Phase 1
N=56
Pharmacokinetic Drug-drug Interaction Study of Encorafenib and Binimetinib on Probe Drugs in Patients With BRAF V600-mutant Melanoma or Other Advanced Solid Tumors
Advanced Solid Tumors · Metastatic Melanoma
Bottom Line
View on ClinicalTrials.gov: NCT03864042 ↗Enrolled (actual)
56
Serious AEs
19.8%
Results posted
Sep 2024
Primary outcome: Primary: Maximum Concentration (Cmax) of Plasma Midazolam on Day -7, Day 1, and Day 14 — 9.45; 11.1; 2.44 nanograms per milliliter (ng/mL)
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 1
- Interventions
- losartan (Drug); dextromethorphan (Drug); caffeine (Drug); omeprazole (Drug); midazolam (Drug); rosuvastatin (Drug); bupropion immediate release (IR) (Drug); encorafenib (Drug); binimetinib (Drug); modafinil (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Pfizer
- Primary completion
- Jul 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Maximum Concentration (Cmax) of Plasma Midazolam on Day -7, Day 1, and Day 14 |
9.45; 11.1; 2.44 | — |
| PRIMARY Cmax of Plasma Total 1-OH Midazolam on Day -7, Day 1, and Day 14 |
45.2; 50.5; 56.7 | — |
| PRIMARY Cmax of Plasma Free 1-OH Midazolam on Day -7, Day 1, and Day 14 |
3.36; 4.52; 2.09 | — |
| PRIMARY Cmax of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1, and Day 14 |
41.5; 45.4; 54.1 | — |
| PRIMARY Cmax of Plasma Absolute Caffeine on Day -7, Day 1, and Day 14 |
1150; 1210; 1300 | — |
| PRIMARY Cmax of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1, and Day 14 |
984; 1070; 1110 | — |
| PRIMARY Cmax of Plasma Paraxanthine on Day -7, Day 1, and Day 14 |
357; 319; 247 | — |
| PRIMARY Cmax of Plasma Omeprazole on Day -7, Day 1, and Day 14 |
267; 354; 271 | — |
| PRIMARY Cmax of Plasma 5-OH Omeprazole on Day -7, Day 1, and Day 14 |
91.8; 90.4; 64.4 | — |
| PRIMARY Cmax of Plasma Rosuvastatin on Day -7, Day 1 and Day 14 |
6.98; 30.3; 18.7 | — |
| PRIMARY Cmax of Plasma Bupropion on Day -7, Day 1 and Day 14 |
94.0; 70.9; 71.0 | — |
| PRIMARY Cmax of Plasma Hydroxybupropion on Day -7, Day 1 and Day 14 |
181; 189; 256 | — |
| PRIMARY Area Under the Concentration-Time Profile From Time 0 to The Time of The Last Quantifiable Concentration (AUClast) of Plasma Midazolam on Day -7, Day 1, and Day 14 |
25.7; 27.6; 4.52 | — |
| PRIMARY AUClast of Plasma Total 1-OH Midazolam on Day -7, Day 1, and Day 14 |
135; 173; 142 | — |
| PRIMARY AUClast of Plasma Free 1-OH Midazolam on Day -7, Day 1, and Day 14 |
8.87; 11.1; 4.55 | — |
| PRIMARY AUClast of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1, and Day 14 |
125; 160; 133 | — |
| PRIMARY AUClast of Plasma Absolute Caffeine on Day -7, Day 1, and Day 14 |
5940; 6480; 7520 | — |
| PRIMARY AUClast of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1, and Day 14 |
5100; 5700; 6430 | — |
| PRIMARY AUClast of Plasma Paraxanthine on Day -7, Day 1, and Day 14 |
2160; 1940; 1470 | — |
| PRIMARY AUClast of Plasma Omeprazole on Day -7, Day 1, and Day 14 |
815; 1020; 674 | — |
| PRIMARY AUClast of Plasma 5-OH Omeprazole in Arm 1 on Day -7, Day 1 and Day 14 |
313; 302; 195 | — |
