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An Open-Label, Randomized, Multicenter Trial of Encorafenib + Binimetinib Evaluating a Standard-dose and a High-dose Regimen in Patients With BRAFV600-mutant Melanoma Brain Metastasis

NCT03911869

Description:

This is a multicenter, randomized open-label Phase 2 study to assess the safety, efficacy and pharmacokinetic (PK) of 2 dosing regimens of encorafenib + binimetinib combination in patients with BRAFV600-mutant melanoma with brain metastasis. Approximately 100 patients will be enrolled, including 9 patients in a Safety Lead-in of the high-dose treatment arm. After a Screening Period, treatment will be administered in 28-day cycles and will continue until disease progression, unacceptable toxicity, withdrawal of consent, start of subsequent anticancer therapy, death.

Related Conditions:
  • Melanoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: An Open-Label, Randomized, Multicenter Trial of Encorafenib + Binimetinib Evaluating a Standard-dose and a High-dose Regimen in Patients With BRAFV600-mutant Melanoma Brain Metastasis
  • Official Title: A Phase 2, Open-Label, Randomized, Multicenter Trial of Encorafenib + Binimetinib Evaluating a Standard-dose and a High-dose Regimen in Patients With BRAFV600-Mutant Melanoma Brain Metastasis

Clinical Trial IDs

  • ORG STUDY ID: ARRAY-818-201
  • SECONDARY ID: C4221006
  • SECONDARY ID: 2018-004555-21
  • NCT ID: NCT03911869

Conditions

  • Brain Metastases

Interventions

DrugSynonymsArms
encorafenibHigh Dose Arm
binimetinibHigh Dose Arm

Purpose

This is a multicenter, randomized open-label Phase 2 study to assess the safety, efficacy and pharmacokinetic (PK) of 2 dosing regimens of encorafenib + binimetinib combination in patients with BRAFV600-mutant melanoma with brain metastasis. Approximately 100 patients will be enrolled, including 9 patients in a Safety Lead-in of the high-dose treatment arm. After a Screening Period, treatment will be administered in 28-day cycles and will continue until disease progression, unacceptable toxicity, withdrawal of consent, start of subsequent anticancer therapy, death.

Trial Arms

NameTypeDescriptionInterventions
Standard Dose ArmExperimentalPatients in the standard-dose treatment arm will receive encorafenib and binimetinib in 28-day cycles. 450 mg encorafenib orally once a day (QD) 45 mg binimetinib orally twice a day (BID) Patients who are able to tolerate the standard dose during the first 4 weeks of treatment (Cycle 1) should be dose-escalated to 600 mg encorafenib QD plus 45 mg binimetinib BID provided they meet protocol-defined criteria.
  • encorafenib
  • binimetinib
High Dose ArmExperimentalPatients in the high-dose treatment arm will receive encorafenib and binimetinib in 28-day cycles. 300 mg encorafenib orally twice a day (BID) 45 mg binimetinib orally twice a day (BID)
  • encorafenib
  • binimetinib

Eligibility Criteria

        Key Inclusion Criteria:

          -  Histologically confirmed diagnosis of cutaneous melanoma with metastases to the brain.

          -  Presence of B-RAF proto-oncogene, V600 mutant (BRAFV600) mutation in tumor tissue
             previously determined by a local PCR or NGS-based assay at any time prior to Screening
             or by a central laboratory during Screening.

          -  Must have at least 1 parenchymal brain lesion ≥ 0.5 cm and ≤ 4 cm, defined as a
             magnetic resonance imaging (MRI) contrast-enhancing lesion that may be accurately
             measured in at least 1 dimension. (Measurable intracranial lesions that have been
             previously irradiated and have not been shown to be progressing following irradiation
             should not be considered as target lesions).

