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TerminatedNCT01701037Updated Jun 23, 2017Results posted

Dabrafenib Alone and in Combination With Trametinib Before Surgery in Treating Patients With Locally or Regionally Advanced Melanoma That Can Be Removed By Surgery

A Phase 2 interventional study of dabrafenib and trametinib in Recurrent Melanoma, Stage IIB Melanoma (Locally Advanced) and Stage IIC Melanoma (Locally Advanced), sponsored by Vanderbilt-Ingram Cancer Center. Terminated at 1 site in United States. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2017-06-23.

Sponsored by Vanderbilt-Ingram Cancer Center · Phase 2, Interventional, and Other

Why this study was terminated
PI leaving VICC, low future accrual predicted, continued funding improbable,
Phase
Phase 2
Study type
Interventional
Enrollment
13
Allocation
Not applicable
Ages
18 Years to 90 Years
Sex
All
01

Study summary

This phase II trial studies how well giving dabrafenib alone and in combination with trametinib before surgery works in treating patients with advanced melanoma that can be removed by surgery. Studying samples of tumor tissue in the laboratory from patients receiving dabrafenib and trametinib may help doctors learn more about the effects of these drugs on cells and help identify biomarkers that determine which patients will respond to these drugs best.

Read the detailed description

PRIMARY OBJECTIVES:

I. To identify markers of intrinsic resistance to v-Raf murine sarcoma viral oncogene homolog B1 (B-RAF) targeted therapy in B-RAF mutation-positive melanoma.

SECONDARY OBJECTIVES:

I. To determine if intrinsic resistance can be reversed by mitogen activated protein kinase (MEK) targeted therapy and to identify biomarkers that correlate with this response.

II. To evaluate the feasibility of pre-surgical targeted therapy and serial tumor biopsies in patients with advanced, operable melanoma to determine if this model can be used to evaluate novel combinations of molecular targeted therapy in the future.

TERTIARY OBJECTIVES:

I. To determine if pre-surgical B-RAF and MEK targeted therapy is active and well tolerated in patients with advanced, operable melanoma. These findings may be used to support clinical trials in un-resectable, B-RAF mutation-positive melanoma.

OUTLINE:

Patients receive dabrafenib orally (PO) twice daily (BID) on days 1-28 adding trametinib on days 15-28 followed by surgery on days 28-30. Treatment continues until the day prior to surgery in the absence of unacceptable toxicity.

After completion of study treatment, patients are followed up for 3 months.

02

Conditions studied

  • Recurrent Melanoma
  • Stage IIB Melanoma (Locally Advanced)
  • Stage IIC Melanoma (Locally Advanced)
  • Stage IIIA Melanoma
  • Stage IIIB Melanoma
  • Stage IIIC Melanoma
  • Stage IV Melanoma (Limited, Resectable)

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Keywords

  • Melanoma, B-RAF, biomarkers, targeted therapy, resistance
03

In context

Melanoma

3,005 studies on the registry are indexed under Melanoma; 519 are open to participants now.

This study's enrollment of 13 is below the median of 38 across 2,350 interventional studies indexed under Melanoma.

Browse Melanoma studies →

Lead sponsor

Vanderbilt-Ingram Cancer Center is the lead sponsor of 220 studies on the registry; 32 are open to participants now.

Of its 23 completed or terminated interventional studies of FDA-regulated products, 18 (78%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Signed written informed consent
  • Patients with locally-or regionally advanced melanoma being considered for resection of the lesion(s) for local-regional control and potential cure

    • Patients with limited, resectable metastatic disease (three or fewer lesions) are eligible if surgical resection is considered to be the best therapeutic option
    • Patients with AJCC clinical stage IIb-IV disease at initial diagnosis, or patients with melanoma of any stage with advanced local or regional recurrence, with or without limited resectable metastatic disease, would be eligible
  • B-RAF V-600 mutation positive by snapshot molecular analysis

    • Individuals with B-RAF V-600 mutations other than V600E are eligible
  • Measurable disease, i.e. presenting with at least one measurable lesion per Response Evaluation Criteria in Solid tumors (RECIST) 1.1
  • All prior treatment related toxicities must be Common Terminology Criteria for Adverse Events (CTCAE) (Version 4.0) =\< Grade 1 at the time of enrollment
  • Adequate baseline organ function defined by the criteria below:

