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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-07-C-0134 |
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Investigator left the institute.
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Lenalidomide may stop the growth of tumor cells by blocking blood flow to the tumor. Sunitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cyclophosphamide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving lenalidomide together with sunitinib and low doses of cyclophosphamide once a day may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving lenalidomide together with sunitinib and cyclophosphamide works in treating patients with stage IV eye melanoma.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is nonrandomized, uncontrolled, open-label study.
Patients receive oral lenalidomide, oral sunitinib malate*, and oral low-dose cyclophosphamide once daily on days 1-28. Treatment repeats every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.
NOTE: *Some patients will not receive sunitinib malate during course 1.
After completion of study treatment, patients are followed every 3 months for 2 years, every 4 months for 3 years and then annually thereafter.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1-lenalidomide & cyclophosphamide | Experimental | Participants first started on 2 Interventions (Dose A-QD) in Cycle 1, with 10 mg Lenalidomide (Len) once daily and 50 mg Cyclophosphamide (Cyc) once daily; 25 mg Sunitinib (Sun) was added once daily as a 3rd Intervention (Dose B-QD) from Cycle 2 onwards. Doses were adjusted in subsequent cycles depending on toxicity, including incremental step downs to 5/25/12.5 mg Len/Cyc/Sun once daily (Dose C-QD) or once every other day (Dose C-QOD). |
|
| Cohort 2-sunitinib & cyclophosphamide | Experimental | 2 participants started Cycle 1 with Dose B as described above and had adjusted-dosing as described for Cohort 1. The remaining 7 participants began Cycle 1 with 10 mg Len, 25 mg Cyc and 12.5 mg Sun once daily (Dose D-QD). Doses were adjusted in subsequent cycles depending on toxicity, including step up to 10/50/12.5 mg Len/Cyc/Sun once daily (Dose E-QD) and step down to Dose D once every other day (Dose D-QOD). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cyclophosphamide | Drug | 25-50 mg by mouth once daily on days 1-28. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Response Rate (Complete and Partial Response) | Response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST). Complete response is the disappearance of all target lesions. Partial response is at least a 30% decrease in the sum of the longest diameter (LD) of target lesions taking as reference the baseline sum LD. | 2 years |
| Toxicity | Here is the number of participants with adverse events. For a detailed list of adverse events see the adverse event module. | 16 months |
| Overall Survival | Time from date of on study to the date of death from any cause or last follow up | up to 16 months |
| Measure | Description | Time Frame |
|---|---|---|
| Progression Free Survival | Proportion of patients who progress or die after the start of treatment | up to 16 months |
| Changes in Gene Expression, Methylation and Protein Modification | Ribonucleic acid (RNA), deoxyribonucleic acid (DNA) and protein obtained from blood, urine and/or tissue was to be evaluated for changes in gene expression, methylation and/or protein modification. |
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DISEASE CHARACTERISTICS:
Histologically confirmed ocular melanoma
Measurable disease
No active brain metastases
PATIENT CHARACTERISTICS:
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Life expectancy > 3 months
Granulocyte count > 1,500/mm^3
Platelet count > 100,000/mm^3
Creatinine ≤ 1.5 mg/dL OR creatinine clearance > 60 mL/min
Bilirubin ≤ 2.0 mg/dL
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 10 times upper limit of normal (ULN)
Prothrombin time (PT)/partial thromboplastin time (PTT)/International Normalized Ratio (INR) normal
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use one highly effective method of contraception (with an additional method) or barrier methods of contraception for ≥ 4 weeks before, during, and for ≥ 4 weeks after completion of study therapy
