A Study Comparing Trametinib and Dabrafenib Combination Therapy to Dabrafenib Monotherapy in Subjects With BRAF-mutant Melanoma

February 8, 2021 updated by: Novartis Pharmaceuticals

A Phase III, Randomized, Double-blinded Study Comparing the Combination of the BRAF Inhibitor, Dabrafenib and the MEK Inhibitor, Trametinib to Dabrafenib and Placebo as First-line Therapy in Subjects With Unresectable (Stage IIIC) or Metastatic (Stage IV) BRAF V600E/K Mutation-positive Cutaneous Melanoma

This was a two-arm, double-blinded, randomized, Phase III study comparing dabrafenib and trametinib combination therapy to dabrafenib administered with a placebo (dabrafenib monotherapy). Subjects with histologically confirmed cutaneous melanoma that is either Stage IIIC (unresectable) or Stage IV, and BRAF V600E/K mutation positive were screened for eligibility. Subjects who had prior systemic anti-cancer treatment in the advanced or metastatic setting were not eligible although prior systemic treatment in the adjuvant setting was allowed. Subjects were stratified according to the baseline lactate dehydrogenase level and BRAF genotype.

Study Overview

Status

Completed

Conditions

Detailed Description

Dabrafenib and trametinib was administered orally at their recommended monotherapy doses of 150 mg b.i.d and 2 mg q.d., respectively. Subjects in the combination therapy arm received both agents; subjects in the dabrafenib monotherapy arm received dabrafenib and placebo. Treatment was continued in both arms until disease progression, death, unacceptable toxicity, or withdrawal of consent.

After treatment discontinuation, subjects were followed for survival and disease progression as applicable to collect data for the secondary objective of overall survival (OS).

Crossover to the combination therapy arm was allowed for subjects still receiving study treatment on the dabrafenib monotherapy arm after the positive result for the final OS analysis.

Study Type

Interventional

Enrollment (Actual)

