- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT01597908
Dabrafenib Plus Trametinib vs Vemurafenib Alone in Unresectable or Metastatic BRAF V600E/K Cutaneous Melanoma (COMBI-v)
A Phase III, Randomised, Open-label Study Comparing the Combination of the BRAF Inhibitor, Dabrafenib and the MEK Inhibitor, Trametinib to the BRAF Inhibitor Vemurafenib in Subjects With Unresectable (Stage IIIc) or Metastatic (Stage IV) BRAF V600E/K Mutation Positive Cutaneous Melanoma
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Screening/Subject eligibility: Subjects with histologically confirmed cutaneous melanoma that was either unresectable or metastatic (Stages IIIC or IV), were screened for eligibility. Eligible subjects were BRAF V600E or V600K mutation positive. 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.
Randomization: A total of 704 subjects were randomized in a ratio of 1:1 to receive combination therapy (352 subjects) or vemurafenib treatment (352 subjects). Subjects were stratified by LDH level (> the ULN versus =< ULN) and BRAF mutation (V600E versus V600K).
Study treatment: Dabrafenib and trametinib were administered orally at their recommended doses of 150 mg b.i.d. and 2.0 mg once daily, respectively. Subjects randomized in the combination therapy arm received both the agents. Subjects randomized in the vemurafenib arm received vemurafenib at the recommended dose of 960 mg orally b.i.d. Subjects in both the arms continued treatment until disease progression, death, unacceptable toxicity, or withdrawal of consent. The protocol was amended on 07-Aug-2014 which allowed subjects who were still receiving vemurafenib to cross over to the dabrafenib and trametinib combination arm, including those subjects who were still receiving vemurafenib monotherapy treatment after disease progression. A washout period of a minimum of 7 days was considered prior to initiating dabrafenib in combination with trametinib. Subjects who experienced disease progression on the vemurafenib monotherapy arm, discontinued vemurafenib monotherapy, and subsequently received another anticancer therapy were ineligible for cross over to the dabrafenib and trametinib combination arm.
Follow-up/Study closure: After study treatment discontinuation, subjects were followed for survival and disease progression as applicable. This study completed once all the subjects had at least the 5-years of follow-up.
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 3
Contactos y Ubicaciones
Ubicaciones de estudio
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Baden-Wuerttemberg
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Heidelberg, Baden-Wuerttemberg, Alemania, 69120
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Heilbronn, Baden-Wuerttemberg, Alemania, 74078
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Mannheim, Baden-Wuerttemberg, Alemania, 68167
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Tuebingen, Baden-Wuerttemberg, Alemania, 72076
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Bayern
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Erlangen, Bayern, Alemania, 91054
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Muenchen, Bayern, Alemania, 80337
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Muenchen, Bayern, Alemania, 80804
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Muenchen, Bayern, Alemania, 80802
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Nuernberg, Bayern, Alemania, 90419
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Regensburg, Bayern, Alemania, 93053
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Wuerzburg, Bayern, Alemania, 97080
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Niedersachsen
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Buxtehude, Niedersachsen, Alemania, 21614
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Hannover, Niedersachsen, Alemania, 30625
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Nordrhein-Westfalen
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Bonn, Nordrhein-Westfalen, Alemania, 53127
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Essen, Nordrhein-Westfalen, Alemania, 45122
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Koeln, Nordrhein-Westfalen, Alemania, 50937
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Rheinland-Pfalz
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Ludwigshafen, Rheinland-Pfalz, Alemania, 67063
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Mainz, Rheinland-Pfalz, Alemania, 55131
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Sachsen
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Dresden, Sachsen, Alemania, 01307
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Leipzig, Sachsen, Alemania, 04103
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Sachsen-Anhalt
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Magdeburg, Sachsen-Anhalt, Alemania, 39120
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Schleswig-Holstein
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Kiel, Schleswig-Holstein, Alemania, 24105
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Luebeck, Schleswig-Holstein, Alemania, 23538
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Thueringen
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Erfurt, Thueringen, Alemania, 99089
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Gera, Thueringen, Alemania, 07548
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Ciudad Autonoma de Buenos Aires, Argentina, C1121ABE
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San Miguel de Tucuman, Argentina, T4000IAK
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Santa Fe, Argentina, 3000
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Buenos Aires
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Capital Federal, Buenos Aires, Argentina, C1426ANZ
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Río Negro
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Viedma, Río Negro, Argentina, R8500ACE
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Santa Fe
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Rosario, Santa Fe, Argentina, S2000KZE
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New South Wales
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North Sydney, New South Wales, Australia, 2060
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Westmead, New South Wales, Australia, 2145
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Queensland
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Greenslopes, Queensland, Australia, 4120
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Herston, Queensland, Australia, 4029
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South Brisbane, Queensland, Australia, 4101
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South Australia
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Woodville, South Australia, Australia, 5011
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Victoria
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Box Hill, Victoria, Australia, 3128
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Melbourne, Victoria, Australia, 3004
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Western Australia
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Nedlands, Western Australia, Australia, 6009
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Graz, Austria, A-8036
