Description:
The purpose of this study is to assess rate of disease relapse and hazard rate of disease
relapse after neoadjuvant therapy based on the statuses of pathologic complete response or
non-pathologic complete response, and postoperative adjuvant therapy.
Title
- Brief Title: Adjuvant Therapy Based on Pathologic Response After Neoadjuvant Encorafenib Binimetinib in Melanoma
- Official Title: A Randomized Pilot Trial of Adjuvant Therapy Based on Pathologic Response After Neoadjuvant Encorafenib and Binimetinib in Advanced Melanoma
Clinical Trial IDs
- ORG STUDY ID:
MCC-20641
- NCT ID:
NCT04741997
Conditions
- Melanoma Stage III
- Melanoma Stage IV
- BRAF V600 Mutation
Interventions
Drug | Synonyms | Arms |
---|
Encorafenib Pill | | Encorafenib and Binimetinib after Non-Pathologic Complete Response |
Binimetinib Pill | | Encorafenib and Binimetinib after Non-Pathologic Complete Response |
Nivolumab | | Nivolumab after Non-Pathologic Complete Response |
Purpose
The purpose of this study is to assess rate of disease relapse and hazard rate of disease
relapse after neoadjuvant therapy based on the statuses of pathologic complete response or
non-pathologic complete response, and postoperative adjuvant therapy.
Trial Arms
Name | Type | Description | Interventions |
---|
Surveillance | Active Comparator | Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have pathologic complete response they will receive adjuvant treatment for 24 weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery. | - Encorafenib Pill
- Binimetinib Pill
|
Encorafenib and Binimetinib after Pathologic Complete Response | Experimental | Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have pathologic complete response they will continue to receive encorafenib and binimetinib for 24 more weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery. | - Encorafenib Pill
- Binimetinib Pill
|
Encorafenib and Binimetinib after Non-Pathologic Complete Response | Experimental | Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have non-pathologic complete response they will continue to receive encorafenib and binimetinib for 24 more weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery. | - Encorafenib Pill
- Binimetinib Pill
|
Nivolumab after Non-Pathologic Complete Response | Experimental | Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have non-pathologic complete response they will receive nivolumab for 24 weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery. | - Encorafenib Pill
- Binimetinib Pill
- Nivolumab
|
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years at the time of informed consent
- Histologically confirmed diagnosis of melanoma. Any primary or unknown origin is
permitted.
- Melanoma must have a BRAFV600 mutation (using a CLIA-validated assay), either stage
III (B/C/D) or Stage IV (AJCC 8th edition).
- ECOG performance status ≤ 2
- Adequate laboratory parameters as well:
- a. Hemoglobin ≥ 8 g/dL.
- b. Platelets ≥ 75 × 109/L;
- c. AST and ALT ≤ 2.5 × ULN; in participants with liver metastases ≤ 5 × ULN;
- d. Total bilirubin ≤ 1.5 × ULN and < 2 mg/dL; OR total bilirubin >1.5 × ULN with
indirect bilirubin < 1.5 × ULN;
- e. Serum creatinine ≤ 2.0 × ULN
- Female participants of childbearing potential as described in protocol, must have a
negative serum or urine β-HCG test result. Female participants of childbearing
potential must agree to use methods of contraception that are highly effective or
acceptable, as described in Section 4.3.1. Participants must agree to not use hormonal
contraceptives, as encorafenib can result in decreased concentration and loss of
efficacy. Male participants must agree to use methods of contraception that are highly
effective or acceptable per protocol.
Exclusion Criteria:
- Participants may have received prior therapy with BRAF and/or a MEK inhibitor if it
was completed at least 6 months prior to study enrollment. Patients who had prior
disease progression while on BRAF/MEK inhibitor therapy are not eligible. (Progression
after stopping treatment is permitted.) Participants may have received prior therapy
an anti-PD-1/PD-L1 or CTLA-4 inhibitor.
- Participants must not have had adverse events related to encorafenib and/or
binimetinib specifically, that required discontinuation of one or both drugs due to
toxicity.
- Participants who have had major surgery or radiotherapy ≤ 14 days prior to start of
study treatment or who have not recovered from side effects of such procedure.
- Participants must be willing to avoid consuming grapefruit, pomegranates, star fruits,
Seville oranges or products containing the juice during the study while they are
taking encorafenib/binimetinib.
- Uncontrolled or symptomatic brain metastases or leptomeningeal carcinomatosis that are
not stable, require steroids, are potentially life-threatening or have required
radiation within 28 days prior to starting study drug. Patients with previously
treated brain metastases may participate provided they are stable (e.g.,without
evidence of progression by radiographic imaging for at least 28 days before the first
dose of study treatment and neurologic symptoms have returned to baseline).
- Impaired cardiovascular function as below:
- a. Congestive heart failure requiring treatment (New York Heart Association Grade ≥
3);
- b. presence of uncontrolled atrial fibrillation or uncontrolled paroxysmal
supraventricular tachycardia
- c. Baseline QTcF interval ≥ 500 ms.
- Known history of retinal vein occlusion (RVO)
- Current use of a prohibited medication (including herbal medications, supplements, or
foods), as described in protocol, or use of a prohibited medication ≤ 1 week prior to
the start of study treatment.
- Participants with a prior or concurrent malignancy whose natural history or treatment
(in the opinion of the treating physician) does not have the potential to interfere
with the safety or efficacy assessment of the investigational regimen are eligible for
this trial.
- Participants with known human immunodeficiency virus (HIV)-infection are eligible
providing they are on effective anti-retroviral therapy and have undetectable viral
load at their most recent viral load test and within 90 days prior to randomization.
- Participants with a known history of hepatitis C virus (HCV) infection must have been
treated and cured. Participants with HCV infection who are currently on treatment must
have an undetectable HCV viral load prior to randomization.
- Pregnancy or breast feeding.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Rate of Disease Relapse |
Time Frame: | After surgery up to 24 weeks |
Safety Issue: | |
Description: | Investigators will estimate the rate of disease relapse after neoadjuvant therapy based on pathologic complete response status and postoperative adjuvant therapy within each arm. |
Secondary Outcome Measures
Measure: | Relapse Free Survival |
Time Frame: | After surgery up to 24 weeks |
Safety Issue: | |
Description: | Relapse free survival is defined as time from surgery until disease relapse |
Measure: | Rate of Pathologic Complete Response |
Time Frame: | At 26 weeks |
Safety Issue: | |
Description: | Investigators will measure the rate of pathologic complete response after surgery. |
Measure: | Rate of Non-Pathologic Complete Response |
Time Frame: | At 26 weeks |
Safety Issue: | |
Description: | Investigators will measure the rate of non-pathologic complete response after surgery. |
Measure: | Overall Response Rate |
Time Frame: | Up to 26 weeks |
Safety Issue: | |
Description: | Overall response rate will be measured after neoadjuvant therapy (for participants who have measurable disease per RECIST 1.1 at start of neoadjuvant therapy). |
Measure: | Overall Survival |
Time Frame: | After surgery, up to 5 years |
Safety Issue: | |
Description: | Overall survival will be measured from time of surgery to death from any cause. |
Details
Phase: | Early Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | H. Lee Moffitt Cancer Center and Research Institute |
Trial Keywords
Last Updated
July 13, 2021