| PRIMARY AUClast of Plasma Rosuvastatin on Day -7, Day 1 and Day 14 |
33.6; 93.8; 52.8 | — |
| PRIMARY AUClast of Plasma Bupropion on Day -7, Day 1 and Day 14 |
339; 261; 250 | — |
| PRIMARY AUClast of Plasma Hydroxybupropion on Day -7, Day 1 and Day 14 |
1090; 1080; 1610 | — |
| PRIMARY The Amount Eliminated Via Urine Over an 8-Hour Period (Ae0-8) of Losartan on Day -7, Day 1 and Day 14 |
0.239; 0.349; 0.286 | — |
| PRIMARY Ae0-8 of E-3174 on Day -7, Day 1 and Day 14 |
0.227; 0.332; 0.205 | — |
| PRIMARY Ae0-8 of Dextromethorphan on Day -7, Day 1 and Day 14 |
0.0264; 0.0323; 0.0225 | — |
| PRIMARY Ae0-8 of Dextrorphan on Day -7, Day 1 and Day 14 |
3.78; 4.41; 3.55 | — |
| PRIMARY Cmax of Plasma Encorafenib on Day 14 and Day 21 in Arm 3 |
3540; 2830 | — |
| PRIMARY Cmax of Plasma LHY746 on Day 14 and Day 21 in Arm 3 |
2460; 2510 | — |
| PRIMARY AUClast of Plasma Encorafenib on Day 14 and Day 21 in Arm 3 |
11900; 9100 | — |
| PRIMARY AUClast of Plasma LHY746 on Day 14 and Day 21 in Arm 3 |
31100; 33100 | — |
| SECONDARY Ratio of AUClast Values of the Metabolite Compared to Parent (MRAUClast) for 1-OH Midazolam/Midazolam on Day -7, Day 1 and Day 14 |
5.00; 5.97; 30.1 | — |
| SECONDARY Ratio of AUC From Time Zero Extrapolated to Infinity (AUCinf) Values of the Metabolite Compared to Parent (MRAUCinf) for 1-OH Midazolam/Midazolam on Day -7, Day 1 and Day 14 |
4.31; 5.21; 29.5 | — |
| SECONDARY MRAUClast for Paraxanthine/Caffeine on Day -7, Day 1 and Day 14 |
0.392; 0.324; 0.211 | — |
| SECONDARY MRAUClast for 5-OH Omeprazole/Omeprazole on Day -7, Day 1 and Day 14 |
0.309; 0.282; 0.277 | — |
| SECONDARY MRAUCinf for 5-OH Omeprazole/Omeprazole on Day -7, Day 1 and Day 14 |
0.312; 0.960; 0.312 | — |
| SECONDARY MRAUClast for Hydroxybupropion/Bupropion on Day -7, Day 1 and Day 14 |
3.01; 3.88; 6.04 | — |
| SECONDARY MRAUClast for LHY746/Encorafenib in Arm 3 on Day 14 and Day 21 |
3.31; 4.62 | — |
| SECONDARY Ratio of Cmax Values of the Metabolite Compared to Parent (MRCmax) for 1-OH Midazolam/Midazolam on Day -7, Day 1 and Day 14 |
4.56; 4.36; 22.2 | — |
| SECONDARY MRCmax for Paraxanthine/Caffeine on Day -7, Day 1 and Day 14 |
0.335; 0.285; 0.205 | — |
| SECONDARY MRCmax for 5-OH Omeprazole/Omeprazole on Day -7, Day 1 and Day 14 |
0.273; 0.244; 0.227 | — |
| SECONDARY MRCmax for Hydroxybupropion/Bupropion on Day -7, Day 1 and Day 14 |
1.80; 2.51; 3.38 | — |
| SECONDARY MRCmax for LHY746/Encorafenib in Arm 3 on Day 14 and Day 21 |
0.883; 1.13 | — |
| SECONDARY Ratio of Ae0-8 Values of the Metabolite Compared to Parent (MRAe0-8) for E-3174/Losartan on Day -7, Day 1 and Day 14 |
0.920; 0.921; 0.693 | — |
| SECONDARY MRAe0-8 for Dextrorphan/Dextromethorphan on Day -7, Day 1 and Day 14 |
151; 144; 167 | — |
| SECONDARY Time to Reach Cmax (Tmax) of Plasma Midazolam on Day -7, Day 1 and Day 14 |
1.00; 0.88; 0.88 | — |
| SECONDARY Tmax of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14 |
1.00; 0.90; 0.88 | — |
| SECONDARY Tmax of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14 |
1.00; 0.90; 0.92 | — |
| SECONDARY Tmax of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14 |
