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The purpose of this study is to find out what effects an experimental drug, called interleukin 21 or rIL-21, will have on malignant melanoma and whether these effects look promising compared to dacarbazine. In addition, this study will look at the side effects of rIL-21, and some special blood tests will be done to check the level of rIL-21 in the blood. This study will also look at previously removed melanoma tissue to determine which patients might benefit most from this treatment.
This research is being done because currently there is no effective treatment for this type of cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| rIL-21 | Active Comparator |
| |
| Dacarbazine | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| rIL-21 | Drug | 30 μg/kg IV Daily x 5, weeks 1, 3 and 5 every 8 weeks |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Progression Free Survival | Progression free survival is defined as the time from randomization to the time of the first documented progression event or death by any cause. A patient who stops treatment with study drug and goes on to receive alternative therapy prior to documentation of disease progression, will be censored at the date alternative therapy began. If a patient has not progressed or received alternative therapy, progression free survival (PFS) will be censored at the date of the last disease assessment. | From randomization to progression or death, up to 22 months |
| Measure | Description | Time Frame |
|---|---|---|
| Response Rate | Tumour response is defined per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Complete Response (CR): Disappearance of target and non-target lesions and normalization of tumour markers. Pathological lymph nodes must have short axis measures < 10 mm (Note: continue to record the measurement even if < 10 mm and considered CR). Residual lesions (other than nodes < 10 mm) thought to be non-malignant should be further investigated (by cytology or PET scans) before CR can be accepted. Confirmation of complete response is not required in this randomized study. Partial Response (PR): At least a 30% decrease in the sum of measures (longest diameter for tumour lesions and short axis measure for nodes) of target lesions, taking as reference the baseline sum of diameters. Confirmation of partial response is not required in this randomized study. Overall Response (OR) = CR + PR. |
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Inclusion Criteria:
Chest X-ray > 20 mm, CT scan (with slice thickness of < 5 mm) >10 mm (longest diameter), Physical exam (using calipers) > 10 mm, Lymph nodes by CT scan > 15 mm measured in short axis.
All radiology studies must be performed within 21 days prior to randomization (Exception: Within 28 days if negative).
Immunotherapy: Prior adjuvant immunotherapy for melanoma is permitted if completed ≥ 1 month prior to study entry. No immunotherapy for metastatic disease is permitted. rIL-21 or dacarbazine must be the first systemic therapy for metastatic disease.
Chemotherapy: Patients must not have received any prior chemotherapy (including regional therapy). rIL-21 or dacarbazine must be the first systemic therapy for metastatic disease (except for RAF and MEK-Inhibitors).
Surgery: Previous surgery is permissible. Patient must be > 4 weeks since any major surgery.
Radiation Therapy: Previous radiation therapy is permitted with exception of radiation therapy for brain metastases. Patients must be > 4 weeks since the last treatment with radiation. Exceptions may be made, however, for low dose, non-myelosuppressive radiotherapy. Patients must have recovered from the toxic effects of radiation.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Teresa Petrella | Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, ON | Study Chair |
| Kerry Savage | BCCA - Vancouver Cancer Centre, Vancouver, BC | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Angeles Clinic and Research Institute | Los Angeles | California | 90025 | United States | ||
| Tom Baker Cancer Centre |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Result | Petrella TM, Mihalcioiu C, Monzon J, McWhirter E, Belanger K, Savage KJ, Song X, Hamid O, Cheng T, Davis M, Lee CW, Spatz A, Hagerman L, Chen BE, Dancey J Final Efficacy Results of a Randomized Phase II Study of Recombinant Interleukin-21 Compared to Dacarbazine in Patients with Recurrent or Metastatic Melanoma Journal of Oncology Research and Treatment:4(1):10001322019 |
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| ID | Title | Description |
|---|---|---|
| FG000 | rIL-21 | rIL-21: 30 μg/kg IV Daily x 5, weeks 1, 3 and 5 every 8 weeks |
| FG001 | Dacarbazine | Dacarbazine: 1000 mg/m2 IV Day 1, every 3 weeks |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Dacarbazine |
| Drug |
1000 mg/m2 IV Day 1, every 3 weeks |
|
| From the start of study treatment until the end of treatment (before disease progression) |
| Overall Survival | For patients who have died, overall survival is calculated in months from the day of randomization to date of death. Otherwise, survival is censored at the last day the patient is known alive. | From randomization to death of any cause, up to 22 months |
| Safety and Toxicity Profile (Participants With Grade 3 4 5 Adverse Event) | To determine the safety and toxicity profile of rIL-21 and dacarbazine in patients with chemotherapy and immunotherapy-naive metastatic or recurrent malignant melanoma. Adverse events were measured according to the Common Terminology Criteria version 4.0 for Adverse Events. Number of patients with worst adverse event of grade 3 4 or 5 were counted for both rIL-21 and Dacarbazine arms. | Over study period, up to 22 months |
| Calgary |
| Alberta |
| T2N 4N2 |
| Canada |
| BCCA - Fraser Valley Cancer Centre | Surrey | British Columbia | V3V 1Z2 | Canada |
| BCCA - Vancouver Cancer Centre | Vancouver | British Columbia | V5Z 4E6 | Canada |
| BCCA - Vancouver Island Cancer Centre | Victoria | British Columbia | V8R 6V5 | Canada |
| CancerCare Manitoba | Winnipeg | Manitoba | R3E 0V9 | Canada |
| Atlantic Health Sciences Corporation | Saint John | New Brunswick | E2L 4L2 | Canada |
| QEII Health Sciences Center | Halifax | Nova Scotia | B3H 1V7 | Canada |
| Northeast Cancer Center Health Sciences | Greater Sudbury | Ontario | P3E 5J1 | Canada |
| Juravinski Cancer Centre at Hamilton Health Sciences | Hamilton | Ontario | L8V 5C2 | Canada |
| London Regional Cancer Program | London | Ontario | N6A 4L6 | Canada |
| Ottawa Health Research Institute - General Division | Ottawa | Ontario | K1H 8L6 | Canada |
