CR + PR.,
4 Month Progression-free Survival4 monthsEstimated using the product-limit method of Kaplan and Meier. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Secondary

MeasureTime frameDescription
Overall SurvivalFrom the initial date of treatment to the recorded date of death, assessed up to 5 yearsWill be estimated by the Kaplan-Meier method.
Number of Participants With ToxicitiesUp to 5 yearsThe descriptions and grading scales found in the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 were utilized for AE grading and reporting. Grade 3 and higher adverse events considered possibly, probably or definitely related to aflibercept are summarized.
Impact of the VEGF Trap Therapy on Laboratory CorrelatesUp to 5 years

Countries

United States

Participant flow

Participants by arm

ArmCount
Arm I
Patients receive Aflibercept IV at 4 mg/kg over 1 hour on day 1. Treatment repeats every 14 days for at least 6 courses in the absence of disease progression or unacceptable toxicity. ziv-aflibercept: Given IV pharmacological study: Correlative studies
41
Total41

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyPrior RFA ablation of liver1

Baseline characteristics

CharacteristicArm I
Age, Continuous57 years
Race/Ethnicity, Customized
Caucasian
41 participants
Region of Enrollment
United States
41 participants
Sex: Female, Male
Female
15 Participants
Sex: Female, Male
Male
26 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
41 / 41
serious
Total, serious adverse events
13 / 41

Outcome results

Primary

4 Month Progression-free Survival

Estimated using the product-limit method of Kaplan and Meier. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Time frame: 4 months

ArmMeasureValue (NUMBER)
Arm I4 Month Progression-free Survival50 percentage of patients
Primary

Objective Response Rate (CR + PR)

Using the RECIST v1.0 criteria for target lesions assessed by CT or MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Objective Response = CR + PR.,

Time frame: Start of treatment to disease progression/recurrence, up to 5 years

ArmMeasureValue (NUMBER)
Arm IObjective Response Rate (CR + PR)7.5 percentage of participants
Secondary

Impact of the VEGF Trap Therapy on Laboratory Correlates

Time frame: Up to 5 years

Population: Laboratory Correlate data were not collected.

Secondary

Number of Participants With Toxicities

The descriptions and grading scales found in the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 were utilized for AE grading and reporting. Grade 3 and higher adverse events considered possibly, probably or definitely related to aflibercept are summarized.

Time frame: Up to 5 years

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Arm INumber of Participants With ToxicitiesGrade 4 : LV Diastolic Dys0 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Thrombocytopenia1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Hypertension9 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Hypotension1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : LV Diastolic Dys1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : GI Bleed1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Cerebrovascular ischemia0 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Headache1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Extraocular muscle paresis1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Fatigue1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Hyponatremia2 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Osteonecrosis of mandibular bone1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Back Pain1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Chest Pain1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Increased creatinine1 Participants
Arm INumber of Participants With ToxicitiesGrade 3 : Proteinuria6 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Thrombocytopenia0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Hypertension0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Hypotension0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : GI Bleed0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Cerebrovascular ischemia1 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Headache0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Extraocular muscle paresis0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Fatigue0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Hyponatremia0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Osteonecrosis of mandibular bone0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Back Pain0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Chest Pain0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Increased creatinine0 Participants
Arm INumber of Participants With ToxicitiesGrade 4 : Proteinuria0 Participants
Secondary

Overall Survival

Will be estimated by the Kaplan-Meier method.

Time frame: From the initial date of treatment to the recorded date of death, assessed up to 5 years

ArmMeasureValue (MEDIAN)
Arm IOverall Survival16.3 Months

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026