RECRUITING

Using Nivolumab Alone or With Cabozantinib to Prevent Mucosal Melanoma Return After Surgery

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase II trial tests whether nivolumab in combination with cabozantinib works in patients with mucosal melanoma. Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It works by blocking the action of an abnormal protein that signals tumor cells to multiply. This helps stop the spread of tumor cells. Giving nivolumab in combination with cabozantinib could prevent cancer from returning.

Official Title

A Randomized Phase II Trial of Adjuvant Nivolumab With or Without Cabozantinib in Patients With Resected Mucosal Melanoma

Quick Facts

Study Start:2022-08-11
Study Completion:2024-12-19
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT05111574

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * STEP 0 INCLUSION CRITERIA
  2. * Histologically proven mucosal melanoma by local pathology
  3. * Central PD-L1 tumor tissue submission
  4. * STEP 1 INCLUSION CRITERIA
  5. * Receipt of the central PD-L1 testing results available
  6. * Disease status-Resected R0 or R1 disease patients. Patients eligible for randomization have resected R0 or R1 disease (with negative margins or positive microscopic margins) that must meet one of the following 4 criteria as defined below:
  7. * Regional lymph node (LN) involvement; OR
  8. * In-transit metastases/satellite primary disease; OR
  9. * Single localized, primary disease meeting one of the following site-specific requirements:
  10. * Head/neck - Sinonasal (including nasopharynx): any primary lesion; Nasal or oral cavity; pT4a or above, given slightly improved OS
  11. * NOTE: Conjunctival: does not meet the qualification for eligibility
  12. * Anorectal - any primary lesion
  13. * Vaginal/cervical - any primary, as they have 5 year OS rates of 5-25%
  14. * Urinary tract - any primary urethral or bladder tumor
  15. * Penile
  16. * Vulvar- American Joint Committee on Cancer (AJCC) cutaneous stage IIB or higher
  17. * Esophageal/gallbladder - any primary
  18. * Locoregionally recurrent following prior resection, meeting at least one of the above criteria
  19. * In addition, patients must have undergone cross-sectional imaging of the brain, chest, abdomen and pelvis with no evidence of distant metastatic disease
  20. * Disease status-Non-resected R2 or metastatic disease patients
  21. * Non-resected R2 or metastatic disease that is assessable and measurable radiographically or by physical examination
  22. * Prior Treatment:
  23. * No prior systemic checkpoint inhibitor therapy of mucosal melanoma, including in the adjuvant setting, is allowed. Prior adjuvant chemotherapy or interferon is allowed.
  24. * No other active, concurrent malignancy that requires ongoing systemic treatment or interferes with radiographic assessment of melanoma response as determined by the investigator. Exceptions may allow for adjuvant no evidence of disease (NED) cancers undergoing hormone based therapy may be eligible pending the other eligibility criteria are met and the principal investigator (PI) affirms the hormonal agent would not change the melanoma response.
  25. * Any radiation must have completed 28 days prior to randomization and the patient must have adequately recovered from its effects.
  26. * For resectable patients only: Surgery must have completed 28 days prior to randomization.
  27. * For resectable patients only: Surgery must have completed no more than 84 days prior to randomization.
  28. * Not pregnant and not nursing, because this study has an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative pregnancy test done =\< 7 days prior to registration is required
  29. * Age \>= 18 years
  30. * Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  31. * Absolute neutrophil count (ANC) \>= 1,500/mm\^3
  32. * Platelet count \>= 100,000/mm\^3
  33. * Creatinine =\< 1.5 x upper limit of normal (ULN) OR creatinine clearance (CrCl) \>= 50mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal
  34. * Albumin \>= 2.8 g/dL
  35. * Total bilirubin =\< 1.5 x upper limit of normal (ULN)
  36. * Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 2.5 x upper limit of normal (ULN)
  37. * No cardiovascular disease, including:
  38. * No history of acute coronary syndromes (including myocardial infarction and unstable angina), coronary artery bypass graft (CABG) coronary angioplasty, or stenting within 6 months prior to study entry.
  39. * No history of current class II or higher congestive heart failure as defined by the New York Heart Association (NYHA) functional classification system.
