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Clinical Stage III Cutaneous Melanoma AJCC v8Phase 2NCT04356729

A Phase II Trial of PD-L1 Therapy Combined With Anti-VEGF Therapy in Unresectable or Metastatic Melanoma

A Phase 2 study testing Atezolizumab and Bevacizumab in people with Clinical Stage III Cutaneous Melanoma AJCC v8 and Stage IV Melanoma, run by F. Stephen Hodi, MD at 3 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This research study is studying a combination of two drugs that change the immune system and tumor as a possible treatment for metastatic or unresectable stage III or IV cutaneous melanoma. The names of the study drugs involved in this study are: Atezolizumab Bevacizumab Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Atezolizumab and Bevacizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
3 sitesUnited States
Study dates
6 Aug 2020to 1 Jun 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants must have histologically or cytologically confirmed metastatic or unresectable stage III or IV cutaneous melanoma.
  • PD-L1 negative staining in at least one biopsy sample.
  • Age ≥ 18 years
  • ECOG performance status ≤ 2 (Karnofsky ≥60%, see Appendix A)
  • Participants may have received any number of prior therapies for treatment of their cutaneous melanoma, excluding prior treatment with anti-PD-L1 therapeutic antibodies or bevacizumab.
  • Participants must have measurable disease per RECIST v1.1.
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  • Participants must have availability of a representative tumor specimen for exploratory biomarker research.
  • Participants must have normal organ and marrow function as defined below:
  • lymphocyte count ≥ 500/mcL
  • absolute neutrophil count ≥ 1,500/mcL without granulocyte colony-stimulating factor support
  • platelets* ≥100,000/mcL
  • hemoglobin* ≥9 g/dL
  • serum bilirubin ≤1.5 x ULN with the following exception: participants with known Gilbert's Disease: serum bilirubin level ≤ 3x ULN
  • AST(SGOT)/ALT(SGPT) ≤2.5 × institutional ULN, with the following exceptions: Participants with documented liver metastases: AST and ALT ≤ 5 x ULN
  • alkaline phosphatase (ALP) ≤2.5 × institutional ULN, with the following exceptions:
  • participants with documented liver or bone metastases: ALP ≤ 5 x ULN
  • serum creatinine ≤ 1.5 x ULN OR creatinine clearance ≥ 60 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
  • serum albumin ≥ 2.5 g/dL
  • For participants not receiving therapeutic anticoagulation: INR or aPTT ≤1.5 ULN
  • Urine dipstick for proteinuria < 2+ (within 7 days prior to Cycle 1 Day 1). Participants discovered to have ≥ 2 + proteinuria on dipstick urinalysis at baseline should undergo a 24-hour urine collection and must demonstrate < 1 g of protein in 24 hours. Note: Participants cannot be transfused to meet this criterion
  • For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods with a failure rate of < 1% per year during the treatment period and for 5 months after the last dose of atezolizumab, and 6 months after the last dose of bevacizumab.
  • Examples of contraceptive methods with a failure rate of < 1 % per year include bilateral tubal ligation, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices.
  • The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception.
  • For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agreement to refrain from donating sperm, as defined below: With female partners of childbearing potential or pregnant female partners, men must remain abstinent or use a condom during the treatment period and for 5 months after the last dose of atezolizumab and 6 months after the last dose of bevacizumab, to avoid exposing the embryo. Men must refrain from donating sperm during this same period. The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception.
  • Ability to understand and the willingness to sign a written informed consent document.

