RECRUITINGPhase 2INTERVENTIONAL

Nodal Radiation Therapy for Sentinel Lymph Node Positive Melanoma

The Role of Nodal Radiation Therapy in Sentinel Lymph Node Positive Melanoma

About This Trial

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.

Who May Be Eligible (Plain English)

Who May Qualify: - 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 willing to sign a consent form for participation in this trial - Eastern Cooperative Oncology Group (ECOG) performance status of 3 or less - expected to live at least 6 months - Patients capable of childbearing are using adequate contraception - Available for follow-up Who Should NOT Join This Trial: - 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 Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language

Inclusion Criteria: * 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 Exclusion Criteria: * 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

Treatments Being Tested

OTHER

Immunotherapy

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.

OTHER

Quality-of-Life Assessment

Ancillary studies

RADIATION

Radiation Therapy

Undergo nodal radiation therapy

Locations (3)

Baptist - MD Anderson Cancer Center

Jacksonville, Florida, United States

Cooper Hospital UNIV MED CTR.

Camden, New Jersey, United States

M D Anderson Cancer Center

Houston, Texas, United States