423

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Buenos Aires
      • Caba, Buenos Aires, Argentina, C1425DTG
        • Novartis Investigative Site
      • Capital Federal, Buenos Aires, Argentina, C1426ANZ
        • Novartis Investigative Site
      • Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina, C1050AAK
        • Novartis Investigative Site
    • New South Wales
      • North Sydney, New South Wales, Australia, 2060
        • Novartis Investigative Site
      • Westmead, New South Wales, Australia, 2145
        • Novartis Investigative Site
    • Queensland
      • Woolloongabba, Queensland, Australia, 4102
        • Novartis Investigative Site
    • South Australia
      • Adelaide, South Australia, Australia, 5000
        • Novartis Investigative Site
    • Victoria
      • Heidelberg, Victoria, Australia, 3084
        • Novartis Investigative Site
    • Western Australia
      • Nedlands, Western Australia, Australia, 6009
        • Novartis Investigative Site
    • Alberta
      • Edmonton, Alberta, Canada, T6G 1Z2
        • Novartis Investigative Site
    • Ontario
      • Hamilton, Ontario, Canada, L8V 5C2
        • Novartis Investigative Site
      • London, Ontario, Canada, N6A 4L6
        • Novartis Investigative Site
      • Toronto, Ontario, Canada, M5G 2M9
        • Novartis Investigative Site
    • Quebec
      • Montreal, Quebec, Canada, H2W 1S6
        • Novartis Investigative Site
      • Montreal, Quebec, Canada, H3A 1A1
        • Novartis Investigative Site
      • Bordeaux, France, 33075
        • Novartis Investigative Site
      • Boulogne-Billancourt, France, 92100
        • Novartis Investigative Site
      • Lyon Cedex 08, France, 69373
        • Novartis Investigative Site
      • Marseille cedex 5, France, 13385
        • Novartis Investigative Site
      • Paris, France, 75006
        • Novartis Investigative Site
      • Paris, France, 75018
        • Novartis Investigative Site
      • Paris Cedex 10, France, 75475
        • Novartis Investigative Site
      • Toulouse Cedex, France, 31052
        • Novartis Investigative Site
      • Vandoeuvre les Nancy, France, 54511
        • Novartis Investigative Site
      • Berlin, Germany, 10117
        • Novartis Investigative Site
    • Baden-Wuerttemberg
      • Heidelberg, Baden-Wuerttemberg, Germany, 69120
        • Novartis Investigative Site
      • Heilbronn, Baden-Wuerttemberg, Germany, 74078
        • Novartis Investigative Site
      • Mannheim, Baden-Wuerttemberg, Germany, 68167
        • Novartis Investigative Site
      • Tuebingen, Baden-Wuerttemberg, Germany, 72076
        • Novartis Investigative Site
      • Ulm, Baden-Wuerttemberg, Germany, 89081
        • Novartis Investigative Site
    • Bayern
      • Augsburg, Bayern, Germany, 86179
        • Novartis Investigative Site
      • Erlangen, Bayern, Germany, 91054
        • Novartis Investigative Site
      • Muenchen, Bayern, Germany, 80337
        • Novartis Investigative Site
      • Muenchen, Bayern, Germany, 80804
        • Novartis Investigative Site
      • Muenchen, Bayern, Germany, 81675
        • Novartis Investigative Site
      • Nuernberg, Bayern, Germany, 90419
        • Novartis Investigative Site
      • Regensburg, Bayern, Germany, 93053
        • Novartis Investigative Site
      • Wuerzburg, Bayern, Germany, 97080
        • Novartis Investigative Site
    • Hessen
      • Darmstadt, Hessen, Germany, 64283
        • Novartis Investigative Site
      • Marburg, Hessen, Germany, 35033
        • Novartis Investigative Site
    • Niedersachsen
      • Buxtehude, Niedersachsen, Germany, 21614
        • Novartis Investigative Site
      • Hannover, Niedersachsen, Germany, 30625
        • Novartis Investigative Site
    • Nordrhein-Westfalen
