Ultraviolet Light Therapy Using Methoxsalen With or Without Bexarotene in Treating Patients With Mycosis Fungoides

European Organisation for Research and Treatment of Cancer (EORTC)

Status and phase

Terminated

Phase 3

Conditions

Lymphoma

Treatments

Procedure: UV light therapy

Drug: methoxypsoralen

Drug: bexarotene

Study type

Interventional

Funder types

NETWORK

Identifiers

NCT00056056

EORTC-21011

2004-003701-24 (EudraCT Number)

Details and patient eligibility

About

RATIONALE: Ultraviolet light therapy uses light and drugs that make cancer cells more sensitive to light to kill tumor cells. It is not yet known whether ultraviolet light therapy is more effective with or without bexarotene in treating mycosis fungoides.

PURPOSE: Randomized phase III trial to compare the effectiveness of ultraviolet light therapy using methoxsalen with or without bexarotene in treating patients who have mycosis fungoides.

Full description

OBJECTIVES:

Determine if ultraviolet A light therapy with methoxsalen (PUVA) with or without bexarotene yields a significantly higher overall response rate in patients with mycosis fungoides.
Compare the overall response rate (CCR and partial response) in patients treated with these regimens.
Compare the duration of CCR and time to relapse of patients treated with these regimens.
Compare the number of PUVA sessions necessary to achieve a CCR in these patients.
Determine the percentage of dropouts by patients treated with these regimens.
Determine the safety of these regimens in these patients.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to participating center, age (60 and under vs over 60), and stage of disease (IB vs IIA). Patients are randomized to 1 of 2 treatment arms.

Arm I: Patients receive PUVA comprising oral methoxsalen given 2 hours before whole body ultraviolet A therapy. PUVA is given 3 times per week.
Arm II: Patients receive oral bexarotene once daily and PUVA as in arm I. In both arms, treatment repeats for up to 16 weeks in the absence of complete clinical response, disease progression, or unacceptable toxicity.

Patients are followed every 8 weeks until the first documented progression or relapse.

PROJECTED ACCRUAL: A total of 145 patients will be accrued for this study within 25 months.

Enrollment

93 patients

Sex

All

Ages

18 to 120 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

DISEASE CHARACTERISTICS:

Histologically confirmed mycosis fungoides
- Stage IB or IIA
- Confirmed by current or prior diagnostic lesion biopsy

PATIENT CHARACTERISTICS:

Age

Over 18

Performance status

Karnofsky 60-100%

Life expectancy

Not specified

Hematopoietic

WBC at least 2,000/mm^3
Hemoglobin at least 9 g/dL

Hepatic

Bilirubin no greater than 1.5 times upper limit of normal (ULN)
AST and ALT no greater than 2.5 times ULN

Renal

Creatinine no greater than 2 times ULN
Calcium no greater than 11.5 mg/dL

Cardiovascular

No New York Heart Association grade III or IV cardiac insufficiency

Other

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for at least 3 months after study participation* NOTE: *Women using hormonal contraception must also use a non-hormonal treatment
Fasting triglycerides normal (prior antilipemic agents allowed to reach normalization)
Willing and able to avoid prolonged exposure to the sun
- Willing to limit sun exposure on day of PUVA therapy
No prior intolerance of or unresponsiveness to PUVA therapy
No other prior or concurrent malignant tumor except adequately treated carcinoma in situ of the cervix or basal cell or squamous cell skin cancer
No prior pancreatitis
No other concurrent serious illness or infection that would preclude study participation
No concurrent excessive alcohol consumption
No photosensitivity due to intrinsic (e.g., lupus) or extrinsic (e.g., photosensitive drugs) factors
No psychological, familial, sociological, or geographical condition that would preclude study compliance
No known contraindications to study drug
No known hypersensitivity to retinoids or hypervitaminosis A
No uncontrolled diabetes mellitus
No uncontrolled thyroid disease

PRIOR CONCURRENT THERAPY:

Biologic therapy

At least 3 months since prior interferon therapy

Chemotherapy

No prior systemic combination chemotherapy
No prior participation in another study of bexarotene
At least 3 months since prior topical chemotherapy

Endocrine therapy

At least 1 month since prior topical corticosteroids

Radiotherapy

At least 6 months since prior total skin electron beam therapy
At least 1 month since prior superficial radiotherapy

Surgery

Not specified

Other

At least 30 days since prior participation in another investigational drug study
At least 3 months since prior photopheresis
At least 1 month since prior UVB/PUVA phototherapy
At least 1 month since prior retinoid class drugs
At least 1 month since prior beta-carotene compounds
At least 1 month since other prior topical medications (e.g., tar baths)
No prior participation in this study
No other concurrent anticancer therapy
No other concurrent investigational drug therapy
No concurrent drugs associated with pancreatic toxicity or known to increase triglyceride concentrations