A Study Comparing GSK2118436 to Dacarbazine (DTIC) in Previously Untreated Subjects With BRAF Mutation Positive Advanced (Stage III) or Metastatic (Stage IV) Melanoma
A Phase III Randomized, Open-label Study Comparing GSK2118436 to Dacarbazine (DTIC) in Previously Untreated Subjects With BRAF Mutation Positive Advanced (Stage III) or Metastatic (Stage IV) Melanoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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New South Wales
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Westmead, New South Wales, Australia, 2145
- GSK Investigational Site
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Queensland
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Southport, Queensland, Australia, 4215
- GSK Investigational Site
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South Australia
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Adelaide, South Australia, Australia, 5000
- GSK Investigational Site
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Western Australia
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Nedlands, Western Australia, Australia, 6009
- GSK Investigational Site
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Alberta
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Edmonton, Alberta, Canada, T6G 1Z2
- GSK Investigational Site
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British Columbia
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Kelowna, British Columbia, Canada, V1Y 5L3
- GSK Investigational Site
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Ontario
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Toronto, Ontario, Canada, M4N 3M5
- GSK Investigational Site
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Toronto, Ontario, Canada, M5G 2M9
- GSK Investigational Site
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Quebec
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Montreal, Quebec, Canada, H3T 1E2
- GSK Investigational Site
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Bordeaux, France, 33075
- GSK Investigational Site
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Lille, France, 59037
- GSK Investigational Site
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Marseille Cedex 5, France, 13385
- GSK Investigational Site
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Nice, France, 06202
- GSK Investigational Site
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Paris, France, 75006
- GSK Investigational Site
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Paris cedex 18, France, 75877
- GSK Investigational Site
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Reims, France, 51092
- GSK Investigational Site
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Villejuif, France, 94805
- GSK Investigational Site
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Baden-Wuerttemberg
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Heidelberg, Baden-Wuerttemberg, Germany, 69120
- GSK Investigational Site
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Ulm, Baden-Wuerttemberg, Germany, 89081
- GSK Investigational Site
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Bayern
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Erlangen, Bayern, Germany, 91054
- GSK Investigational Site
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Nuernberg, Bayern, Germany, 90419
- GSK Investigational Site
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Regensburg, Bayern, Germany, 93053
- GSK Investigational Site
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Hessen
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Kassel, Hessen, Germany, 34125
- GSK Investigational Site
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Wiesbaden, Hessen, Germany, 65191
- GSK Investigational Site
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Niedersachsen
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Hannover, Niedersachsen, Germany, 30449
- GSK Investigational Site
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Nordrhein-Westfalen
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Bonn, Nordrhein-Westfalen, Germany, 53127
- GSK Investigational Site
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Essen, Nordrhein-Westfalen, Germany, 45122
- GSK Investigational Site
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Koeln, Nordrhein-Westfalen, Germany, 50937
- GSK Investigational Site
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Muenster, Nordrhein-Westfalen, Germany, 48149
- GSK Investigational Site
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Rheinland-Pfalz
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Koblenz, Rheinland-Pfalz, Germany, 56068
- GSK Investigational Site
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Ludwigshafen, Rheinland-Pfalz, Germany, 67063
- GSK Investigational Site
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Mainz, Rheinland-Pfalz, Germany, 55131
- GSK Investigational Site
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Saarland
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Homburg, Saarland, Germany, 66421
- GSK Investigational Site
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Sachsen-Anhalt
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Magdeburg, Sachsen-Anhalt, Germany, 39120
- GSK Investigational Site
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Schleswig-Holstein
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Kiel, Schleswig-Holstein, Germany, 24105
- GSK Investigational Site
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Thueringen
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Erfurt, Thueringen, Germany, 99089
- GSK Investigational Site
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Gera, Thueringen, Germany, 07548
- GSK Investigational Site
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Jena, Thueringen, Germany, 07740
- GSK Investigational Site
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Budapest, Hungary, H-1122
- GSK Investigational Site
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Debrecen, Hungary, 4032
- GSK Investigational Site
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Gyor, Hungary, H-9024
- GSK Investigational Site
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Miskolc, Hungary, 3526
- GSK Investigational Site
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Pecs, Hungary, 7624
- GSK Investigational Site
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Cork, Ireland
- GSK Investigational Site
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Dublin, Ireland, 8
- GSK Investigational Site
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Dublin, Ireland, 9
- GSK Investigational Site
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Dublin, Ireland, 4
- GSK Investigational Site
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Dublin, Ireland, 7
- GSK Investigational Site
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Galway, Ireland, Co Galway
- GSK Investigational Site
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Emilia-Romagna
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Modena, Emilia-Romagna, Italy, 41100
- GSK Investigational Site
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Friuli-Venezia-Giulia
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Udine, Friuli-Venezia-Giulia, Italy, 33100
- GSK Investigational Site
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Lazio
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Roma, Lazio, Italy, 00144
- GSK Investigational Site
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Roma, Lazio, Italy, 00167
- GSK Investigational Site
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Liguria
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Genova, Liguria, Italy, 16132
- GSK Investigational Site
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Lombardia
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Rozzano (MI), Lombardia, Italy, 20089
- GSK Investigational Site
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Toscana
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Siena, Toscana, Italy, 53100
- GSK Investigational Site
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Umbria
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Terni, Umbria, Italy, 05100
- GSK Investigational Site
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Veneto
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Padova, Veneto, Italy, 35128
- GSK Investigational Site
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Amsterdam, Netherlands, 1066 CX
- GSK Investigational Site
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Brzozow, Poland, 36-200
- GSK Investigational Site
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Konin, Poland, 62-500
- GSK Investigational Site
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Krakow, Poland, 31-115
- GSK Investigational Site
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Slupsk, Poland, 76-200
- GSK Investigational Site
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Warszawa, Poland, 02-781
- GSK Investigational Site
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Kazan, Russian Federation, 420029
- GSK Investigational Site
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Moscow, Russian Federation, 115478
- GSK Investigational Site
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Ryazan, Russian Federation, 390011
- GSK Investigational Site
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St. Petersburg, Russian Federation, 198255
- GSK Investigational Site
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St. Petersburg, Russian Federation, 191104
- GSK Investigational Site
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St. Petersburg, Russian Federation, 197758
- GSK Investigational Site
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Stavropol, Russian Federation, 355047
- GSK Investigational Site
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Badalona, Spain, 08916
- GSK Investigational Site
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Barcelona, Spain, 08036
- GSK Investigational Site
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Barcelona, Spain, 08035
- GSK Investigational Site
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Hospitalet de Llobregat, Barcelona, Spain, 08907
- GSK Investigational Site
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Madrid, Spain, 28041
- GSK Investigational Site
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Madrid, Spain, 28007
- GSK Investigational Site
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Madrid, Spain, 28040
- GSK Investigational Site
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Madrid, Spain, 28034
- GSK Investigational Site
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Madrid, Spain, 28033
- GSK Investigational Site
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Madrid, Spain, 28050
- GSK Investigational Site
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Pamplona, Spain, 31008
- GSK Investigational Site
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Sevilla, Spain, 41013
- GSK Investigational Site
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Alabama
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Birmingham, Alabama, United States, 35243
- GSK Investigational Site
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Mobile, Alabama, United States, 36608
- GSK Investigational Site
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California
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La Jolla, California, United States, 92093
- GSK Investigational Site
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Los Angeles, California, United States, 90095
- GSK Investigational Site
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San Francisco, California, United States, 94115
- GSK Investigational Site
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Vallejo, California, United States, 94589
- GSK Investigational Site
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Florida
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Orlando, Florida, United States, 32806
- GSK Investigational Site
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Indiana
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Indianapolis, Indiana, United States, 46202
- GSK Investigational Site
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Michigan
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Ann Arbor, Michigan, United States, 48109
- GSK Investigational Site
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New Hampshire
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Lebanon, New Hampshire, United States, 03756
- GSK Investigational Site
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New York
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New York, New York, United States, 10065
- GSK Investigational Site
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adults at least 18 years of age
- Has advanced (unresectable Stage III) or metastatic (Stage IV) melanoma that is BRAF mutation positive (V600E)
- Is treatment naive for advanced (unresectable) or metastatic melanoma, with the exception of Interleukin 2 (IL-2) which is allowed.
- Has measurable disease according to RECIST 1.1 criteria.
- Women of child-bearing potential must have a negative pregnancy test within 14 days prior to the first dose of study treatment.
- Women with reproductive potential must be willing to practice acceptable methods of birth control during the study and for up to 4 weeks after the last dose of study medication.
- Men with reproductive potential must be willing to practice acceptable methods of birth control during the study and for up to 16 weeks after the last dose of study medication.
- Must have adequate organ function.
- Must have Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1.
Exclusion Criteria:
- Currently receiving cancer therapy (chemotherapy, radiation therapy, immunotherapy, biologic therapy or surgery).
- Evidence of active central nervous system (CNS) disease.
- Previous treatment for metastatic melanoma, including treatment with BRAF or MEK inhibitor.
- A history of other malignancy. Subjects who have been disease-free for 5 years or subjects with a history of complete resected non-melanoma skin cancer or successfully treated in situ carcinoma are eligible.
- History of Human Immunodeficiency Virus (HIV) infection.
- Certain cardiac abnormalities
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: GSK2118436
Subjects in this arm will receive GSK2118436 150 mg twice daily.
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150 mg twice daily
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Active Comparator: Dacarbazine (DTIC)
Subjects will receive intravenous dacarbazine (DTIC) 1000 mg/m2 every 3 weeks
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Intravenous (IV), 1000 mg/m2 every 3 weeks until initial progression
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Experimental: Crossover
Subjects who initially receive DTIC will be allowed to receive GSK2118436 after initial progression.
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150 mg twice daily
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Progression-free Survival (PFS) as Assessed by the Investigator
Time Frame: Time interval between the date of randomization and the earlier of the date of disease progression or the date of death due to any cause (up to 9.9 months)
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PFS is defined as the interval of time between the date of randomization and the earlier of the date of disease progression or the date of death due to any cause.
Disease progression was based on radiographic or photographic evidence, and assessments were made by the investigator according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start).
In addition, the sum must have an absolute increase from nadir of 5 millimeters (mm).
For participants who did not progress or die, PFS was censored at the date of last contact.
Data are presented as median and 96% confidence interval.
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Time interval between the date of randomization and the earlier of the date of disease progression or the date of death due to any cause (up to 9.9 months)
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Progression-free Survival (PFS) as Assessed by an Independent Radiologist: Randomized Phase
Time Frame: Time interval between the date of randomization and the earlier of the date of disease progression or the date of death due to any cause (up to 9.9 months)
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PFS is defined as the interval of time between the date of randomization and the earlier of the date of disease progression or the date of death due to any cause.
Disease progression was based on radiographic or photographic evidence, and assessments were made by an independent radiologist according to RECIST version 1.1.
PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start).
In addition, the sum must have an absolute increase from nadir of 5 mm.
For participants who did not progress or die, PFS was censored at the date of last contact.
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Time interval between the date of randomization and the earlier of the date of disease progression or the date of death due to any cause (up to 9.9 months)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Overall Survival
Time Frame: Time interval between the date of randomization and the date of death due to any cause (up to 22.1 months)
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Overall survival is defined as the interval of time between the date of randomization and the date of death due to any cause.
For participants who did not die, overall survival was censored at the date of last contact.
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Time interval between the date of randomization and the date of death due to any cause (up to 22.1 months)
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Number of Participants With a Best Overall Response of Confirmed Complete Response (CR) or Confirmed Partial Response (PR) as Assessed by the Investigator: Randomized Phase
Time Frame: From randomization until the first documented evidence of a confirmed complete response or partial response (median of 6.6 weeks)
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A participant was defined as a responder if he/she achieved either a CR (the disappearance of all target lesions.
Any pathological lymph nodes must be <10 mm in the short axis.) or PR (at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters [e.g., percent change from Baseline]).
Response was evaluated by an investigator per RECIST, version 1.1.
A participant without a post-Baseline assessment of response was considered a non-responder.
Confirmation, per RECIST version 1.1, requires a confimatory disease assessment of CR or PR at least 28 days after the initial disease assessment of CR or PR.
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From randomization until the first documented evidence of a confirmed complete response or partial response (median of 6.6 weeks)
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Number of Participants With a Best Overall Response of Confirmed CR or PR as Assessed by an Independent Radiologist: Randomized Phase
Time Frame: From randomization until the first documented evidence of a confirmed complete response or partial response (median of 12.0 weeks)
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A participant was defined as a responder if he/she achieved either a CR (the disappearance of all target lesions.
Any pathological lymph nodes must be <10 mm in the short axis.) or PR (at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters [e.g., percent change from Baseline]).