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Innsbruck, Austria, 6020
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Salzburg, Austria, A-5020
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Wien, Austria, 1090
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Wien, Austria, A-1030
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Sao Paulo - SP, Brasil, 01323-900
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Rio Grande Do Sul
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Ijui, Rio Grande Do Sul, Brasil, 98700-000
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Santa Catarina
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Itajai, Santa Catarina, Brasil, 88301-215
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Brasschaat, Bélgica, 2930
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Brussel, Bélgica, 1090
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Brussels, Bélgica, 1200
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Gent, Bélgica, 9000
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Kortrijk, Bélgica, 8500
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Leuven, Bélgica, 3000
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Namur, Bélgica, 5000
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Wilrijk, Bélgica, 2610
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Quebec, Canadá, G1R 2J6
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Alberta
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Calgary, Alberta, Canadá, T2N 4N2
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British Columbia
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Kelowna, British Columbia, Canadá, V1Y 5L3
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Vancouver, British Columbia, Canadá, V5Z 4E6
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Manitoba
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Winnipeg, Manitoba, Canadá, R3E 0V9
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Nova Scotia
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Halifax, Nova Scotia, Canadá, B3H 2Y9
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Ontario
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Kingston, Ontario, Canadá, K7L 5P9
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Oshawa, Ontario, Canadá, L1G 2B9
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Ottawa, Ontario, Canadá, K1H 8L6
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Toronto, Ontario, Canadá, M5G 2M9
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Toronto, Ontario, Canadá, M4N 3M5
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Quebec
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Montreal, Quebec, Canadá, H2L 4M1
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Olomouc, Chequia, 775 20
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Ostrava, Chequia, 708 52
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Praha 10, Chequia, 100 34
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Praha 2, Chequia, 128 08
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Zlin, Chequia, 76275
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Goyang-si, Gyeonggi-Do, Corea, república de, 410-769
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Seoul, Corea, república de, 03080
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Seoul, Corea, república de, 135-710
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Arhus C, Dinamarca, 8000
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Herlev, Dinamarca, 2730
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Odense, Dinamarca, 5000 C
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Barcelona, España, 08036
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Hospitalet de Llobregat, Barcelona, España, 08907
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Las Palmas De Gran Canaria, España, 35016
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Madrid, España, 28007
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Madrid, España, 28050
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Palma de Mallorca, España, 07010
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Pamplona, España, 31008
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Valencia, España, 46014
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Valencia, España, 46009
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Alabama
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Birmingham, Alabama, Estados Unidos, 35243
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Arizona
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Gilbert, Arizona, Estados Unidos, 85234
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California
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Beverly Hills, California, Estados Unidos, 90211
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San Francisco, California, Estados Unidos, 94115
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Vallejo, California, Estados Unidos, 94589
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Colorado
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Aurora, Colorado, Estados Unidos, 80010
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Florida
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Jacksonville, Florida, Estados Unidos, 32204
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Miami Beach, Florida, Estados Unidos, 33140
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Orlando, Florida, Estados Unidos, 32804
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Georgia
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Atlanta, Georgia, Estados Unidos, 30322
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Atlanta, Georgia, Estados Unidos, 30341
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Iowa
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Iowa City, Iowa, Estados Unidos, 52242
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Michigan
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Ann Arbor, Michigan, Estados Unidos, 48109
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Minnesota
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Fridley, Minnesota, Estados Unidos, 55432
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Missouri
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Saint Louis, Missouri, Estados Unidos, 63110
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Nevada
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Las Vegas, Nevada, Estados Unidos, 89148
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New Jersey
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Hackensack, New Jersey, Estados Unidos, 07601
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New Brunswick, New Jersey, Estados Unidos, 08901
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New York
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New York, New York, Estados Unidos, 10029
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North Carolina
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Chapel Hill, North Carolina, Estados Unidos, 27599-7600
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Charlotte, North Carolina, Estados Unidos, 28204
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Durham, North Carolina, Estados Unidos, 27710
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Ohio
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Cincinnati, Ohio, Estados Unidos, 45219
