Phase II Trial Comparing Stereotactic Body Radiotherapy Combined with Immunotherapy Versus Immunotherapy Alone in Adults with Limited Spread of Melanoma Outside the Brain
Led by Melanoma Institute Australia · Updated on 2026-05-07
129
Participants Needed
5
Research Sites
N/A
Total Duration
AI-Summary
What this Trial Is About
Researchers are evaluating whether adding stereotactic body radiotherapy SBRT to standard immunotherapy improves treatment outcomes for patients with advanced or metastatic melanoma that has spread outside the brain. This Phase II trial explores if combining precise radiotherapy with immune checkpoint inhibitors enhances anti-tumor immune response and prolongs survival compared to immunotherapy alone. The study is based on promising early data showing potential synergy between radiation and immunotherapy in various cancers, including melanoma.
Participants will be randomly assigned to one of two groups one receiving concurrent SBRT plus standard first-line immunotherapy, and the other receiving immunotherapy alone. SBRT delivers high doses of radiation precisely to 1 to 5 extracranial metastatic sites over several days between the first and third cycles of immunotherapy. Immunotherapy will be administered as per current standard care protocols approved by regulatory agencies. The trial aims to assess the safety and effectiveness of this combined approach versus immunotherapy alone.
During the study, participants will undergo regular assessments including imaging scans to measure tumor response, blood tests, and quality of life questionnaires over a five-year period. Researchers will monitor overall survival, progression-free survival, local tumor control, adverse events, and the need for additional treatments. Safety and tolerability of the treatments will also be closely tracked. The total time participants are involved may extend up to five years to evaluate long-term outcomes and effects of the therapies.
CONDITIONS
Brief Title
Stereotactic Ablative Radiotherapy (XRT) and Immunotherapy for Oligometastatic Extracranial Melanoma
Research Team
M
Monica Osorio
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First diagnosis of AJCC Stage IV cutaneous, acral, or unknown primary melanoma with 1 to 5 extracranial metastases
Up to 4 in-transit metastases allowed in addition to distant metastases
Prior surgery for symptomatic disease permitted if remaining extracranial metastases are 5 or fewer
At least one metastasis measurable as a target lesion per RECIST 1.1
No evidence of brain metastases on MRI or CT brain scan
All lesions can be treated with a minimum SBRT biologically effective dose of 48Gy
Able to tolerate immunotherapy as determined by a medical oncologist
Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
Women of childbearing potential must have a negative pregnancy test within 7 days of randomisation
You will not qualify if you...
Diagnosis of ocular or mucosal melanoma
Serious or unstable medical conditions affecting safety or compliance
Immediate need for radiotherapy such as spinal cord compression
Prior radiotherapy for Stage IV melanoma (adjuvant radiotherapy for Stage I-III allowed if not included in baseline lesions)
Inability to treat all disease sites with SBRT
Prior systemic drug therapy for melanoma except neoadjuvant or adjuvant for Stage I-III
Contraindications to planned immunotherapy regimen
Moderate or severe liver dysfunction in patients with liver metastases
History of other malignancies unless disease-free for at least 1 year and low risk of recurrence
Pregnant or breastfeeding females
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Between cycle 1 and cycle 3 of immunotherapy (duration depends on immunotherapy regimen)
Participants receive either concurrent stereotactic body radiotherapy with immunotherapy or immunotherapy alone as standard of care treatment for their extracranial melanoma oligometastases.
Visits as scheduled for immunotherapy cycles and radiotherapy treatment sessions
Follow-up
Duration - Up to 5 years
Participants are monitored for overall survival, progression-free survival, treatment safety, and quality of life for up to 5 years after treatment.
Regular visits for assessments over 5 years
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Study protocol of a randomised phase II trial of concurrent stereotactic body radiotherapy with immunotherapy versus immunotherapy alone in patients with 1-5 extracranial melanoma oligometastases (AXIOM).