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Brief Title: Atorvastatin for Preventing Disease Metastasis in Patients With Resected High-Risk Stage IIA Melanoma
Official Title: A Decentralized Phase II Randomized Controlled Trial of Atorvastatin in Resected High-Risk Melanoma
Study ID: NCT06157099
Brief Summary: This clinical trial tests whether atorvastatin prevents metastasis of resected high-risk stage IIA melanoma.The vast majority of melanomas are diagnosed at an early, localized stage. However, approximately 10-15% of these localized melanomas will eventually metastasize, despite appropriate local treatment. Once metastasis occurs, median survival is less than two years. Melanomas at high risk of metastasis can be identified by gene expression profiling. Statin drugs, like atorvastatin, have been used to treat high cholesterol for the prevention of major adverse cardiovascular events, but not for preventing melanoma metastasis. Statins could prevent melanoma metastasis through decreasing tumor cell migration, decreasing tumor cell adhesion, and increasing immune system response. Statins are also efficient inhibitors of new lymphatic vessels formation. Since tumor lymphatic vessels serve as highways to lymph nodes and may suppress immune system responses, statins may block a critical step towards melanoma metastasis. Using atorvastatin may have the potential to prevent metastasis and improve outcomes in patients with resected high-risk melanoma.
Detailed Description: PRIMARY OBJECTIVE: I. To compare recurrence-free survival (RFS) of patients with high-risk melanoma treated with atorvastatin to placebo. SECONDARY OBJECTIVES: I. To compare distant metastasis-free survival (DMFS) between treatment arms. II. To compare overall survival (OS) between treatment arms. III. To assess the clinical utility of gene expression profiling in melanoma. EXPLORATORY OBJECTIVE: I. To assess the clinical utility of gene expression profiling in melanoma. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive placebo orally (PO) once per day in the absence of disease progression or unacceptable toxicity for up to 5 years and undergo computed tomography (CT) and/or magnetic resonance imaging (MRI) throughout the study. ARM II: Patients receive atorvastatin PO once per day in the absence of disease progression or unacceptable toxicity for up to 5 years and CT and/or MRI throughout the study. After completion of study treatment, patients are followed for 5 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
OHSU Knight Cancer Institute, Portland, Oregon, United States
Name: Wesley Yu, M.D.
Affiliation: OHSU Knight Cancer Institute
Role: PRINCIPAL_INVESTIGATOR