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Columbus, Ohio, Estados Unidos, 43210
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Oregon
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Bend, Oregon, Estados Unidos, 97701
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Portland, Oregon, Estados Unidos, 97213
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Portland, Oregon, Estados Unidos, 97239
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South Carolina
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Charleston, South Carolina, Estados Unidos, 29425
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Greenville, South Carolina, Estados Unidos, 29605
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Tennessee
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Nashville, Tennessee, Estados Unidos, 37232
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Texas
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Dallas, Texas, Estados Unidos, 75246
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Utah
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Salt Lake City, Utah, Estados Unidos, 84106
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Salt Lake City, Utah, Estados Unidos, 84112-5550
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Vermont
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Burlington, Vermont, Estados Unidos, 05403
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Virginia
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Charlottesville, Virginia, Estados Unidos, 22903
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Wisconsin
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Milwaukee, Wisconsin, Estados Unidos, 53226
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Chelyabinsk, Federación Rusa, 454087
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Magnitogorsk, Federación Rusa, 455001
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Moscow, Federación Rusa, 115478
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Moscow, Federación Rusa, 143423
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Nizhniy Novgorod, Federación Rusa, 603081
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Ryazan, Federación Rusa, 390011
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St. Petersburg, Federación Rusa, 197758
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Helsinki, Finlandia, 00029
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Jyvaskyla, Finlandia, 40620
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Tampere, Finlandia, 33520
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Turku, Finlandia, 20520
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Bordeaux, Francia, 33075
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Grenoble, Francia, 38043
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Lille, Francia, 59037
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Marseille cedex 5, Francia, 13385
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Montpellier cedex 5, Francia, 34295
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Nantes, Francia, 44093
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Nice, Francia, 06202
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Paris Cedex 10, Francia, 75475
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Reims Cedex, Francia, 51092
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Rennes Cedex, Francia, 35042
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Villejuif cedex, Francia, 94805
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Budapest, Hungría, H-1122
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Budapest, Hungría, 1062
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Debrecen, Hungría, 4032
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Gyor, Hungría, H-9024
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Kaposvar, Hungría, 7400
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Miskolc, Hungría, 3526
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Szeged, Hungría, 6720
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Co.Cork, Irlanda
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Dublin, Irlanda, 7
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Dublin, Irlanda, 9
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Dublin, Irlanda, 4
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Galway, Irlanda
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Jerusalem, Israel
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Ramat Gan, Israel, 52621
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Campania
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Napoli, Campania, Italia, 80131
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Lazio
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Roma, Lazio, Italia, 00167
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Liguria
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Genova, Liguria, Italia, 16132
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Lombardia
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Bergamo, Lombardia, Italia, 24128
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Milano, Lombardia, Italia, 20133
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Milano, Lombardia, Italia, 20141
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Toscana
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Pisa, Toscana, Italia, 56126
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Veneto
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Padova, Veneto, Italia, 35128
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Kristiansand, Noruega, 4604
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Lorenskog, Noruega, 1478
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Oslo, Noruega, 0310
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Christchurch, Nueva Zelanda, 8011
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Newtown, Wellington, Nueva Zelanda, 6002
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Amsterdam, Países Bajos, 1066 CX
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Amsterdam, Países Bajos, 1081 HV
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Groningen, Países Bajos, 9713 GZ
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Leeuwarden, Países Bajos, 8934 AD
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Leiden, Países Bajos, 2333 ZA
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Rotterdam, Países Bajos, 3015 GD
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Gdansk, Polonia, 80-215
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Konin, Polonia, 62-500
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Poznan, Polonia, 60-693
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Warszawa, Polonia, 02-781
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Cambridge, Reino Unido, CB2 0QQ
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Glasgow, Reino Unido, G12 0YN
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London, Reino Unido, NW3 2QG
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London, Reino Unido, SE1 7EH
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Manchester, Reino Unido, M20 4BX
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Southampton, Reino Unido, SO16 6YD
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Swansea, Reino Unido, SA2 8QA
