- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04741997
Adjuvant Therapy Based on Pathologic Response After Neoadjuvant Encorafenib Binimetinib in Melanoma
February 13, 2024 updated by: H. Lee Moffitt Cancer Center and Research Institute
A Randomized Pilot Trial of Adjuvant Therapy Based on Pathologic Response After Neoadjuvant Encorafenib and Binimetinib in Advanced Melanoma
The purpose of this study is to assess rate of disease relapse and hazard rate of disease relapse after neoadjuvant therapy based on the statuses of pathologic complete response or non-pathologic complete response, and postoperative adjuvant therapy.
Study Overview
Status
Recruiting
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
50
Phase
- Early Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Krystal Victoria
- Phone Number: 813-745-0218
- Email: Krystal.Victoria@moffitt.org
Study Locations
-
-
Florida
-
Tampa, Florida, United States, 33612
- Recruiting
- Moffitt Cancer Center
-
Sub-Investigator:
- Andrew Brohl, MD
-
Sub-Investigator:
- Joseph Markowitz, MD, PhD
-
Sub-Investigator:
- Ahmad Tarhini, MD, PhD
-
Contact:
- Krystal Victoria
- Phone Number: 813-745-0218
- Email: Krystal.Victoria@moffitt.org
-
Principal Investigator:
- Zeynep Eroglu, MD
-
Sub-Investigator:
- Nikhil Khushaslani, MD
-
-
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
Description
Inclusion Criteria:
- Age ≥ 18 years at the time of informed consent
- Histologically confirmed diagnosis of melanoma. Any primary or unknown origin is permitted.
- Melanoma must have a BRAFV600 mutation (using a CLIA-validated assay), either stage III (B/C/D) or Stage IV (AJCC 8th edition).
- ECOG performance status ≤ 2
- Adequate laboratory parameters as well:
- a. Hemoglobin ≥ 8 g/dL.
- b. Platelets ≥ 75 × 109/L;
- c. AST and ALT ≤ 2.5 × ULN; in participants with liver metastases ≤ 5 × ULN;
- d. Total bilirubin ≤ 1.5 × ULN and < 2 mg/dL; OR total bilirubin >1.5 × ULN with indirect bilirubin < 1.5 × ULN;
- e. Serum creatinine ≤ 2.0 × ULN
- Female participants of childbearing potential as described in protocol, must have a negative serum or urine β-HCG test result. Female participants of childbearing potential must agree to use methods of contraception that are highly effective or acceptable, as described in Section 4.3.1. Participants must agree to not use hormonal contraceptives, as encorafenib can result in decreased concentration and loss of efficacy. Male participants must agree to use methods of contraception that are highly effective or acceptable per protocol.
Exclusion Criteria:
- Participants may have received prior therapy with BRAF and/or a MEK inhibitor if it was completed at least 6 months prior to study enrollment. Patients who had prior disease progression while on BRAF/MEK inhibitor therapy are not eligible. (Progression after stopping treatment is permitted.) Participants may have received prior therapy an anti-PD-1/PD-L1 or CTLA-4 inhibitor.
- Participants must not have had adverse events related to encorafenib and/or binimetinib specifically, that required discontinuation of one or both drugs due to toxicity.
- Participants who have had major surgery or radiotherapy ≤ 14 days prior to start of study treatment or who have not recovered from side effects of such procedure.
- Participants must be willing to avoid consuming grapefruit, pomegranates, star fruits, Seville oranges or products containing the juice during the study while they are taking encorafenib/binimetinib.
- Uncontrolled or symptomatic brain metastases or leptomeningeal carcinomatosis that are not stable, require steroids, are potentially life-threatening or have required radiation within 28 days prior to starting study drug. Patients with previously treated brain metastases may participate provided they are stable (e.g.,without evidence of progression by radiographic imaging for at least 28 days before the first dose of study treatment and neurologic symptoms have returned to baseline).
- Impaired cardiovascular function as below:
- a. Congestive heart failure requiring treatment (New York Heart Association Grade ≥ 3);
- b. presence of uncontrolled atrial fibrillation or uncontrolled paroxysmal supraventricular tachycardia
- c. Baseline QTcF interval ≥ 500 ms.
