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Cutaneous MelanomaPhase 3NCT02288897

PV-10 vs Chemotherapy or Oncolytic Viral Therapy for Treatment of Locally Advanced Cutaneous Melanoma

A Phase 3 study testing PV-10 (10% rose bengal disodium) and Dacarbazine, temozolomide or talimogene laherparepvec in people with Cutaneous Melanoma, run by Provectus Biopharmaceuticals, Inc. at 23 sites in 5 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is an international multicenter, open-label, randomized controlled trial (RCT) of single-agent intralesional PV-10 versus systemic chemotherapy or intralesional oncolytic viral therapy to assess treatment of locally advanced cutaneous melanoma in patients who (1) are not candidates for targeted therapy and (2)… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cutaneous Melanoma
What is being tested?
PV-10 (10% rose bengal disodium) and Dacarbazine, temozolomide or talimogene laherparepvec
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
23 sitesin 5 countries
Study dates
Apr 2015to Sep 2019
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 years or older, male or female
  • Histologically or cytologically confirmed melanoma
  • Recurrent, satellite or in-transit locally advanced cutaneous or subcutaneous melanoma metastases (i.e., American Joint Committee on Cancer (AJCC) Stage IIIB, IIIC or Stage IV M1a with no active nodal metastases)
  • At least 1 measurable Target Lesion that can be accurately measured by calipers or computed tomography (CT) consisting of:
  • at least one cutaneous lesion (each lesion ≥ 10 mm in longest diameter or up to 5 lesions having a sum of longest diameters ≥ 10 mm); and/or
  • at least one subcutaneous lesion (each lesion ≥ 10 mm in longest diameter by CT);
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  • where Target Lesions should be at least 10 mm from any other lesion
  • No lesion > 50 mm in longest diameter; and no more than 50 lesions
  • Calculated required PV-10 dose ≤ 15 mL (based on total tumor burden)
  • Performance Status: Eastern Cooperative Oncology Group (ECOG) 0-2
  • Not a candidate for treatment with an immune checkpoint inhibitor (e.g., failed or did not tolerate prior therapy, or due to co-morbidities, pre-existing autoimmune disease, drug unavailability or standard of care)
  • Not a candidate for targeted therapy with BRAF or combined BRAF/MEK inhibitors (e.g., failed or did not tolerate prior therapy, BRAF V600 wild-type or due to drug unavailability or standard of care)
  • Clinical Laboratories:
  • Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L and platelet count ≥100 x 10^9/L
  • Creatinine ≤ 3 times the upper limit of normal (ULN)
  • Estimated creatinine clearance (CrCl) or estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2
  • Total bilirubin ≤ 3 times the upper limit of normal (ULN)
  • Aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP) ≤ 5 times the upper limit of normal (ULN)
  • Lactate dehydrogenase (LDH) ≤ 2 times the upper limit of normal (ULN).
  • Thyroid function abnormality ≤ Grade 2
  • Candidate for at least one comparator drug:
  • Subjects must be candidates for at least one of the designated comparator drugs

Who cannot join

  • Presence or history of visceral melanoma metastasis
  • Presence of active nodal metastases (e.g., radiologic or clinical evidence of current nodal disease)
  • Presence of more than 50 melanoma lesions
  • Radiation therapy to any Study Lesion within 6 weeks of initial study treatment.
  • Chemotherapy or other systemic cancer therapy within 4 weeks of initial study treatment (6 weeks for nitrosoureas or mitomycin), or regional chemotherapy (limb infusion or perfusion) within 12 weeks of initial study treatment
  • Immunotherapy for cancer within 4 weeks of initial study treatment
Show all 21Show fewer
  • Local treatment (e.g., surgery, cryotherapy, laser ablation) to any Study Lesion within 4 weeks of initial study treatment
  • Anti-tumor vaccine therapy within 6 weeks of initial study treatment.
  • Investigational agents within 4 weeks of initial study treatment.
  • Concurrent or Intercurrent Illness:
  • Impaired wound healing or other extremity complications due to diabetes mellitus in subjects whose Study Lesions are located in an extremity
  • Severe peripheral vascular disease in subjects whose Study Lesions are located in an extremity
  • Significant concurrent or intercurrent illness, psychiatric disorders, or alcohol or chemical dependence that would, in the opinion of the Investigator, compromise the subject's safety or compliance or interfere with interpretation of study results.
  • Uncontrolled thyroid disease or cystic fibrosis
  • Clinically significant acute or unstable cardiovascular, cerebrovascular (stroke), renal, gastrointestinal, pulmonary, immunological, endocrine, or central nervous system disorders
  • Pregnancy:
  • Female subjects who are pregnant or lactating
  • Female subjects who have positive serum pregnancy test taken within 14 days of study treatment
  • Female subjects of child-bearing potential who are unwilling to use highly effective contraception (e.g., combined (estrogen and progestogen containing) or progestogen-only hormonal contraceptives, intrauterine devices, bilateral tubal ligation, vasectomized partner, sexual abstinence or equivalent measures) for the duration of study treatment
  • Contraindication for all comparators:
  • Subjects with contraindications to all of the designated comparator drugs

Trial locations and contacts

23 sites in 5 countries.

