Phase 2
N=77
Study to Investigate the Objective Response Rate of Dabrafenib in Combination With Trametinib in Subjects With BRAF V600 Mutation-Positive Melanoma
Cancer · Melanoma
Bottom Line
View on ClinicalTrials.gov: NCT02083354 ↗Enrolled (actual)
77
Serious AEs
23.4%
Results posted
Mar 2021
Primary outcome: Primary: Objective Response Rate (ORR) — 61 Percentage of Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Dabrafenib (Drug); Trametinib (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- Feb 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Objective Response Rate (ORR) |
61 | — |
| SECONDARY Progression-free Survival (PFS) - Median |
9.17 | — |
| SECONDARY Progression-free Survival (PFS) |
52; 4; 10; 11 | — |
| SECONDARY Duration of Response (DOR) - Estimate for Duration of Response - Median |
12.65 | — |
| SECONDARY Duration of Response (DOR) |
27; 2; 9; 10 | — |
| SECONDARY Overall Survival (OS) - Median |
22.90 | — |
| SECONDARY Overall Survival (OS) |
43; 13; 21 | — |
| SECONDARY Number of Participants With Adverse Events |
76; 69; 18; 9; 4; 1 | — |
| SECONDARY Population Pharmacokinetics of Dabrafenib - Cmax |
2950; 2300 | — |
| SECONDARY Population Pharmacokinetics of Dabrafenib - Tmax |
1.95; 1.5 | — |
| SECONDARY Population Pharmacokinetics of Dabrafenib - AUC(0-12) |
11400; 6600 | — |
| SECONDARY Population Pharmacokinetics of Dabrafenib - Ctrough |
77 | — |
| SECONDARY Population Pharmacokinetics of Dabrafenib - Racc |
0.624 | — |
| SECONDARY Population Pharmacokinetics of Hydroxydabrafenib - Cmax |
1230; 1200 | — |
| SECONDARY Population Pharmacokinetics of Hydroxydabrafenib - Tmax |
3.08; 1.96 | — |
| SECONDARY Population Pharmacokinetics of Hydroxydabrafenib - AUC(0-12) |
7930; 4440 | — |
| SECONDARY Population Pharmacokinetics of Hydroxydabrafenib - Rm/p |
0.68; 0.653 | — |
| SECONDARY Population Pharmacokinetics of Hydroxydabrafenib - Ctrough |
94 | — |
| SECONDARY Population Pharmacokinetics of Hydroxydabrafenib - Racc |
0.56 | — |
| SECONDARY Population Pharmacokinetics of Desmethyl-dabrafenib - Cmax |
48.9; 466 | — |
| SECONDARY Population Pharmacokinetics of Desmethyl-dabrafenib - Tmax |
9.9; 2.48 | — |
| SECONDARY Population Pharmacokinetics of Desmethyl-dabrafenib - AUC(0-12) |
3960 | — |
| SECONDARY Population Pharmacokinetics of Desmethyl-dabrafenib - Rm/p |
0.616 | — |
| SECONDARY Population Pharmacokinetics of Desmethyl-dabrafenib - Ctrough |
365 | — |
| SECONDARY Population Pharmacokinetics of Carboxydabrafenib - Cmax |
3760; 9750 | — |
| SECONDARY Population Pharmacokinetics of Carboxydabrafenib - Tmax |
8.94; 3.5 | — |
| SECONDARY Population Pharmacokinetics of Carboxydabrafenib - AUC(0-12) |
34400; 86500 | — |
| SECONDARY Population Pharmacokinetics of Carboxydabrafenib - Rm/p |
3.34; 12.4 | — |
| SECONDARY Population Pharmacokinetics of Carboxydabrafenib - Ctrough |
5160 | — |
| SECONDARY Population Pharmacokinetics of Carboxydabrafenib - Racc |
1.51 | — |
| SECONDARY Population Pharmacokinetics of Trametinib - Cmax |
9.87; 25.9 | — |
| SECONDARY Population Pharmacokinetics of Trametinib - Tmax |
1.5; 11.3 | — |
| SECONDARY Population Pharmacokinetics of Trametinib - AUC(0-t) |
72.6; 346 | — |
| SECONDARY Population Pharmacokinetics of Trametinib - AUC(0-24) |
72.7; 357 | — |
| SECONDARY Population Pharmacokinetics of Trametinib - Ctrough |
11.2 | — |
| SECONDARY Population Pharmacokinetics of Trametinib - Racc |
5.16 | — |
Summary
This was a single-arm, open-label, multi-center, Phase II study to evaluate dabrafenib and trametinib combination therapy in subjects with BRAF V600 mutation-positive, unresectable or metastatic Acral lentiginous or cutaneous melanoma. This study evaluated the objective response rate (ORR), progression free survival (PFS), duration of response, overall survival (OS), safety and efficacy, to assess steady state (all subjects) exposure to dabrafenib, dabrafenib metabolites, and trametinib and characterize the population pharmacokinetics (PK) and pharmacodynamics (PD) of dabrafenib and trametinib. Enrolled subjects were administered dabrafenib 150 milligram (mg) orally twice daily and trametinib 2 mg orally once daily. Treatment continued until disease progression, death, unacceptable toxicity, or withdrawal of consent, or study closure. After treatment discontinuation, subjects were followed for survival and disease progression as applicable.