1.00; 0.90; 0.88 | — |
| SECONDARY Tmax of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14 |
1.00; 0.93; 0.90 | — |
| SECONDARY Tmax of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14 |
1.00; 0.94; 0.98 | — |
| SECONDARY Tmax of Plasma Paraxanthine on Day -7, Day 1 and Day 14 |
7.18; 7.63; 6.00 | — |
| SECONDARY Tmax of Plasma Omeprazole on Day -7, Day 1 and Day 14 |
2.20; 3.00; 3.00 | — |
| SECONDARY Tmax of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14 |
2.97; 3.80; 3.00 | — |
| SECONDARY Tmax of Plasma Rosuvastatin on Day -7, Day 1 and Day 14 |
2.40; 1.85; 1.40 | — |
| SECONDARY Tmax of Plasma Bupropion on Day -7, Day 1 and Day 14 |
1.87; 1.93; 1.92 | — |
| SECONDARY Tmax of Plasma Hydroxybupropion on Day -7, Day 1 and Day 14 |
4.00; 7.68; 3.94 | — |
| SECONDARY AUCinf of Plasma Midazolam on Day -7, Day 1 and Day 14 |
27.1; 27.1; 5.10 | — |
| SECONDARY AUCinf of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14 |
150; 172; 154 | — |
| SECONDARY AUCinf of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14 |
9.98; 13.1; 5.52 | — |
| SECONDARY AUCinf of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14 |
139; 167; 143 | — |
| SECONDARY AUCinf of Plasma Omeprazole on Day -7, Day 1 and Day 14 |
1630; 1170; 904 | — |
| SECONDARY AUCinf of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14 |
557; 880; 294 | — |
| SECONDARY AUCinf of Plasma Rosuvastatin on Day -7, Day 1 and Day 14 |
75.4; 139; 62.9 | — |
| SECONDARY AUCinf of Plasma Bupropion on Day -7, Day 1 and Day 14 |
398; 390; 298 | — |
| SECONDARY Percent of AUC Extrapolated (AUC%Extrap) of Plasma Midazolam on Day -7, Day 1 and Day 14 |
19.1; 19.3; 8.76 | — |
| SECONDARY AUC%Extrap of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14 |
15.2; 21.9; 12.6 | — |
| SECONDARY AUC%Extrap of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14 |
14.1; 12.9; 12.8 | — |
| SECONDARY AUC%Extrap of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14 |
15.3; 22.6; 14.1 | — |
| SECONDARY AUC%Extrap of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14 |
48.3; 53.2; 61.0 | — |
| SECONDARY AUC%Extrap of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14 |
46.7; 54.8; 58.0 | — |
| SECONDARY AUC%Extrap of Plasma Omeprazole on Day -7, Day 1 and Day 14 |
7.35; 11.9; 4.22 | — |
| SECONDARY AUC%Extrap of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14 |
12.4; 26.1; 8.07 | — |
| SECONDARY Apparent Terminal Elimination Rate Constant (Kel) of Plasma Midazolam on Day -7, Day 1 and Day 14 |
0.196; 0.188; 0.347 | — |
| SECONDARY Kel of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14 |
0.248; 0.199; 0.259 | — |
| SECONDARY Kel of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14 |
0.231; 0.236; 0.269 | — |
| SECONDARY Kel of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14 |
0.241; 0.197; 0.277 | — |
| SECONDARY Kel of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14 |
0.0870; 0.0753; 0.0575 | — |
| SECONDARY Kel of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14 |
0.0893; 0.0739; 0.0656 | — |
