The purpose of this study is to evaluate how effective Sunitinib works in treating acral lentiginous and mucosal melanoma which has spread beyond the local region. Suninitib is a protein-tyrosine kinase inhibitor and acts as a c-kit inhibitor drug. It is believed to work by blocking signals on certain cancer cells which allow the malignant cells to multiply and spread due to a change in the genetic make up of the cancer cell.

OBJECTIVES:

Primary

• To determine the proportion of participants with metastatic mucosal or acral/lentiginous melanoma who are alive and without disease progression at two months after beginning treatment with sunitinib.
• To determine the best overall response rate.

Secondary

• To determine the time to progression and overall survival.
• To correlate c-kit mutational status with response to therapy.
• To evaluate the use of FDG-PET scanning in determining early biologic response to therapy.
• To assess amplification of c-kit status through quantitative PCR and/or FISH and other related molecular pathway targets.

Inclusion Criteria:

• History of primary mucosal or acral/lentiginous melanoma
• Histologically documented stage III unresectable or IV metastatic melanoma
• ECOG Performance Status 0,1 or 2
• Estimated life expectancy of 6 months or greater
• 18 years of age or older
• Lab values as outlined in protocol
• Tumor blocks or slides must be available of either primary or metastatic tumor site for c-kit mutation testing
• Negative pregnancy test within 48 hours of starting treatment
• At least one measurable site of disease as defined by at least 1cm in greatest dimension

Exclusion Criteria:

• Severe and/or uncontrolled medical disease
• Pregnant or nursing mothers
• Known brain metastasis. History of or known spinal cord compression, or carcinomatous meningitis, or evidence of symptomatic brain or leptomeningeal disease on screening CT or MRI scan
• Less than 5 years free of another primary malignancy except: if the other primary malignancy is not currently clinically significant nor requiring active intervention, or if other primary malignancy is a basal cell skin cancer or cervical carcinoma in situ
• Grade III/IV cardiac problems as defined by the New York Heart Association Criteria
• Ongoing cardiac dysrhythmias of grade 2 or greater, atrial fibrillation, QTc interval >450msec for males of >470 msec for females
• Hypertension that cannot be controlled by medication
• Any of the following within 12 months prior to starting treatment: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism
• NCI CTCAE version 3.0 grade 3 hemorrhage within 4 weeks of starting the study treatment
• Concurrent treatment with warfarin
• Prior treatment with SU011248 or any other antiangiogenic agent
• No H2 blockers or proton pump inhibitors
• Known chronic liver disease
• Known HIV infection
• Previous radiotherapy to 25% or more of the bone marrow and/or radiation therapy within 4 weeks prior to study entry
• Major surgery within 4 weeks prior to study entry
• Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication

The analysis dataset is comprised of treated patients.

AE assessment was ongoing from the start of study drug and up to day 30 post-treatment.

Maximum grade toxicity by type was first calculated. Serious AEs were defined as events with treatment-attribution of possibly, probably or definitely and grade 3 or higher per CTCAEv3. Other AEs were defined as events with treatment-attribution of possible, probable or definite and grades 1 or 2 per CTCAEv3.