Eligibility Criteria
Inclusion Criteria
- Signed written informed consent, which includes compliance with the requirements and restrictions listed in the consent form.
- >=18 years of age.
- Histologically confirmed acral lentiginous or cutaneous melanoma that is either Stage IIIC (unresectable) or Stage IV (metastatic), and BRAF V600 mutation-positive. The test was to have been conducted at a designated central laboratory.
- Measurable disease (i.e., present with at least one measurable lesion) by RECIST version1.1.
- Performance status score of 0 or 1 according to the Eastern Cooperative Oncology Group (ECOG) scale.
- All prior anti-cancer treatment-related toxicities (except alopecia and laboratory values) must be = 1.2 × 10^9/liter (L); Hemoglobin: >=9 grams (g)/deciliter (dL); Platelet count: >=100 x 10^9/L; Prothrombin Time/International Normalized Ratio (INR) (Subjects receiving anticoagulation treatment may be allowed to participate with INR established within the therapeutic range prior to enrolment) and Partial Thromboplastin Time: =2.5 g/dL; Total bilirubin: =50 milliliter (mL)/ minute (min); Left Ventricular Ejection Fraction (LVEF) (ECHO scans must be used throughout the study) : >= Lower limit of normal (LLN) by ECHO.
- Subjects with East Asian origin.
Exclusion Criteria
- Primary mucosal or ocular melanoma.
- Prior treatment with a BRAF inhibitor (including but not limited to dabrafenib, vemurafenib, LGX818, and XL281/BMS-908662) or a MEK inhibitor (including but not limited to trametinib, AZD6244, and RDEA119).
- Any major surgery, extensive radiotherapy, chemotherapy with delayed toxicity, biologic anti-cancer therapy, or immuno anti-cancer therapy within 21 days prior to enrolment /or daily or weekly chemotherapy without the potential for delayed toxicity within 14 days prior to enrolment. (Note: Ipilimumab, pembrolizumab and nivolumab treatment must ended at least 8 weeks prior to enrollment).
- Taken an investigational drug within 28 days or 5 half-lives (minimum 14 days), whichever is shorter, prior to enrolment. (Note: in case ipilimuamb, pembrolizmab and nivolumab are investigational drug in the regions and countries, and in case of PD-L1 antibody, these investigational treatment must have ended at least 8 weeks prior to enrollment ).
- Current use of a prohibited medication.
- Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the study treatments, their excipients, and/or dimethyl sulfoxide (DMSO).
- A history of Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV) infection (subjects with laboratory evidence of cleared HBV and/or HCV will be permitted).
- Leptomeningeal or brain metastases or metastases causing spinal cord compression that were: symptomatic or untreated or not stable for 3 months (must be documented by imaging) or requiring corticosteroids. Subjects that were on a stable dose of corticosteroids >1 month or on replacement dose only, or have been off of corticosteroids for at least 2 weeks can be enrolled with approval of the medical monitor. Subjects must also have been off of enzyme-inducing anticonvulsants for >4 weeks.
- History of malignancy other than disease under study within 3 years of study enrolment with exceptions of subjects with a history of completely resected non-melanoma skin cancer, or subjects with indolent second malignancies were eligible only after the approval of the sponsor's medical monitor.
- History of malignancy with confirmed activating RAS mutation at any time. Note: Prospective RAS testing was not required. However, if the results of previous RAS testing were known, they must have been used in assessing eligibility
- Any serious or unstable pre-existing medical conditions (aside from malignancy exceptions specified above), psychiatric disorders, or other conditions that could have interfered with the subject's safety, obtaining informed consent, or compliance with study procedures.
- A history or evidence of cardiovascular r
Data sourced from ClinicalTrials.gov (NCT02083354). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.