      • Bonn, Nordrhein-Westfalen, Germany, 53127
        • Novartis Investigative Site
      • Essen, Nordrhein-Westfalen, Germany, 45122
        • Novartis Investigative Site
      • Koeln, Nordrhein-Westfalen, Germany, 50937
        • Novartis Investigative Site
    • Rheinland-Pfalz
      • Mainz, Rheinland-Pfalz, Germany, 55131
        • Novartis Investigative Site
    • Saarland
      • Homburg, Saarland, Germany, 66421
        • Novartis Investigative Site
    • Sachsen
      • Dresden, Sachsen, Germany, 01307
        • Novartis Investigative Site
      • Leipzig, Sachsen, Germany, 04103
        • Novartis Investigative Site
    • Sachsen-Anhalt
      • Magdeburg, Sachsen-Anhalt, Germany, 39120
        • Novartis Investigative Site
    • Schleswig-Holstein
      • Kiel, Schleswig-Holstein, Germany, 24105
        • Novartis Investigative Site
      • Luebeck, Schleswig-Holstein, Germany, 23538
        • Novartis Investigative Site
    • Thueringen
      • Erfurt, Thueringen, Germany, 99089
        • Novartis Investigative Site
      • Gera, Thueringen, Germany, 07548
        • Novartis Investigative Site
      • Jena, Thueringen, Germany, 07740
        • Novartis Investigative Site
      • Athens, Greece, 11527
        • Novartis Investigative Site
      • N. Faliro, Greece, 185 47
        • Novartis Investigative Site
      • Thessaloniki, Greece, 564 29
        • Novartis Investigative Site
    • Lazio
      • Roma, Lazio, Italy, 00167
        • Novartis Investigative Site
      • Roma, Lazio, Italy, 00144
        • Novartis Investigative Site
    • Liguria
      • Genova, Liguria, Italy, 16132
        • Novartis Investigative Site
    • Lombardia
      • Bergamo, Lombardia, Italy, 24127
        • Novartis Investigative Site
      • Milano, Lombardia, Italy, 20133
        • Novartis Investigative Site
      • Milano, Lombardia, Italy, 20141
        • Novartis Investigative Site
    • Piemonte
      • Candiolo (TO), Piemonte, Italy, 10060
        • Novartis Investigative Site
    • Veneto
      • Padova, Veneto, Italy, 35128
        • Novartis Investigative Site
      • Amsterdam, Netherlands, 1066 CX
        • Novartis Investigative Site
      • Amsterdam, Netherlands, 1081 HV
        • Novartis Investigative Site
      • Zwolle, Netherlands, 8025 AB
        • Novartis Investigative Site
      • Kazan, Russian Federation, 420029
        • Novartis Investigative Site
      • Moscow, Russian Federation, 143423
        • Novartis Investigative Site
      • St. Petersburg, Russian Federation, 197758
        • Novartis Investigative Site
      • Stavropol, Russian Federation, 355047
        • Novartis Investigative Site
      • Barcelona, Spain, 08035
        • Novartis Investigative Site
      • Barcelona, Spain, 08036
        • Novartis Investigative Site
      • Madrid, Spain, 28041
        • Novartis Investigative Site
      • Madrid, Spain, 28034
        • Novartis Investigative Site
      • Madrid, Spain, 28046
        • Novartis Investigative Site
      • Pamplona, Spain, 31008
        • Novartis Investigative Site
      • Valencia, Spain, 46010
        • Novartis Investigative Site
      • Goteborg, Sweden, SE-413 45
        • Novartis Investigative Site
      • Lund, Sweden, SE-221 85
        • Novartis Investigative Site
      • Stockholm, Sweden, SE-171 76
        • Novartis Investigative Site
      • Uppsala, Sweden, SE-751 85
        • Novartis Investigative Site
      • Dnipropetrovsk, Ukraine, 49102
        • Novartis Investigative Site
      • Dnipropetrovsk, Ukraine, 49100
        • Novartis Investigative Site
      • Donetsk, Ukraine, 83092
        • Novartis Investigative Site
      • Khmelnytskyi, Ukraine, 29009
        • Novartis Investigative Site
      • Kyiv, Ukraine, 03022
        • Novartis Investigative Site
