Patients in the study will be treated with Melphalan/HDS and will receive up to 6 total treatments. This study will evaluate the safety and effects of the treatment.
The study will consist of 3 phases: Screening/Baseline Phase: Screening assessments will be conducted within 28 days prior to the eligibility date to determine each patient's overall eligibility and baseline characteristics. These assessments will include medical history, physical examination, Eastern Cooperative Oncology Group (ECOG) performance status (PS), Quality of Life questionnaire, 12 lead electrocardiogram (ECG), echocardiogram (ECHO), vital signs, full hematology and biochemistry, Quality of Life questionnaire, radiologic assessments of baseline disease status and concomitant medications. For patients with a history of liver surgery or major vasculature surgery, an angiogram evaluation of their vasculature will be performed for compatibility for Percutaneous Hepatic Perfusion (PHP) prior to confirming eligibility. Eligibility date: This is the date on which all screening assessments have been completed and the patient is determined to be eligible for the trial. Treatment Phase: The first study treatment should occur within 14 days of the eligibility date. Eligible patients will be treated with Melphalan/HDS 3.0 mg/kg Ideal Body Weight (IBW). Melphalan/HDS treatment will be administered every 6 weeks for a total of 6 cycles with an acceptable delay of another 2 weeks before the next planned treatment to allow for recovery of melphalan-related toxicity, if needed. Tumor response will be assessed every 12 weeks (+ 2 weeks) until disease progression. Patients with progressive disease (PD) will be discontinued from study treatment, and will continue to be followed until death. Melphalan/HDS treatment will also be discontinued if recovery from treatment related toxicity requires more than 8 weeks from the last treatment. An end-of-treatment visit (EOT) will be conducted approximately 6 to 8 weeks following the final study treatment. Follow-up Phase: Once the patient has completed the end-of-treatment (EOT) visit in accordance with the schedule of events they will enter the follow-up phase. If the disease has not progressed at the EOT, the patient will need to continue with disease assessment visits every 12 weeks (± 2 weeks) until disease progression is documented. After disease progression, follow-up is to be by phone every 3 months for survival status until death.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Melphalan administered directly to the liver via the Hepatic Delivery System (HDS) infused over a 30 minute period, followed by a 30 minute washout period
Stanford Cancer Institute
Palo Alto, California, United States
Moffitt Cancer Center
Tampa, Florida, United States
Duke University Medical Center
Durham, North Carolina, United States
The Ohio State University
Columbus, Ohio, United States
Adverse Events
The number and type of adverse events will be assessed per CTCAE version 5.0.
Time frame: From eligibility until death due to any cause, for up to 104 weeks
Efficacy (ORR)
Defined as the proportion of patients with a best overall response (BOR) based on a confirmed complete response or partial response (CR+PR) determined by the investigator per the Response Evaluation Criteria in Solid Tumors (RECIST v1.1).
Time frame: Every 12 (+/-2) weeks until progression, for up to 104 weeks
Efficacy (OS)
The time from the eligibility date to date of death due to any cause
Time frame: From eligibility until death due to any cause, for up to 104 weeks
Efficacy (PFS)
The time from the eligibility date to the first documented progression or death due to any cause determined by the investigator
Time frame: Every 12 (+/-2) weeks until progression, for up to 104 weeks
Quality of Life (FHSI-8)
FHSI-8 Quality of Life Survey
Time frame: Every 6-8 weeks until the end of treatment, for up to 52 weeks
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University of Tennessee Health Science Center
Memphis, Tennessee, United States