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
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.
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.
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 →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.
Patients with locally-or regionally advanced melanoma being considered for resection of the lesion(s) for local-regional control and potential cure
B-RAF V-600 mutation positive by snapshot molecular analysis
Adequate baseline organ function defined by the criteria below:
Exclusion Criteria:
Patients with a history of severe cardiovascular disease as defined:
b. Visible retinal pathology as assessed by ophthalmic examination that is considered a risk factor for RVO or CSR such as:
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
150 mg given PO
Also known as: BRAF inhibitor GSK2118436, GSK2118436
2 mg given PO
Also known as: GSK1120212
Correlative studies
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
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
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
Investigational Agent Taken
Median number of pills taken
Time frame: Up to 3 months
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
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
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.
| Milestone | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| Started | 13 |
| Completed | 13 |
| Not completed | 0 |
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.
| proportion of responders | Dabrafenib 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) |
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.
| percentage of reduction | Dabrafenib 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) |
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
| participants | Dabrafenib and Trametinib |
|---|---|
| Number of patients with worst-grade toxicity 1 | 1 |
| Number of patients with worst-grade toxicity 2 | 6 |
| Number of patients with worst-grade toxicity 3 | 6 |
| Number of patients with worst-grade toxicity 4 | 0 |
| Number of patients with worst-grade toxicity 5 | 0 |
Median number of pills taken
| Number of pills taken | Dabrafenib and Trametinib |
|---|---|
| Median number of GSK1120212 taken | 13 ± 1.90 |
| Median number of GSK2118436 taken | 54 ± 6.34 |
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.
| percentage of participants | Dabrafenib and Trametinib |
|---|---|
| Percent of Patients Completing Second and Third (Surgical) Biopsies | 92 |
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.
| percentage of biopsies w/adequate tissue | Dabrafenib and Trametinib |
|---|---|
| Percentage of Biopsies With Adequate Tissue for Biomarker Analysis | 92 |
Collected over Serious adverse events and Adverse events were collected over 25 months period.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Basic Science (Dabrafenib, Trametinib) | — | 1/13 (7.7%) | 13/13 (100%) |
| Event | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| Atrial fibrillationCardiac disorders | 1/13 |
| StrokeNervous system disorders | 1/13 |
| Kidney InjuryRenal and urinary disorders | 1/13 |
| Event | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| FatigueGeneral disorders | 8/13 |
| Rash maculo-papularSkin and subcutaneous tissue disorders | 7/13 |
| HyperglycemiaMetabolism and nutrition disorders | 6/13 |
| ChillsGeneral disorders | 5/13 |
| NauseaGastrointestinal disorders | 5/13 |
| ArthralgiaMusculoskeletal and connective tissue disorders | 5/13 |
| HeadacheNervous system disorders | 4/13 |
| FeverGeneral disorders | 3/13 |
| PruritusSkin and subcutaneous tissue disorders | 3/13 |
| Alanine aminotransferase increasedInvestigations | 3/13 |
| Age, Customized(Participants) | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| 20-29 | 1 |
| 30-39 | 2 |
| 40-49 | 2 |
| 50-59 | 3 |
| 60-69 | 3 |
| 70-79 | 2 |
| Sex: Female, Male(Participants) | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| Female | 7 |
| Male | 6 |
| Ethnicity (NIH/OMB)(Participants) | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| Hispanic or Latino | 0 |
| Not Hispanic or Latino | 13 |
| Unknown or Not Reported | 0 |
| Race (NIH/OMB)(Participants) | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 0 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 0 |
| White | 13 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
| Region of Enrollment(Participants) | Basic Science (Dabrafenib, Trametinib) |
|---|---|
| United States | 13 |
This study is terminated, as verified in Jun 2017. You cannot join it, but the record below documents what was studied.
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Vanderbilt-Ingram Cancer Center