- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02367859
Dabrafenib and Trametinib in Treating Patients With BRAF Mutated Ameloblastoma
A Pilot Study of Dabrafenib and Trametinib for Patients With BRAF Mutated Ameloblastoma
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To observe the response rate of ameloblastoma to dabrafenib and trametinib at 6 weeks.
SECONDARY OBJECTIVES:
I. Feasibility and safety in this patient population. II. Response will be assessed pathologically. III. Two main histologic assays for treatment response will be used: tumor necrosis and phosphorylated-mitogen-activated protein kinase kinase 1 (MEK), phosphorylated-extracellular signal-regulated kinase (ERK), and Ki-67 levels as measured by immunohistochemistry.
OUTLINE:
Patients receive dabrafenib orally (PO) twice daily (BID) every 12 hours and trametinib 2 mg daily PO for 6 weeks in the absence of disease progression or unacceptable toxicity. Patients whose disease is judged to be not amenable to resection will continue dabrafenib and trametinib indefinitely as long as there has not been tumor progression.
After completion of study treatment, patients are followed up for at least 4 weeks.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
California
-
Stanford, California, United States, 94305
- Stanford University, School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histological diagnosis of ameloblastoma; all stages are eligible; patients must have evaluable disease by Response Evaluation Criteria in Solid Tumors (RECIST) criteria
- B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E or other known dabrafenib sensitive BRAF mutation in tumor by any Clinical Laboratory Improvement Amendments (CLIA) certified lab; may include, for example, Sanger sequencing, SNaPshot platform, immunohistochemistry, Foundation One tests, etc.)
- Life expectancy > 3 months
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
- Absolute neutrophil count (ANC) > 1.5 x10^9/L
- Platelet (PLT) > 99 x 10^9/L
- Hemoglobin > 8 g/dL
- Total bilirubin (Tbili) < 1.6 x upper limit of normal (ULN)
- Aspartate aminotransferase (AST), alanine aminotransferase (ALT) < 2.6 x ULN
- Alkaline phosphatase (alk phos) < 2.6 x ULN
- Serum creatinine < 1.6 x ULN or creatinine clearance > 50 ml/min
- Ability to understand and the willingness to sign a written informed consent document
- Patients of childbearing potential must agree to use effective contraception until at least 6 months after treatment with dabrafenib
- Able to swallow and retain oral medication and must not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels
- Left ventricular ejection fraction equal to or greater than normal
Exclusion Criteria:
- No prior treatment with agents targeting BRAF mutant tyrosine kinases or radiation of target lesions
- Invasive malignancy other than ameloblastoma within 3 years, excluding curatively treated basal cell carcinoma, and other highly curable cancers such as early stage cutaneous squamous cell carcinoma (T1 NO) cervical carcinoma in situ (CIS), early stage prostate cancer, thyroid cancer or breast cancer
- Uncontrolled hypertension, chronic heart failure (CHF), or other major medical illness
- Prior allergic reactions attributed to compounds of similar chemical or biologic composition to dabrafenib
- Concomitant use of strong inhibitors (e.g., ketoconazole, nefazodone, clarithromycin, gemfibrozil) or strong inducers (e.g., rifampin, phenytoin, carbamazepine, phenobarbital, St John's wort) of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) or cytochrome P450, family 2, subfamily C, polypeptide 8 (CYP2C8)
- Concomitant use of proton pump inhibitors, H2-receptor antagonists, antacids
- Known glucose-6-phosphate dehydrogenase (G6PD) deficiency
- Pregnant or nursing patients; women of childbearing potential must have a negative pregnancy test within 14 days of enrollment
- Electrocardiogram (EKG) with QTcB (Bazett's formula) > 480 ms done within 14 days of enrollment
- Interstitial lung disease or pneumonitis
- A history of retinal vein occlusion (RVO)
- Congestive heart failure NYHA class III or worse (Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.)
- A history of acute coronary syndromes (including myocardial infarction or unstable angina), coronary angioplasty, or stenting within 6 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment (dabrafenib)
Patients receive dabrafenib PO BID every 12 hours plus trametinib daily PO for 6 weeks in the absence of disease progression or unacceptable toxicity.
Patients whose disease is judged to be not amenable to resection will continue dabrafenib and trametinib indefinitely as long as there has not been tumor progression.
|
Given PO
Other Names:
Given PO
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Tumor Response
Time Frame: 6 weeks
|
Tumor response was assessed per the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Overall tumor response was assessed as the number of participants achieving either a complete response (CR) or a partial response (PR). The criteria are:
The outcome is reported as the number of participants achieving the different levels of tumor response per RECIST, a number without dispersion. |
6 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percent Tumor Necrosis
Time Frame: 6 weeks
|
Percent of tumor necrosis at the time of endpoint biopsy or surgical resection will be assessed.
The tumor specimen from resection will be examined and the volume of the necrosis compared to the volume of the total tumor determined by central pathology.
Percent tumor necrosis, in increments of 10%, will be determined.
The outcome will be reported as the mean percent tumor necrosis, with standard deviation.
|
6 weeks
|
Change in Proliferation
Time Frame: 6 weeks
|
An immunohistochemical laboratory analysis to assess proliferation will be performed on the initial pre-treatment biopsy (baseline) vs either the endpoint tumor biopsy or the tumor specimen from the resection.
Ki-67 immunohistochemistry will be scored by at least 2 pathologists using percentage positive cells as the primary metric.
Proliferation will be assessed as the difference from baseline in Ki-67 labeling to the end of treatment (tumor biopsy or the tumor specimen).
The outcome will be expressed as the mean, with standard deviation.
|
6 weeks
|
Phosphorylation of Tumor Markers MEK and ERK
Time Frame: 6 weeks
|
An immunohistochemical laboratory analysis to assess phosphorylation of the tumor markers MEK and ERK on the initial pre-treatment biopsy (baseline) vs either the endpoint tumor biopsy or the tumor specimen from the resection.
Immunohistochemistry will be scored by at least 2 pathologists using percentage positive cells and intensity of staining as the primary metrics.
Phosphorylation of MEK and ERK will be assessed as the observed difference in phosphorylated MEK and ERK labeling from baseline to the end of treatment (tumor biopsy or the tumor specimen).
The outcome will be expressed as the mean, with standard deviation.
|
6 weeks
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Alexander Colevas, Stanford University
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB-32275
- NCI-2015-00169 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- ENT0043 (Other Identifier: OnCore)
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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