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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2011-02524 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| CDR0000684220 | |||
| 10-085 | Other Identifier | Memorial Sloan-Kettering Cancer Center | |
| 8491 | Other Identifier | CTEP | |
| N01CM62206 | U.S. NIH Grant/Contract | View source | |
| P30CA008748 | U.S. NIH Grant/Contract | View source | |
| U01CA069856 | U.S. NIH Grant/Contract | View source |
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This phase Ib/II trial studies the side effects and best dose of gamma-secretase/Notch signalling pathway inhibitor RO4929097 when given together with cisplatin, vinblastine, and temozolomide and to see how well they work in treating patients with recurrent or metastatic melanoma. Gamma-secretase/Notch signalling pathway inhibitor RO4929097 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cisplatin, vinblastine, and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving gamma-secretase/Notch signalling pathway inhibitor RO4929097 together with combination chemotherapy may kill more tumor cells.
PRIMARY OBJECTIVES:
I. To characterize the safety and tolerability of daily RO4929097 (gamma-secretase/Notch signalling pathway inhibitor RO4929097) administered orally daily in combination with CVT (starting dose: cisplatin 25 mg/m^2 intravenous [IV] daily x 3; vinblastine 1.2 mg/m^2 IV daily x 3, and temozolomide [TMZ] 150 mg/m^2 orally [PO] daily x 5) administered on an every 21 day schedule. (Phase Ib) II. To determine the maximum-tolerated dose (MTD) of RO4929097 with CVT in patients with metastatic melanoma with correlative biomarkers for Notch pathway signaling and gamma secretase enzyme activity. (Phase Ib) III. Based on the MTD from the phase Ib study, to conduct a phase II trial and to determine the response rate and overall survival. (Phase II)
SECONDARY OBJECTIVES:
I. To describe the pharmacokinetics and pharmacodynamics of the combination of RO4929097 and temozolomide. (Phase Ib) II. To obtain tissue biopsy for correlative studies before the initiation of therapy and one week after treatment with RO4929097 and CVT. (Phase Ib and II) III. To determine the progression-free survival of patients treated at the phase II dose. (Phase II)
OUTLINE: This is phase I dose-escalation study of gamma-secretase inhibitor RO4929097, followed by a phase II study.
Patients receive gamma-secretase/Notch signalling pathway inhibitor RO4929097 PO once daily (QD) on days 1-21, cisplatin IV over 30 minutes and vinblastine IV over 30 minutes on days 1-3, and temozolomide PO QD on days 1-5. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients without progressive disease continue to receive gamma-secretase/Notch signalling pathway inhibitor RO4929097 and temozolomide as above in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed up for 24 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (RO4929097, cisplatin, vinblastine, temozolomide) | Experimental | Patients receive gamma-secretase/Notch signalling pathway inhibitor RO4929097 PO QD on days 1-21, cisplatin IV over 30 minutes and vinblastine IV over 30 minutes on days 1-3, and temozolomide PO QD on days 1-5. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients without progressive disease continue to receive gamma-secretase/Notch signalling pathway inhibitor RO4929097 and temozolomide as above in the absence of disease progression or unacceptable toxicity. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cisplatin | Drug | Given IV |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall Objective Response | Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Progression, 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; Stable Disease (SD), neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for disease progression | From the time measurement criteria are met for CR or PR until the first date that recurrent or progressive disease is objectively documented, assessed up to 2 years |
| Maximum-tolerated Dose for Cisplatin, Vinblastine and TMZ | based on the incidence of dose-limiting toxicity as assessed the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (Phase IB) Data is not yet available, as it's currently being analyzed. | 21 days |
| Overall Survival (Phase II) | Overall response rate (complete [CR] or partial response [PR]) according to RECIST version 1.1 | Up to 2 years |
| Maximum Tolerated Dose for RO4929097 | based on the incidence of dose-limiting toxicity as assessed the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (Phase IB) | 21 days |
| Measure | Description | Time Frame |
|---|---|---|
| Participants' Change in Protein Levels | Participants' pre and post-treatment protein levels will be compared | Baseline up to 2 weeks |
| Cycle 1 AUC/Pharmacokinetics of Gamma-secretase Inhibitor RO4929097 in Combination With Temozolomide (Phase IB) |
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Inclusion Criteria:
Patients must have histologically or cytologically Memorial Sloan Kettering Cancer Center (MSKCC) confirmed recurrent or metastatic melanoma