Ejection fraction normal by echocardiogram
No acute, critical illness, including serious untreated infection
No history of any of the following:
No known human immunodeficiency virus (HIV) positivity
No known hypersensitivity reaction to thalidomide, lenalidomide, sunitinib malate, or cyclophosphamide
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Steven K. Libutti, MD | NCI - Surgery Branch | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office | Bethesda | Maryland | 20892-1182 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Cohort 1-lenalidomide & Cyclophosphamide | Participants first started on 2 Interventions (Dose A-QD) in Cycle 1, with 10 mg Lenalidomide (Len) once daily and 50 mg Cyclophosphamide (Cyc) once daily; 25 mg Sunitinib (Sun) was added once daily as a 3rd Intervention (Dose B-QD) from Cycle 2 onwards. Doses were adjusted in subsequent cycles depending on toxicity, including incremental step downs to 5/25/12.5 mg Len/Cyc/Sun once daily (Dose C-QD) or once every other day (Dose C-QOD). |
| FG001 | Cohort 2-sunitinib & Cyclophosphamide | 2 participants started Cycle 1 with Dose B as described above and had adjusted-dosing as described for Cohort 1. The remaining 7 participants began Cycle 1 with 10 mg Len, 25 mg Cyc and 12.5 mg Sun once daily (Dose D-QD). Doses were adjusted in subsequent cycles depending on toxicity, including step up to 10/50/12.5 mg Len/Cyc/Sun once daily (Dose E-QD) and step down to Dose D once every other day (Dose D-QOD). |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dosing Schedule 1: Len & Cyc |
| |||||||||||||
| Dosing Schedule 1: Len, Cyc, & Sun |
| |||||||||||||
| Dosing Schedule 2: Len, Cyc, & Sun |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Cohort 1-lenalidomide & Cyclophosphamide | Participants first started on 2 Interventions (Dose A-QD) in Cycle 1, with 10 mg Lenalidomide (Len) once daily and 50 mg Cyclophosphamide (Cyc) once daily; 25 mg Sunitinib (Sun) was added once daily as a 3rd Intervention (Dose B-QD) from Cycle 2 onwards. Doses were adjusted in subsequent cycles depending on toxicity, including incremental step downs to 5/25/12.5 mg Len/Cyc/Sun once daily (Dose C-QD) or once every other day (Dose C-QOD). |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Response Rate (Complete and Partial Response) | Response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST). Complete response is the disappearance of all target lesions. Partial response is at least a 30% decrease in the sum of the longest diameter (LD) of target lesions taking as reference the baseline sum LD. | Cohort 2 = 9 patients. Two patients received Dose B-QD in cycle 1 as outlined in participant flow. Seven patients received Dose D-QD in cycle 1 as outlined in participant flow. | Posted | Number | Participants | 2 years |
|
16 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cohort 1-lenalidomide & Cyclophosphamide | Participants first started on 2 Interventions (Dose A-QD) in Cycle 1, with 10 mg Lenalidomide (Len) once daily and 50 mg Cyclophosphamide (Cyc) once daily; 25 mg Sunitinib (Sun) was added once daily as a 3rd Intervention (Dose B-QD) from Cycle 2 onwards. Doses were adjusted in subsequent cycles depending on toxicity, including incremental step downs to 5/25/12.5 mg Len/Cyc/Sun once daily (Dose C-QD) or once every other day (Dose C-QOD). |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Infection | Infections and infestations | CTCv3.0 | Systematic Assessment | (documented clinically or microbiologically) with grade 3 or 4 neutrophils (ANC < 1.0 x 10e9/L): lung pneumonia |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Albumin, serum-low (hypoalbuminemia) | Metabolism and nutrition disorders | CTCv3.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Steven A. Rosenberg, M.D. | National Cancer Institute, National Institutes of Health | 301-435-7507 | sbpso@mail.nih.gov |
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| ID | Term |
|---|---|
| D000098943 | Uveal Melanoma |
| ID | Term |
|---|---|
| D008545 | Melanoma |
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
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| ID | Term |
