A Phase 2 interventional study of Biopsy Procedure and Biospecimen Collection in Clinical Stage 0 Cutaneous Melanoma AJCC v8, Clinical Stage I Cutaneous Melanoma AJCC v8 and Clinical Stage II Cutaneous Melanoma AJCC v8, sponsored by ECOG-ACRIN Cancer Research Group. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-15.
Sponsored by ECOG-ACRIN Cancer Research Group · Phase 2, Interventional, and Prevention
This phase II trial tests how well sulforaphane works in preventing melanoma in patients with multiple atypical moles (nevi) and a prior history of melanoma. Patients with a history of melanoma and multiple atypical nevi are at a significantly increased risk of developing additional melanomas than those without atypical nevi. Prevention measures usually include sun protection, monthly skin self-examinations and regular skin examinations from a doctor. Sulforaphane is a naturally-occurring substance found in many cruciferous vegetables, including broccoli, that may prevent melanoma from forming.
PRIMARY OBJECTIVE:
I. To evaluate the effects of oral sulforaphane versus (vs) placebo on change in the total area of atypical and common pigmented nevocellular nevi on the posterior trunk at 12 months after randomization as assessed by digital photographic imaging and analysis using Derma-AI image analysis software, specifically assessed in patients treated for the entire 12-month treatment period (per-protocol analysis).
SECONDARY OBJECTIVES:
I. To evaluate the effects of oral sulforaphane vs placebo on the number of atypical and common pigmented nevocellular nevi with moderate and significant changes in area on the posterior trunk at 12 months after randomization as assessed by digital photographic imaging and analysis using Derma-AI image analysis software, specifically assessed in patients treated for the entire 12-month treatment period (Intent-to-Treat [ITT] analysis).
II. To determine the effects of 12 months of sulforaphane treatment versus vs placebo on the total area and features of atypical nevi at 12 months, assessed as above in all randomized patients.
III. To assess the safety/tolerability of sulforaphane (three Avmacol® Extra Strength [Nutramax] tablets once daily over 12 months), assessed per Common Terminology Criteria for Adverse Events (CTCAE), as well as by dosing deviations among all treated patients.
EXPLORATORY OBJECTIVES:
I. Effects of sulforaphane on inflammation and immunity:
Ia. To evaluate the effects of sulforaphane on circulating serum cytokine and chemokine levels, as assessed by multiplex technology (Luminex or similar); Ib. To evaluate the effects of sulforaphane on immune cell infiltration in atypical melanocytic nevocellular nevi, as assessed by traditional histopathology and immunohistochemistry.
III. To evaluate dermoscopic features of targeted prespecified atypical melanocytic nevocellular nevi at each timepoint.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM A: Patients receive sulforaphane orally (PO) twice daily (BID) for up to 12 months in the absence of unacceptable toxicity. Patients also undergo optional excisional biopsy at baseline, 3 and 12 months and post treatment and blood sample collection throughout study.
ARM B: Patients receive placebo PO BID for up to 12 months in the absence of unacceptable toxicity. Patients also undergo optional excisional biopsy at baseline, 3 and 12 months and post treatment and blood sample collection throughout study.
After completion of study treatment, patients are followed every 3 months for 24 months from randomization.
Inclusion Criteria:
Patient must have ≥ 3 clinically atypical nevi, assessed within 30 days prior to randomization, that are consistent with the International Agency for Research on Cancer (IARC) definition as follows.
Patient must not be pregnant. All patients of childbearing potential must have a blood test or urine study within 14 days prior to randomization to rule out pregnancy. A patient of childbearing potential is defined as anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
Patients receive sulforaphane PO BID for up to 12 months in the absence of unacceptable toxicity. Patients also undergo optional excisional biopsy at baseline, 3 and 12 months and post treatment and blood sample collection throughout study.
Procedure: Biopsy Procedure · Procedure: Biospecimen Collection · Drug: Sulforaphane
Patients receive placebo PO BID for up to 12 months in the absence of unacceptable toxicity. Patients also undergo optional excisional biopsy at baseline, 3 and 12 months and post treatment and blood sample collection throughout study.
Procedure: Biopsy Procedure · Procedure: Biospecimen Collection · Drug: Placebo Administration
Undergo optional excisional biopsy
Also known as: Biopsy, BIOPSY_TYPE, Bx
Undergo blood sample collection
Also known as: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection
Given PO
Given PO
Also known as: (+/-)-Sulforaphane, 1-isothiocyanato-4-methylsulfinyl-butane, Sulfaforaphane, Sulforafan, Sulphoraphane
Change in total area of atypical and common pigmented nevocellular nevi on the posterior trunk
Changes in the total area of nevi compared between the arms will be assessed by Derma-AI digital photographic imaging and analysis using image analysis software. The difference in the change of total area of nevi between the two arms will be compared using the Wilcoxon rank sum test.
Time frame: From baseline to 12 months after randomization
Number of changed atypical nevi on the posterior trunk
The number of changed atypical nevi will be assessed via automated image analysis. The difference in baseline and post-treatment measures will be compared between the two arms using the Wilcoxon rank-sum test. Both intent-to-treat and per-protocol analyses will be conducted.
Time frame: At baseline and 12 months after randomization
Incidence of adverse events (AEs)
Incidence of AEs assessed per Common Terminology Criteria for Adverse Events as well as by dosing deviations. Toxicity rate for individual AEs, categorized AEs and worst degree AEs will be compared between the two arms using the Fisher's exact test.
Time frame: Up to 12 months
Circulating serum cytokine and chemokine levels
Assessed by multiplex technology. The Wilcoxon rank-sum test will be used to compare the level of each value between timepoints. The Wilcoxon rank-sum test will be used to compare changes in levels between patients receiving sulforaphane and placebo.
Time frame: At baseline and at 3 and 12 months
Immune cell infiltration
Assessed by traditional histopathology and immunohistochemistry. Traditional histopathologic features of nevi will be reported descriptively. The Wilcoxon rank-sum test will be used to compare changes in levels between patients.
Time frame: At baseline and at 3 and 12 months
Dermoscopic features of the atypical nevi
Dermoscopy and dermoscopic photographs will be performed on the index nevi at each timepoint, and morphologic features will be reported descriptively.
Time frame: Up to 12 months
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ECOG-ACRIN Cancer Research Group