Who cannot join

  • Participants with symptomatic, untreated, or actively progressing CNS metastases will be excluded. If a participant has a known history of treated CNS lesions, they are eligible provided that all of the following criteria are met:
  • Measurable disease, per RECIST v1.1, must be present outside the CNS.
  • The participant has no history of intracranial hemorrhage or spinal cord hemorrhage.
  • Metastases are limited to the cerebellum or the supratentorial region (i.e., no metastases to the midbrain, pons, medulla, or spinal cord).
  • There is no evidence of interim progression between completion of CNS-directed therapy and the screening brain scan
  • The participant has not received stereotactic radiotherapy within 7 days prior to initiation of study treatment or whole-brain radiotherapy within 14 days prior to initiation of study treatment.
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  • The participant has no ongoing requirement for corticosteroids as therapy for CNS disease. Anticonvulsant therapy at a stable dose is permitted. Asymptomatic patients with CNS metastases newly detected at screening are eligible for the study after receiving radiotherapy or surgery, with no need to repeat the screening brain scan.
  • History of leptomeningeal disease.
  • Uncontrolled tumor-related pain.
  • NOTE: Participants requiring pain medication must be on a stable regimen at study entry.
  • Symptomatic lesions amendable to palliative radiotherapy (e.g., bone metastases or metastases causing nerve impingement) should be treated prior to enrollment. Participants should be recovered from the effects of radiation. There is no required minimum recovery period.
  • Asymptomatic metastatic lesions that would likely cause functional deficits or intractable pain with further growth (e.g., epidural metastasis that is not currently associated with spinal cord compression) should be considered for loco-regional therapy if appropriate prior to enrollment.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to atezolizumab and/or bevacizumab.
  • Uncontrolled or symptomatic hypercalcemia (> 1.5 mmol/L ionized calcium or calcium > 12 mg/dL or corrected serum calcium > ULN)
  • Active or history of autoimmune disease or immune deficiency, including, but not limited to, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipid antibody syndrome,Wegener granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, or multiple sclerosis with the following exceptions:
  • Patients with a history of autoimmune-related hypothyroidism who are on thyroid-replacement hormone are eligible for the study.
  • Patients with controlled Type 1 diabetes mellitus who are on an insulin regimen are eligible for the study.
  • Patients with eczema, psoriasis, lichen simplex chronicus, or vitiligo with dermatologic manifestations only (e.g., patients with psoriatic arthritis are excluded) are eligible for the study provided all of following conditions are met: Rash must cover <10% of body surface area, Disease is well controlled at baseline and requires only low-potency topical corticosteroids, No occurrence of acute exacerbations of the underlying condition requiring psoralen plus ultraviolet. A radiation, methotrexate,retinoids, biologic agents, oral calcineurin inhibitors, or high-potency or oral corticosteroids within the previous 12 months.
  • History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted.
  • Participants who test positive for HIV at time of screening are ineligible because of the increased risk of lethal infections when treated with marrow-suppressive therapy.
  • Active hepatitis B virus (HBV) infection (chronic or acute), defined as having a positive hepatitis B surface antigen (HBsAg) test at screening. Participants with a negative HBsAg test and a positive total hepatitis B core antibody (HBcAb) test at screening are eligible for the study.
  • Active hepatitis C virus (HCV) infection, defined as a positive HCV antibody test followed by a positive HCV RNA test at screening. The HCV RNA test will be performed only for participants who have a positive HCV antibody test.
  • Participants with active tuberculosis will be excluded.
  • Significant cardiovascular disease, such as a New York Heart Association Class II or greater cardiac disease, myocardial infarction, or cerebrovascular accident within 3 months prior to initiation of study treatment, unstable arrhythmia, or unstable angina.
  • Major surgical procedure other than for diagnosis within 4 weeks prior to initiation of study treatment, or anticipation of need for a major surgical procedure during the course of the study.
  • History of other malignancy within 2 years prior to screening, with the exception of those with a negligible risk of metastasis or death (e.g., 5-year OS of > 90%), such as adequately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, localized prostate cancer, ductal carcinoma in situ, or Stage I uterine cancer.