|---|---|
| D003520 | Cyclophosphamide |
| D000077269 | Lenalidomide |
| D000077210 | Sunitinib |
| ID | Term |
|---|---|
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
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| lenalidomide | Drug | 10 mg by mouth once daily on days 1-28. |
|
|
| sunitinib malate | Drug | 12.5 - 25 mg by mouth once daily on days 1-28. |
|
|
| Baseline and end of treatment course 1 and 2, approximately 42 days |
| NOT COMPLETED |
|
| NOT COMPLETED |
|
| BG001 | Cohort 2-sunitinib & Cyclophosphamide | 2 participants started Cycle 1 with Dose B as described above and had adjusted-dosing as described for Cohort 1. The remaining 7 participants began Cycle 1 with 10 mg Len, 25 mg Cyc and 12.5 mg Sun once daily (Dose D-QD). Doses were adjusted in subsequent cycles depending on toxicity, including step up to 10/50/12.5 mg Len/Cyc/Sun once daily (Dose E-QD) and step down to Dose D once every other day (Dose D-QOD). |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| OG001 | Cohort 2-sunitinib & Cyclophosphamide | 2 participants started Cycle 1 with Dose B as described above and had adjusted-dosing as described for Cohort 1. The remaining 7 participants began Cycle 1 with 10 mg Len, 25 mg Cyc and 12.5 mg Sun once daily (Dose D-QD). Doses were adjusted in subsequent cycles depending on toxicity, including step up to 10/50/12.5 mg Len/Cyc/Sun once daily (Dose E-QD) and step down to Dose D once every other day (Dose D-QOD). |
|
|
| Primary | Toxicity | Here is the number of participants with adverse events. For a detailed list of adverse events see the adverse event module. | Cohort 2 = 9 patients. Two patients received Dose B-QD in cycle 1 as outlined in participant flow. Seven patients received Dose D-QD in cycle 1 as outlined in participant flow. | Posted | Number | Participants | 16 months |
|
|
|
| Primary | Overall Survival | Time from date of on study to the date of death from any cause or last follow up | Overall survival is not the same as response, to obtain overall survival the investigator would have to follow patients until death, which the original investigator left the institution well before this outcome could be accomplished. | Posted | up to 16 months |
|
|
| Secondary | Progression Free Survival | Proportion of patients who progress or die after the start of treatment | Overall survival is not the same as response, to obtain overall survival the investigator would have to follow patients until death, which the original investigator left the institution well before this outcome could be accomplished | Posted | up to 16 months |
|
|
| Secondary | Changes in Gene Expression, Methylation and Protein Modification | Ribonucleic acid (RNA), deoxyribonucleic acid (DNA) and protein obtained from blood, urine and/or tissue was to be evaluated for changes in gene expression, methylation and/or protein modification. | Overall survival is not the same as response, to obtain overall survival the investigator would have to follow patients until death, which the original investigator left the institution well before this outcome could be accomplished | Posted | Baseline and end of treatment course 1 and 2, approximately 42 days |
|
|
| 0 |
| 3 |
| 3 |
| 3 |
| EG001 | Cohort 2-sunitinib & Cyclophosphamide | 2 participants started Cycle 1 with Dose B as described above and had adjusted-dosing as described for Cohort 1. The remaining 7 participants began Cycle 1 with 10 mg Len, 25 mg Cyc and 12.5 mg Sun once daily (Dose D-QD). Doses were adjusted in subsequent cycles depending on toxicity, including step up to 10/50/12.5 mg Len/Cyc/Sun once daily (Dose E-QD) and step down to Dose D once every other day (Dose D-QOD). | 2 | 9 | 8 | 9 |
|
| Leukocytes (total WBC) | Investigations | CTCv3.0 | Systematic Assessment |
|
| Neutrophils/granulocytes (ANC/AG) | Investigations | CTCv3.0 | Systematic Assessment |
|
| Obstruction, GI: cecum | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Distension/bloating, abdominal | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Dyspnea (shortness of breath) | Respiratory, thoracic and mediastinal disorders | CTCv3.0 | Systematic Assessment |
|
| Fatigue (asthenia, lethargy, malaise) | General disorders | CTCv3.0 | Systematic Assessment |