      • Lviv, Ukraine, 79031
        • Novartis Investigative Site
      • Sumy, Ukraine, 40005
        • Novartis Investigative Site
      • Aberdeen, United Kingdom, AB25 2ZN
        • Novartis Investigative Site
      • Bebington, United Kingdom, CH63 4JY
        • Novartis Investigative Site
      • Edgbaston, Birmingham, United Kingdom, B15 2TH
        • Novartis Investigative Site
      • Leeds, United Kingdom, LS9 7TF
        • Novartis Investigative Site
      • London, United Kingdom, SW3 6JJ
        • Novartis Investigative Site
      • Newcastle upon Tyne, United Kingdom, NE7 7DN
        • Novartis Investigative Site
      • Nottingham, United Kingdom, NG5 1PB
        • Novartis Investigative Site
      • Oxford, United Kingdom, OX3 7LJ
        • Novartis Investigative Site
      • Preston, United Kingdom, PR2 9HT
        • Novartis Investigative Site
    • Middlesex
      • Northwood, Middlesex, United Kingdom, HA6 2RN
        • Novartis Investigative Site
    • Surrey
      • Sutton, Surrey, United Kingdom, SM2 5PT
        • Novartis Investigative Site
    • Arizona
      • Scottsdale, Arizona, United States, 85258
        • Novartis Investigative Site
      • Tucson, Arizona, United States, 85719
        • Novartis Investigative Site
    • California
      • Los Angeles, California, United States, 90024
        • Novartis Investigative Site
    • Florida
      • Fort Myers, Florida, United States, 33916
        • Novartis Investigative Site
      • Saint Petersburg, Florida, United States, 33705
        • Novartis Investigative Site
      • Tampa, Florida, United States, 33612
        • Novartis Investigative Site
      • West Palm Beach, Florida, United States, 33401
        • Novartis Investigative Site
    • Illinois
      • Peoria, Illinois, United States, 61615-7822
        • Novartis Investigative Site
    • Indiana
      • Indianapolis, Indiana, United States, 46202
        • Novartis Investigative Site
    • Massachusetts
      • Boston, Massachusetts, United States, 02114
        • Novartis Investigative Site
      • Boston, Massachusetts, United States, 02215
        • Novartis Investigative Site
    • New York
      • New York, New York, United States, 10065
        • Novartis Investigative Site
    • Ohio
      • Cincinnati, Ohio, United States, 45242
        • Novartis Investigative Site
    • Pennsylvania
      • Philadelphia, Pennsylvania, United States, 19104
        • Novartis Investigative Site
    • South Carolina
      • Columbia, South Carolina, United States, 29210
        • Novartis Investigative Site
    • Tennessee
      • Chattanooga, Tennessee, United States, 37404
        • Novartis Investigative Site
      • Nashville, Tennessee, United States, 37203
        • Novartis Investigative Site
    • Texas
      • Fort Worth, Texas, United States, 76104
        • Novartis Investigative Site
    • Virginia
      • Richmond, Virginia, United States, 23230
        • Novartis Investigative Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Histologically confirmed cutaneous melanoma that is either Stage IIIC (unresectable) or Stage IV (metastatic), and determined to be BRAF V600E/K mutation-positive using the bioMerieux (bMx) investigational use only (IUO) THxID BRAF Assay (IDE: G120011). The assay will be conducted by a central reference laboratory. Subjects with ocular or mucosal melanoma are not eligible.
  • The subject must have a radiologically measurable tumor
  • The subject is able to carry out daily life activities without significant difficulty (ECOG performance status score of 0 or 1).
  • Able to swallow and retain oral medication
  • Sexually active subjects must use acceptable methods of contraception during the course of the study
  • Adequate organ system function and blood counts

