Vemurafenib and Cobimetinib in Treating Patients with BRAF V600E Mutation Positive Craniopharyngioma
Phase II Trial of BRAF/MEK Inhibitors in Papillary Craniopharyngiomas
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the activity of BRAF and MEK inhibitor combination in untreated papillary craniopharyngiomas as measured by best response at any time during the first four cycles of BRAF and MEK inhibitor treatment.
II. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas that have progressed after prior radiation treatment with or without surgical resection as measured by best response at any time during the first four cycles of BRAF and MEK inhibitor treatment.
SECONDARY OBJECTIVES:
I. To determine the progression-free survival of patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.
II. To determine the toxicity of BRAF/MEK inhibitors in patients with papillary craniopharyngiomas.
III. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas as measured by response of enhancing volume of craniopharyngioma.
IV. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas as measured by response of nonenhancing volume of craniopharyngioma.
V. To determine the overall survival of patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.
VI. To determine the duration of response in patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.
TERTIARY OBJECTIVES:
I. To evaluate visual fields in patients with papillary craniopharyngiomas who have received BRAF/MEK inhibitors.
II. To evaluate pituitary hormone replacement over time in patients with papillary craniopharyngiomas who have received BRAF/MEK inhibitors.
III. To evaluate the time to response in patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.
IV. To assess toxicity that may be associated with radiotherapy in patients with papillary craniopharyngiomas who have received BRAF/MEK inhibitors.
V. To evaluate molecular biomarkers of response in papillary craniopharyngiomas.
VI. To evaluate circulating tumor cells and cell-free circulating deoxyribonucleic acid (DNA) in patients with papillary craniopharyngiomas.
OUTLINE:
Patients receive vemurafenib orally (PO) twice daily (BID) on day 1-28 and cobimetinib PO once daily (QD) on days 1-21. Treatment repeats every 28 days for up to 5 courses in the absence of disease progression or unacceptable toxicity. Patients may then receive radiation therapy, surgery, or continued treatment with vemurafenib and cobimetinib at the discretion of the treating physician.
After completion of study treatment, patients with disease progression are followed up every 16 weeks for 2 years and all other patients are followed up every 6 months for 5 years.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Priscilla K. Brastianos, MD
- Phone Number: 617-643-1938
- Email: pbrastianos@partners.org
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35233
- University of Alabama at Birmingham Cancer Center
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California
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Auburn, California, United States, 95603
- Sutter Cancer Centers Radiation Oncology Services-Auburn
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Berkeley, California, United States, 94704
- Alta Bates Summit Medical Center-Herrick Campus
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Burlingame, California, United States, 94010
- Mills-Peninsula Medical Center
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Cameron Park, California, United States, 95682
- Sutter Cancer Centers Radiation Oncology Services-Cameron Park
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Castro Valley, California, United States, 94546
- Eden Hospital Medical Center
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Los Angeles, California, United States, 90027
- Kaiser Permanente Los Angeles Medical Center
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Modesto, California, United States, 95355
- Memorial Medical Center
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Mountain View, California, United States, 94040
- Palo Alto Medical Foundation-Camino Division
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Orange, California, United States, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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Palo Alto, California, United States, 94301
- Palo Alto Medical Foundation Health Care
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Roseville, California, United States, 95661
- Sutter Cancer Centers Radiation Oncology Services-Roseville
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Roseville, California, United States, 95661
- Sutter Roseville Medical Center
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Sacramento, California, United States, 95816
- Sutter Medical Center Sacramento
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San Francisco, California, United States, 94115
- California Pacific Medical Center-Pacific Campus
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Sunnyvale, California, United States, 94086
- Palo Alto Medical Foundation-Sunnyvale
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Vacaville, California, United States, 95687
- Sutter Cancer Centers Radiation Oncology Services-Vacaville
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Vallejo, California, United States, 94589
- Sutter Solano Medical Center/Cancer Center
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Connecticut
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New Haven, Connecticut, United States, 06520
- Yale University
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New Haven, Connecticut, United States, 06510
- Smilow Cancer Center/Yale-New Haven Hospital
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Trumbull, Connecticut, United States, 06611
- Smilow Cancer Hospital Care Center-Trumbull
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Florida
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Jacksonville, Florida, United States, 32224-9980
- Mayo Clinic in Florida
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Miami, Florida, United States, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Tampa, Florida, United States, 33606
- Tampa General Hospital
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Idaho