23 sites in 5 countries

United States12 sites
  • St Luke's University Hospital and Health Network

    Easton, Pennsylvania, 18045

  • Penn State Hershey Cancer Institute

    Hershey, Pennsylvania, 17033

  • M.D. Anderson Cancer Center

    Houston, Texas, 77030

  • Dartmouth-Hitchcock Medical Center

    Lebanon, New Hampshire, 03756

  • Mount Sinai Comprehensive Cancer Center

    Miami Beach, Florida, 33140

  • Atlantic Health System

    Morristown, New Jersey, 07960

  • Huntsman Cancer Institute

    Salt Lake City, Utah, 84112

  • Sharp Memorial Hospital - Clinical Oncology Research

    San Diego, California, 92123

  • Washington University School of Medicine - Dermatology

    St Louis, Missouri, 63110

  • Moffitt Cancer Center and Research Institute

    Tampa, Florida, 33612

  • Oklahoma Cancer Specialists and Research Institute

    Tulsa, Oklahoma, 74146

  • Wake Forest Baptist Health

    Winston-Salem, North Carolina, 27157

Other trials in United States

Germany4 sites
  • Klinik für Dermatologie, Venerologie und Allergologie Charite Universitätsmedizin Berlin

    Berlin

  • Klinik für Dermatologie Universitätsklinikum Essen Studienzentrum

    Essen

  • Klinik für Dermatologie, Venerologie und Allergologie Universitätsklinikum Schleswig-Holstein Hautkrebszentrum

    Kiel

  • Hautklinik Klinikum der Johannes Gutenberg Universität Hautkrebszentrum

    Mainz

Other trials in Germany

Italy3 sites
  • IRCCS Instituto Nazionale Tumori "Fondazione Giovanni Pascale"

    Naples

  • Istituto Dermopatico dell'Immacolata (IDI IRCCS)

    Rome

  • Azienda Sanitaria Azienda Ospedaliera Universitaria Senese

    Siena

Other trials in Italy

France2 sites
  • Unité Cancéro-Dermatologie, Hôtel-Dieu CHU Nantes

    Nantes

  • Institut Claudius Regaud, IUCT ONCOPOLE

    Toulouse, 31059

Other trials in France

Mexico2 sites
  • Neurociencias Estudios Clínicos S.C.

    Culiacán, Sinaloa, 80020

  • Centro de Estudios y Prevención del Cancer A.C.

    Juchitán de Zaragoza, Oaxaca, 70000

Other trials in Mexico

About this study

Official title: PV-10 Intralesional Injection vs Systemic Chemotherapy or Oncolytic Viral Therapy for Treatment of Locally Advanced Cutaneous Melanoma

This is an international multicenter, open-label, randomized controlled trial (RCT) of single-agent intralesional PV-10 versus systemic chemotherapy or intralesional oncolytic viral therapy to assess treatment of locally advanced cutaneous melanoma in patients who (1) are not candidates for targeted therapy and (2) are not candidates for an immune checkpoint inhibitor. Subjects in the comparator arm will receive the Investigator's choice of dacarbazine (DTIC), temozolomide (TMZ) or intralesional talimogene laherparepvec as determined by Investigator preference and standard of care in the Investigator's country or region. Effectiveness will be assessed by comparison of progression-free survival (PFS) between all intent-to-treat (ITT) subjects in the two study treatment arms.

Read the detailed description

Subjects will be randomized using a 2:1 treatment allocation (i.e. two-thirds of the subjects will receive PV-10).

Subjects in the comparator arm who have completed at least 1 cycle of study treatment and who meet the study protocol definition of disease progression but do not have evidence of visceral metastases will be eligible to enter the crossover portion of the study and receive PV-10. Subjects crossing over must meet all study inclusion and exclusion criteria for clinical laboratories, thyroid function, concurrent or intercurrent illness and pregnancy at the time of crossover.

Assessment of progression will be performed by an Independent Review Committee (IRC) based on Response Evaluation Criteria in Solid Tumors (RECIST) ver. 1.1 criteria. Events signaling progression include increase in size and/or number of lesions, distant or nodal disease progression, or death. All secondary endpoints involving disease response and progression will be based on the IRC determination.

An interim assessment of efficacy and safety will be performed by the IRC when 50% of the events required for the primary endpoint have occurred.

