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Not yet recruitingNCT07807878BAP1treatUpdated Sep 8, 2026

Trial of Temozolomide in BAP1 Mutated Patients With Advanced or Metastatic Cutaneous Melanoma

A Phase 2 interventional study of Temozolomide (TMZ) in Cutaneous Melanoma, sponsored by Assistance Publique Hopitaux De Marseille. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-08.

Sponsored by Assistance Publique Hopitaux De Marseille · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
28
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

BAP1, or BRCA1-associated protein 1, is a gene involved in DNA repair via homologous recombination and is considered a tumor suppressor gene. It is lost or inactivated in a large number of tumors, and the presence of germline BAP1 mutations is associated with a syndrome of tumor predisposition.

Following our team's observation of two exceptional responses to temozolomide in patients who had reached a therapeutic impasse-one of which lasted 11 months and involved both intracerebral and extracerebral tumors-we hypothesize that this mutation may lead to increased susceptibility to chemotherapy.

Read the detailed description

Although the therapeutic management of melanoma has undergone a revolution over the past decade with the advent of immune checkpoint inhibitors on the one hand, and BRAF- and MEK-targeted therapies in patients harboring a BRAF V600 mutation on the other hand, half of patients do not achieve a durable response to these strategies. In light of these major advances, chemotherapy has gradually been abandoned, even in patients with limited therapeutic options, because of its very low response rate.

BAP1, or BRCA1-associated protein 1, is involved in DNA repair through homologous recombination and is considered a tumor suppressor gene. It is lost or inactivated in a wide range of tumors, and the presence of germline BAP1 mutations is associated with a tumor predisposition syndrome (BAP1 tumor predisposition syndrome, BAP1-TPDS).

Following the observation by our team of two exceptional responses, both intracranial and extracranial, lasting more than six months, in two young patients with metastatic melanoma harboring a constitutional BAP1 mutation, treated in the third and eighth lines of therapy, respectively, we hypothesize that this mutation may confer increased susceptibility to chemotherapy, as has been reported in pleural mesothelioma. This increased susceptibility could help guide the therapeutic strategy for affected patients, who account for approximately 1% of cutaneous melanomas in the germline setting and 5-17% of cutaneous melanomas when somatic mutations are considered.

As it remains unclear whether this effect is restricted to germline BAP1 mutations, we chose to include both germline and somatic BAP1 mutations in this study. This is particularly relevant because, in routine clinical practice, the germline or somatic nature of a BAP1 mutation is often determined at a later stage. Somatic mutation testing is frequently performed only as part of a molecular biology panel before predictive medicine strategies are considered, guided by molecular tumor boards, in patients with limited therapeutic options.

Validation of this hypothesis could make it possible to identify patients who may benefit from this readily available and inexpensive treatment.

02

Conditions studied

  • Cutaneous Melanoma

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03

In context

Melanoma

3,370 studies on the registry are indexed under Melanoma; 578 are open to participants now.

This study's planned enrollment of 28 is below the median of 40 across 2,649 interventional studies indexed under Melanoma.

Browse Melanoma studies →

Lead sponsor

Assistance Publique Hopitaux De Marseille is the lead sponsor of 702 studies on the registry; 139 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adult patient (≥18 years old)
  • Patients who have received information about the study and have signed an form.
  • Histopathological confirmation of a diagnosis of stage III (unresectable) or stage IV () cutaneous melanoma according to the 8th edition of the AJCC staging system.
  • Patient has experienced treatment failure after undergoing at least one line of Immunotherapy with at least one (anti-PD1, anti-PD1+anti-CTLA4, or anti-PD1+anti-LAG3) and one line of targeted therapy combining BRAF and MEK inhibitors, if indicated.
  • The patient must have an (ECOG) performance status of 3 or lower.
  • The patient must have at least one defined by the , version 1.1 (RECIST 1.1).
  • The patient must have a pathogenic BAP1 alteration identified by a molecular biology technique in tumor tissue or in circulating cell-free DNA.
  • The inclusion of patients is subject to the following criteria:
  • ≥ 1.5 x 109/L (≥ 1500 per mm3)
  • count ≥ 100 x 109/L
  • ≥ 9 g/dL
  • ASAT and/or ALAT ≤ 2.5 x (ULN); patient with liver metastases ≤ 5 × ULN
  • Total ≤ 1.5 x ULN
  • Creatinine ≤ 1.5 x ULN or calculated ≥ 50 ml/min for patients with creatinine levels > 1.5 x ULN (according to Cockroft-Gault Appendix D) ;
  • (INR) or prothrombin time (PT) and activated partial thromboplastin time (aPTT) ≤ 1.5 x ULN
  • Female patients with a negative highly sensitive pregnancy test, or female patients.

Exclusion criteria

Exclusion Criteria:

  • Patients with non-cutaneous melanoma, whether uveal, mucosal, of unknown primary origin or
  • Patients who have received a minimum of one for melanoma treatment
  • Positive serology results for (HIV), active or C infection (acute or chronic) or uncontrolled infection
  • Concomitant presence or history of another , except for the following: appropriately treated squamous or basal cell carcinoma of the skin (adequate healing is required prior to study entry); any other solid tumor, curatively treated and without evidence of recurrence for at least 2 years prior to study entry.
  • Participation in or ongoing treatment with another agent or use of an investigational device within 28 days prior to study treatment.

NB: Participants who have entered the follow-up phase if an investigational study may participate as long as it has been 4 weeks or an interval of five-half-lives, whichever the shortest is, after the last dose of the previous investigational agent.

  • Subjects covered by Articles L1121-5 through L1121-8 of the Public Health Code (minors, adults under guardianship or conservatorship, patients deprived of their liberty, and pregnant or breastfeeding women).
  • Any pathology that, in the investigator's opinion, may be a to the patient's participation in the clinical study, for reasons of safety or compliance with clinical study procedures.
  • Patient with to IMP temozolomide (including hypersensitivity to dacarbazine, severe myelosuppression) or to any of its .
Terms in these criteria, in plain language(23)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
28 participants (estimated)

Study arms

  • Experimental
    patients with advanced cutaneous melanoma with a BAP1 mutation

    Patient will be treated with temozolomide at a dose of 200mg/m2 from day 1 to day 5, every 28 days, for up to two years

    Drug: Temozolomide (TMZ)

Interventions

  • Patients will be treated at a dose of 200mg/m2 from day 1 to day 5, every 28 days, for up to two years

06

What researchers measure

Primary outcomes

  1. Overall response rate at day 84

    Overall response rate will be defined as the percentage of patients with a partial response or a complete response according to RECIST 1.1 criteria.

    Time frame: 84 days

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07807878
Responsible party
Sponsor
First posted
Sep 8, 2026
Start date
Jun 1, 2027 (estimated)
Primary completion
Jan 1, 2030 (estimated)
Completion
Jun 1, 2031 (estimated)
Last update
Sep 8, 2026

Study contacts

Clement PIERRE, PhD
Contact
clement.pierre@ap-hm.fr
+33491435796
Nausicaa MALISSEN, Doctor
principal investigator · assistance publique - hôpitaux de Marseille

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Temozolomide

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