A Phase I/II Trial of Vemurafenib and Metformin to Unresectable Stage IIIC and Stage IV BRAF.V600E+ Melanoma Patients
Summary
The main purpose of this study is to evaluate the safety of Vemurafenib in combination with Metformin in melanoma patients. The phase II part of the study will also evaluate the clinical activity of the combined regiment. Based on pre-clinical studies and a phase I trial, the investigators hypothesize that the combination of an FDA-approved non-toxic dose of oral Metformin with Vemurafenib will yield little toxicity and improve clinical outcomes in terms of objective response rates and survival in metastatic melanoma patients.
Detailed description
This is a Phase I/II study. Phase I will be evaluating the safety of the FDA-approved Vemurafenib (960 mg orally, daily) in combination with Metformin (500 mg orally, twice daily for 2 weeks, then 850 mg orally,twice daily) in patients with unresectable Stage IIIC and Stage IV melanoma. Phase II will evaluate the clinical activity of the combined Vemurafenib/Metformin regimen. The safety profile of this combined Vemurafenib/Metformin regimen will be monitored during both phases. The treatment period consists of 28-day cycles until progression or unacceptable toxicity occurs.
Arms & interventions
- DrugVemurafenib
Vemurafenib (960 mg PO daily) in patients with unresectable BRAFV600E positive Stage IIIC and Stage IV melanoma
- DrugMetformin
Metformin (500 mg PO BID x 2 weeks, then 850 mg PO BID)
Outcome measures
Primary
Observation of CTCAE grade 4 or higher adverse events in six patients
In the phase I portion, six patients will be enrolled and observed for CTCAE grade 4 or higher events. If three or more grade 4 or higher adverse events are observed among the six patients, the study will be halted.
Time frame: Duration of phase I portion, approximately six months
Secondary
Overall Survival Follow up
Time frame: Every 12 weeks (+/- 7 days) after last drug dose, for up to 3 full years
Number of adverse events
Time frame: Duration of study, estimated to be approximately 60 months
type of adverse events
Time frame: Duration of study, estimated to be approximately 60 months
Objective response rate (ORR)as measure of efficacy
Time frame: Duration of study (approximately 60 months)
Eligibility criteria
Study locations (1)
James Graham Brown Cancer Center-University of Louisville
Louisville, Kentucky, 40202
References
- Cerezo M, Tomic T, Ballotti R, Rocchi S. Is it time to test biguanide metformin in the treatment of melanoma? Pigment Cell Melanoma Res. 2015 Jan;28(1):8-20. doi: 10.1111/pcmr.12267. Epub 2014 Jun 26.(PubMed)