Merkel Positron Emission Tomography (PET) Protocol (MP3)

November 17, 2022 updated by: Trans Tasman Radiation Oncology Group

A Phase II Efficacy Study of Chemo-Radiotherapy in PET Stage II and III Merkel Cell Carcinoma of the Skin

A Phase II Study designed to evaluate the efficacy of Chemo-Radiotherapy in achieving loco-regional control in patients with Merkel Cell Carcinoma (MCC) of the skin. Patients will undergo PET scans to assist in staging and planning the patient's treatment as well as assessing response at the conclusion of treatment.

Study Overview

Study Type

Interventional

Enrollment (Actual)

43

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • New South Wales
      • Campbelltown, New South Wales, Australia
        • Campbelltown
      • Liverpool, New South Wales, Australia
        • Liverpool Hospital
      • Sydney, New South Wales, Australia
        • Royal Prince Alfred
      • Waratah, New South Wales, Australia, 2298
        • Calvary Mater Newcastle
      • Westmead, New South Wales, Australia, 2145
        • Westmead Hospital
    • Queensland
      • Brisbane, Queensland, Australia, 4101
        • Radiation Oncology Services - Mater Centre
      • Brisbane, Queensland, Australia
        • Princess Alexandra Hospital Radiation Oncology
      • Herston, Queensland, Australia, 4029
        • Royal Brisbane Hospital
      • Toowoomba, Queensland, Australia, 4350
        • Oncology Research Australia
      • Tugun, Queensland, Australia, 4224
        • Genesis Cancer Care (previously Premion)
    • Victoria
      • Geelong, Victoria, Australia
        • Geelong Hospital
      • Melbourne, Victoria, Australia, 3000
        • Peter MacCallum Cancer Centre
    • Western Australia
      • Nedlands, Western Australia, Australia, 6009
        • Sir Charles Gairdner

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria for Trial Registration:

Patients may be registered on the trial only if they meet all of the following criteria:

  • Age 18 years or older
  • Written informed consent to participate in the study
  • Able to undergo 18-FDG PET scan (no uncontrolled diabetes mellitus or severe claustrophobia).
  • Available for follow-up.
  • Using adequate contraception if capable of child bearing
  • Any Merkel Cell carcinoma confined to the primary and/or nodal sites
  • ECOG 0-2.
  • Full Blood Count (FBC) should be satisfactory ( Haemoglobin > or equal to 10g/dl, neutrophils > or equal to 2.0 x 109 /l and platelets > or equal to 100 x 109 /l) and renal function (GFR > or equal to 50 ml/min) and hepatic function ( ALT < 5 X upper limit normal, bilirubin < 1.5 X upper limit normal)
  • Patients must be able to tolerate protocol treatment

Exclusion Criteria for Registration:

  • Previous chemotherapy in the past 5 years or prior radiotherapy to the area of concern
  • Unable to comply with treatment protocol eg dementia
  • Other malignancy in the past 5 years other than non-melanoma skin cancer.
  • Women who are pregnant or lactating.
  • Clinical evidence of metastatic disease.
  • Immunosuppression from long term steroid use or immunosuppressive drugs.
  • Any serious illness or medical condition that precludes the safe administration of the chemotherapy including:

    1. Active infection
    2. Uncontrolled or unstable cardiac disease including unstable angina, myocardial infarction within the last 3 months, and recurrent ventricular arrhythmias

Inclusion Criteria for Treatment Registration:

Patients may proceed to protocol treatment if they meet the following criteria:

  • High risk disease with no evidence of distant spread: Biopsy proven MCC with a primary that is > 2cm (T2N0M0= Stage II) and/or regional nodes (any T, N1M0= Stage III); OR Recurrent MCC not previously treated with radiation treatment; Dermal or in-transit metastasis with or without nodes; Occult primary with involved nodes
  • Patients who have no metastases on CT or PET scan OR If CT is suggestive of metastases, they must be PET negative

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm A
Conventional radical radiotherapy in this trial means that those patients with microscopic disease receive a dose of 50Gy using daily incremental fractions of 2Gy over 25 fractions and those with macroscopic disease receive 54Gy in 27 fractions.

During radiotherapy: Carboplatin (AUC2) commences on day 1 of radiation and is repeated at weekly intervals on days 8, 15, 22 and 29 (of radiation).

After radiotherapy: 3 weeks after completing radiotherapy, 3 cycles of 3 weekly carboplatin (AUC4.5) intravenously on day 1.

After Radiotherapy: 3 weeks after completing the radiation therapy, 3 cycles of 3 weekly etoposide (80mg/M2/day) intravenously days 1-3

Microscopic Disease: 50Gy delivered in 2Gy doses over 25 fractions

Macroscopic Disease: 54Gy delivered in 2Gy doses over 27 fractions

Other Names:
  • RT
  • Radiation Therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Time to loco-regional failure curve
Time Frame: Minimum of 18 months follow up
Minimum of 18 months follow up
Incidence of grade 3 and 4 toxicity and incidence of febrile neutropenia
Time Frame: Duration of Radiotherapy treatment
Duration of Radiotherapy treatment

Secondary Outcome Measures

Outcome Measure
Time Frame
Overall survival and time to distant failure curves
Time Frame: 3 year acturarial curves
3 year acturarial curves
Proportion of patients for which PET can influence management.
Time Frame: 12 weeks post Radiotherapy
12 weeks post Radiotherapy
Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of PET.
Time Frame: 12 weeks post Radiotherapy
12 weeks post Radiotherapy
Post-treatment PET complete response rate for patients with unresected disease
Time Frame: 12 weeks post Radiotherapy
12 weeks post Radiotherapy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: Michael Poulsen, Trans Tasman Radiation Oncology Group

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2009

Primary Completion (Actual)

June 1, 2021

Study Completion (Actual)

June 1, 2021

Study Registration Dates

First Submitted

November 12, 2009

First Submitted That Met QC Criteria

November 13, 2009

First Posted (Estimate)

November 16, 2009

Study Record Updates

Last Update Posted (Actual)

November 18, 2022

Last Update Submitted That Met QC Criteria

November 17, 2022

Last Verified

November 1, 2022

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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