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
調査の概要
詳細な説明
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.
研究の種類
入学 (実際)
段階
- フェーズ 3
連絡先と場所
研究場所
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Co.Cork、アイルランド
- Novartis Investigative Site
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Dublin、アイルランド、7
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Dublin、アイルランド、9
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Dublin、アイルランド、4
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Galway、アイルランド
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Alabama
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Birmingham、Alabama、アメリカ、35243
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Arizona
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Gilbert、Arizona、アメリカ、85234
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California
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Beverly Hills、California、アメリカ、90211
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San Francisco、California、アメリカ、94115
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Vallejo、California、アメリカ、94589
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Colorado
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Aurora、Colorado、アメリカ、80010
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Florida
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Jacksonville、Florida、アメリカ、32204
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Miami Beach、Florida、アメリカ、33140
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Orlando、Florida、アメリカ、32804
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Georgia
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Atlanta、Georgia、アメリカ、30322
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Atlanta、Georgia、アメリカ、30341
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Iowa
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Iowa City、Iowa、アメリカ、52242
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Michigan
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Ann Arbor、Michigan、アメリカ、48109
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Minnesota
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Fridley、Minnesota、アメリカ、55432
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Missouri
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Saint Louis、Missouri、アメリカ、63110
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Nevada
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Las Vegas、Nevada、アメリカ、89148
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New Jersey
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Hackensack、New Jersey、アメリカ、07601
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New Brunswick、New Jersey、アメリカ、08901
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New York
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New York、New York、アメリカ、10029
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North Carolina
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Chapel Hill、North Carolina、アメリカ、27599-7600
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Charlotte、North Carolina、アメリカ、28204
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Durham、North Carolina、アメリカ、27710
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Ohio
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Cincinnati、Ohio、アメリカ、45219
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Columbus、Ohio、アメリカ、43210
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Oregon
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Bend、Oregon、アメリカ、97701
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Portland、Oregon、アメリカ、97213
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Portland、Oregon、アメリカ、97239
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South Carolina
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Charleston、South Carolina、アメリカ、29425
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Greenville、South Carolina、アメリカ、29605
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Tennessee
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Nashville、Tennessee、アメリカ、37232
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Texas
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Dallas、Texas、アメリカ、75246
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Utah
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Salt Lake City、Utah、アメリカ、84106
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Salt Lake City、Utah、アメリカ、84112-5550
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Vermont
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Burlington、Vermont、アメリカ、05403
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Virginia
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Charlottesville、Virginia、アメリカ、22903
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Wisconsin
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Milwaukee、Wisconsin、アメリカ、53226
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Ciudad Autonoma de Buenos Aires、アルゼンチン、C1121ABE
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San Miguel de Tucuman、アルゼンチン、T4000IAK
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Santa Fe、アルゼンチン、3000
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Buenos Aires
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Capital Federal、Buenos Aires、アルゼンチン、C1426ANZ
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Río Negro
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Viedma、Río Negro、アルゼンチン、R8500ACE
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Santa Fe
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Rosario、Santa Fe、アルゼンチン、S2000KZE
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Cambridge、イギリス、CB2 0QQ
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Glasgow、イギリス、G12 0YN
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London、イギリス、NW3 2QG
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London、イギリス、SE1 7EH
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Manchester、イギリス、M20 4BX
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Southampton、イギリス、SO16 6YD
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Swansea、イギリス、SA2 8QA
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Jerusalem、イスラエル
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Ramat Gan、イスラエル、52621
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Campania
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Napoli、Campania、イタリア、80131
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Lazio
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Roma、Lazio、イタリア、00167
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Liguria
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Genova、Liguria、イタリア、16132
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Lombardia
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Bergamo、Lombardia、イタリア、24128
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Milano、Lombardia、イタリア、20133
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Milano、Lombardia、イタリア、20141
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Toscana
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Pisa、Toscana、イタリア、56126
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Veneto
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Padova、Veneto、イタリア、35128