All Patients must have measurable disease as defined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1; measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded); each lesion must be > 10 mm when measured by computed tomography (CT), magnetic resonance imaging (MRI) or caliper measurement by clinical exam; or > 20 mm when measured by chest x-ray; lymph nodes must be > 15 mm in short axis when measured by CT or MRI
Patients may have had up to one prior systemic therapy for recurrent or metastatic disease, but cannot have previously been treated with cisplatin, vinblastine, temozolomide, dacarbazine, or a gamma-secretase inhibitor; at least 3 weeks must have elapsed since the last dose of systemic therapy; for small molecule targeted therapy, at least 5 half-lives must have elapsed; at least 6 weeks must have elapsed if the last regimen included carmustine (BCNU) or mitomycin C or an anti-cytotoxic T-lymphocyte antigen 4 (CTLA4) antibody
Life expectancy of greater than 3 months
Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
Hemoglobin >= 9 g/dL
Leukocytes >= 3,000/mcL
Absolute neutrophil count >= 1,500/mcL
Platelets >= 100,000/mcL
Total bilirubin =< institutional upper limit of normal
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3 X institutional upper limit of normal
Creatinine within normal institutional limits OR creatinine clearance >= 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
Women of childbearing potential and men must use two forms of contraception (i.e., barrier contraception and one other method of contraception) at least 4 weeks prior to study entry, for the duration of study participation, and for at least 12 months post-treatment; should a woman become pregnant or suspect she is pregnant while she or her partner are participating in this study and for 12 months after study participation, the patient should inform the treating physician immediately
Women of childbearing potential are required to have a negative serum pregnancy test (with a sensitivity of at least 25 mIU/mL) within 10-14 days and within 24 hours prior to the first dose of RO4929097 (serum or urine); a pregnancy test (serum or urine) will be administered every 4 weeks if their menstrual cycles are regular or every 2 weeks if their cycles are irregular while on study within the 24-hour period prior to the administration of RO4929097; a positive urine test must be confirmed by a serum pregnancy test; prior to dispensing RO4929097, the investigator must confirm and document the patient's use of two contraceptive methods, dates of negative pregnancy test, and confirm the patient's understanding of the teratogenic potential of RO4929097
Female patients of childbearing potential are defined as follows:
Female patients may be considered to NOT be of childbearing potential for the following reasons:
Ability to understand and the willingness to sign a written informed consent document
Patients with accessible tumor must agree to undergo pre- and post-treatment tumor biopsies
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mark Dickson | Memorial Sloan Kettering Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Memorial Sloan-Kettering Cancer Center | New York | New York | 10065 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Treatment (RO4929097, Cisplatin, Vinblastine, Temozolomide) | Patients receive gamma-secretase/Notch signalling pathway inhibitor RO4929097, vinblastine and temozolomide |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Gamma-Secretase Inhibitor RO4929097 | Drug | Given PO |
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| Laboratory Biomarker Analysis | Other | Correlative studies |
|
| Pharmacological Study | Other | Correlative studies |
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| Temozolomide | Drug | Given PO |
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| Vinblastine Sulfate | Drug | Given IV |
|
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| Days 4 and 5 |
| Cycle 1 C Max/Pharmacokinetics of Gamma-secretase Inhibitor RO4929097 in Combination With Temozolomide (Phase IB) | At Cycle 1 |
| Cycle 1 Mean Day 2 Trough/Pharmacokinetics of Gamma-secretase Inhibitor RO4929097 in Combination With Temozolomide (Phase IB) | At Day 2 of Cycle 1 |
| Number of Participants With Presence or Absence of Markers of Notch Signalling Pathway Inhibition in Patient Tumors (Phase Ib) | The association of response or clinical benefit with the presence or absence of markers of pathway inhibition in patient tumors will be tested using Fisher's exact test. | 2 weeks |
| Progression-free Survival (Phase II) | Progression-free survival curves will be generated using Kaplan-Meier methodology. | Time from start of treatment to time of progression or death, whichever occurs first, assessed up to 2 years |