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Linkoping, Suecia, SE-581 85
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Umea, Suecia, SE-901 85
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Basel, Suiza, 4031
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Lausanne, Suiza, 1011
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Zurich, Suiza, 8091
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Tainan, Taiwán, 704
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Taipei, Taiwán, 100
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Taoyuan, Taiwán, 333
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Dnipropetrovsk, Ucrania, 49102
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Donetsk, Ucrania, 83092
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Kharkiv, Ucrania, 61070
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Kyiv, Ucrania, 03022
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Lviv, Ucrania, 79031
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Sumy, Ucrania, 40005
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Uzhgorod, Ucrania, 88017
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Key Inclusion Criteria:
- >= 18 years of age
- Stage IIIc or Stage IV BRAF V600E/K cutaneous melanoma
- Measurable disease according to RECIST 1.1
- Women of childbearing potential with negative serum pregnancy test prior to randomisation
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
- Adequate baseline organ function
Key Exclusion Criteria:
- Any prior use of a BRAF or MEK inhibitor
- Prior systemic anti-cancer treatment in the advanced or metastatic setting; prior systemic treatment in the adjuvant setting is allowed
- History of another malignancy (except subjects who have been disease free for 3 years or with a history of completely resected non-melanoma skin cancer)
- Known HIV, HBV, HCV infection (except chronic or cleared HBV and HCV infection which will be allowed)
- Brain metastases (except if all known lesions were previously treated with surgery or stereotactic radiosurgery and lesions, if still present, are confirmed stable for >= 12 weeks prior to randomisation or if no longer present are confirmed no evidence of disease for >= 12 weeks, and are asymptomatic with no corticosteroid requirements for >= 4 weeks prior to randomisation, and no enzyme inducing anticonvulsants for >= 4 weeks prior to randomisation
- History or evidence of cardiovascular risk (LVEF < LLN; QTcB >= 480 msec; blood pressure or systolic >=140 mmHg or diastolic >= 90 mmHg which cannot be controlled by anti-hypertensive therapy)
- History or current evidence/risk of retinal vein occlusion (RVO) or central serous retinopathy (CSR)
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Experimental: Dabrafenib plus Trametinib
BRAF inhibitor plus MEK inhibitor
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Dabrafenib 150 mg twice daily orally
Otros nombres:
Trametinib 2 mg once daily orally
Otros nombres:
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Comparador activo: Vemurafenib
BRAF inhibitor
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Vemurafenib 960 mg twice daily orally
Otros nombres:
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Overall Survival (OS)
Periodo de tiempo: From the date of randomization until date of death due to any cause (up to approximately 6 years)
|
Overall Survival (OS) was defined as the interval of time between the date of randomization and the date of death due to any cause.
For patients who did not die, OS was censored at the date of last contact.
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From the date of randomization until date of death due to any cause (up to approximately 6 years)
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Progression-Free Survival (PFS), as Assessed by the Investigator
Periodo de tiempo: From randomization until the earliest date of disease progression (PD) or death due to any cause (up to approximately 6 years)
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Progression-free survival (PFS) was defined as the interval of time between the date of randomization and the first documented occurrence of disease progression or death due to any cause.
PFS for investigator-assessed response was summarized per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1, which is a set of published rules defining when cancer patients improve (respond), stay the same (stabilize), or worsen (progress) during treatment.
Disease progression was defined as at least a 20% increase in the sum of the diameters of target lesions with an absolute increase of at least 5 millimeters (mm) or the appearance of at least 1 new lesion, or the worsening of non-target lesions significant enough to require study treatment discontinuation.
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From randomization until the earliest date of disease progression (PD) or death due to any cause (up to approximately 6 years)
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Overall Response Rate (ORR) During Randomized Phase, as Assessed by the Investigator
Periodo de tiempo: From randomization until the first documented complete response or partial response (up to approximately 6 years)
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Overall response was defined as the percentage of confirmed responders (complete response [CR] + partial response [PR] per RECIST, Version 1.1) as summarized by Investigator assessment.
CR was defined as the disappearance of all evidence of target lesions.
PR was defined as at least a 30% reduction from Baseline in the sum of the longest diameter (LD) of all target lesions.
Data were reported as those participants with measureable disease at Baseline.
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From randomization until the first documented complete response or partial response (up to approximately 6 years)
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Duration of Response (DOR), as Assessed by the Investigator
Periodo de tiempo: From the time of the first documented response (CR or PR) until disease progression (up to approximately 6 years)
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Duration of Response (DOR) was defined as the time from the first documented evidence of a CR (disappearance of all evidence of target lesions) or a PR (at least a 30% reduction from Baseline in the sum of the longest diameter of all target lesions) until disease progression or death due to any cause.
PD was defined as at least a 20% increase in the sum of the diameters of target lesions with an absolute increase of at least 5 mm or the appearance of at least1 new lesion, or the worsening of non-target lesions significant enough to require study treatment discontinuation.
Data were summarized per RECIST, Version 1.1.
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From the time of the first documented response (CR or PR) until disease progression (up to approximately 6 years)
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Colaboradores e Investigadores
Patrocinador
Publicaciones y enlaces útiles
Publicaciones Generales
- Schadendorf D, Robert C, Dummer R, Flaherty KT, Tawbi HA, Menzies AM, Banerjee H, Lau M, Long GV. Pyrexia in patients treated with dabrafenib plus trametinib across clinical trials in BRAF-mutant cancers. Eur J Cancer. 2021 Aug;153:234-241. doi: 10.1016/j.ejca.2021.05.005. Epub 2021 Jul 2.