| SECONDARY Kel of Plasma Omeprazole on Day -7, Day 1 and Day 14 |
0.401; 0.296; 0.461 | — |
| SECONDARY Kel of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14 |
0.303; 0.197; 0.386 | — |
| SECONDARY Terminal Elimination Half-Life (T1/2) of Plasma Midazolam on Day -7, Day 1 and Day 14 |
3.54; 3.69; 2.00 | — |
| SECONDARY T1/2 of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14 |
2.80; 3.48; 2.68 | — |
| SECONDARY T1/2 of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14 |
3.00; 2.93; 2.58 | — |
| SECONDARY T1/2 of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14 |
2.87; 3.53; 2.50 | — |
| SECONDARY T1/2 of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14 |
7.97; 9.20; 12.1 | — |
| SECONDARY T1/2 of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14 |
7.76; 9.38; 10.6 | — |
| SECONDARY T1/2 of Plasma Omeprazole on Day -7, Day 1 and Day 14 |
1.73; 2.34; 1.50 | — |
| SECONDARY T1/2 of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14 |
2.29; 3.53; 1.80 | — |
| SECONDARY T1/2 of Plasma Rosuvastatin on Day -7, Day 1 and Day 14 |
3.25; 2.13; 1.86 | — |
| SECONDARY T1/2 of Plasma Bupropion on Day -7, Day 1 and Day 14 |
2.81; 3.24; 2.75 | — |
| SECONDARY Apparent Clearance (CL/F) of Plasma Midazolam on Day -7, Day 1 and Day 14 |
73.9; 73.9; 392 | — |
| SECONDARY CL/F of Plasma Omeprazole on Day -7, Day 1 and Day 14 |
12.3; 17.0; 22.1 | — |
| SECONDARY Apparent Total Volume of Distribution Following Oral Administration (Vz/F) of Plasma Midazolam on Day -7, Day 1 and Day 14 |
306; 339; 1030 | — |
| SECONDARY Vz/F of Plasma Omeprazole on Day -7, Day 1 and Day 14 |
29.1; 44.6; 45.9 | — |
| SECONDARY Percentage of Dose Recovered in Urine (Fe) for Losartan on Day -7, Day 1 and Day 14 |
0.478; 0.699; 0.572 | — |
| SECONDARY Fe for E-3174 on Day -7, Day 1 and Day 14 |
0.440; 0.644; 0.396 | — |
| SECONDARY Fe for Dextromethorphan on Day -7, Day 1 and Day 14 |
0.0881; 0.108; 0.0750 | — |
| SECONDARY Fe for Dextrorphan on Day -7, Day 1 and Day 14 |
13.3; 15.6; 12.5 | — |
| SECONDARY Cmax of Encorafenib on Day 1 and Day 14 |
6150; 6060; 3240; 2940 | — |
| SECONDARY Cmax of LHY746 on Day 1 and Day 14 |
943; 953; 2490; 2340 | — |
| SECONDARY Cmax of Binimetinib on Day 1 and Day 14 |
661; 549; 521; 566 | — |
| SECONDARY Cmax of AR00426032 on Day 1 and Day 14 |
57.0; 63.3; 23.3; 27.4 | — |
| SECONDARY AUClast of Encorafenib on Day 1 and Day 14 |
24500; 25900; 12700; 13100 | — |
| SECONDARY AUClast of LHY746 on Day 1 and Day 14 |
5130; 4990; 34000; 32800 | — |
| SECONDARY AUClast of Binimetinib on Day 1 and Day 14 |
2290; 2040; 2190; 2210 | — |
| SECONDARY AUClast of AR00426032 on Day 1 and Day 14 |
236; 256; 108; 122 | — |
| SECONDARY Tmax of Encorafenib on Day 1 and Day 14 |
2.00; 1.87; 1.94; 1.93 | — |
| SECONDARY Tmax of LHY746 on Day 1 and Day 14 |
6.93; 7.42; 2.98; 3.47 | — |
| SECONDARY Tmax of Binimetinib on Day 1 and Day 14 |
1.97; 1.97; 1.98; 1.93 | — |
| SECONDARY Tmax of AR00426032 on Day 1 and Day 14 |
2.02; 2.48; 2.00; 2.00 | — |
| SECONDARY AUCinf of Encorafenib on Day 1 |
26200; 45100 | — |
| SECONDARY AUCinf of Binimetinib on Day 1 |