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Dnipropetrovsk、ウクライナ、49102
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Donetsk、ウクライナ、83092
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Kharkiv、ウクライナ、61070
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Kyiv、ウクライナ、03022
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Lviv、ウクライナ、79031
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Sumy、ウクライナ、40005
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Uzhgorod、ウクライナ、88017
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Amsterdam、オランダ、1066 CX
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Amsterdam、オランダ、1081 HV
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Groningen、オランダ、9713 GZ
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Leeuwarden、オランダ、8934 AD
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Leiden、オランダ、2333 ZA
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Rotterdam、オランダ、3015 GD
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New South Wales
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North Sydney、New South Wales、オーストラリア、2060
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Westmead、New South Wales、オーストラリア、2145
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Queensland
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Greenslopes、Queensland、オーストラリア、4120
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Herston、Queensland、オーストラリア、4029
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South Brisbane、Queensland、オーストラリア、4101
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South Australia
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Woodville、South Australia、オーストラリア、5011
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Victoria
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Box Hill、Victoria、オーストラリア、3128
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Melbourne、Victoria、オーストラリア、3004
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Western Australia
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Nedlands、Western Australia、オーストラリア、6009
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Graz、オーストリア、A-8036
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Innsbruck、オーストリア、6020
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Salzburg、オーストリア、A-5020
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Wien、オーストリア、1090
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Wien、オーストリア、A-1030
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Quebec、カナダ、G1R 2J6
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Alberta
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Calgary、Alberta、カナダ、T2N 4N2
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British Columbia
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Kelowna、British Columbia、カナダ、V1Y 5L3
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Vancouver、British Columbia、カナダ、V5Z 4E6
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Manitoba
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Winnipeg、Manitoba、カナダ、R3E 0V9
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Nova Scotia
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Halifax、Nova Scotia、カナダ、B3H 2Y9
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Ontario
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Kingston、Ontario、カナダ、K7L 5P9
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Oshawa、Ontario、カナダ、L1G 2B9
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Ottawa、Ontario、カナダ、K1H 8L6
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Toronto、Ontario、カナダ、M5G 2M9
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Toronto、Ontario、カナダ、M4N 3M5
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Quebec
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Montreal、Quebec、カナダ、H2L 4M1
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Basel、スイス、4031
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Lausanne、スイス、1011
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Zurich、スイス、8091
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Linkoping、スウェーデン、SE-581 85
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Umea、スウェーデン、SE-901 85
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Barcelona、スペイン、08036
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Hospitalet de Llobregat, Barcelona、スペイン、08907
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Las Palmas De Gran Canaria、スペイン、35016
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Madrid、スペイン、28007
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Madrid、スペイン、28050
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Palma de Mallorca、スペイン、07010
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Pamplona、スペイン、31008
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Valencia、スペイン、46014
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Valencia、スペイン、46009
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Olomouc、チェコ、775 20
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Ostrava、チェコ、708 52
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Praha 10、チェコ、100 34
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Praha 2、チェコ、128 08
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Zlin、チェコ、76275
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Arhus C、デンマーク、8000
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Herlev、デンマーク、2730
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Odense、デンマーク、5000 C
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Baden-Wuerttemberg
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Heidelberg、Baden-Wuerttemberg、ドイツ、69120
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Heilbronn、Baden-Wuerttemberg、ドイツ、74078
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Mannheim、Baden-Wuerttemberg、ドイツ、68167
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Tuebingen、Baden-Wuerttemberg、ドイツ、72076
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Bayern
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Erlangen、Bayern、ドイツ、91054
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Muenchen、Bayern、ドイツ、80337
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Muenchen、Bayern、ドイツ、80804
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Muenchen、Bayern、ドイツ、80802
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Nuernberg、Bayern、ドイツ、90419
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Regensburg、Bayern、ドイツ、93053
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Wuerzburg、Bayern、ドイツ、97080
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Niedersachsen
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Buxtehude、Niedersachsen、ドイツ、21614
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Hannover、Niedersachsen、ドイツ、30625
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Nordrhein-Westfalen
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Bonn、Nordrhein-Westfalen、ドイツ、53127
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Essen、Nordrhein-Westfalen、ドイツ、45122
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Koeln、Nordrhein-Westfalen、ドイツ、50937
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Rheinland-Pfalz
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Ludwigshafen、Rheinland-Pfalz、ドイツ、67063
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Mainz、Rheinland-Pfalz、ドイツ、55131