    • Absolute Neutrophil Count (ANC) >= 1.5 X 10\^9/L
    • Platelet Count >= 60 X 10\^9/L
    • Hemoglobin >= 9 g/dl
    • Creatinine =\< 2 mg/dl
    • Aspartate aminotransferase (AST) =\< 100 U/L
    • Alanine aminotransferase (ALT) =\< 100 U/L
    • Alkaline Phosphatase =\< 380 U/L
    • Total Bilirubin =\< 2.0 mg/dl
  • Women of childbearing potential must have a negative serum pregnancy test within 14 days of first dose of study treatment and agree to use effective contraception during the study and for 7 days following the last dose of study treatment
  • Men with a female partner of childbearing potential must have either had a prior vasectomy or agree to use effective contraception from 1 day prior to administration of the first dose of study treatment until 7 days after the last dose of study treatment

Exclusion criteria

Exclusion Criteria:

  • ECOG Performance Status > 2
  • Lactating female
  • Any serious and/or unstable pre-existing medical, psychiatric disorder, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures
  • Any serious medical condition that would render the patient unable to undergo surgical resection or would limit life expectancy to less than 1 year
  • Any prohibited medication
  • Administration of an investigational drug within 30 days or 5 half-lives, whichever is longer, preceding the first dose of study treatment
  • A known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to GSK-2118436 (dabrafenib) or GSK-1120212 (trametinib) or excipient that contraindicates their participation
  • Patients with a history of severe cardiovascular disease as defined:

    • Symptomatic or uncontrolled cardiac arrhythmias
    • Treatment refractory hypertension, defined as a systolic blood pressure > 160mm Hg and/or diastolic > 100 mmHg which cannot be controlled by antihypertensive therapy.
    • Current ≥ NYHA Class II congestive heart failure
    • History of myocardial infarction or unstable angina within 6 months prior to study entry.
    • History of stroke or TIA within 6 months prior to study entry
    • QTc ≥ 480 msec
    • Cardiac valvular disease ≥ grade 2.
  • Patients with a history of interstitial lung disease or interstitial pneumonitis
  • A history of known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV) infection.
  • History of another active malignancy within the past 5 years, or any malignancy with a confirmed activating RAS mutation. Please note that prospective RAS mutation testing is not required, however, if results of previous RAS testing are known, they must be used in assessing eligibility. Subjects with a history of completely resected non-melanoma skin cancer are eligible.
  • A history or current evidence/risk of retinal vein occlusion (RVO) or CSR including:
  • a. Presence of predisposing factors to RVO or CSR (e.g., uncontrolled glaucoma or ocular hypertension, uncontrolled hypertension, uncontrolled diabetes mellitus, or a history of hyperviscosity or hypercoagulability syndromes); or
  • b. Visible retinal pathology as assessed by ophthalmic examination that is considered a risk factor for RVO or CSR such as:

    • i. Evidence of new optic disc cupping;
    • ii. Evidence of new visual field defects on automated perimetry;
    • iii. Intraocular pressure >21 mmHg as measured by tonography.
05

Study design

Phase
Phase 2
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
13 participants (actual)

Study arms

  • Experimental
    Dabrafenib and Trametinib

    Patients receive dabrafenib PO BID on days 1-28 adding trametinib on days 15-28 followed by surgery on days 28-30. Treatment continues in the absence of unacceptable toxicity.

    Drug: dabrafenib · Drug: trametinib · Other: laboratory biomarker analysis

Interventions

  • Drugdabrafenib

    150 mg given PO

    Also known as: BRAF inhibitor GSK2118436, GSK2118436

  • Drugtrametinib

    2 mg given PO

    Also known as: GSK1120212

  • Otherlaboratory biomarker analysis

    Correlative studies

06

What researchers measure

Primary outcomes

  1. Clinical Tumor Response Rate (Response is Based on Greater Than 30% Reduction From Baseline in Tumor Volume by RECIST Criteria) at Day 14.

    Tumor response is defined as greater than 30% reduction from baseline in tumor volume by RECIST criteria. To determine whether a patient is responded at day 14, the patient must have the tumor volume evaluated at both baseline and day 14. The tumor response rate is calculated as the proportion of patients responded among all evaluated patients.

    Time frame: day 14

Secondary outcomes

  1. Change in Tumor Volume Reduction in Participants With Intrinsic Resistance to B-RAF Targeted Therapy From Day 14 to Day 28.

    Tumor volume reduction is calculated as the tumor volume change relative to the baseline measurement (percent). Change in tumor volume reduction from day 14 to day 28 is calculated as the difference of tumor volume reduction at day 28 and day 14. The median and Inter-Quartile Range are reported.

