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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT00297895




Registration number
NCT00297895
Ethics application status
Date submitted
27/02/2006
Date registered
1/03/2006
Date last updated
13/05/2022

Titles & IDs
Public title
Multicenter Selective Lymphadenectomy Trial II (MSLT-II)
Scientific title
A Phase III Multicenter Randomized Trial of Sentinel Lymphadenectomy and Complete Lymph Node Dissection Versus Sentinel Lymphadenectomy Alone in Cutaneous Melanoma Patients With Molecular or Histopathological Evidence of Metastases in the Sentinel Node
Secondary ID [1] 0 0
P01CA029605
Secondary ID [2] 0 0
MSLT-II
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Melanoma 0 0
Condition category
Condition code
Cancer 0 0 0 0
Malignant melanoma

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Surgery - Completion Lymphadenectomy
Treatment: Surgery - Monitoring with nodal ultrasound

Active Comparator: Ultrasound observation + delayed CLND if recurrence detected -

Active Comparator: CLND -


Treatment: Surgery: Completion Lymphadenectomy
complete lymph node dissection of lymph node basin with positive node

Treatment: Surgery: Monitoring with nodal ultrasound
serial ultrasound monitoring of SLND positive basin. If recurrence detected, subject has CLND.
Intervention code [1] 0 0
Treatment: Surgery
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Melanoma-specific survival. This is defined as the time between the date of a subject's randomization (or date of CLND for those randomized to the CLND arm) and the date of death due to melanoma. Subjects are followed until death or 10yrs.
Timepoint [1] 0 0
10 years
Secondary outcome [1] 0 0
Disease-free survival over 10 years of follow up
Timepoint [1] 0 0
10 years
Secondary outcome [2] 0 0
Recurrence during 10 years of follow up
Timepoint [2] 0 0
10 years

Eligibility
Key inclusion criteria
1. Ability to provide informed consent.

2. Between 18 and 75 years of age.

3. Have a primary melanoma that is cutaneous (including head, neck, trunk, extremity,
scalp, palm, sole, subungual skin tissues).

4. Have clear margins following WLE.

5. ECOG performance status 0-1.

6. Life expectancy of at least 10 years from the time of diagnosis, not considering the
melanoma in question, as determined by the PI.

7. Willing to return to the MSLT-II center for follow up examinations and procedures as
outlined in the protocol.

8. Randomization and/or CLND (as appropriate to randomization arm) must be completed no
more than 120 days following the diagnostic biopsy of the primary melanoma.

9. Have a melanoma-related tumor-positive SN, determined by either of the following
methods:

1. Diagnosis of tumor-positive SN by MSLT-II center institutional pathologist by
either H&E or IHC (using S-100, Mart-1, and HMB-45).

2. Diagnosis of tumor-positive SN by RT-PCR analysis performed at JWCI, provided the
primary melanoma fits into one of the following categories:

- Breslow thickness of 1.20 mm or greater and Clark Level III

- Clark Level IV or V, regardless of Breslow thickness

- Ulceration, regardless of Breslow thickness or Clark level
Minimum age
18 Years
Maximum age
75 Years
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. History of previous or concurrent (i.e., second primary) invasive melanoma.

2. Primary melanoma of the eye, ears, mucous membranes or internal viscera. (Primary of
the skin of the external ear is acceptable.)

3. Physical, clinical, radiographic or pathologic evidence of satellite, in-transit,
regional, or distant metastatic disease.

4. Any additional solid tumor or hematologic malignancy during the past 5 years except T1
skin lesions of squamous cell carcinoma, basal cell carcinoma, or uterine cervical
cancer.

5. Skin grafts, tissue transfers or flaps that have the potential to alter the lymphatic
drainage pattern from the primary melanoma to a LN basin.

6. Allergy to vital blue dye or any radiocolloid.

7. Inability to localize 1-2 SN drainage basins via LM (e.g., no basins found, more than
2 basins found, proximity of the primary melanoma to the regional draining basin,
etc.)

8. CLNDs or SLs (before evaluation of the current melanoma) that may have altered the
lymphatic drainage pattern from the primary cutaneous melanoma to a potential LN
basin.