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Sachsen
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Dresden、Sachsen、ドイツ、01307
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Leipzig、Sachsen、ドイツ、04103
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Sachsen-Anhalt
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Magdeburg、Sachsen-Anhalt、ドイツ、39120
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Schleswig-Holstein
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Kiel、Schleswig-Holstein、ドイツ、24105
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Luebeck、Schleswig-Holstein、ドイツ、23538
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Thueringen
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Erfurt、Thueringen、ドイツ、99089
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Gera、Thueringen、ドイツ、07548
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Christchurch、ニュージーランド、8011
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Newtown, Wellington、ニュージーランド、6002
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Kristiansand、ノルウェー、4604
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Lorenskog、ノルウェー、1478
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Oslo、ノルウェー、0310
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Budapest、ハンガリー、H-1122
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Budapest、ハンガリー、1062
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Debrecen、ハンガリー、4032
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Gyor、ハンガリー、H-9024
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Kaposvar、ハンガリー、7400
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Miskolc、ハンガリー、3526
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Szeged、ハンガリー、6720
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Helsinki、フィンランド、00029
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Jyvaskyla、フィンランド、40620
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Tampere、フィンランド、33520
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Turku、フィンランド、20520
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Bordeaux、フランス、33075
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Grenoble、フランス、38043
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Lille、フランス、59037
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Marseille cedex 5、フランス、13385
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Montpellier cedex 5、フランス、34295
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Nantes、フランス、44093
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Nice、フランス、06202
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Paris Cedex 10、フランス、75475
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Reims Cedex、フランス、51092
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Rennes Cedex、フランス、35042
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Villejuif cedex、フランス、94805
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Sao Paulo - SP、ブラジル、01323-900
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Rio Grande Do Sul
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Ijui、Rio Grande Do Sul、ブラジル、98700-000
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Santa Catarina
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Itajai、Santa Catarina、ブラジル、88301-215
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Brasschaat、ベルギー、2930
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Brussel、ベルギー、1090
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Brussels、ベルギー、1200
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Gent、ベルギー、9000
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Kortrijk、ベルギー、8500
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Leuven、ベルギー、3000
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Namur、ベルギー、5000
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Wilrijk、ベルギー、2610
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Gdansk、ポーランド、80-215
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Konin、ポーランド、62-500
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Poznan、ポーランド、60-693
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Warszawa、ポーランド、02-781
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Chelyabinsk、ロシア連邦、454087
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Magnitogorsk、ロシア連邦、455001
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Moscow、ロシア連邦、115478
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Moscow、ロシア連邦、143423
- Novartis Investigative Site
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Nizhniy Novgorod、ロシア連邦、603081
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Ryazan、ロシア連邦、390011
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St. Petersburg、ロシア連邦、197758
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-
-
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Tainan、台湾、704
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Taipei、台湾、100
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Taoyuan、台湾、333
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Goyang-si, Gyeonggi-Do、大韓民国、410-769
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Seoul、大韓民国、03080
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Seoul、大韓民国、135-710
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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)
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Dabrafenib plus Trametinib
BRAF inhibitor plus MEK inhibitor
|
Dabrafenib 150 mg twice daily orally
他の名前:
Trametinib 2 mg once daily orally
他の名前:
|
|
アクティブコンパレータ:Vemurafenib
BRAF inhibitor
|
Vemurafenib 960 mg twice daily orally
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Overall Survival (OS)
時間枠: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.
|
From the date of randomization until date of death due to any cause (up to approximately 6 years)
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Progression-Free Survival (PFS), as Assessed by the Investigator
時間枠:From randomization until the earliest date of disease progression (PD) or death due to any cause (up to approximately 6 years)
|
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.
|
From randomization until the earliest date of disease progression (PD) or death due to any cause (up to approximately 6 years)
|
|
Overall Response Rate (ORR) During Randomized Phase, as Assessed by the Investigator
時間枠:From randomization until the first documented complete response or partial response (up to approximately 6 years)
|
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.
|
From randomization until the first documented complete response or partial response (up to approximately 6 years)
|
|
Duration of Response (DOR), as Assessed by the Investigator
時間枠:From the time of the first documented response (CR or PR) until disease progression (up to approximately 6 years)
|
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.
|
From the time of the first documented response (CR or PR) until disease progression (up to approximately 6 years)
|
協力者と研究者
スポンサー
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 116513
- CDRB436B2302 (その他の識別子:Novartis)
- 2011-006088-23 (EudraCT番号)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
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.
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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