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Boise, Idaho, United States, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Caldwell, Idaho, United States, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
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Coeur D'Alene, Idaho, United States, 83814
- Kootenai Health - Coeur d'Alene
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Meridian, Idaho, United States, 83642
- Idaho Urologic Institute-Meridian
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Nampa, Idaho, United States, 83687
- Saint Alphonsus Cancer Care Center-Nampa
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Post Falls, Idaho, United States, 83854
- Kootenai Clinic Cancer Services - Post Falls
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Illinois
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Chicago, Illinois, United States, 60612
- Rush University Medical Center
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Kansas
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Garden City, Kansas, United States, 67846
- Central Care Cancer Center - Garden City
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Great Bend, Kansas, United States, 67530
- Central Care Cancer Center - Great Bend
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Maryland
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Baltimore, Maryland, United States, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Dana-Farber Cancer Institute
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital Cancer Center
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Michigan
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Ann Arbor, Michigan, United States, 48109
- University of Michigan Comprehensive Cancer Center
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Battle Creek, Michigan, United States, 49017
- Bronson Battle Creek
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Grand Rapids, Michigan, United States, 49503
- Trinity Health Grand Rapids Hospital
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Grand Rapids, Michigan, United States, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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Grand Rapids, Michigan, United States, 49503
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
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Kalamazoo, Michigan, United States, 49007
- West Michigan Cancer Center
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Kalamazoo, Michigan, United States, 49007
- Bronson Methodist Hospital
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Kalamazoo, Michigan, United States, 49048
- Borgess Medical Center
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Muskegon, Michigan, United States, 49444
- Trinity Health Muskegon Hospital
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Niles, Michigan, United States, 49120
- Corewell Health Lakeland Hospitals - Niles Hospital
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Norton Shores, Michigan, United States, 49444
- Cancer and Hematology Centers of Western Michigan - Norton Shores
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Reed City, Michigan, United States, 49677
- Corewell Health Reed City Hospital
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Saint Joseph, Michigan, United States, 49085
- Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
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Saint Joseph, Michigan, United States, 49085
- Corewell Health Lakeland Hospitals - Saint Joseph Hospital
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Traverse City, Michigan, United States, 49684
- Munson Medical Center
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Wyoming, Michigan, United States, 49519
- University of Michigan Health - West
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Minnesota
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Burnsville, Minnesota, United States, 55337
- Fairview Ridges Hospital
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Burnsville, Minnesota, United States, 55337
- Minnesota Oncology - Burnsville
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Coon Rapids, Minnesota, United States, 55433
- Mercy Hospital
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Edina, Minnesota, United States, 55435
- Fairview Southdale Hospital
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Fridley, Minnesota, United States, 55432
- Unity Hospital
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Maple Grove, Minnesota, United States, 55369
- Fairview Clinics and Surgery Center Maple Grove
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Maplewood, Minnesota, United States, 55109
- Saint John's Hospital - Healtheast
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Maplewood, Minnesota, United States, 55109
- Minnesota Oncology Hematology PA-Maplewood
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Minneapolis, Minnesota, United States, 55415
- Hennepin County Medical Center
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Minneapolis, Minnesota, United States, 55407
- Abbott-Northwestern Hospital
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Minneapolis, Minnesota, United States, 55454
- Health Partners Inc
-
Monticello, Minnesota, United States, 55362
- Monticello Cancer Center
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Robbinsdale, Minnesota, United States, 55422
- North Memorial Medical Health Center
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Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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Saint Louis Park, Minnesota, United States, 55416
- Park Nicollet Clinic - Saint Louis Park
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Saint Paul, Minnesota, United States, 55101
- Regions Hospital
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Saint Paul, Minnesota, United States, 55102
- United Hospital
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Shakopee, Minnesota, United States, 55379
- Saint Francis Regional Medical Center
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Stillwater, Minnesota, United States, 55082
- Lakeview Hospital
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Waconia, Minnesota, United States, 55387