9. Organic brain syndrome or significant impairment of basal cognitive function or any
psychiatric disorder that might preclude participation in the full protocol, or be
exacerbated by therapy (e.g., severe depression).

10. Melanoma-related operative procedures not corresponding to criteria described in the
protocol.

11. Primary or secondary immune deficiencies or known significant autoimmune disease.

12. History of organ transplantation.

13. Oral or parenteral immunosuppressive agents (not topical or inhaled steroids) at any
time during study participation or within 6 months prior to enrollment.

14. Pregnant or lactating women.

15. Participation in concurrent therapy protocols of alternative local nodal basin
therapies that might confound the analysis of this trial is not permitted. For
example, radiation of a non-resected node basin is not acceptable because it might
influence outgrowth of residual melanoma in that nodal basin. However, systemic
adjuvant therapy or clinical trial adjuvant protocols after the finding of a positive
node on LM/SL or delayed nodal recurrence in the ultrasound observation arm are both
acceptable according to the standard of care at the multicenter site. Patients with
positive sentinel nodes or thick primary melanomas who are considered by the
multicenter site's investigator as high-risk may receive systemic adjuvant therapy
according to the standard practice of that particular site.

16. SLND pathology shows, on microscopic examination, that melanoma extends through the
lymph node capsule into the adjacent soft tissue.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
30/09/2004
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
30/09/2019
Sample size
Target
Accrual to date
Final
1939
Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
Recruitment hospital [1] 0 0
Newcastle Melanoma Unit - Newcastle
Recruitment hospital [2] 0 0
Melanoma Institute Australia - Sydney
Recruitment hospital [3] 0 0
Princess Alexandra Hospital - Woolloongabba
Recruitment hospital [4] 0 0
Alfred Hospital - East Hawthorn
Recruitment hospital [5] 0 0
Peter MacCallum Cancer Centre - East Melbourne
Recruitment postcode(s) [1] 0 0
2298 - Newcastle
Recruitment postcode(s) [2] 0 0
2060 - Sydney
Recruitment postcode(s) [3] 0 0
4102 - Woolloongabba
Recruitment postcode(s) [4] 0 0
3123 - East Hawthorn
Recruitment postcode(s) [5] 0 0
3677 - East Melbourne
Recruitment outside Australia
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United States of America
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California
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Colorado
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Florida
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Illinois
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Kentucky
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Maryland
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Michigan
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Missouri
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New Hampshire
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New York
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North Carolina
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Ohio
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Pennsylvania
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South Carolina
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Tennessee
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Texas
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Utah
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Virginia
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Washington
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United States of America
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Wisconsin
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Canada
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Alberta
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Canada
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Ontario
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Finland
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Helsinki
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Germany
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Lubeck
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Germany
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Nurnberg
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Germany
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Wurzburg
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Israel
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Tel-Aviv
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Italy
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Milan
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Italy
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Naples
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Italy
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Padova
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Italy
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Padua
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Netherlands
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Amsterdam
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Netherlands
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Groningen
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Spain
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Barcelona
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Sweden
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Lund
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Switzerland
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Lausanne
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Switzerland
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Zurich
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United Kingdom
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Norwich
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United Kingdom
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London

Funding & Sponsors
Primary sponsor type
Other
Name
Saint John's Cancer Institute
Address
Country
Other collaborator category [1] 0 0
Government body
Name [1] 0 0
National Institutes of Health (NIH)
Address [1] 0 0
Country [1] 0 0
Other collaborator category [2] 0 0
Government body
Name [2] 0 0
National Cancer Institute (NCI)
Address [2] 0 0
Country [2] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
Subjects must be diagnosed with melanoma. All subjects receive sentinel lymphadenectomy. If
the subject is sentinel node positive and meets study requirements, the subject is randomized
to receive either (1) completion lymphadenectomy (2) observation with nodal ultrasound.
Subjects are then followed for 10 years.
Trial website
https://clinicaltrials.gov/ct2/show/NCT00297895
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Richard Essner, M.D.
Address 0 0
Saint John's Cancer Institute
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries