RATIONALE: Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving sorafenib together with temozolomide may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of giving sorafenib together with temozolomide in treating patients with stage III or stage IV melanoma.
OBJECTIVES: Primary * Determine the safety profile and the maximum tolerated dose of sorafenib tosylate and temozolomide in patients with stage III-IV melanoma. (Phase I) * Evaluate progression-free survival at 12 weeks. (Phase II) Secondary * Evaluate tumor response according to RECIST criteria. * Evaluate overall and progression-free survival. * Evaluate the effect of treatment on tumor vascularization. * Compare the pharmacokinetic profile of temozolomide with and without sorafenib tosylate. * Evaluate the number and the role of lymphocytes. * Correlate tumor response rate with BRAF mutation status. * Correlate response rate with MGMT activity. * Compare the efficacy of genomics and proteomics as a means of discovery of serum biomarkers. * Study the prognostic and predictive value of circulating endothelial cells and circulating endothelial progenitors. OUTLINE: This is a phase I dose-escalation study followed by a phase II study. Patients receive oral sorafenib tosylate twice daily on days 1-28 (days 8-28 of course 1) and oral temozolomide once daily on days 1-7 and 15-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients with accessible tumors (cutaneous or sub-cutaneous) undergo biopsies at baseline and day 28 for analysis of BRAF mutations and MGMT expression.
Study Type
INTERVENTIONAL
Purpose
TREATMENT
Masking
NONE
Enrollment
58
Institut Gustave Roussy
Villejuif, France
Maximum tolerated dose (Phase I)
Progression-free survival at 12 weeks (Phase II)
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