- Ridgeview Medical Center
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Willmar, Minnesota, United States, 56201
- Rice Memorial Hospital
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Woodbury, Minnesota, United States, 55125
- Minnesota Oncology Hematology PA-Woodbury
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Missouri
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Bolivar, Missouri, United States, 65613
- Central Care Cancer Center - Bolivar
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Kansas City, Missouri, United States, 64132
- Research Medical Center
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Saint Louis, Missouri, United States, 63110
- Washington University School of Medicine
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Montana
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Billings, Montana, United States, 59101
- Billings Clinic Cancer Center
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Bozeman, Montana, United States, 59715
- Bozeman Health Deaconess Hospital
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Great Falls, Montana, United States, 59405
- Great Falls Clinic
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Great Falls, Montana, United States, 59405
- Benefis Sletten Cancer Institute
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Kalispell, Montana, United States, 59901
- Kalispell Regional Medical Center
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Missoula, Montana, United States, 59804
- Community Medical Center
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New Hampshire
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Lebanon, New Hampshire, United States, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
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New Jersey
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Newark, New Jersey, United States, 07101
- Rutgers New Jersey Medical School
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New York
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New York, New York, United States, 10065
- NYP/Weill Cornell Medical Center
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New York, New York, United States, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
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North Carolina
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Chapel Hill, North Carolina, United States, 27599
- UNC Lineberger Comprehensive Cancer Center
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Winston-Salem, North Carolina, United States, 27157
- Wake Forest University Health Sciences
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Oklahoma
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Lawton, Oklahoma, United States, 73505
- Cancer Centers of Southwest Oklahoma Research
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Oklahoma City, Oklahoma, United States, 73104
- University of Oklahoma Health Sciences Center
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Texas
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Houston, Texas, United States, 77030
- M D Anderson Cancer Center
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Utah
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Farmington, Utah, United States, 84025
- Farmington Health Center
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Salt Lake City, Utah, United States, 84112
- Huntsman Cancer Institute/University of Utah
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South Jordan, Utah, United States, 84009
- South Jordan Health Center
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Virginia
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Fairfax, Virginia, United States, 22031
- Inova Schar Cancer Institute
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Washington
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Seattle, Washington, United States, 98195
- University of Washington Medical Center - Montlake
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Seattle, Washington, United States, 98109
- FHCC South Lake Union
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Seattle, Washington, United States, 98109
- Fred Hutchinson Cancer Center
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West Virginia
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Bridgeport, West Virginia, United States, 26330
- United Hospital Center
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Morgantown, West Virginia, United States, 26506
- West Virginia University Healthcare
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Parkersburg, West Virginia, United States, 26101
- Camden Clark Medical Center
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Wisconsin
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Milwaukee, Wisconsin, United States, 53215
- Aurora Saint Luke's Medical Center
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New Richmond, Wisconsin, United States, 54017
- Cancer Center of Western Wisconsin
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Wyoming
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Sheridan, Wyoming, United States, 82801
- Welch Cancer Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
- Pre-registration: Patients must have local diagnosis of papillary craniopharyngioma and have tissue slides available for submission to central pathology review; central pathology review will include immunohistochemistry (IHC) testing for BRAF V600E mutation (VE1 clone) and beta-catenin IHC (membranous, non-nuclear pattern) if needed to confirm diagnosis of papillary craniopharyngioma
- Histologically proven papillary craniopharyngioma as documented by central pathology review with positive BRAF V600E mutation by IHC
Measurable disease and/or non-measurable disease
- Measurable disease, defined as bidimensionally measurable lesions with clearly defined margins by magnetic resonance imaging (MRI) scans, with a minimum diameter of 10 mm in both dimensions
- Progressive disease required in cohort B, defined as an increase in the bidirectional area by 25% within the past 13 months after surgery or radiation; progressive or recurrent disease is not required in cohort A, but is allowed provided it is a new diagnosis and patient has not received prior treatment.
