An Expanded Cohort Trial of Bortezomib and Sorafenib in Advanced Malignant Melanoma

Inclusion Criteria:

• Histological or cytological confirmation of malignant melanoma that is metastatic or unresectable
• Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension as 10mm or greater with spiral CT scan
• Patients may have received up to 4 prior treatments for their disease including immunotherapies such as high-dose interleukin 2 and antibodies directed against the human cytotoxic T-lymphocyte antigen 4
• 18 years of age or older
• Life expectancy of greater than three months
• ECOG Performance status of 0 or 1
• Adequate organ and marrow function as outlined in the protocol
• Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment
• INT < 1.5 or a PT/PTT within normal limits. Patients receiving anti-coagulation treatment wih an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be measured prior to initiation of sorafenib and monitored at least weekly, or as defined by the local standard of care, until INR is stable
• Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation.

Exclusion Criteria:

• Chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events dur to agents administered more than 4 weeks earlier
• Participants may not be receiving any other study agents
• Known, active CNS disease, including primary brain tumor, seizures not controlled with standard medical therapy, any unstable or untreated brain metastasis, or history of stroke within the past 12 months
• Prior therapy with bortezomib, sorafenib, or other proteasome inhibitor
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to sorafenib and bortezomib
• Participants receiving any medications or substances that are inducers of CYP3A4
• Known cardiac disease including congestive heart failure > class II NHYA, unstable angina or new onset angina, myocardial infarction within the past 6 months, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening has to be documented by the investigator as not medically relevant
• Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
• Uncontrolled intercurrent illness
• Pregnant women
• Individuals with a history of a different malignancy are ineligible except for the circumstances outlined in the protocol
• HIV-positive individuals on combination antiretroviral therapy
• Uncontrolled hypertension despite optimal medical management
• Thrombolic or embolic events
• Pulmonary hemorrhage/bleeding event CTCAE Grade 2 or greater within 4 weeks of first dose of study drug
• Any other hemorrhage/bleeding event CTCAE Grade 3 or greater within 4 weeks of first dose of study drug
• Serious non-healing wound, ulcer or bone fracture
• Evidence or history of bleeding diathesis or coagulopathy
• Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study drug
• Any condition that impairs patient's ability to swallow whole pills
• Any malabsorption problem
• Known hypersensitivity to boron or mannitol
• Grade 2 or greater peripheral neuropathy within 14 days before enrollment