|
| Febrile Neutropenia | Blood and lymphatic system disorders | CTCv3.0 | Systematic Assessment | (fever of unknown origin without clinically or microbiologically documented infection)(ANC <1.0 x 10e9/L, fever >=38.5 degrees C) |
|
| Fracture | Injury, poisoning and procedural complications | CTCv3.0 | Systematic Assessment |
|
| Heartburn/dyspepsia | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| hemorrhoids | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Hypopigmentation | Skin and subcutaneous tissue disorders | CTCv3.0 | Systematic Assessment |
|
| Leukocytes (total WBC) | Investigations | CTCv3.0 | Systematic Assessment |
|
| Lymphopenia | Investigations | CTCv3.0 | Systematic Assessment |
|
| Mood alteration::Depression | Psychiatric disorders | CTCv3.0 | Systematic Assessment |
|
| Mucositis/stomatitis (clinical exam)::Oral cavity | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Nasal cavity/paranasal sinus reactions | Respiratory, thoracic and mediastinal disorders | CTCv3.0 | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Neutrophils/granulocytes (ANC/AG) | Investigations | CTCv3.0 | Systematic Assessment |
|
| Pain: Abdomen NOS | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Pain::Head/headache | Nervous system disorders | CTCv3.0 | Systematic Assessment |
|
| Pain::Joint | Musculoskeletal and connective tissue disorders | CTCv3.0 | Systematic Assessment |
|
| Pain::Muscle | Musculoskeletal and connective tissue disorders | CTCv3.0 | Systematic Assessment |
|
| Pain::Neck | Musculoskeletal and connective tissue disorders | CTCv3.0 | Systematic Assessment |
|
| Phosphate, serum-low (hypophosphatemia) | Metabolism and nutrition disorders | CTCv3.0 | Systematic Assessment |
|
| Photosensitivity | Eye disorders | CTCv3.0 | Systematic Assessment |
|
| Platelets | Investigations | CTCv3.0 | Systematic Assessment |
|
| Rash/desquamation | Skin and subcutaneous tissue disorders | CTCv3.0 | Systematic Assessment |
|
| Rigors/chills | General disorders | CTCv3.0 | Systematic Assessment |
|
| Sweating (diaphoresis) | Skin and subcutaneous tissue disorders | CTCv3.0 | Systematic Assessment |
|
| Taste alteration (dysgeusia) | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| ALT, SGPT (serum glutamic pyruvic transaminase) | Investigations | CTCv3.0 | Systematic Assessment |
|
| AST, SGOT(serum glutamic oxaloacetic transaminase) | Investigations | CTCv3.0 | Systematic Assessment |
|
| Anorexia | Metabolism and nutrition disorders | CTCv3.0 | Systematic Assessment |
|
| Bilirubin (hyperbilirubinemia) | Investigations | CTCv3.0 | Systematic Assessment |
|
| Dry skin | Skin and subcutaneous tissue disorders | CTCv3.0 | Systematic Assessment |
|
| Edema: limb | General disorders | CTCv3.0 | Systematic Assessment |
|
| Hemorrhage, GI::Rectum | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Infection | Infections and infestations | CTCv3.0 | Systematic Assessment | (documented clinically or microbiologically) with Grade 3 or 4 neutrophils (ANC <1.0 x 10e9/L)::Skin (cellulites) |
|
| Infection with normal ANC or Grade 1 or 2 neutrophils::Skin (cellulitis) | Infections and infestations | CTCv3.0 | Systematic Assessment |
|
| Pain::Oral cavity | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Pain::Oral gums | Gastrointestinal disorders | CTCv3.0 | Systematic Assessment |
|
| Vaginal dryness | Reproductive system and breast disorders | CTCv3.0 | Systematic Assessment |
|
| Fever (in the absence of neutropenia, where neutropenia is defined as ANC <1.0 x 10e9/L) | General disorders | CTCv3.0 | Systematic Assessment |
|
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| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D014604 | Uveal Neoplasms |
| D005134 | Eye Neoplasms |
| D009371 | Neoplasms by Site |
| D005128 | Eye Diseases |
| D014603 | Uveal Diseases |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D010797 | Phthalimides |
| D010795 | Phthalic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D010881 | Piperidones |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D054833 | Isoindoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D011758 | Pyrroles |
| D001393 | Azoles |
| D007211 | Indoles |