Prior treatment
- Cohort A: No prior therapy received other than surgery
Cohort B: Prior radiation therapy required (any type of prior radiation is allowed)
- For patients treated with external beam radiation therapy, interstitial brachytherapy or radiosurgery, an interval of >= 3 months must have elapsed from completion of radiation therapy to registration
- Recovered to Common Terminology Criteria for Adverse Events (CTCAE) grade 1 or less toxicity attributed to radiation with exception of alopecia, fatigue
For patients enrolling on Cohort A or Cohort B:
- For patients treated with surgery, an interval of >= 21 days must have elapsed prior to registration
- No prior treatment with BRAF or MEK inhibitors
- Steroid dosing stable for at least 4 days prior to registration
- Not pregnant and not nursing; for women of childbearing potential only, a negative pregnancy test done =< 7 days prior to registration is required
- ECOG performance status =< 2
Comorbid conditions
- No evidence of active bleeding, bleeding diathesis, or hemoptysis (>= 1/2 teaspoon of red blood) =< 8 weeks prior to registration
- No evidence of intracranial hemorrhage =< 4 weeks prior to registration
- Patients who have experienced thromboembolic event within 6 months prior to registration must be on stable therapeutic anticoagulation for at least 4 weeks prior to registration
- No symptomatic congestive heart failure (New York Heart Association class II, III, or IV) within 6 months prior to registration
- No current unstable angina or uncontrolled arrhythmia
- No uncontrolled hypertension at time of registration (blood pressure [BP] > 150/95 despite antihypertensive therapy)
- No known history of prolonged QT syndrome
- No known history of ventricular arrhythmia within 6 months of registration
- No known history of uveitis or iritis =< 4 weeks prior to registration
- No known history of or evidence of retinal pathology that is considered a risk factor for neurosensory retinal detachment, retinal vein occlusion (RVO), or neovascular macular degeneration within 12 months of registration
- No known history of chronic lung disease
Concomitant medications
- Chronic concomitant treatment with strong CYP3A4 inducers or CYP3A4 inhibitors is not allowed; patients must discontinue the drug at least 14 days prior to study registration
- Chronic concomitant treatment with CYP1A2 substrate is not allowed; patients must discontinue the drug at least 14 days prior to study registration
- Absolute neutrophil count >= 1500/mm^3
- Platelets >= 100,000/mm^3
- Creatinine =< 1.5 mg/dL OR creatinine clearance >= 45mL/min
- Bilirubin =< 1.5 upper limit of normal (ULN)
- Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 ULN
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Treatment (vemurafenib, cobimetinib)
Patients receive vemurafenib PO BID on day 1-28 and cobimetinib PO QD on days 1-21.
Treatment repeats every 28 days for up to 5 courses in the absence of disease progression or unacceptable toxicity.
Patients may then receive radiation therapy, surgery, or continued treatment with vemurafenib and cobimetinib at the discretion of the treating physician.
|
Correlative studies
Ancillary studies
Given PO
Given PO
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Response rate
Time Frame: Up to 5 years
|
Defined as the number of responses achieved during treatment with BRAF and MEK inhibitors divided by the total number of evaluable patients and assessed by contrast-enhanced magnetic resonance imaging or computed tomography.
Point estimates will be generated for response rates within each cohort with corresponding 95% binomial confidence intervals.
Simon's two-stage design with one interim analysis for futility will be applied to evaluate response rate within each cohort.
|
Up to 5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-free survival
Time Frame: Up to 5 years
|
Will be summarized for each cohort within each cohort with Kaplan-Meier curves and estimates.
|
Up to 5 years
|
|
Overall survival
Time Frame: Up to 5 years
|
Will be summarized for each cohort within each cohort with Kaplan-Meier curves and estimates.
|
Up to 5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Priscilla K. Brastianos, MD, Massachusetts General Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Bone Diseases
- Musculoskeletal Diseases
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Bone Neoplasms
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Adamantinoma
- Craniopharyngioma
- Antineoplastic Agents
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Protein Kinase Inhibitors
- Vemurafenib
Other Study ID Numbers
Other Study ID Numbers
- A071601
- U10CA180821 (U.S. NIH Grant/Contract)
- NCI-2017-00740 (Registry Identifier: NCI Clinical Trial Reporting Program)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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