- Robert C, Grob JJ, Stroyakovskiy D, Karaszewska B, Hauschild A, Levchenko E, Chiarion Sileni V, Schachter J, Garbe C, Bondarenko I, Gogas H, Mandala M, Haanen JBAG, Lebbe C, Mackiewicz A, Rutkowski P, Nathan PD, Ribas A, Davies MA, Flaherty KT, Burgess P, Tan M, Gasal E, Voi M, Schadendorf D, Long GV. Five-Year Outcomes with Dabrafenib plus Trametinib in Metastatic Melanoma. N Engl J Med. 2019 Aug 15;381(7):626-636. doi: 10.1056/NEJMoa1904059. Epub 2019 Jun 4.
- Long GV, Grob JJ, Nathan P, Ribas A, Robert C, Schadendorf D, Lane SR, Mak C, Legenne P, Flaherty KT, Davies MA. Factors predictive of response, disease progression, and overall survival after dabrafenib and trametinib combination treatment: a pooled analysis of individual patient data from randomised trials. Lancet Oncol. 2016 Dec;17(12):1743-1754. doi: 10.1016/S1470-2045(16)30578-2. Epub 2016 Nov 16.
- Grob JJ, Amonkar MM, Karaszewska B, Schachter J, Dummer R, Mackiewicz A, Stroyakovskiy D, Drucis K, Grange F, Chiarion-Sileni V, Rutkowski P, Lichinitser M, Levchenko E, Wolter P, Hauschild A, Long GV, Nathan P, Ribas A, Flaherty K, Sun P, Legos JJ, McDowell DO, Mookerjee B, Schadendorf D, Robert C. Comparison of dabrafenib and trametinib combination therapy with vemurafenib monotherapy on health-related quality of life in patients with unresectable or metastatic cutaneous BRAF Val600-mutation-positive melanoma (COMBI-v): results of a phase 3, open-label, randomised trial. Lancet Oncol. 2015 Oct;16(13):1389-98. doi: 10.1016/S1470-2045(15)00087-X.
- Robert C, Karaszewska B, Schachter J, Rutkowski P, Mackiewicz A, Stroiakovski D, Lichinitser M, Dummer R, Grange F, Mortier L, Chiarion-Sileni V, Drucis K, Krajsova I, Hauschild A, Lorigan P, Wolter P, Long GV, Flaherty K, Nathan P, Ribas A, Martin AM, Sun P, Crist W, Legos J, Rubin SD, Little SM, Schadendorf D. Improved overall survival in melanoma with combined dabrafenib and trametinib. N Engl J Med. 2015 Jan 1;372(1):30-9. doi: 10.1056/NEJMoa1412690. Epub 2014 Nov 16.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Neoplasias por tipo histológico
- Neoplasias
- Tumores neuroectodérmicos
- Neoplasias De Células Germinales Y Embrionarias
- Neoplasias De Tejido Nervioso
- Tumores neuroendocrinos
- Nevos y Melanomas
- Melanoma
- Mecanismos moleculares de acción farmacológica
- Inhibidores de enzimas
- Agentes antineoplásicos
- Inhibidores de la proteína quinasa
- Trametinib
- Dabrafenib
- Vemurafenib
Otros números de identificación del estudio
- 116513
- CDRB436B2302 (Otro identificador: Novartis)
- 2011-006088-23 (Número EudraCT)
Plan de datos de participantes individuales (IPD)
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Descripción del plan IPD
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com.
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre Dabrafenib
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Novartis PharmaceuticalsTerminadoDeterioro hepáticoEstados Unidos
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Novartis PharmaceuticalsTerminado
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UNC Lineberger Comprehensive Cancer CenterGlaxoSmithKlineTerminadoMelanoma irresecable | Melanoma en estadio IV | Melanoma en estadio III | Melanoma mutante BRAFEstados Unidos
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Universitair Ziekenhuis BrusselTerminadoMelanoma malignoBélgica
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Fondazione Melanoma OnlusRetirado
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University Medical Center GroningenTerminado
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GlaxoSmithKlineTerminado
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Novartis PharmaceuticalsTerminado
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Spirita Oncology, LLCUniversity of ArizonaTerminadoMetástasis cerebrales | Melanoma malignoEstados Unidos
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Novartis PharmaceuticalsReclutamientoTumor sólido avanzado o recurrente irresecable con mutación BRAF V600E positivaJapón