NILOMEL is a phase II multicentric uncontrolled open national trial assessing the efficacy of Nilotinib in first or second line treatment of primary melanomas , stage III unresectable melanomas, or Stage IV melanomas with c-KIT mutation or amplification. The primary objective is overall response rate (partial and complete response) according to RECIST 1.1 criteria, assessed using CT-SCAN (stage IV melanoma) or MRI (unresectable melanoma) after 6 months therapy with Nilotinib 800 mg/d. Secondary objectives include: * Disease control rate (complete, partial response and stable disease) * Metabolic response * Tolerance NCI CTCAE Version 3.0 * Biomarkers associated to response and disease control.
NILOMEL is a phase II multicentric uncontrolled open national trial assessing the efficacy of Nilotinib in first or second line treatment of primary melanomas , stage III unresectable melanomas, or Stage IV melanomas with c-KIT mutation or amplification (in case of c-KIT amplification, no B-RAF nor N-Ras mutation should be detected). The primary objective is overall response rate (partial and complete response) according to RECIST 1.1 criteria, assessed using CT-SCAN (stage IV melanoma) or MRI (unresectable melanoma) after 6 months therapy with Nilotinib 800 mg/d. Secondary objectives include: * Disease control rate (complete, partial response and stable disease) according to RECIST * Metabolic response rate (TEP-SCAN) * Tolerance NCI CTCAE Version 3.0 * Biomarkers associated to response and disease control (evaluated at M0, M1 and M6). Protein analysis of c-KIT, PI3K, MAPK and STAT signalling pathways as well as PDGFR and Ephrin signalling pathways. Patients with progressive disease after 3 months therapy will be withdrawn. Patient with stable disease after 3 months will continue Nilotinib until evaluation at 6 months. Patients with stable disease or progressive disease at 6 months will continue Nilotinib until progression. The trial has been planned using a one-stage design (Fleming TR) . We considered that a response rate under 7.5% would define the null hypothesis of no efficacy . To detect a response rate of 30% or more with power 90% using a one-sided test at the 0.05 level, 25 patients have to be recruited. Accrual for 2.5 years total study duration: 3 years
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
25
Nilotinib 400 mg twice per day
Hôpital Saint-Louis
Paris, France
RECRUITINGObjective response
Partial or complete response per Response Evaluation Criteria in Solid Tumors (RECIST).
Time frame: 6 months
Disease control
Complete or partial response or stable disease per Response Evaluation Criteria in Solid Tumors (RECIST).
Time frame: 6 months
Objective response
Partial or complete response per Response Evaluation Criteria in Solid Tumors (RECIST).
Time frame: 3 months
Metabolic response
Metabolic response as evaluated by TEP-SCAN
Time frame: 6 months
Tolerance
Tolerance will be evaluated according to National Cancer Institute (NCI) Criteria for Adverse Events, CTCAE v3.0
Time frame: 1 year
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