2970; 3280 | — |
| SECONDARY AUCinf of AR00426032 on Day 1 |
270; 432 | — |
| SECONDARY T1/2 of Encorafenib on Day 1 and Day 14 |
3.98; 3.77; 4.37; 3.58 | — |
| SECONDARY T1/2 of LHY746 on Day 1 and Day 14 |
9.47; 22.5; 9.27; 11.2 | — |
| SECONDARY T1/2 of Binimetinib on Day 1 and Day 14 |
2.62; 2.45; 3.90; 3.70 | — |
| SECONDARY T1/2 of AR00426032 on Day 1 and Day 14 |
2.96; 3.15; 3.97; 3.89 | — |
| SECONDARY AUC%Extrap of Encorafenib on Day 1 |
24.4 | — |
| SECONDARY AUC%Extrap of LHY746 on Day 1 |
52.9 | — |
| SECONDARY AUC%Extrap of Binimetinib on Day 1 |
13.7 | — |
| SECONDARY AUC%Extrap of AR00426032 on Day 1 |
19.8 | — |
| SECONDARY Kel of Encorafenib on Day 1 |
0.174 | — |
| SECONDARY Kel of LHY746 on Day 1 |
0.0732 | — |
| SECONDARY Kel of Binimetinib on Day 1 |
0.265 | — |
| SECONDARY Kel of AR00426032 on Day 1 |
0.234 | — |
| SECONDARY CL/F of Encorafenib on Day 1 |
17.2 | — |
| SECONDARY CL/F of Binimetinib on Day 1 |
15.1 | — |
| SECONDARY Vz/F of Encorafenib on Day 1 |
53.4 | — |
| SECONDARY Vz/F of Binimetinib on Day 1 |
47.6 | — |
| SECONDARY Cmax of Binimetinib on Day 14 and Day 21 |
660; 663 | — |
| SECONDARY Cmax of AR00426032 on Day 14 and Day 21 |
25.9; 24.7 | — |
| SECONDARY AUClast of Binimetinib on Day 14 and Day 21 |
2400; 2290 | — |
| SECONDARY AUClast of AR00426032 on Day 14 and Day 21 |
114; 112 | — |
| SECONDARY Tmax of Encorafenib on Day 14 and Day 21 |
1.00; 1.00 | — |
| SECONDARY Tmax of LHY746 on Day 14 and Day 21 |
2.05; 2.10 | — |
| SECONDARY Tmax of Binimetinib on Day 14 and Day 21 |
1.00; 1.00 | — |
| SECONDARY Tmax of AR00426032 on Day 14 and Day 21 |
2.00; 2.00 | — |
| SECONDARY T1/2 of Encorafenib on Day 14 and Day 21 |
3.48; 3.57 | — |
| SECONDARY T1/2 of LHY746 on Day 14 and Day 21 |
8.67; 8.01 | — |
| SECONDARY T1/2 of Binimetinib on Day 14 and Day 21 |
4.62; 4.55 | — |
| SECONDARY T1/2 of AR00426032 on Day 14 and Day 21 |
5.60; 5.22 | — |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (TEAEs) in the DDI Phase |
26; 9; 11; 24; 6; 10 | — |
| SECONDARY Number of Participants With Laboratory Abnormalities in the DDI Phase |
0; 1; 0; 3; 2; 0 | — |
| SECONDARY Number of Participants With Notable Abnormalities in Vital Signs in the DDI Phase |
4; 4; 0; 0; 0; 1 | — |
| SECONDARY Number of Participants With Notable Electrocardiogram (ECG) Findings in the DDI Phase |
6; 3; 2; 1; 0; 1 | — |
| SECONDARY Number of Participants With Left Ventricular Ejection Fraction (LVEF) Abnormalities in the DDI Phase |
4; 2; 0 | — |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (TEAEs) in the Post-DDI Phase |
17; 5; 4; 10; 2; 2 | — |
Summary
This is an open-label, 3-arm, fixed-sequence study to evaluate the effect of single and multiple oral doses of encorafenib in combination with binimetinib on the single oral dose pharmacokinetics (PK) of cytochrome P450 (CYP) enzyme probe substrates using a probe cocktail, on an organic anion-transporting polypeptide/breast cancer resistance protein (OATP/BCRP) substrate using rosuvastatin and on a CYP2B6 substrate using bupropion. The effect of multiple oral doses of the moderate cytochrome P450 (CYP) inhibitor modafinil on encorafenib in combination with binimetinib will also be assessed. The study will have 2 treatment phases, a drug-drug interaction (DDI) phase followed by a post-DDI phase.