- Known history of retinal vein occlusion (RVO)
- Current use of a prohibited medication (including herbal medications, supplements, or foods), as described in protocol, or use of a prohibited medication ≤ 1 week prior to the start of study treatment.
- Participants with a prior or concurrent malignancy whose natural history or treatment (in the opinion of the treating physician) does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.
- Participants with known human immunodeficiency virus (HIV)-infection are eligible providing they are on effective anti-retroviral therapy and have undetectable viral load at their most recent viral load test and within 90 days prior to randomization.
- Participants with a known history of hepatitis C virus (HCV) infection must have been treated and cured. Participants with HCV infection who are currently on treatment must have an undetectable HCV viral load prior to randomization.
- Pregnancy or breast feeding.
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 Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Surveillance
Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection.
If participants have pathologic complete response they will receive adjuvant treatment for 24 weeks.
Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.
|
Encorafenib 450 mg will be administered orally once per day in continuous 28-day cycles
Binimetinib 45 mg will be administered orally twice per day in continuous 28-day cycles
|
Experimental: Encorafenib and Binimetinib after Pathologic Complete Response
Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection.
If participants have pathologic complete response they will continue to receive encorafenib and binimetinib for 24 more weeks.
Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.
|
Encorafenib 450 mg will be administered orally once per day in continuous 28-day cycles
Binimetinib 45 mg will be administered orally twice per day in continuous 28-day cycles
|
Experimental: Encorafenib and Binimetinib after Non-Pathologic Complete Response
Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection.
If participants have non-pathologic complete response they will continue to receive encorafenib and binimetinib for 24 more weeks.
Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.
|
Encorafenib 450 mg will be administered orally once per day in continuous 28-day cycles
Binimetinib 45 mg will be administered orally twice per day in continuous 28-day cycles
|
Experimental: Nivolumab after Non-Pathologic Complete Response
Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection.
If participants have non-pathologic complete response they will receive nivolumab for 24 weeks.
Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.
|
Encorafenib 450 mg will be administered orally once per day in continuous 28-day cycles
Binimetinib 45 mg will be administered orally twice per day in continuous 28-day cycles
Nivolumab will be administered at a dose of 480 mg IV infusion over 30 minutes every 4 weeks.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of Disease Relapse
Time Frame: After surgery up to 24 weeks
|
Investigators will estimate the rate of disease relapse after neoadjuvant therapy based on pathologic complete response status and postoperative adjuvant therapy within each arm.
|
After surgery up to 24 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Relapse Free Survival
Time Frame: After surgery up to 24 weeks
|
Relapse free survival is defined as time from surgery until disease relapse
|
After surgery up to 24 weeks
|
Rate of Pathologic Complete Response
Time Frame: At 26 weeks
|
Investigators will measure the rate of pathologic complete response after surgery.
|
At 26 weeks
|
Rate of Non-Pathologic Complete Response
Time Frame: At 26 weeks
|
Investigators will measure the rate of non-pathologic complete response after surgery.
|
At 26 weeks
|
Overall Response Rate
Time Frame: Up to 26 weeks
|
Overall response rate will be measured after neoadjuvant therapy (for participants who have measurable disease per RECIST 1.1 at start of neoadjuvant therapy).
|
Up to 26 weeks
|
Overall Survival
Time Frame: After surgery, up to 5 years
|
Overall survival will be measured from time of surgery to death from any cause.
|
After surgery, up to 5 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Zeynep Eroglu, MD, Moffitt Cancer Center
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 24, 2021
Primary Completion (Estimated)
January 1, 2026
Study Completion (Estimated)
January 1, 2027
Study Registration Dates
First Submitted
February 2, 2021
First Submitted That Met QC Criteria
February 4, 2021
First Posted (Actual)
February 5, 2021
Study Record Updates
Last Update Posted (Actual)
February 14, 2024
Last Update Submitted That Met QC Criteria
February 13, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Keywords
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
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Nivolumab
Other Study ID Numbers
- MCC-20641
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
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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