Condition category
Cancer
Date applied
29/10/2010
Date assigned
29/10/2010
Last edited
27/02/2014
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Contact information

Type

Scientific

Primary contact

Ms Linda Collins

ORCID ID

Contact details

Old Road Campus
Roosevelt Drive
Headington
Oxford
OX3 7DQ
United Kingdom
Linda.Collins@clinpharm.ox.ac.uk

Additional identifiers

EudraCT number

2009-018153-23

ClinicalTrials.gov number

Protocol/serial number

8672

Study information

Scientific title

Docetaxel +/- AZD6244 in Melanoma - A double blind randomised phase 2 trial of docetaxel with or without AZD6244 in wt BRAF advanced melanoma

Acronym

DOC-MEK

Study hypothesis

This is a randomised, double-blind placebo controlled phase 2 trial. Patient will be randomly assigned 1:1 between two treatment arms. They will receive either docetaxel 75 mg/m^2 intravenously (IV) and placebo given twice daily (bd), or AZD6244 75 mg bd daily with docetaxel 75 mg/m^2 IV. Docetaxel will be administered every 3 weeks for a maximum 6 cycles, but AZD6244/placebo may be continued beyond this, until disease progression.

The objective is to assess whether the combination of AZD6244 with docetaxel is worthy of evaluation in a definitive randomised study, with the null hypothesis being that the combination has activity similar to that of docetaxel alone in this population. After consent has been obtained mutational analysis of tumour BRAF will be performed on archival tumour tissue, where this information is not already known, to assess eligibility for the study. If there is no archival tissue a fresh biopsy will be requested from the patient. A blood sample will also be taken for future genetic analysis.

Once taking part in the trial patients will need to attend their oncology unit regularly for monitoring and the delivery of treatment. Patients will undergo complete physical examination at screening, on C1D1, C1D8, C1D15, C2D1, C2D8 and day 1 of every subsequent cycle. Blood for haematology, biochemistry and clotting will be taken at each of these visits. A 12-lead electrocardiogram (ECG) will be performed at screening. Disease assessment will be by computed tomography (CT) scanning using modified Response Evaluation Criteria in Solid Tumours (RECIST) criteria after 9 and 18 weeks, then every 3 months until disease progression.

Ethics approval

Oxfordshire REC A approved on 30/09/2010 (ref: 10/H0604/59)

Study design

Multicentre randomised interventional treatment trial

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Hospitals

Trial type

Treatment

Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet

Condition

Topic: National Cancer Research Network; Subtopic: Melanoma; Disease: Melanoma

Intervention

Patients will receive 75 mg AZD6244 or placebo orally twice a day on a continuous schedule. Capsules should be taken whole and not opened or crushed. They should be taken on an empty stomach (no food or drink for 2 hours before or 1 hour after treatment), with approximately 240 ml of water. Doses should be taken approximately 12 hours apart. Wherever possible doses should not be missed but if a dose is missed then the next dose should be taken at the allotted time.

Docetaxel arm: Patients will receive docetaxel 75 mg/m2, rounded to the nearest 10 mg, based on the most recent body surface area, as a 1-hour IV infusion in 250 ml of either 5% glucose solution or 0.9% sodium chloride solution. Standard pre-medication with steroids should be given, consisting of dexamethasone 8 mg b.d. for 3 days starting 1 day prior to docetaxel administration. Treatment will be given on day 1 and every 3 weeks for up to 6 cycles. The dose of docetaxel may be reduced or delayed if necessary.

Intervention type

Drug

Phase

Phase II

Drug names

Docetaxel, AZD6244

Primary outcome measures

Progression free survival, assessed at end of trial

Secondary outcome measures

Assessed at end of trial:
1. Immunohistochemistry of proteins in the MAPkinase pathway
2. Genotyping of tumours
3. Adverse events using CTCAE v4.0
4. Vital signs and weight
5. Biochemistry, haematology and urinalysis
6. Overall survival (OS)
7. Objective response rate (ORR)
8. Progression free survival at 6 months (PFS)