Being tested
PV-10 (10% rose bengal disodium), Dacarbazine, temozolomide or talimogene laherparepvec
Keywords
Stage III, Stage IIIB, Stage IIIC, Stage IV (M1a), Stage 3, Stage 4, IVM1a, IV(M1a), IV-M1a, in-transit, in transit, intransit, satellite, recurrent
Medical subject headings
Melanoma, Recurrence

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PV-10 (10% rose bengal disodium)Drug

  • Dacarbazine, temozolomide or talimogene laherparepvecDrug

Study groups in NCT02288897
Study groupRoleWhat they receive
PV-10ExperimentalSubjects will receive intralesional PV-10 to all Study Lesions on study Day 1. PV-10 should be re-administered at 28-day intervals until complete response, disease progression or study termination occurs.
Receives: Drug: PV-10 (10% rose bengal disodium)
Chemotherapy or Oncolytic Viral TherapyActive comparatorSubjects will receive (a) dacarbazine (intravenously at 850 m/m2) or temozolomide (orally at 200 mg/m2 daily for 5 consecutive days), administered at consecutive 28-day intervals, or (b) intralesional talimogene laherparepvec administered on an initial 21 interval followed by consecutive 14 day intervals, until complete response, disease progression or study termination occurs.
Receives: Drug: Dacarbazine, temozolomide or talimogene laherparepvec

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression-free Survival (PFS)

    PFS was estimated via Kaplan-Meier analysis using Response Evaluation Criteria In Solid Tumors (RECIST v1.1) criteria. Subjects who did not have an event of progression or death were censored at their last assessment date.

    Assessment of progression was performed by the sponsor based on review of lesion measurement and clinical progression data reported by each investigator. Events signaling progression included increase in size and/or number of study lesions, onset of visceral metastatic disease, and death. For target lesions (assigned prior to randomization), complete response (CR) required disappearance of all target lesions; partial response (PR) required >= 30% decrease in sum of the longest diameter (SLD) of all target lesions; progressive disease (PD) required >=20% increase in SLD of target lesions. Non-target lesions were followed for CR, PD, or non-CR/non-PD status using equivalent thresholds. Progression occurred when PD was observed in either target or non-target lesion.

    Measured: Assessed every 12 weeks until disease progression, withdrawal of consent, or study termination; progression detected between formal assessments was documented at the time of detection; median follow-up time for PFS was 26.6 weeks, maximum was 125.8 weeks.

Secondary outcomes (4)
  1. Complete Response Rate (CRR)

    CRR was assessed using RECIST v1.1 criteria, and required disappearance of all target and non-target lesions.

    Measured: Assessed every 12 weeks until disease progression, withdrawal of consent, or study termination; median follow-up time for CRR was 26.6 weeks, maximum was 125.8 weeks.

  2. Duration of Complete Response (DCR)

    DCR was estimated via Kaplan-Meier analysis for participants achieving a complete response, and was defined as the interval from first complete response to disease progression or death; responders who did not have an event of progression or death were censored at their last assessment date. Complete response was assessed using RECIST v1.1 criteria, and required disappearance of all target and non-target lesions.

    Measured: Assessed every 12 weeks until disease progression, withdrawal of consent, or study termination; median follow-up time for DCR was 26.7 weeks, maximum was 77.7 weeks.

  3. Overall Survival (OS)

    OS was documented at 12 week intervals commencing on withdrawal from active study participation. Documentation was made by subject clinic visit or other personal contact, telephonic contact, review of medical records, or other unequivocal evidence of survival status. OS was estimated via Kaplan-Meier analysis, and was defined as the interval from randomization to death; subjects who did not have an event of death were censored at their last assessment date.

    Measured: Assessed every 12 weeks upon withdrawal from active study participation until death, withdrawal of consent, or study termination; median follow-up time for survival was 82.4 weeks, maximum was 167.0 weeks.

  4. Number of Participants With Adverse Events

    Safety and tolerability were assessed by monitoring the frequency, duration, severity and attribution of adverse events and evaluating changes in laboratory values and vital signs.

    Measured: Assessed every 4 weeks until 28 days after last treatment; median duration of treatment was 11.8 and 9.5 weeks in each treatment group, respectively.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Nov 2014 (estimated)
  2. Study startApr 2015
  3. Primary completionApr 2019
  4. Study completionSep 2019

Why it stopped: Inadequate rate of enrollment

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02288897
Sponsor's protocol ID
PV-10-MM-31
Status last verified
Jan 2022
First submitted
4 Nov 2014
Last updated
19 Jan 2022
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing PV-10 (10% rose bengal disodium) and Dacarbazine, temozolomide or talimogene laherparepvec in people with Cutaneous Melanoma, run by Provectus Biopharmaceuticals, Inc. at 23 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 22 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 19 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in United States, Germany, Italy, France, Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Jan 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-free Survival (PFS) (time frame: Assessed every 12 weeks until disease progression, withdrawal of consent, or study termination; progression detected between formal assessments was documented at the time of detection; median follow-up time for PFS was 26.6 weeks, maximum was 125.8 weeks.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Jan 2022.

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