  40. * No refractory hypertension defined as a blood pressure of systolic \> 140 mmHg and/or diastolic \> 90 mmHg despite adequate attempts at anti-hypertensive therapy.
  41. * No history of myocarditis.
  42. * No history of syncope of cardiovascular etiology, uncontrolled cardiac arrhythmia, history of Mobitz II second degree or third degree heart block without a permanent pacemaker in Association (NYHA) class II to IV heart failure, or stroke/transient ischemic attack (TIA) within the past 3 months.
  43. * No corrected QT interval by Fridericia's formula (QTcF) \> 500 msec. Note: if initial QTcF is found to be \> 500 ms, two additional electrocardiograms (EKGs) separated by at least 3 minutes should be performed. If the average of these three consecutive results for QTcF is =\< 500 ms, the subject meets eligibility in this regard.
  44. * No underlying hematologic issues, including:
  45. * Congenital bleeding diathesis
  46. * Gastrointestinal (GI) bleeding requiring intervention within the past 6 months, unless directly related to mucosal melanoma
  47. * Active hemoptysis within 42 days prior to study enrollment.
  48. * Active tumor lesions with cavitations or tumor lesions which invade, encase, or abut major blood vessels. The anatomic location and characteristics of primary tumors or metastases as well as the medical history should be carefully reviewed in the selection of subjects for treatment with cabozantinib/placebo.
  49. * Pulmonary emboli or deep vein thromboses (DVT) that require an active anticoagulation regimen.
  50. * No known or suspected history of cytopenia (low white blood cell \[WBC\], hemoglobin or platelet count) of greater than 3 months duration with an unknown cause, myelodysplastic syndrome, or hematologic malignancies.
  51. * No clinical, laboratory or radiographic evidence of an active bacterial, fungal, or viral infection requiring treatment at the time of pre-registration (e.g., active symptoms of COVID-19 infection or a post-infectious symptomatic autoimmune syndrome, serious bacterial infections requiring antibiotics).
  52. * No known or suspected gastrointestinal disorder affecting absorption of oral medications.
  53. * Comorbid conditions:
  54. * No active autoimmune disease or any condition requiring systemic treatment with either corticosteroids (\> 10 mg daily of prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses \> 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.
  55. * No history of autoimmune motor neuropathy (e.g., Guillain-Barre syndrome, myasthenia gravis) or non-infectious pneumonitis.
  56. * No history of severe allergic reactions to an unknown allergen or any components of the study drugs or its excipients.
  57. * No history of gastrointestinal perforation or abdominal fistula.
  58. * No clinically suspected central nervous system (CNS) (leptomeningeal or parenchymal) metastases. Patients with a history of CNS metastasis(s) will be allowed as long as
  59. * The metastatic site(s) were adequately treated as demonstrated by clinical and radiographic improvement, AND
  60. * The patient has recovered from the intervention (no residual adverse events \> Common Terminology Criteria for Adverse Events \[CTCAE\] grade 1), AND
  61. * The patient has remained without occurrence of new or worsening CNS symptoms for a period of 28 days prior to enrollment.
  62. * No history of seizure or any condition that may increase the patient's seizure risk (e.g., prior cortical stroke, significant brain trauma) within 2 years.
  63. * No clinically active or chronic liver disease resulting in moderate/severe hepatic impairment (Child-Pugh class B or C), ascites, coagulopathy or bleeding due to liver dysfunction.
  64. * No untreated spinal cord compression or evidence of spinal metastases with a risk of impending fracture or spinal cord compression. Spinal metastases must have completed planned radiation or surgical therapy prior to registration.
  65. * Concomitant medications:
  66. * Chronic concomitant treatment with strong inhibitors of CYP3A4 is not allowed on this study. Patients on strong CYP3A4 inhibitors must discontinue the drug for 5 days prior to the start of study treatment.
  67. * Chronic concomitant treatment with strong CYP3A4 inducers is not allowed. Patients must discontinue the drug 5 days prior to the start of study treatment.
  1. Pregnancy or breastfeeding
  2. Severe psychiatric disorders
  3. Active substance abuse
  4. Unstable medical conditions
  5. Inability to comply with study requirements

Contacts and Locations

Principal Investigator

Alexander N Shoushtari
PRINCIPAL_INVESTIGATOR
Alliance for Clinical Trials in Oncology

Study Locations (Sites)

