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Dabrafenib Plus Trametinib vs Vemurafenib Alone in Unresectable or Metastatic BRAF V600E/K Cutaneous Melanoma (COMBI-v)

8 februari 2021 bijgewerkt door: Novartis Pharmaceuticals

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

This was a two-arm, open-label, randomized, Phase III study comparing dabrafenib (GSK2118436) and trametinib (GSK1120212) combination therapy with vemurafenib.

Studie Overzicht

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

704

Fase

  • Fase 3

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Ciudad Autonoma de Buenos Aires, Argentinië, C1121ABE
        • Novartis Investigative Site
      • San Miguel de Tucuman, Argentinië, T4000IAK
        • Novartis Investigative Site
      • Santa Fe, Argentinië, 3000
        • Novartis Investigative Site
    • Buenos Aires
      • Capital Federal, Buenos Aires, Argentinië, C1426ANZ
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    • Río Negro
      • Viedma, Río Negro, Argentinië, R8500ACE
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    • Santa Fe
      • Rosario, Santa Fe, Argentinië, S2000KZE
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    • New South Wales
      • North Sydney, New South Wales, Australië, 2060
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      • Westmead, New South Wales, Australië, 2145
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    • Queensland
      • Greenslopes, Queensland, Australië, 4120
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      • Herston, Queensland, Australië, 4029
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      • South Brisbane, Queensland, Australië, 4101
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    • South Australia
      • Woodville, South Australia, Australië, 5011
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    • Victoria
      • Box Hill, Victoria, Australië, 3128
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      • Melbourne, Victoria, Australië, 3004
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    • Western Australia
      • Nedlands, Western Australia, Australië, 6009
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      • Brussel, België, 1090
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      • Brussels, België, 1200
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      • Napoli, Campania, Italië, 80131
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      • Bergamo, Lombardia, Italië, 24128
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      • Milano, Lombardia, Italië, 20141
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    • Toscana
      • Pisa, Toscana, Italië, 56126
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    • Veneto
      • Padova, Veneto, Italië, 35128
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      • Goyang-si, Gyeonggi-Do, Korea, republiek van, 410-769
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      • Seoul, Korea, republiek van, 03080
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      • Seoul, Korea, republiek van, 135-710
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      • Amsterdam, Nederland, 1066 CX
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      • Amsterdam, Nederland, 1081 HV
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      • Groningen, Nederland, 9713 GZ
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      • Leeuwarden, Nederland, 8934 AD
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      • Leiden, Nederland, 2333 ZA
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      • Rotterdam, Nederland, 3015 GD
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      • Christchurch, Nieuw-Zeeland, 8011
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      • Newtown, Wellington, Nieuw-Zeeland, 6002
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      • Oslo, Noorwegen, 0310
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      • Graz, Oostenrijk, A-8036
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      • Nizhniy Novgorod, Russische Federatie, 603081
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      • Ryazan, Russische Federatie, 390011
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      • St. Petersburg, Russische Federatie, 197758
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      • Barcelona, Spanje, 08036
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      • Hospitalet de Llobregat, Barcelona, Spanje, 08907
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      • Praha 10, Tsjechië, 100 34
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      • Praha 2, Tsjechië, 128 08
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      • Zlin, Tsjechië, 76275
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      • Cambridge, Verenigd Koninkrijk, CB2 0QQ
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      • Glasgow, Verenigd Koninkrijk, G12 0YN
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    • Alabama
      • Birmingham, Alabama, Verenigde Staten, 35243
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    • Arizona
      • Gilbert, Arizona, Verenigde Staten, 85234
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    • California
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    • Colorado
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      • Ann Arbor, Michigan, Verenigde Staten, 48109
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      • Las Vegas, Nevada, Verenigde Staten, 89148
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    • New Jersey
      • Hackensack, New Jersey, Verenigde Staten, 07601
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    • New York
      • New York, New York, Verenigde Staten, 10029
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    • North Carolina
      • Chapel Hill, North Carolina, Verenigde Staten, 27599-7600
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    • Ohio
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Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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)

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Dabrafenib plus Trametinib
BRAF inhibitor plus MEK inhibitor
Dabrafenib 150 mg twice daily orally
Andere namen:
  • GSK2118436
Trametinib 2 mg once daily orally
Andere namen:
  • GSK1120212
Actieve vergelijker: Vemurafenib
BRAF inhibitor
Vemurafenib 960 mg twice daily orally
Andere namen:
  • Monotherapie

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Overall Survival (OS)
Tijdsspanne: 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)

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Progression-Free Survival (PFS), as Assessed by the Investigator
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

4 juni 2012

Primaire voltooiing (Werkelijk)

17 april 2014

Studie voltooiing (Werkelijk)

25 april 2019

Studieregistratiedata

Eerst ingediend

10 mei 2012

Eerst ingediend dat voldeed aan de QC-criteria

10 mei 2012

Eerst geplaatst (Schatting)

14 mei 2012

Updates van studierecords

Laatste update geplaatst (Werkelijk)

24 februari 2021

Laatste update ingediend die voldeed aan QC-criteria

8 februari 2021

Laatst geverifieerd

1 februari 2021

Meer informatie

Termen gerelateerd aan deze studie

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

Ja

Beschrijving IPD-plan

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.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Abonneren