| Participants Evaluated for Toxicity | Number of patients with AE's as assessed by NCI CTCAE v. 4.0 Please see Adverse Events section for specifics. | Up to 30 days post-treatment |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Treatment (RO4929097, Cisplatin, Vinblastine, Temozolomide) | Patients receive gamma-secretase/Notch signalling pathway inhibitor RO4929097, vinblastine and temozolomide |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| 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 | Overall Objective Response | Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Progression, 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; Stable Disease (SD), neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for disease progression | Posted | Count of Participants | Participants | From the time measurement criteria are met for CR or PR until the first date that recurrent or progressive disease is objectively documented, assessed up to 2 years |
|
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| |||||||||||||||||||||||||||||||
| Primary | Maximum-tolerated Dose for Cisplatin, Vinblastine and TMZ | based on the incidence of dose-limiting toxicity as assessed the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (Phase IB) Data is not yet available, as it's currently being analyzed. | Posted | Number | mg/m2 | 21 days |
|
| ||||||||||||||||||||||||||||||||
| Primary | Overall Survival (Phase II) | Overall response rate (complete [CR] or partial response [PR]) according to RECIST version 1.1 | Posted | Number | participants | Up to 2 years |
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| Primary | Maximum Tolerated Dose for RO4929097 | based on the incidence of dose-limiting toxicity as assessed the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (Phase IB) | Posted | Number | mg/day | 21 days |
|
| ||||||||||||||||||||||||||||||||
| Secondary | Participants' Change in Protein Levels | Participants' pre and post-treatment protein levels will be compared | Posted | Count of Participants | Participants | Baseline up to 2 weeks |
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| ||||||||||||||||||||||||||||||||
| Secondary | Cycle 1 AUC/Pharmacokinetics of Gamma-secretase Inhibitor RO4929097 in Combination With Temozolomide (Phase IB) | Posted | Mean | Standard Deviation | hr·ng/mL | Days 4 and 5 |
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| Secondary | Cycle 1 C Max/Pharmacokinetics of Gamma-secretase Inhibitor RO4929097 in Combination With Temozolomide (Phase IB) | Posted | Mean | Standard Deviation | ng/mL | At Cycle 1 |
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| Secondary | Cycle 1 Mean Day 2 Trough/Pharmacokinetics of Gamma-secretase Inhibitor RO4929097 in Combination With Temozolomide (Phase IB) | Posted | Mean | Standard Deviation | ng/mL | At Day 2 of Cycle 1 |
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| Secondary | Number of Participants With Presence or Absence of Markers of Notch Signalling Pathway Inhibition in Patient Tumors (Phase Ib) | The association of response or clinical benefit with the presence or absence of markers of pathway inhibition in patient tumors will be tested using Fisher's exact test. | Posted | Count of Participants | Participants | 2 weeks |
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| Secondary | Progression-free Survival (Phase II) | Progression-free survival curves will be generated using Kaplan-Meier methodology. | Posted | Median | Full Range | months | Time from start of treatment to time of progression or death, whichever occurs first, assessed up to 2 years |
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| |||||||||||||||||||||||||||||||
| Secondary | Participants Evaluated for Toxicity | Number of patients with AE's as assessed by NCI CTCAE v. 4.0 Please see Adverse Events section for specifics. | Posted | Count of Participants | Participants | Up to 30 days post-treatment |
|
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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 | Treatment (RO4929097, Cisplatin, Vinblastine, Temozolomide) | Patients receive gamma-secretase/Notch signalling pathway inhibitor RO4929097, vinblastine and temozolomide | 11 | 14 | 13 | 14 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute kidney injury | Renal and urinary disorders | CTC-4.0 | Systematic Assessment |
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| Alanine aminotransferase increased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Anemia | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Creatinine increased | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hyperglycemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hyponatremia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
| |
| Infections and infestations | Infections and infestations | CTC-4.0 | Systematic Assessment |
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| Lymphocyte count decreased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Neutrophil count decreased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Pain | General disorders | CTC-4.0 | Systematic Assessment |
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| Spinal fracture | Musculoskeletal and connective tissue disorders | CTC-4.0 | Systematic Assessment |
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| White blood cell decreased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Alanine aminotransferase increased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
| |
| Alkaline phosphatase increased | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