Eligibility Criteria
Key Inclusion Criteria - Patients must meet all of the inclusion criteria to be eligible for enrollment into the study:
- Histologically confirmed diagnosis of locally advanced, unresectable or metastatic cutaneous melanoma or unknown primary melanoma American Joint Committee on Cancer (AJCC) Stage IIIB, IIIC or IV; or other BRAF V600-mutant advanced solid tumors
- Presence of BRAF V600E and/or V600K mutation in tumor tissue prior to enrollment, as determined using a local test;
- Evidence of measurable or non-measurable lesions
- Patient with unresectable locally advanced or metastatic melanoma who has received no prior treatment or progressed on or after prior systemic therapy; Note: Prior therapy with a BRAF proto-oncogene serine-threonine protein kinase (BRAF) inhibitor and/or a mitogen-activated protein (MAP) kinase (MEK) inhibitor is permitted except in the regimen immediately prior to study entry
- Patient with other (non-melanoma) BRAF V600E and/or V600K -mutant advanced solid tumors who has progressed on standard therapy or for whom there are no available standard therapies; Note: Prior therapy with a BRAF inhibitor and/or a MEK inhibitor is permitted except in the regimen immediately prior to study entry
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1
- Adequate bone marrow, hepatic and renal function as specified in the protocol
- ARM 1 ONLY: Non-smoker who has not used nicotine containing products for at least 3 months prior to the first dose.
Key Exclusion Criteria - Patients meeting any of the following criteria are not eligible for enrollment in the study:
- Symptomatic brain metastasis. Patients previously treated or untreated for these conditions that are asymptomatic in the absence of corticosteroid and anti-epileptic therapy are allowed. Brain metastases must be stable, with imaging (e.g., magnetic resonance imaging [MRI] or computed tomography [CT] demonstrating no current evidence of progressive brain metastases at screening);
- Symptomatic or untreated leptomeningeal disease;
- History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes);
- Clinically significant cardiac disease
- Known hyper-coagulability risks other than malignancy (e.g., Factor V Leiden syndrome);
- Thromboembolic event except catheter-related venous thrombosis ≤ 12 weeks prior to starting study treatment.
- Discontinuation of prior BRAF and/or MEK inhibitor treatment due to left ventricular dysfunction, pneumonitis/interstitial lung disease, or retinal vein occlusion;
- ARM 1 ONLY: Positive urine cotinine test at screening
- ARM 3 ONLY:
- History of psychosis, depression or mania;
- History of angioedema;
- History of mitral valve prolapse;
- History of left ventricular hypertrophy;
Data sourced from ClinicalTrials.gov (NCT03864042). 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.