  • Severe infection within 4 weeks prior to initiation of study treatment, including, but not limited to, hospitalization for complications of infection, bacteremia, or severe pneumonia.
  • Treatment with therapeutic oral or IV antibiotics within 2 weeks prior to initiation of study treatment. Patients receiving prophylactic antibiotics (e.g., to prevent a urinary tract infection or chronic obstructive pulmonary disease exacerbation) are eligible for the study.
  • Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that contraindicates the use of an investigational drug, may affect the interpretation of the results, or may render the patient at high risk from treatment complications.
  • Prior allogeneic stem cell or solid organ transplantation.
  • Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study treatment, or anticipation of need for such a vaccine during the course of the study or within 5 months after the last dose of atezolizumab.
  • Treatment with investigational therapy within 28 days prior to initiation of study treatment.
  • Prior treatment with bevacizumab or prior PD-L1 targeted therapy.
  • Treatment with systemic immunostimulatory agents (including, but not limited to,interferon and interleukin 2 [IL-2]) within 4 weeks or five half-lives of the drug (whichever is shorter) prior to initiation of study treatment.
  • Treatment with systemic immunosuppressive medication (including, but not limited to, corticosteroids, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-TNF-α agents) within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during the course of the study, with the following exceptions:
  • Patients who received acute, low-dose systemic immunosuppressant medication or a one-time pulse dose of systemic immunosuppressant medication (e.g. 48 hours of corticosteroids for a contrast allergy) are eligible for the study.
  • Patients on physiologic replacement doses of steroids less than 10mg daily prednisone equivalent are allowed. Higher replacement doses should be discussed with the overall PI to determine if patient can be included on the trial.
  • Patients who received mineralocorticoids (e.g., fludrocortisone), corticosteroids for chronic obstructive pulmonary disease (COPD) or asthma, or low-dose corticosteroids for orthostatic hypotension or adrenal insufficiency are eligible for the study.
  • History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins.
  • Known hypersensitivity to Chinese hamster ovary cell products or to any component of the atezolizumab formulation.
  • Known allergy or hypersensitivity to any component of the bevacizumab formulation.
  • Inadequately controlled arterial hypertension (defined as systolic blood pressure [BP] > 150 mm Hg and/or diastolic BP >100 mmHg), based on an average of at least three BP readings at two or more sessions. Anti-hypertensive therapy to achieve these parameters is allowed.
  • History of hypertensive crisis or hypertensive encephalopathy.
  • Significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to Cycle 1 Day 1.
  • History of hemoptysis (≥ 2.5 mL of bright red blood per episode) within 1 month prior to Cycle 1 Day 1.
  • Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation).
  • Current or recent (within 10 days of Cycle 1 Day 1) use of aspirin (> 325 mg/day) or current or recent treatment with dipyramidole, ticlopidine, clopidogrel, and cilostazol.
  • Current or recent (within 10 days prior to Cycle 1 Day 1) use of full-dose oral or parenteral anticoagulants or thrombolytic agents for therapeutic purpose (as opposed to prophylactic). Prophylactic anticoagulation for the patency of venous access devices is allowed provided the activity of the agent results in an INR < 1.5 x ULN and aPTT is within normal limits (according to the institutional standards) within 14 days prior to Cycle 1 Day 1. Prophylactic use of low-molecular weight heparin (LMWH) (i.e., enoxaparin 40 mg/day) is allowed. However, the use of direct oral anticoagulant therapies such as dabigatran (Pradaxa®) and rivaroxaban (Xarelto®) is not recommended due to bleeding risk.
  • History of abdominal or tracheoesophageal fistula, GI perforation, or intra-abdominal abscess within 6 months prior to Cycle 1 Day 1.
  • Evidence of abdominal free air that is not explained by paracentesis or recent surgical procedure.
  • Serious, non-healing or dehiscing wound, active ulcer, or untreated bone fracture.
  • Major surgical procedure within 4 weeks prior to Cycle 1 Day 1 or anticipation of need for a major surgical procedure during the study.
  • History of intra-abdominal inflammatory process within 6 months prior to Cycle 1 Day 1, including, but not limited to, peptic ulcer disease, diverticulitis, or colitis.
  • Chronic daily treatment with a non-steroidal anti-inflammatory drug (NSAID).
  • Pregnant or breastfeeding, or intending to become pregnant during the study or within 5 months after the last dose of atezolizumab and 6 months after the last dose of bevacizumab. Women of childbearing potential must have a negative serum pregnancy test result within 14 days prior to initiation of study treatment.