| |
| Anemia | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
| |
| Anorexia | General disorders | CTC-4.0 | Systematic Assessment |
| |
| Aspartate aminotransferase increased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
| |
| Blood bilirubin increased | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
| |
| CPK increased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | CTC-4.0 | Systematic Assessment |
| |
| Creatinine increased | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
| |
| Diarrhea | Gastrointestinal disorders | CTC-4.0 | Systematic Assessment |
| |
| Dyspnea | Respiratory, thoracic and mediastinal disorders | CTC-4.0 | Systematic Assessment |
| |
| Fatigue | General disorders | CTC-4.0 | Systematic Assessment |
| |
| Flank pain | General disorders | CTC-4.0 | Systematic Assessment |
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| Hypercalcemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hyperglycemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hyperkalemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hypermagnesemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hypertension | Cardiac disorders | CTC-4.0 | Systematic Assessment |
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| Hypoalbuminemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hypocalcemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hypoglycemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hypokalemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hypomagnesemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hyponatremia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Hypophosphatemia | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Lipase increased | Metabolism and nutrition disorders | CTC-4.0 | Systematic Assessment |
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| Lymphocyte count decreased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Nausea | General disorders | CTC-4.0 | Systematic Assessment |
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| Neck pain | General disorders | CTC-4.0 | Systematic Assessment |
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| Neutrophil count decreased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Peripheral sensory neuropathy | Nervous system disorders | CTC-4.0 | Systematic Assessment |
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| Platelet count decreased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | CTC-4.0 | Systematic Assessment |
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| Serum amylase increased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Thromboembolic event | Cardiac disorders | CTC-4.0 | Systematic Assessment |
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| Urinary tract infection | Renal and urinary disorders | CTC-4.0 | Systematic Assessment |
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| White blood cell decreased | Blood and lymphatic system disorders | CTC-4.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Mark Dickson | Memorial Sloan Kettering Cancer Center | 646-888-4164 | DicksonM@mskcc.org |
| 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 |
|---|---|
| D002945 | Cisplatin |
| C044245 | 1,2-diaminocyclohexaneplatinum II citrate |
| D010984 | Platinum |
| C545185 | 2,2-dimethyl-N-(6-oxo-6,7-dihydro-5H-dibenzo(b,d)azepin-7-yl)-N'-(2,2,3,3,3-pentafluoropropyl)malonamide |
| D000077204 | Temozolomide |
| D014747 | Vinblastine |
| ID | Term |
|---|---|
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D019216 | Metals, Heavy |
| D004602 | Elements |
| D028561 | Transition Elements |
| D008670 | Metals |
| D003606 | Dacarbazine |
| D014226 | Triazenes |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D014748 | Vinca Alkaloids |
| D046948 | Secologanin Tryptamine Alkaloids |
| D026121 | Indole Alkaloids |
| D000470 | Alkaloids |
| D007211 | Indoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D054836 | Indolizidines |
| D007212 | Indolizines |
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| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
| Cisplatin |
| |||||
| Vinblastine |
| |||||
| Temozolomide |
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| Denominators |
|---|
| Categories |
|---|
| Partial Response |
| |||||
| Stable Disease |
| |||||
| Progression of Disease |
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| Title | Denominators | Categories |
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| Title |
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| Denominators |
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| Categories |
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| Categories |
|---|
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| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
| Insufficient tissue to asses any change |
| |||||
| Sig decrease in post-treatment cleaved Notch |
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| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
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| Title | Denominators | Categories |
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