    Time frame: Day 14 and day 28

  2. Number of Patients With Worst Grade Toxicities by Grade According to National Cancer Institute (NCI) CTCAE Version 4.0

    The intensity of the adverse event will be graded according to Version 4.0 of the National Cancer Institute Common Terminology Criteria for Adverse Events (June 14, 2010): Grade 1 - Mild Grade 2 - Moderate Grade 3 - Severe or medically significant Grade 4 - Life-threatening Grade 5 - Death related to adverse event

    Time frame: Up to 3 months

  3. Investigational Agent Taken

    Median number of pills taken

    Time frame: Up to 3 months

  4. Percent of Patients Completing Second and Third (Surgical) Biopsies

    Biopsies will be assessed whether or not tissue is acquired at specified time points. Tissue is obtained through core, punch, incisional or excisional biopsy or surgical resection, based upon the clinical situation. Standard operating procedures for biopsies, sample preparation and analysis have been defined.

    Time frame: Up to 3 months

  5. Percentage of Biopsies With Adequate Tissue for Biomarker Analysis

    Measured by the percent of tumor necrosis on hematoxylin and eosin stains; RNA gel electrophoresis, percent of adequate tissue for immunohistochemical stains in tissue microarray and cyTOF analysis.

    Time frame: Up to 3 months

07

Results

Posted Jun 23, 2017

Participant flow

This study opened to accrual at Vanderbilt-Ingram Cancer Center (VICC) in January 2013 and ran through March 2015 when it closed prematurely due to PI's departure.

Participant flow — Overall Study
MilestoneBasic Science (Dabrafenib, Trametinib)
Started13
Completed13
Not completed0

Outcome measures

PrimaryClinical Tumor Response Rate (Response is Based on Greater Than 30% Reduction From Baseline in Tumor Volume by RECIST Criteria) at Day 14.

Tumor response is defined as greater than 30% reduction from baseline in tumor volume by RECIST criteria. To determine whether a patient is responded at day 14, the patient must have the tumor volume evaluated at both baseline and day 14. The tumor response rate is calculated as the proportion of patients responded among all evaluated patients.

Time frame:
day 14
Reported as:
Number · proportion of responders
Clinical Tumor Response Rate (Response is Based on Greater Than 30% Reduction From Baseline in Tumor Volume by RECIST Criteria) at Day 14.
proportion of respondersDabrafenib and Trametinib
Clinical Tumor Response Rate (Response is Based on Greater Than 30% Reduction From Baseline in Tumor Volume by RECIST Criteria) at Day 14.0.833 (0.552 to 0.953)
SecondaryChange in Tumor Volume Reduction in Participants With Intrinsic Resistance to B-RAF Targeted Therapy From Day 14 to Day 28.

Tumor volume reduction is calculated as the tumor volume change relative to the baseline measurement (percent). Change in tumor volume reduction from day 14 to day 28 is calculated as the difference of tumor volume reduction at day 28 and day 14. The median and Inter-Quartile Range are reported.

Time frame:
Day 14 and day 28
Reported as:
Median · percentage of reduction
Change in Tumor Volume Reduction in Participants With Intrinsic Resistance to B-RAF Targeted Therapy From Day 14 to Day 28.
percentage of reductionDabrafenib and Trametinib
Change in Tumor Volume Reduction in Participants With Intrinsic Resistance to B-RAF Targeted Therapy From Day 14 to Day 28.18.0 (16.5 to 23.5)
SecondaryNumber of Patients With Worst Grade Toxicities by Grade According to National Cancer Institute (NCI) CTCAE Version 4.0

The intensity of the adverse event will be graded according to Version 4.0 of the National Cancer Institute Common Terminology Criteria for Adverse Events (June 14, 2010): Grade 1 - Mild Grade 2 - Moderate Grade 3 - Severe or medically significant Grade 4 - Life-threatening Grade 5 - Death related to adverse event

Time frame:
Up to 3 months
Reported as:
Number · participants
Number of Patients With Worst Grade Toxicities by Grade According to National Cancer Institute (NCI) CTCAE Version 4.0
participantsDabrafenib and Trametinib
Number of patients with worst-grade toxicity 11
Number of patients with worst-grade toxicity 26
Number of patients with worst-grade toxicity 36
Number of patients with worst-grade toxicity 40
Number of patients with worst-grade toxicity 50
SecondaryInvestigational Agent Taken

Median number of pills taken

Time frame:
Up to 3 months
Reported as:
Median · Number of pills taken
Investigational Agent Taken
Number of pills takenDabrafenib and Trametinib
Median number of GSK1120212 taken13 ± 1.90
Median number of GSK2118436 taken54 ± 6.34
SecondaryPercent of Patients Completing Second and Third (Surgical) Biopsies

Biopsies will be assessed whether or not tissue is acquired at specified time points. Tissue is obtained through core, punch, incisional or excisional biopsy or surgical resection, based upon the clinical situation. Standard operating procedures for biopsies, sample preparation and analysis have been defined.