Overall trial start date

13/10/2010

Overall trial end date

30/10/2011

Reason abandoned

Eligibility

Participant inclusion criteria

1. Aged greater than or equal to 16 years, either sex
2. Able to provide evidence from an accredited laboratory of wt BRAF status for their melanoma, or ascertainment of wt BRAF status from a sample of melanoma provided for mutational analysis in Oxford
3. Unresectable stage 3 or 4, histologically proven cutaneous or unknown primary melanoma
4. At least 1 lesion, not previously irradiated, that can be accurately measured on CT or magnetic resonance imaging (MRI) as defined by modified RECIST criteria
5. Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1
6. Life expectancy of at least 12 weeks
7. The patient is willing to give consent to the main study and able to comply with the protocol for the duration of the study, including scheduled follow-up visits and examinations
8. Haematological and biochemical indices within the ranges shown below:
8.1. Haemoglobin (Hb) greater than 10 g/dL
8.2. White blood count (WBC) greater than 3 x 10^9/L
8.3. Platelet count greater than 100,000/µL
8.4. Absolute neutrophil count greater than 1.5 x 10^9/L
8.5. Serum bilirubin less than or equal to 1.2 x upper limit of normal (ULN)
8.6. Asparate aminotransferase (AST) (SGOT) or alanine aminotranferase (ALT) less than or equal to 2.5 x ULN
8.7. Lactate dehydrogenase (LDH) less than or equal to 2 x ULN
8.8. Creatinine clearance (Cockcroft-Gault) greater than 50 ml/min

Participant type

Patient

Age group

Adult

Gender

Both

Target number of participants

Planned sample size: 80

Participant exclusion criteria

1. Any anti-cancer therapy (including radiotherapy and participation in other clinical trials) within 28 days prior to Day 1
2. Prior DNA damaging agents or cytotoxic chemotherapy for metastatic melanoma
3. Any unresolved toxicity from prior anti-cancer therapy that is greater than CTCAE grade 2
4. Pregnancy or breastfeeding women. Female patients must have a negative urinary or serum pregnancy test or have evidence of post-menopausal status (defined as absence of menstruation for greater than 12 months, bilateral oophrectomy or hysterectomy).
5. Grade greater than or equal to 2 peripheral neuropathy at study entry
6. Patients of reproductive potential who are not willing to use adequate contraceptive measures for the duration of the study (both male and female patients)
7. Known severe hypersensitivity reactions to docetaxel or other drugs formulated in polysorbate 80
8. Ocular or mucosal malignant melanoma
9. Another active malignancy within the past five years
10. Evidence of brain metastases, unless surgically resected/stereotactic radiosurgery treated brain metastasis with no evidence of relapse on cerebral MRI, or treated brain metastasis and stable off treatment, including steroids, for 3 months
11. Clinically significant and uncontrolled major medical condition(s): such as active infection, bleeding diathesis
12. Patients who are known to be serologically positive for hepatitis B, hepatitis C or human immunodeficiency virus (HIV)
13. Cardiac conditions, including uncontrolled hypertension (blood pressure [BP] greater than 160/100 despite treatment), heart failure New York Heart Association (NYHA) class 2 or above, prior or current cardiomyopathy, myocardial infarction within 6 months or angina requiring nitrate therapy more than once a week
14. Previous treatment with EGFR, ras, raf or MEK inhibitors
15. Inability to swallow capsules, refractory nausea and vomiting, chronic gastrointestinal diseases (e.g., inflammatory bowel disease) or significant bowel resection that would preclude adequate absorption
16. Taking medication that significantly induces or inhibits CYP3A4

Recruitment start date

13/10/2010

Recruitment end date

30/10/2011

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Old Road Campus
Oxford
OX3 7DQ
United Kingdom

Sponsor information

Organisation

Oxford University (UK)

Sponsor details

Wellcome Trust Centre for Human Genetics
Roosevelt Drive
Oxford
OX3 7BN
United Kingdom

Sponsor type

University/education

Website

http://www.well.ox.ac.uk/home

Funders

Funder type

Industry

Funder name

AstraZeneca UK Limited (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

2014 results in: http://www.ncbi.nlm.nih.gov/pubmed/24567366

Publication citations

  1. Results

    Gupta A, Love S, Schuh A, Shanyinde M, Larkin JM, Plummer R, Nathan PD, Danson S, Ottensmeier CH, Lorigan P, Collins L, Wise A, Asher R, Lisle R, Middleton MR, DOC-MEK: a double-blind randomized phase II trial of docetaxel with or without selumetinib in wild-type BRAF advanced melanoma., Ann. Oncol., 2014, 25, 5, 968-974, doi: 10.1093/annonc/mdu054.

Additional files

Editorial Notes