Sutter Auburn Faith Hospital
Auburn, California, 95602
United States
Alta Bates Summit Medical Center-Herrick Campus
Berkeley, California, 94704
United States
Palo Alto Medical Foundation-Fremont
Fremont, California, 94538
United States
Keck Medicine of USC Koreatown
Los Angeles, California, 90020
United States
Los Angeles General Medical Center
Los Angeles, California, 90033
United States
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
United States
Memorial Medical Center
Modesto, California, 95355
United States
USC Norris Oncology/Hematology-Newport Beach
Newport Beach, California, 92663
United States
Palo Alto Medical Foundation Health Care
Palo Alto, California, 94301
United States
Stanford Cancer Institute Palo Alto
Palo Alto, California, 94304
United States
Sutter Roseville Medical Center
Roseville, California, 95661
United States
Sutter Medical Center Sacramento
Sacramento, California, 95816
United States
California Pacific Medical Center-Pacific Campus
San Francisco, California, 94115
United States
UCSF Medical Center-Mission Bay
San Francisco, California, 94158
United States
Palo Alto Medical Foundation-Santa Cruz
Santa Cruz, California, 95065
United States
Sutter Pacific Medical Foundation
Santa Rosa, California, 95403
United States
Palo Alto Medical Foundation-Sunnyvale
Sunnyvale, California, 94086
United States
Sutter Solano Medical Center/Cancer Center
Vallejo, California, 94589
United States
UM Sylvester Comprehensive Cancer Center at Aventura
Aventura, Florida, 33180
United States
UM Sylvester Comprehensive Cancer Center at Coral Gables
Coral Gables, Florida, 33146
United States
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, 33442
United States
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
United States
UM Sylvester Comprehensive Cancer Center at Plantation
Plantation, Florida, 33324
United States
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
United States
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
United States
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, 83814
United States
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
United States
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
United States
Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho, 83864
United States
Rush - Copley Medical Center
Aurora, Illinois, 60504
United States
Centralia Oncology Clinic
Centralia, Illinois, 62801
United States
Northwestern University
Chicago, Illinois, 60611
United States
Carle at The Riverfront
Danville, Illinois, 61832
United States
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
United States
Decatur Memorial Hospital
Decatur, Illinois, 62526
United States
Carle Physician Group-Effingham
Effingham, Illinois, 62401
United States
Crossroads Cancer Center
Effingham, Illinois, 62401
United States
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
United States
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
United States
Northwestern Medicine Orland Park
Orland Park, Illinois, 60462
United States
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
United States
Springfield Clinic
Springfield, Illinois, 62702
United States
Springfield Memorial Hospital
Springfield, Illinois, 62781
United States
Carle Cancer Center
Urbana, Illinois, 61801
United States
Rush-Copley Healthcare Center
Yorkville, Illinois, 60560
United States
Mary Greeley Medical Center
Ames, Iowa, 50010
United States
McFarland Clinic - Ames
Ames, Iowa, 50010
United States
Mission Cancer and Blood - Ankeny
Ankeny, Iowa, 50023
United States
McFarland Clinic - Boone
Boone, Iowa, 50036
United States
Mission Cancer and Blood - West Des Moines
Clive, Iowa, 50325
United States
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
United States
Mission Cancer and Blood - Laurel
Des Moines, Iowa, 50314
United States
McFarland Clinic - Trinity Cancer Center
Fort Dodge, Iowa, 50501
United States
McFarland Clinic - Jefferson
Jefferson, Iowa, 50129
United States
McFarland Clinic - Marshalltown
Marshalltown, Iowa, 50158
United States
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
United States
Bronson Battle Creek
Battle Creek, Michigan, 49017
United States
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
United States
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
United States
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
United States
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
United States
Ascension Borgess Cancer Center
Kalamazoo, Michigan, 49009
United States
Trinity Health Muskegon Hospital
Muskegon, Michigan, 49444
United States
Corewell Health Lakeland Hospitals - Niles Hospital
Niles, Michigan, 49120
United States
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores, Michigan, 49444
United States
Corewell Health Reed City Hospital
Reed City, Michigan, 49677
United States
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
United States
Munson Medical Center
Traverse City, Michigan, 49684
United States
University of Michigan Health - West
Wyoming, Michigan, 49519
United States
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
United States
Mercy Hospital
Coon Rapids, Minnesota, 55433
