NCT04594187

Brief Summary

This phase II trial seeks to determine the role of nodal radiation therapy after sentinel lymph node biopsy (SLNB) for patients with high risk sentinel lymph node positive melanoma who are planned for immunotherapy without completion lymph node dissection. Prior studies of patients with more advanced melanoma have shown nodal radiation therapy can decrease the risk of nodal recurrence but it is not known if this same benefit will be seen in patients with high risk sentinel lymph node positive disease who are planned for immunotherapy.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
168

participants targeted

Target at P75+ for phase_2

Timeline
17mo left

Started Aug 2021

Longer than P75 for phase_2

Geographic Reach
1 country

3 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress78%
Aug 2021Dec 2027

First Submitted

Initial submission to the registry

October 10, 2020

Completed
10 days until next milestone

First Posted

Study publicly available on registry

October 20, 2020

Completed
10 months until next milestone

Study Start

First participant enrolled

August 26, 2021

Completed
6.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2027

Last Updated

February 17, 2026

Status Verified

February 1, 2025

Enrollment Period

6.4 years

First QC Date

October 10, 2020

Last Update Submit

February 12, 2026

Conditions

Outcome Measures

Primary Outcomes (1)

  • Time to regional nodal recurrence

    Regional nodal recurrence will be assessed by physical exam and routine surveillance imaging during follow-up

    From date of sentinel lymph node biopsy, assessed up to 5 years

Secondary Outcomes (6)

  • Time to locoregional recurrence

    From date of sentinel lymph node biopsy, assessed up to 5 years

  • Time to distant metastasis

    From date of sentinel lymph node biopsy, assessed up to 5 years

  • Progression-free survival

    From date of sentinel lymph node biopsy to recurrence event or last follow-up, assessed up to 5 years

  • Overall survival

    From date of sentinel lymph node biopsy to last follow-up, assessed up to 5 years

  • Incidence of long term toxicity

    Up to 5 years

  • +1 more secondary outcomes

Other Outcomes (2)

  • Tissue associated biomarkers of disease control and radiation-associated toxicity

    Up to 5 years

  • Optional blood associated biomarkers of disease control and radiation-associated toxicity

    Up to 5 years

Study Arms (2)

Group I (immunotherapy, radiation therapy)

EXPERIMENTAL

Within 12 weeks of SLNB, patients start nodal radiation therapy (30 Gy in 5 treatments over 2-2.5 weeks). Immunotherapy planned to begin at any time after SLNB.

Other: ImmunotherapyOther: Quality-of-Life AssessmentRadiation: Radiation Therapy

Group II (immunotherapy)

ACTIVE COMPARATOR

Patients planned to undergo immunotherapy.

Other: ImmunotherapyOther: Quality-of-Life Assessment

Interventions

All patients must be planned for treatment with any immunotherapy agent after sentinel lymph node biopsy (e.g. pembrolizumab or nivolumab). For patients receiving radiation therapy initiation may be before, during or after radiation.

Also known as: Immunological, Immunological Therapy, Immunologically Directed Therapy
Group I (immunotherapy, radiation therapy)Group II (immunotherapy)

Ancillary studies

Also known as: Quality of Life Assessment
Group I (immunotherapy, radiation therapy)Group II (immunotherapy)

Undergo nodal radiation therapy

Also known as: Cancer Radiotherapy, Irradiate, Irradiated, Irradiation, Radiation, Radiation Therapy, NOS, Radiotherapeutics, Radiotherapy, RT, Therapy, Radiation
Group I (immunotherapy, radiation therapy)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Must be planned for post-operative immunotherapy
  • No evidence of distant metastasis as determined by clinical examination and any form of imaging
  • No evidence of clinically involved lymph nodes prior to SLNB
  • Pathologically confirmed sentinel lymph node positive melanoma with high risk features (extracapsular extension \[ECE\] or 0.5 mm+ nodal tumor implant or 2+ involved nodes or lymphovascular invasion of the primary tumor)
  • Has provided written informed consent for participation in this trial
  • Eastern Cooperative Oncology Group (ECOG) performance status of 3 or less
  • Life expectancy greater than 6 months
  • Patients capable of childbearing are using adequate contraception
  • Available for follow-up

You may not qualify if:

  • Complete lymph node dissection (CLND) of the nodal basin containing the positive SLN
  • Distant metastasis
  • Previous radiation therapy (RT) to the nodal area planned for RT such that the prior RT field would be included in the current treatment field. In other words, treatment on this trial would require re-irradiation of tissues
  • Women who are pregnant
  • Adults unable to consent, individuals who are not yet adults, pregnant women and prisoners will be excluded from this study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Baptist - MD Anderson Cancer Center

Jacksonville, Florida, 32207, United States

RECRUITING

Cooper Hospital UNIV MED CTR.

Camden, New Jersey, 08103, United States

RECRUITING

M D Anderson Cancer Center

Houston, Texas, 77030, United States

RECRUITING

Related Links

MeSH Terms

Conditions

Melanoma

Interventions

ImmunotherapyAdjuvants, ImmunologicRadiotherapyRadiation

Condition Hierarchy (Ancestors)

Neuroendocrine TumorsNeuroectodermal TumorsNeoplasms, Germ Cell and EmbryonalNeoplasms by Histologic TypeNeoplasmsNeoplasms, Nerve TissueNevi and MelanomasSkin NeoplasmsNeoplasms by SiteSkin DiseasesSkin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

ImmunomodulationBiological TherapyTherapeuticsImmunologic FactorsPhysiological Effects of DrugsPharmacologic ActionsChemical Actions and UsesPhysical Phenomena

Study Officials

  • Devarati Mitra

    M.D. Anderson Cancer Center

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 10, 2020

First Posted

October 20, 2020

Study Start

August 26, 2021

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2027

Last Updated

February 17, 2026

Record last verified: 2025-02

Locations