Response was evaluated by an independent radiologist per RECIST, version 1.1.
A participant without a post-Baseline assessment of response was considered a non-responder.
Confirmation, per RECIST version 1.1, requires a confimatory disease assessment of CR or PR at least 28 days after the initial disease assessment of CR or PR.
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From randomization until the first documented evidence of a confirmed complete response or partial response (median of 12.0 weeks)
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Duration of Response as Assessed by the Investigator: Randomized Phase
Time Frame: Time from the first documented evidence of PR or CR until the first documented sign of disease progression or death due to any cause (up to 65.6 weeks)
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Duration of response for participants with either a CR (the disappearance of all target lesions.
Any pathological lymph nodes must be <10 mm in the short axis.) or PR (at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters [e.g., percent change from Baseline]) was defined as the time from the first documented evidence of a PR or CR until the first documented sign of PD or death due to any cause.
PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start).
In addition, the sum must have an absolute increase from nadir of 5 mm.
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Time from the first documented evidence of PR or CR until the first documented sign of disease progression or death due to any cause (up to 65.6 weeks)
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Duration of Response as Assessed by an Independent Radiologist: Randomized Phase
Time Frame: Time from the first documented evidence of PR or CR until the first documented sign of disease progression or death due to any cause (up to 7.4 months)
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Duration of response for participants with either a CR (the disappearance of all target lesions.
Any pathological lymph nodes must be <10 mm in the short axis.) or PR (at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters [e.g., percent change from Baseline]) was defined as the time from the first documented evidence of a PR or CR until the first documented sign of PD or death due to any cause.
PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start).
In addition, the sum must have an absolute increase from nadir of 5 mm.
NA indicates that data is not available.
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Time from the first documented evidence of PR or CR until the first documented sign of disease progression or death due to any cause (up to 7.4 months)
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Progression-free Survival (PFS2) as Assessed by the Investigator: Crossover Phase
Time Frame: Time from first dose of GSK2118436 in participants who crossover after initial progression to the earliest date of radiographical or photographical PD or death due to any cause (up to 6.4 months)
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PFS2 is defined as the time from the first dose of GSK2118436, in participants randomized to DTIC who crossed over to GSK2118436 after initial progression, to the earliest date of radiographic or photographic disease progression or death due to any cause.
Disease progression was based on radiographic or photographic evidence, and assessments were made by the investigator according to RECIST version 1.1.
PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start).
In addition, the sum must have an absolute increase from nadir of 5 mm.
For participants who did not progress or die, PFS was censored at the date of last contact.
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Time from first dose of GSK2118436 in participants who crossover after initial progression to the earliest date of radiographical or photographical PD or death due to any cause (up to 6.4 months)
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Number of Participants With a Best Overall Response of Confirmed Complete Response (CR) or Confirmed Partial Response (PR) as Assessed by the Investigator: Crossover Phase
Time Frame: From randomization until the first documented evidence of a confirmed complete response or partial response (up to 6.4 months)
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A participant was defined as a responder if he/she achieved either a CR (the disappearance of all target lesions.
Any pathological lymph nodes must be <10 mm in the short axis.) or PR (at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters [e.g., percent change from Baseline]).
Response was evaluated by an investigator per RECIST, version 1.1.
A participant without a post-Baseline assessment of response was considered a non-responder.
Confirmation, per RECIST version 1.1, requires a confimatory disease assessment of CR or PR at least 28 days after the initial disease assessment of CR or PR.
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From randomization until the first documented evidence of a confirmed complete response or partial response (up to 6.4 months)
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Duration of Response as Assessed by the Investigator: Crossover Phase
Time Frame: Time from the first documented evidence of PR or CR until the first documented sign of disease progression or death due to any cause (up to 6.4 months)
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Duration of response for participants with either a CR (the disappearance of all target lesions.
Any pathological lymph nodes must be <10 mm in the short axis.) or PR (at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters [e.g., percent change from Baseline]) was defined as the time from the first documented evidence of a PR or CR until the first documented sign of PD or death due to any cause.
PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start).
In addition, the sum must have an absolute increase from nadir of 5 mm.