Trial locations and contacts

3 sites in 1 country.

United States3 sites

  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02115

  • Massachusetts General Hospital

    Boston, Massachusetts, 02214

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

Other trials in United States

About this study

This research study is studying a combination of two drugs that change the immune system and tumor as a possible treatment for metastatic or unresectable stage III or IV cutaneous melanoma.

The names of the study drugs involved in this study are:

  • Atezolizumab
  • Bevacizumab
Read the detailed description

The research study procedures include screening for eligibility, study treatment including evaluations, a biopsy, and follow up visits.

This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific disease. "Investigational" means that the drug is being studied. The U.S. Food and Drug Administration (FDA) has not approved atezolizumab for this specific disease but it has been approved for other uses. The U.S. Food and Drug Administration (FDA) has not approved bevacizumab for this specific disease but it has been approved for other uses.

Atezolizumab and bevacizumab are types of immunotherapy. Immunotherapy works by encouraging the body's own immune system to attack the cancer cells and stop the growth of cancer. Atezolizumab and bevacizumab work by stopping various molecules on cancer cells and body cells from working against the immune system's natural fight against cancer.

Keywords
Metastatic stage III cutaneous melanoma, Metastatic stage IV cutaneous melanoma, Unresectable stage III cutaneous melanoma, Unresectable stage IV cutaneous melanoma
Medical subject headings
Melanoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AtezolizumabDrug

    Also called Tecentriq

    Atezolizumab will be administered intravenously at a fixed predetermined dose every three weeks ith 21 consecutive days defined as a treatment cycle.

  • BevacizumabDrug

    Also called Avastin, Mvasi

    Bevacizumab will be administered intravenously at a fixed predetermined dose every three weeks, with 21 consecutive days defined as a treatment cycle.

Study groups in NCT04356729
Study groupRoleWhat they receive
Atezolizumab and BevacizumabExperimentalThe research study procedures include screening for eligibility, study treatment including evaluations, a biopsy, and follow up visits. * Atezolizumab will be administered intravenously at a fixed predetermined dose every three weeks * Bevacizumab will be administered intravenously at a fixed predetermined dose every three weeks, with 21 consecutive days defined as a treatment cycle. Treatment will be administered on an outpatient basis Study treatment will continue until study doctors decide to stop therapy due to criteria which may include disease progression, adverse events or changes in condition. Participants will be followed for survival health information following treatment until the study ends, which could be approximately 5 years from start of treatment
Receives: Drug: Atezolizumab; Drug: Bevacizumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Response Rate in PD-L1 negative melanoma

    The primary endpoint for this study is overall response rate in PDL1 negative melanoma to combination anti-PD-L1 therapy and anti-VEGF therapy by RECIST criteria. The proportion of patients with complete response or partial response as best response to therapy will be summarized and presented with a two-sided, 90% Wald confidence interval.

    Measured: 5 Years

Secondary outcomes (5)

  1. Overall survival

    Time from start of treatment to death

    Measured: start of treatment and death from any cause up to 5 years

  2. Time to tumor progression

    Time to tumor progression (TTP) is the time interval between the dates of the start of trial treatment and first documentation of progressive disease

    Measured: up to 5 years

  3. Duration of response

    The time-to-event endpoints will each be summarized using the method of KaplanMeier Point estimates for each endpoint will be presented with 90% confidence intervals derived using log(-log(endpoint)) methodology.

    Measured: patients with objective response (confirmed CR or PR as best overall response) as the interval between dates of first documentation of objective response and first documentation of progressive disease up to 5 years

  4. Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE 5.

    Adverse events

    Measured: initiation of study treatment, during study treatment, and 30 days after the last dose of study treatment or study discontinuation/termination, whichever occurs first up to 5 years

  5. Change tumor-infiltrating lymphocytes (TILs)

    Pre-treatment percentages of stromal infiltrating lymphocytes will be summarized descriptively for the two response groups and compared using Wilcoxon rank-sum tests.

    Changes in TILs between baseline and progression/treatment discontinuation will be calculated (post-pre) for each patient and summarized descriptivelyChanges in TILs between baseline and progression/treatment discontinuation will be calculated (post-pre) for each patient and summarized descriptively

    Measured: baseline and progression/treatment discontinuation up to 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Apr 2020
  2. Study start6 Aug 2020
  3. Primary completion1 Jun 2026
  4. Study completion1 Jun 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04356729
Sponsor's protocol ID
19-604
Status last verified
Aug 2026
First submitted
20 Apr 2020
Last updated
5 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to Sponsor Investigator or designee. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Atezolizumab and Bevacizumab in people with Clinical Stage III Cutaneous Melanoma AJCC v8 and Stage IV Melanoma, run by F. Stephen Hodi, MD at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 25 inclusion and 55 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 5 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Response Rate in PD-L1 negative melanoma (time frame: 5 Years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04356729.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Aug 2026.

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