Time frame:
Up to 3 months
Reported as:
Number · percentage of participants
Percent of Patients Completing Second and Third (Surgical) Biopsies
percentage of participantsDabrafenib and Trametinib
Percent of Patients Completing Second and Third (Surgical) Biopsies92
SecondaryPercentage of Biopsies With Adequate Tissue for Biomarker Analysis

Measured by the percent of tumor necrosis on hematoxylin and eosin stains; RNA gel electrophoresis, percent of adequate tissue for immunohistochemical stains in tissue microarray and cyTOF analysis.

Time frame:
Up to 3 months
Reported as:
Number · percentage of biopsies w/adequate tissue
Percentage of Biopsies With Adequate Tissue for Biomarker Analysis
percentage of biopsies w/adequate tissueDabrafenib and Trametinib
Percentage of Biopsies With Adequate Tissue for Biomarker Analysis92

Adverse events

Collected over Serious adverse events and Adverse events were collected over 25 months period.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Basic Science (Dabrafenib, Trametinib)—1/13 (7.7%)13/13 (100%)
Most frequent serious events
Most frequent serious events
EventBasic Science (Dabrafenib, Trametinib)
Atrial fibrillationCardiac disorders1/13
StrokeNervous system disorders1/13
Kidney InjuryRenal and urinary disorders1/13
Most frequent other events
Showing 10 of 51
Most frequent other events
EventBasic Science (Dabrafenib, Trametinib)
FatigueGeneral disorders8/13
Rash maculo-papularSkin and subcutaneous tissue disorders7/13
HyperglycemiaMetabolism and nutrition disorders6/13
ChillsGeneral disorders5/13
NauseaGastrointestinal disorders5/13
ArthralgiaMusculoskeletal and connective tissue disorders5/13
HeadacheNervous system disorders4/13
FeverGeneral disorders3/13
PruritusSkin and subcutaneous tissue disorders3/13
Alanine aminotransferase increasedInvestigations3/13

Baseline characteristics

Age, Customized
Age, Customized(Participants)Basic Science (Dabrafenib, Trametinib)
20-291
30-392
40-492
50-593
60-693
70-792
Sex: Female, Male
Sex: Female, Male(Participants)Basic Science (Dabrafenib, Trametinib)
Female7
Male6
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Basic Science (Dabrafenib, Trametinib)
Hispanic or Latino0
Not Hispanic or Latino13
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Basic Science (Dabrafenib, Trametinib)
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White13
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(Participants)Basic Science (Dabrafenib, Trametinib)
United States13
08

Study locations

1 site
  • Vanderbilt-Ingram Cancer Center
    Nashville, Tennessee 37232-6838, United States
09

References and documents

Publications

  • Johnson AS, Crandall H, Dahlman K, Kelley MC. Preliminary results from a prospective trial of preoperative combined BRAF and MEK-targeted therapy in advanced BRAF mutation-positive melanoma. J Am Coll Surg. 2015 Apr;220(4):581-93.e1. doi: 10.1016/j.jamcollsurg.2014.12.057. Epub 2015 Jan 30. PubMed 25797743 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 23, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01701037
Lead sponsor
Vanderbilt-Ingram Cancer Center
Collaborators
National Cancer Institute (NCI), National Comprehensive Cancer Network
Responsible party
Mark Kelley, MD (Chief, Division of Surgical Oncology and Endocrine Surgery; Associate Professor of Surgery; Surgical Oncologist, Vanderbilt-Ingram Cancer Center) — Principal investigator
First posted
Oct 4, 2012
Start date
Jan 2013
Primary completion
Feb 2015
Completion
Apr 2015
Results posted
Jun 23, 2017
Last update
Jun 23, 2017

Study contacts

Mark Kelley
principal investigator · Vanderbilt-Ingram Cancer Center

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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