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Time from the first documented evidence of PR or CR until the first documented sign of disease progression or death due to any cause (up to 6.4 months)
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Number of Participants With Non-melanoma Skin Lesions: Randomized Phase
Time Frame: From Screening until study completion or discontinuation from the study (up to 9.9 months)
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Dermatological examinations were performed by the investigator, or at the discretion of the investigator, referred to a dermatologist.
The number of participants with non-melanoma skin lessions was assessed from the time of Screening until study completion or discontinuation from the study for any reason.
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From Screening until study completion or discontinuation from the study (up to 9.9 months)
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Agreement Rate for V600E Mutation Validation of the BRAF Mutation Assay
Time Frame: Screening
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Analytical and clinical validation of the companion diagnostic (cDx) assay was performed to determine the extent of agreement between the bioMerieux cDx assay (THxID BRAF Assay) and the Clinical Trial Assay (CTA) to detect BRAF mutations to determine participant eligibility into the study.
Skin tissue samples collected at the Screening visit were used for this analysis.
Multiple specimen per participant were analyzed.
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Screening
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Hauschild A, Ascierto PA, Schadendorf D, Grob JJ, Ribas A, Kiecker F, Dutriaux C, Demidov LV, Lebbe C, Rutkowski P, Blank CU, Gutzmer R, Millward M, Kefford R, Haas T, D'Amelio A Jr, Gasal E, Mookerjee B, Chapman PB. Long-term outcomes in patients with BRAF V600-mutant metastatic melanoma receiving dabrafenib monotherapy: Analysis from phase 2 and 3 clinical trials. Eur J Cancer. 2020 Jan;125:114-120. doi: 10.1016/j.ejca.2019.10.033.
- Santiago-Walker A, Gagnon R, Mazumdar J, Casey M, Long GV, Schadendorf D, Flaherty K, Kefford R, Hauschild A, Hwu P, Haney P, O'Hagan A, Carver J, Goodman V, Legos J, Martin AM. Correlation of BRAF Mutation Status in Circulating-Free DNA and Tumor and Association with Clinical Outcome across Four BRAFi and MEKi Clinical Trials. Clin Cancer Res. 2016 Feb 1;22(3):567-74. doi: 10.1158/1078-0432.CCR-15-0321. Epub 2015 Oct 7.
- Ouellet D, Gibiansky E, Leonowens C, O'Hagan A, Haney P, Switzky J, Goodman VL. Population pharmacokinetics of dabrafenib, a BRAF inhibitor: effect of dose, time, covariates, and relationship with its metabolites. J Clin Pharmacol. 2014 Jun;54(6):696-706. doi: 10.1002/jcph.263. Epub 2014 Jan 17.
- Hauschild A, Grob JJ, Demidov LV, Jouary T, Gutzmer R, Millward M, Rutkowski P, Blank CU, Miller WH Jr, Kaempgen E, Martin-Algarra S, Karaszewska B, Mauch C, Chiarion-Sileni V, Martin AM, Swann S, Haney P, Mirakhur B, Guckert ME, Goodman V, Chapman PB. Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, phase 3 randomised controlled trial. Lancet. 2012 Jul 28;380(9839):358-65. doi: 10.1016/S0140-6736(12)60868-X. Epub 2012 Jun 25.
- Latimer NR, Abrams KR, Amonkar MM, Stapelkamp C, Swann RS. Adjusting for the Confounding Effects of Treatment Switching-The BREAK-3 Trial: Dabrafenib Versus Dacarbazine. Oncologist. 2015 Jul;20(7):798-805. doi: 10.1634/theoncologist.2014-0429. Epub 2015 Jun 3.
- Grob JJ, Amonkar MM, Martin-Algarra S, Demidov LV, Goodman V, Grotzinger K, Haney P, Kampgen E, Karaszewska B, Mauch C, Miller WH Jr, Millward M, Mirakhur B, Rutkowski P, Chiarion-Sileni V, Swann S, Hauschild A. Patient perception of the benefit of a BRAF inhibitor in metastatic melanoma: quality-of-life analyses of the BREAK-3 study comparing dabrafenib with dacarbazine. Ann Oncol. 2014 Jul;25(7):1428-1436. doi: 10.1093/annonc/mdu154. Epub 2014 Apr 25.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroendocrine Tumors
- Nevi and Melanomas
- Melanoma
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Protein Kinase Inhibitors
- Dabrafenib
- Dacarbazine
Other Study ID Numbers
Other Study ID Numbers
- 113683
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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