Efficacy of Daromun Neoadjuvant Intratumoral Treatment in Clinical Stage IIIB/C/D Melanoma Patients
Start Date
9/20/2018
Completion Date
12/1/2031
Summary
The trial aims to evaluate the efficacy of Daromun neoadjuvant treatment followed by surgery and adjuvant therapy to improve in a statistically significant manner the recurrence-free survival (RFS) of Stage IIIB/C/D melanoma patients with respect to the standard of care (surgery and adjuvant therapy).
Detailed Description
The present study is an open-label, randomized, controlled, two-arm multi-center study of the efficacy of Daromun neoadjuvant intratumoral treatment followed by surgery and adjuvant therapy versus surgery and adjuvant therapy in clinical stage III B/C/D melanoma patients. 186 patients will be randomized in a 1:1 ratio to receive Daromun treatment followed by surgery and adjuvant therapy (Arm 1) or surgery and adjuvant therapy (Arm 2). In both arms, follow-up for assessing recurrence-free survival will be performed up to five years after randomization. Survival information will also be collected in the following year (up to six years in total after randomization). This is an open-label study, so there is no blinding. Patients who successfully complete the screening evaluations and are eligible for participation in the study will be enrolled and randomly assigned (1:1) to two parallel treatment arms: Daromun plus surgery and adjuvant therapy (Arm 1) or surgery and adjuvant therapy (Arm 2). To ensure a balance across treatment groups, stratified randomization with permuted block will be used and separate randomization list for each subgroup (stratum) will be produced. Patients will be stratified on the basis of the following prognostic factors: * Stage of disease (3 levels): Stage IIIB vs. Stage IIIC vs Stage IIID * Planned post-surgical adjuvant therapy (2 levels): anti-PD-1 and other adjuvant therapies. The primary objective of the study is to demonstrate that a neoadjuvant Daromun treatment followed by surgery and adjuvant therapy improves in a statistically significant manner the recurrence-free survival (RFS) of Stage IIIB/C/D melanoma patients with respect to the standard of care (surgery and adjuvant therapy). Primary endpoint of the study is RFS in a time-to-event analysis in the Daromun plus surgery and adjuvant therapy treatment group (Arm 1) versus the surgery plus adjuvant therapy control group (Arm 2). Analysis will be based on the "Intention To Treat" population. The key secondary objective of the study is to demonstrate that a neoadjuvant Daromun treatment followed by surgery and adjuvant therapy improves in a statistically significant manner the overall survival (OS) of patients with resectable Stage IIIB/C/D melanoma patients with respect to the standard of care (surgery and adjuvant therapy). For patients enrolled in both arms, local approved post-surgery adjuvant therapies (as part of the standard of care) are allowed and decided at the investigator's discretion. These include high-dose interferon- α2b, anti-CTLA-4 antibodies (e.g. Ipilimumab), anti-PD1 antibodies (e.g. Nivolumab, Pembrolizumab), targeted therapies (e.g. Dabrafenib + Trametinib), or other new local approved treatments.
Eligibility Criteria
Age Range: 18 years to No maximum
Interventions
Daromun
Surgery
Adjuvant therapy
Conditions
Locations
Mayo Clinic Hospital
Phoenix, Arizona 85054
United States
UC San Diego Moores Cancer Center
La Jolla, California 92093
United States
UC Irvine Health-Chao Family Comprehensive Cancer Center
Orange, California 92868-3201
United States
Moffitt Cancer Center
Tampa, Florida 33612
United States
Winship Cancer Institute, Emory university
Atlanta, Georgia 30322
United States
Rush University Medical Center
Chicago, Illinois 60612
United States
University of Iowa Hospitals and Clinics
Iowa City, Iowa 52242
United States
Mayo Clinic
Rochester, Minnesota 55905
United States
Rutgers Cancer Institute, 195 Little Albany Street
New Brunswick, New Jersey 08903
United States
Ambulatory Care Center at NYC Langarone Health
New York, New York 10016
United States
Memorial Sloan Kettering Cancer Center - Main Campus
Ney York, New York 10065
United States
Duke University Medical Center - Duke Cancer Center
Durham, North Carolina 27710
United States
Ohio State University Wexner Medical Center
Columbus, Ohio 43210
United States
St. Luke's Cancer Center, Clinical Trial, 3rd floor, 1600 St. Luke's Blvd.
Easton, Pennsylvania 18045
United States
Penn State Cancer Institute
Hershey, Pennsylvania 17033
United States
Fox Chase Cancer Center 333 Cottman Avenue
Philadelphia, Pennsylvania 19111
United States
The University of Texas M.D. Anderson Cancer Center
Houston, Texas 77030-4009
United States
Huntsman Cancer Institute, University of Utah 2000 Circle of Hope
Salt Lake City, UT, Utah 84112
United States
VCU - McGlothlin Medical Education Center
Richmond, Virginia 980037
United States
Hospital Universitari Germans Trias i Pujol
Badalona, Barcelona 08916
Spain
Hospital de la Santa Creu i Sant Pau
Barcelona, Barcelona 08025
Spain
Fir Huvh Fundacio Institut De Recerca Hospital Universitari Vall De Hebron
Barcelona, Barcelona 08035
Spain
Hospital Clinic Barcelona
Barcelona, Barcelona 08036
Spain
El Hospital Universitario De Gran Canaria Dr. Negrin
Las Palmas de Gran Canaria, Canarie 35010
Spain
Fundacion Onkologikoa Fundazioa
Donostia / San Sebastian, Gipuzkoa 20014
Spain
MD Anderson Cancer Center
Madrid, Madrid 28033
Spain
Hospital Universitario 12 de Octubre
Madrid, Madrid 28041
Spain
Hospital Universitario Regional de Málaga
Málaga, Malaga 29010
Spain
Hospital Clínico Universitario Virgen de la Arrixaca
Murcia, Murcia 30120
Spain
Hospital Universitario Virgen De La Macarena
Seville, Sevilla 41009
Spain
Hospital General Universitario de Valencia
Valencia,
Spain
Universitätsspital Basel
Basel, Basel 4031
Switzerland
Istituto Oncologico della Svizzera Italiana
Bellinzona, Bellinzona 6500
Switzerland
Insel Gruppe AG
Bern, Canton of Bern 3010
Switzerland
Hôpitaux Universitaires de Genève
Geneva, Canton of Geneva 1205
Switzerland
Kantonsspital St.Gallen
Sankt Gallen, Canton of St. Gallen 9007
Switzerland
Universitätsspital Zürich (USZ)
Zurich, Canton of Zurich 8091
Switzerland