United States
Fairview Southdale Hospital
Edina, Minnesota, 55435
United States
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
United States
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
United States
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
United States
Regions Hospital
Saint Paul, Minnesota, 55101
United States
United Hospital
Saint Paul, Minnesota, 55102
United States
Parkland Health Center - Farmington
Farmington, Missouri, 63640
United States
Missouri Baptist Medical Center
Saint Louis, Missouri, 63131
United States
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670
United States
Missouri Baptist Sullivan Hospital
Sullivan, Missouri, 63080
United States
BJC Outpatient Center at Sunset Hills
Sunset Hills, Missouri, 63127
United States
Community Hospital of Anaconda
Anaconda, Montana, 59711
United States
Billings Clinic Cancer Center
Billings, Montana, 59101
United States
Bozeman Health Deaconess Hospital
Bozeman, Montana, 59715
United States
Benefis Sletten Cancer Institute
Great Falls, Montana, 59405
United States
Logan Health Medical Center
Kalispell, Montana, 59901
United States
Community Medical Center
Missoula, Montana, 59804
United States
Memorial Sloan Kettering Basking Ridge
Basking Ridge, New Jersey, 07920
United States
Memorial Sloan Kettering Westchester
Harrison, New York, 10604
United States
Northwell Health/Center for Advanced Medicine
Lake Success, New York, 11042
United States
NYU Langone Hospital - Long Island
Mineola, New York, 11501
United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
United States
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
United States
Miami Valley Hospital South
Centerville, Ohio, 45459
United States
Case Western Reserve University
Cleveland, Ohio, 44106
United States
Miami Valley Hospital
Dayton, Ohio, 45409
United States
Premier Blood and Cancer Center
Dayton, Ohio, 45409
United States
Dayton Physician LLC - Englewood
Dayton, Ohio, 45415
United States
Miami Valley Hospital North
Dayton, Ohio, 45415
United States
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio, 45005-1066
United States
Miami Valley Cancer Care and Infusion
Greenville, Ohio, 45331
United States
Kettering Medical Center
Kettering, Ohio, 45429
United States
Upper Valley Medical Center
Troy, Ohio, 45373
United States
Cancer Centers of Southwest Oklahoma Research
Lawton, Oklahoma, 73505
United States
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
United States
Saint Alphonsus Cancer Care Center-Ontario
Ontario, Oregon, 97914
United States
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
United States
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
United States
Asplundh Cancer Pavilion
Willow Grove, Pennsylvania, 19090
United States
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
United States
Avera Cancer Institute
Sioux Falls, South Dakota, 57105
United States
M D Anderson Cancer Center
Houston, Texas, 77030
United States
VCU Massey Cancer Center at Stony Point
Richmond, Virginia, 23235
United States
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
United States
HSHS Sacred Heart Hospital
Eau Claire, Wisconsin, 54701
United States
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin, 54701
United States
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
United States
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay, Wisconsin, 54303
United States
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
Madison, Wisconsin, 53718
United States
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin, 53792
United States
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
United States
Marshfield Medical Center - Minocqua
Minocqua, Wisconsin, 54548
United States
Saint Vincent Hospital Cancer Center at Oconto Falls
Oconto Falls, Wisconsin, 54154
United States
Saint Vincent Hospital Cancer Center at Sheboygan
Sheboygan, Wisconsin, 53081
United States
Marshfield Medical Center-River Region at Stevens Point
Stevens Point, Wisconsin, 54482
United States
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay, Wisconsin, 54235-1495
United States
Marshfield Medical Center - Weston
Weston, Wisconsin, 54476
United States

Collaborators and Investigators

Sponsor: National Cancer Institute (NCI)

  • Alexander N Shoushtari, PRINCIPAL_INVESTIGATOR, Alliance for Clinical Trials in Oncology

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2022-08-11
Study Completion Date2024-12-19

Study Record Updates

Study Start Date2022-08-11
Study Completion Date2024-12-19

Terms related to this study

Additional Relevant MeSH Terms

  • Anal Melanoma
  • Bladder Melanoma
  • Cervical Melanoma
  • Esophageal Melanoma
  • Gallbladder Melanoma
  • Mucosal Melanoma
  • Mucosal Melanoma of the Head and Neck
  • Mucosal Melanoma of the Urinary System
  • Nasopharyngeal Melanoma
  • Oral Cavity Mucosal Melanoma
  • Penile Mucosal Melanoma
  • Rectal Melanoma
  • Recurrent Mucosal Melanoma
  • Sinonasal Mucosal Melanoma
  • Stage II Vulvar Cancer AJCC v8
  • Stage III Vulvar Cancer AJCC v8
  • Stage IV Vulvar Cancer AJCC v8
  • Urethral Melanoma
  • Vaginal Melanoma
  • Vulvar Melanoma