Study of ultra-low dose paclitaxel in metastatic melanoma | Antikankerfonds (NL)

Study of ultra-low dose paclitaxel in metastatic melanoma

Immuno-monitoring of patients with metastatic melanoma (AJCC stadium IV) under ultra-low dose paclitaxel (Taxol©): a pilot trial for “proof of principle” (ImmunoPAX).

Status
Completed
 
Cancer types
  • Melanoma
Trial phase
1

Funding

€55,200
ACF funding
€80,400
Estimated trial cost

Why this trial?

Malignant melanoma is a potentially fatal form of skin cancer characterized by a rapid development and spreading to different organs in the body. Despite the recent progress in new treatment options, the metastasized disease is usually not curable.

It is well known that melanoma cancer cells activate the immune system, so that our body can fight harder to destroy these cancer cells adequately. Checkpoint inhibitors, such as Yervoy©, Opdivo© and Keytruda©, are approved medications to treat melanoma, and work by helping the immune system to kill melanoma cancer cells. However, this effect can only be achieved in a minority of patients.

Moreover, it is presumed that cancer cells in general, next to activating the immune system, also suppress it at the same time. Suppressing the immune system prevents the body from fighting against cancer cells. The suppressive mechanisms at play, like myeloid-derived suppressor cells, are believed to be induced due to chronic inflammation found in melanoma lesions that have progressed rapidly.

Therefore, novel immunotherapeutic strategies that activate the body’s immune system to help to attack and destroy melanoma cells are urgently needed.

Why this drug?

The team of Prof. Umansky showed that paclitaxel (a form of chemotherapy) in low doses can decrease substances associated to chronic inflammation and suppression of the immune system in mice and humans. Hence, paclitaxel in low dose can increase the activity of the immune system, making the body more susceptible to treatment and stronger to fight the cancer cells. The performed experiments in mice also showed tumor shrinkage and increased survival time.

The fact that the dose of paclitaxel is low is of major importance. Indeed, it has been shown that lowering the dose of chemotherapy drugs (including paclitaxel) and combining them with other treatment modalities may decrease the toxicity of chemotherapy. Furthermore, it may also boost the efficacy of other anticancer therapies by interfering with the body’s own immune reaction in different ways. Therefore, the investigators of this trial suggest that low-dose paclitaxel would also be beneficial in human melanoma patients.

Trial design

This pilot trial aims at evaluating immuno-modulating effects, safety and efficacy of palliative (end of life) treatment with ultra-low dose paclitaxel in 12 patients with metastatic (spread) melanoma in stage IV or III that cannot be treated with surgery (unresectable). Patients will receive paclitaxel (Taxol©) intravenously once per week for 3 weeks (40.0 mg/m2).

Results

The trial was completed in 2016. Results have been analysed, the investigators expect publication in Q1 2019.

Partners

Researchers:

  • Christoffer Gebhardt, MD, Universitätsmedizin Mannheim - Klinik für Dermatologie, Venerologie und Allergologie, Mannheim, Germany (Principal Investigator)
  • Jochen Utikal, MD, Universitätsmedizin Mannheim - Klinik für Dermatologie, Venerologie und Allergologie, Mannheim, Germany (Deputy Principal Investigator)
  • Viktor Umansky, MD, Universitätsmedizin Mannheim - Klinik für Dermatologie, Venerologie und Allergologie, Mannheim, Germany (Immuno-monitoring)

Sponsor:

  • Universitätsmedizin Mannheim, Mannheim, Germany

Our role

Financial support
Why we support this trial
Intervention has little or no commercial value
Expected survival benefit

Funding

€80,400
Estimated trial cost
€55,200
ACF funding
€11,568
ACF Internal support (2014-2018)
Questions about this trial?
Anticancer Fund logo
The Anticancer Fund
studies [at] anticancerfund.org

References

More info: NCT02332642

The publication is expected in Q1 2019.

Author: Kristine Beckers (Trial Manager)

Last update: January 2019