Melanoma Clinical Trial
Bevacizumab Plus Ipilimumab in Patients With Unresectable Stage III or IV Melanoma
Summary
The purpose of this research study is to determine the safety of using the study drugs bevacizumab and ipilimumab together, and the doses in combination which can be given to people safely. This study also seeks to investigate whether using both study drugs lengthens the amount of time before the participants melanoma worsens.
Full Description
There are two phases to this research study, Induction Phase and Maintenance Phase.
Induction Phase: Participants will receive ipilimumab by an infusion into a vein or central line at weeks 1, 4, 7 and 10 for a total of 4 infusions. Bevacizumab is also given as an infusion into a vein or central line at weeks 1, 4, 7 and 10 along with ipilimumab and then every 3 weeks by itself. During all cycles of study therapy, the participant will have a physical exam on the first day and undergo blood tests at every study visit. At weeks 1, 4, 7, 10 and 12 a urine sample will be obtained for analysis.
Chest, abdomen and pelvic CT scans will be performed at week 12. If the scans at week 12 show that the participants cancer has remained stable or decreased, they will be asked to have repeat CT scans in three months.
Positron Emission Tomography (PET) scans will be done at week 8 and week 16.
Maintenance Phase: If the scans performed at week 12 show the cancer has improved or stayed the same, then the participant will continue to receive bevacizumab every three weeks and undergo a CT scan every 3 months. Also, every 3 months the participant may be eligible to receive additional doses of ipilimumab in addition to the bevacizumab.
Eligibility Criteria
Inclusion Criteria:
Measurable unresectable Stage III or Stage IV melanoma
ECOG Performance Status 0 or 1
4 weeks or greater since treatment
Must have recovered from any acute toxicity associated with prior therapy
Life expectancy of greater than 12 weeks
18 years of age or older
Laboratory values as outlined in protocol
Negative screening tests for HIV, active Hepatitis B and Hepatitis C
Patients who received prior therapy with anthracyclines should have a baseline MUGA or echo with a normal ejection fraction
Exclusion Criteria:
CNS metastases
Pregnant or nursing women
Prior therapy with bevacizumab or ipilimumab
Active infection
Autoimmune disease: Patients with a history of inflammatory bowel disease are excluded from this study as are patients with a history of symptomatic autoimmune disease
Any other malignancy from which the patient has been disease-free for less than 5 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer or carcinoma in situ of the cervix
Any underlying medical condition which, in the principal investigator's opinion, will make the administration of study drug hazardous or obscure the interpretation of adverse events
Any concurrent medical condition requiring the use of systemic steroids
Inadequately controlled hypertension
Any prior history of hypertensive crisis or hypertensive encephalopathy
NYHA Grade II or greater congestive heart failure
History of myocardial infarction or unstable angina within 6 months prior to study enrollment
History of stroke of transient ischemic attack within 6 months prior to study enrollment
Significant known vascular disease
Symptomatic peripheral vascular disease
Evidence of bleeding diathesis or coagulopathy
Major surgical procedure or significant traumatic injury within 28 days prior to study enrollment
Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to study enrollment
History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrollment
Serious, non-healing wound, ulcer or bone fracture
Proteinuria at screening
Known hypersensitivity to any component of bevacizumab
History of hemoptysis within 3 months prior to study enrollment
Current, ongoing treatment with full-dose warfarin or its equivalent
Current or recent (within 10 days of enrollment) use of aspirin (>325mg/day) or chronic use of other NSAIDs
Medications that inhibit platelet function
Known involvement of melanoma within gastrointestinal tract
Ulcerated skin lesions
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There are 2 Locations for this study
Boston Massachusetts, 02115, United States
Boston Massachusetts, 02115, United States
Boston Massachusetts, 02214, United States
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