Exclusion Criteria:

  • Prior treatment with a BRAF or a MEK inhibitor
  • Prior systemic anti-cancer treatment for Stage IIIC (unresectable) or Stage IV (metastatic) melanoma. Prior systemic treatment in the adjuvant setting is allowed. (Note: Ipilimumab treatment must end at least 8 weeks prior to randomization.)
  • The subject has received major surgery or certain tyes of cancer therapy with 21 days of starting treatment
  • Current use of prohibited medication listed in the protocol
  • Left ventricular ejection fraction less than the lower limit of normal
  • Uncontrolled blood pressurl
  • History or current evidence of retinal vein occlusion or central serous retinopathy
  • Brain metastases unless previously treated with surgery or stereotactic radiosurgery and the disease has been stable for at least 12 weeks
  • The subject is pregnant or nursing

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: QUADRUPLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Dabrafenib + Trametinib
Dabrafenib and Trametinib combination
Dabrafenib 150 mg twice daily
Other Names:
  • GSK2118436
Trametinib 2 mg once daily
Other Names:
  • GSK1120212
ACTIVE_COMPARATOR: Dabrafenib + Placebo
Dabrafenib and Trametinib placebo
Dabrafenib 150 mg twice daily
Other Names:
  • GSK2118436
Dabrafenib 150 mg twice daily and trametinib placebo
Other Names:
  • Placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Progression-Free Survival (PFS) as Assessed by the Investigator
Time Frame: From randomization until the earliest date of disease progression (PD) or death due to any cause (up to approximately 6 years)
PFS is defined as the interval between the date of randomization and the earliest date of PD or death due to any cause. PD 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. In addition, the sum must have an absolute increase from nadir of 5 mm. The appearance of one or more new lesions, or the worsening of non-target lesions significant enough to require study treatment discontinuation, was also included as PD. Participants who received anti-cancer therapy prior to the date of documented events, were censored at the last adequate assessment prior to the initiation of therapy. If the participant did not have documented progression or death, PFS was censored at the date of the last adequate assessment.
From randomization until the earliest date of disease progression (PD) or death due to any cause (up to approximately 6 years)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall Survival (OS)
Time Frame: From the date of randomization until date of death due to any cause (up to approximately 6 years)
OS is defined as the interval of time between the date of randomization and the date of death due to any cause. For the participants who did not die, overall survival was censored at the date of last contact.
From the date of randomization until date of death due to any cause (up to approximately 6 years)
Objective Response Rate (ORR) as Assessed by the Investigator
Time Frame: From randomization until the first documented complete response or partial response (up to approximately 6 years)
ORR is defined as the percentage of participants with a confirmed complete response (CR) or partial response (PR). A participant was defined as a responder if he/she sustained a complete response (CR: the disappearance of all target lesions and any pathological lymph nodes must have a short axis of <10 mm and the disappearance of all non-target lesions) or partial response (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 or the persistence of 1 or more non-target lesions or lymph nodes identified as a site of disease at Baseline with a short axis of ≥10mm). Only descriptive analysis performed.
From randomization until the first documented complete response or partial response (up to approximately 6 years)
Duration of Response (DoR)
Time Frame: From the time of the first documented response (CR or PR) until disease progression (up to approximately 6 years)
Duration of response is defined as the time from the first documented complete response (CR: the disappearance of all target lesions and any pathological lymph nodes must have a short axis of <10 mm and the disappearance of all non-target lesions) or partial response (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 or the persistence of 1 or more non-target lesions or lymph nodes identified as a site of disease at Baseline with a short axis of ≥10mm) until disease progression (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 with an absolute increase of at least 5mm or the appearance of one or more new lesions, or the worsening of non target lesions significant enough to require study treatment discontinuation. PD was based on the radiological evidence by investigator. Only descriptive analysis performed.
From the time of the first documented response (CR or PR) until disease progression (up to approximately 6 years)
Trametinib Pharmacokinetic Concentrations
Time Frame: Week 8 (0, 1-3, 4-6 hours post dose), Weeks 16 and 24 (0 hour pre-dose)
Blood samples were collected for Pharmacokinetic (PK) analysis in all participants. Three blood samples were collected at Week 8: pre-dose, 1-3 hours post dose, and 4-6 hours post dose. One pre-dose blood sample was obtained at Weeks 16 and 24. Only descriptive analysis performed.
Week 8 (0, 1-3, 4-6 hours post dose), Weeks 16 and 24 (0 hour pre-dose)
Dabrafenib and Dabrafenib Metabolites (Hydroxy-, Carboxy- and Desmethyl-Dabrafenib) Concentrations
Time Frame: Week 8 (0, 1-3, 4-6 hours post dose), Weeks 16 and 24 (0 hour pre-dose)
Blood samples were collected for PK analysis in all participants. Three blood samples were collected at Week 8: pre-dose, 1-3 hours post dose, and 4-6 hours post dose. One pre-dose blood sample was obtained at Weeks 16 and 24. Plasma concentrations of Dabrafenib (GSK2118436) and its metabolites (Hydroxy-Dabrafenib (GSK2285403), Carboxy-Dabrafenib (GSK2298683), and Desmethyl-Dabrafenib (GSK2167542)) were determined using the currently approved analytical methodology. Only descriptive analysis performed.
Week 8 (0, 1-3, 4-6 hours post dose), Weeks 16 and 24 (0 hour pre-dose)
Number of Participants With Adverse Events and Serious Adverse Events
Time Frame: From the time the first dose of study treatment administered until 30 days after discontinuation of study treatment (up to approximately 6 years).
Analysis of absolute and relative frequencies for Adverse Event (AE) and Serious Adverse Event (SAE) by primary System Organ Class (SOC) to characterize the safety of dabrafenib and trametinib combination therapy through the monitoring of relevant clinical and laboratory safety parameters. In addition, new malignancies and AEs possibly related to study treatment were collected even if they occurred more than 30 days post-treatment. Only descriptive analysis performed.
From the time the first dose of study treatment administered until 30 days after discontinuation of study treatment (up to approximately 6 years).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

May 4, 2012

Primary Completion (ACTUAL)

August 26, 2013

Study Completion (ACTUAL)

February 28, 2019

Study Registration Dates

First Submitted

April 23, 2012

First Submitted That Met QC Criteria

April 23, 2012

First Posted (ESTIMATE)

April 25, 2012

Study Record Updates

Last Update Posted (ACTUAL)

February 17, 2021

Last Update Submitted That Met QC Criteria

February 8, 2021

Last Verified

February 1, 2021

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

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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