          -  Patients may have received the following prior therapies:

               1. Safety Lead-in, Phase 2 Randomized , Phase 2 Arm A Cohort 1: May have received
                  prior local therapy for brain metastases including but not restricted to brain
                  surgery, whole brain radiotherapy, stereotactic radiotherapy or stereotactic
                  radiosurgery. Multiple local (brain) therapies or combinations of local therapies
                  are allowed. For patients receiving local therapy to all brain lesions (including
                  WBRT), progression of pre-existing lesions based on RECIST 1.1 (> 20% increase in
                  longest diameter on baseline scan) or new measurable lesions are required. For
                  patients receiving local therapy for some but not all lesions, disease
                  progression based on RECIST 1.1 is not required as long as there are remaining
                  brain lesions that are measurable and not previously treated.

               2. Phase 2 Arm A Cohort 2: Received no prior local therapy (e.g., brain surgery,
                  craniotomy, SRS or SRT) for brain metastases.

               3. All patients (Safety Lead-In and Phase 2): May have received prior immunotherapy.

               4. All patients (Safety Lead-In and Phase 2): If receiving concomitant
                  corticosteroids must be on a stable or decreasing dose for at least 2 weeks prior
                  to first dose of study treatment (up to a total daily dose of 4mg of
                  dexamethasone or equivalent).

          -  An Eastern Cooperation Oncology Group Performance Status (ECOG PS) of 0 or 1 and
             Karnofsky score ≥ 80

          -  Adequate bone marrow, organ function and laboratory parameters

        Key Exclusion Criteria:

          -  Patients with symptomatic brain metastasis.

          -  Uveal or mucosal melanoma.

          -  History of or current leptomeningeal metastases.

          -  Treatment with SRS or craniotomy within 14 days prior to start of study treatment, or
             treatment with whole-brain radiation within 28 days prior to study treatment. Patients
             who received local therapy should have complete recovery with no neurological
             sequelae.

          -  Either of the following:

               1. Radiation therapy to non-brain visceral metastasis within 2 weeks prior to start
                  of study treatment;

               2. Continuous or intermittent small-molecule therapeutics or investigational agents
                  within 5 half-lives of the agent (or within 4 weeks prior to start of study
                  treatment, when half-life is unknown).

          -  Patients treated in the adjuvant setting with BRAF or MEK inhibitor(s) < 6 months
             prior to enrollment. Patients who received BRAF or MEK inhibitors in the metastatic
             setting are excluded.

          -  Patient has not recovered to ≤ Grade 1 from toxic effects of prior therapy before
             starting study treatment.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Safety Lead-in: Incidence of dose-limiting toxicities (DLTs)
Time Frame:Up to 28 days
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Extracranial response rate per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1)
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Global response rate (brain metastasis response per mRECIST v1.1 and extracranial response per RECIST v1.1)
Time Frame:Up to 24 months
Safety Issue:
Description:Global response rate is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR) per Investigator assessment for brain metastasis and extracranial lesions according to mRECIST v1.1 and RECIST v1.1, respectively.
Measure:Disease control rate (DCR)
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Duration of Response (DOR)
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Progression-free survival (PFS)
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Brain metastasis response rate (BMRR) per mRECIST v1.1 for Safety Lead-in only
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Overall survival (OS)
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Incidence and severity of adverse events (AEs)
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Pharmacokinetics (PK) of binimetinib and its metabolite
Time Frame:Day 1 and Day 15 of Cycle 1 and Day 1 of Cycle 2 and Cycle 3; 28 day cycles
Safety Issue:
Description:Plasma concentrations of binimetinib
Measure:Pharmacokinetics (PK) of encorafenib and its metabolite
Time Frame:Day 1 and Day 15 of Cycle 1 and Day 1 of Cycle 2 and 3; 28 day cycles
Safety Issue:
Description:Plasma concentrations of encorafenib

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:Pfizer

Trial Keywords

  • BRAFV600-mutant
  • melanoma
  • brain metastasis

Last Updated

July 8, 2021