| Odette Cancer Centre | Toronto | Ontario | M4N 3M5 | Canada |
| Univ. Health Network-Princess Margaret Hospital | Toronto | Ontario | M5G 2M9 | Canada |
| Hopital Charles LeMoyne | Greenfield Park | Quebec | J4V 2H1 | Canada |
| CHUM - Hopital Notre-Dame | Montreal | Quebec | H2L 4M1 | Canada |
| McGill University - Dept. Oncology | Montreal | Quebec | H2W 1S6 | Canada |
| Allan Blair Cancer Centre | Regina | Saskatchewan | S4T 7T1 | Canada |
| Saskatoon Cancer Centre | Saskatoon | Saskatchewan | S7N 4H4 | Canada |
| COMPLETED |
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| NOT COMPLETED |
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|
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| ID | Title | Description |
|---|---|---|
| BG000 | rIL-21 | rIL-21: 30 μg/kg IV Daily x 5, weeks 1, 3 and 5 every 8 weeks |
| BG001 | Dacarbazine | Dacarbazine: 1000 mg/m2 IV Day 1, every 3 weeks |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | 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 | Progression Free Survival | Progression free survival is defined as the time from randomization to the time of the first documented progression event or death by any cause. A patient who stops treatment with study drug and goes on to receive alternative therapy prior to documentation of disease progression, will be censored at the date alternative therapy began. If a patient has not progressed or received alternative therapy, progression free survival (PFS) will be censored at the date of the last disease assessment. | treated population | Posted | Median | 95% Confidence Interval | years | From randomization to progression or death, up to 22 months |
|
|
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Response Rate | Tumour response is defined per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Complete Response (CR): Disappearance of target and non-target lesions and normalization of tumour markers. Pathological lymph nodes must have short axis measures < 10 mm (Note: continue to record the measurement even if < 10 mm and considered CR). Residual lesions (other than nodes < 10 mm) thought to be non-malignant should be further investigated (by cytology or PET scans) before CR can be accepted. Confirmation of complete response is not required in this randomized study. Partial Response (PR): At least a 30% decrease in the sum of measures (longest diameter for tumour lesions and short axis measure for nodes) of target lesions, taking as reference the baseline sum of diameters. Confirmation of partial response is not required in this randomized study. Overall Response (OR) = CR + PR. | Posted | Number | 95% Confidence Interval | percentage of participants | From the start of study treatment until the end of treatment (before disease progression) |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Overall Survival | For patients who have died, overall survival is calculated in months from the day of randomization to date of death. Otherwise, survival is censored at the last day the patient is known alive. | Posted | Median | 95% Confidence Interval | months | From randomization to death of any cause, up to 22 months |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Safety and Toxicity Profile (Participants With Grade 3 4 5 Adverse Event) | To determine the safety and toxicity profile of rIL-21 and dacarbazine in patients with chemotherapy and immunotherapy-naive metastatic or recurrent malignant melanoma. Adverse events were measured according to the Common Terminology Criteria version 4.0 for Adverse Events. Number of patients with worst adverse event of grade 3 4 or 5 were counted for both rIL-21 and Dacarbazine arms. | Posted | Number | participants | Over study period, up to 22 months |
|
|
22 months
All grade 3 4 5 Adverse Events (5% or higher) were reported. All Serious Adverse Events were reported.
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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 | rIL-21 | rIL-21: 30 μg/kg IV Daily x 5, weeks 1, 3 and 5 every 8 weeks | 10 | 32 | 12 | 32 | ||
| EG001 | Dacarbazine | Dacarbazine: 1000 mg/m2 IV Day 1, every 3 weeks | 1 | 28 | 3 | 28 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hepatic failure | Hepatobiliary disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Aspartate aminotransferase increased | Investigations | CTCAE (4.0) | Systematic Assessment |
| |
| Infusion related reaction | General disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Atrial fibrillation | Cardiac disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Gait disturbance | General disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Sepsis | Infections and infestations | CTCAE (4.0) | Systematic Assessment |
| |
| Duodenal obstruction | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Fall | Injury, poisoning and procedural complications | CTCAE (4.0) | Systematic Assessment |
| |
| Other skin and subcutaneous tissue disorders | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Autoimmune disorder | Immune system disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Acute Kidney injury | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Ataxia | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Hypotension | Vascular disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Alanine aminotransferase increased | Investigations | CTCAE (4.0) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fatigue | General disorders | CTCAE (4.0) | Systematic Assessment | grade 3 or higher |
|
| Hepatic failure | Hepatobiliary disorders | CTCAE (4.0) | Systematic Assessment | grade 3 or higher |
|
| Skin and tissue | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment | grade 3 or higher |
|
| Chest wall pain | General disorders | CTCAE (4.0) | Systematic Assessment | grade 3 or higher |
|
| Anorexia | Metabolism and nutrition disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Rash maculo-papular | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment | grade 3 or higher |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Janet Dancey | NCIC Clinical Trials Group | 1-613-533-6430 | jdancey@ctg.queensu.ca |
| ID | Term |
|---|---|
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D012878 | Skin Neoplasms |
| D009371 | Neoplasms by Site |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| D003606 | Dacarbazine |
| ID | Term |
|---|---|
| D014226 | Triazenes |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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| Male |
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