MelanomaPhase 3COMBI-ADNCT01682083
Dabrafenib With Trametinib in the Adjuvant Treatment of High-risk BRAF V600 Mutation-positive Melanoma (COMBI-AD).
A Phase 3 study testing Dabrafenib and Trametinib in people with Melanoma, run by Novartis Pharmaceuticals at 168 sites in 25 countries.
Trial summary
This was a two-arm, randomized, double-blind Phase III study of dabrafenib in combination with trametinib versus 2 placebos in the adjuvant treatment of melanoma after surgical resection. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Melanoma
- What is being tested?
- Dabrafenib and Trametinib
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 870 participants
- Where
- 168 sitesin 25 countries
- Study dates
- 8 Jan 2013to 31 Jul 2023
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- At least 18 years of age
- Completely resected histologically confirmed high-risk (Stage IIIa [lymph node metastasis > 1 mm], IIIb or IIIc) cutaneous melanoma determined to be V600E/K mutation positive using the bioMerieux (bMX) THxID BRAF Assay by a central laboratory. Patients presenting with initial resectable lymph node recurrence after a diagnosis of Stage I or II melanoma were eligible
- Must be surgically rendered free of disease (defined as the date of the most recent surgery) no more than 12 weeks before randomization
- Recovered from definitive surgery (e.g., no uncontrolled wound infections or indwelling drains)
- ECOG Performance Status of 0-1
- Had adequate hematologic, hepatic, renal and cardiac function.
Who cannot join
- Known mucosal or ocular melanoma or the presence of unresectable in-transit metastases
- Evidence of distant metastatic disease on Screening evaluation
- Prior anti-cancer treatment (chemotherapy, immunotherapy, biologic therapy, vaccine therapy, or investigational treatment) including radiotherapy for melanoma. Prior surgery for melanoma was allowed
- History of another malignancy including melanoma or a concurrent malignancy. Patients who previously had Stage III melanoma or any malignancy with confirmed activating RAS mutation at any time were not eligible. Exceptions to this include:
- Patients with a history of any malignancy that had been disease-free for at least 5 years were eligible except those with confirmed activating RAS mutations
- Patients with a history of completely resected non-melanoma skin cancer (e.g., basal cell carcinoma, squamous cell carcinoma) were eligible irrespective of the time since the resection
- Patients with successfully treated in situ carcinoma were eligible
- Patients presenting with multiple primary melanomas were eligible only if the lesions were concurrent. Patients who had concurrent multiple primary melanomas that were "distant" were eligible provided each lesion was considered local disease or resectable regional disease.
Trial locations and contacts
168 sites in 25 countries.
168 sites in 25 countries
Germany24 sites
Novartis Investigative Site
Berlin, 10249
Novartis Investigative Site
Bochum, North Rhine-Westphalia, 44791
Novartis Investigative Site
Cologne, North Rhine-Westphalia, 50937
Novartis Investigative Site
Darmstadt, Hesse, 64297
Novartis Investigative Site
Erfurt, Thuringia, 99089
Novartis Investigative Site
Essen, North Rhine-Westphalia, 45147
Novartis Investigative Site
Freiburg im Breisgau, Baden-Wurttemberg, 79104
Novartis Investigative Site
Gera, Thuringia, 07548
Novartis Investigative Site
Hanover, Lower Saxony, 30625
Novartis Investigative Site
Heilbronn, Baden-Wurttemberg, 74078
Novartis Investigative Site
Kiel, Schleswig-Holstein, 24105
Novartis Investigative Site
Lübeck, Schleswig-Holstein, 23538
Novartis Investigative Site
Magdeburg, Saxony-Anhalt, 39120
Novartis Investigative Site
Mainz, Rhineland-Palatinate, 55131
Novartis Investigative Site
Mannheim, Baden-Wurttemberg, 68167
Novartis Investigative Site
Marburg, Hesse, 35033
Novartis Investigative Site
Munich, Bavaria, 80337
Novartis Investigative Site
Nuremberg, Bavaria, 90419
Novartis Investigative Site
Regensburg, Bavaria, 93053
Novartis Investigative Site
Schwerin, Mecklenburg-Vorpommern, 19049
Novartis Investigative Site
Tübingen, Baden-Wurttemberg, 72076
Novartis Investigative Site
Ulm, Baden-Wurttemberg, 89081
Novartis Investigative Site
Wiesbaden, Hesse, 65199
Novartis Investigative Site
Würzburg, Bavaria, 97080
United States20 sites
Novartis Investigative Site
Ann Arbor, Michigan, 48019
Novartis Investigative Site
Atlanta, Georgia, 30322
Novartis Investigative Site
Atlanta, Georgia, 30341
Novartis Investigative Site
Aurora, Colorado, 80045
Novartis Investigative Site
Birmingham, Alabama, 35243
Novartis Investigative Site
Boston, Massachusetts, 02114
Novartis Investigative Site
Boston, Massachusetts, 02115
Novartis Investigative Site
Columbus, Ohio, 43210
Novartis Investigative Site
Dallas, Texas, 75390
Novartis Investigative Site
Lake Worth, Florida, 33461
Novartis Investigative Site
Lutherville-Timonium, Maryland, 21093
Novartis Investigative Site
Nashville, Tennessee, 37203
Novartis Investigative Site
Orlando, Florida, 32806
Novartis Investigative Site
Pittsburgh, Pennsylvania, 15232
Novartis Investigative Site
Portland, Oregon, 97123
Novartis Investigative Site
San Francisco, California, 94115
Novartis Investigative Site
San Francisco, California, 94143
Novartis Investigative Site
Tampa, Florida, 33612
Novartis Investigative Site
Tucson, Arizona, 85724
Novartis Investigative Site
Winston-Salem, North Carolina, 27157
France17 sites
Novartis Investigative Site
Bordeaux, 33075
Novartis Investigative Site
Boulogne-Billancourt, 92100
Novartis Investigative Site
Brest, 29609
Novartis Investigative Site
Dijon, 21079
Novartis Investigative Site
Grenoble, 38043
Novartis Investigative Site
Lille, 59037
Novartis Investigative Site
Marseille, 13385
Novartis Investigative Site
Montpellier, 34295
Novartis Investigative Site
Nice, 06202
Novartis Investigative Site
Paris, 75014
Novartis Investigative Site
Paris, 75475
Novartis Investigative Site
Pierre-Bénite, 69495
Novartis Investigative Site
Reims, 51092
Novartis Investigative Site
Rennes, 35042
Novartis Investigative Site
Toulouse, 31059
Novartis Investigative Site
Tours, 37044
Novartis Investigative Site
Villejuif, 94805
United Kingdom13 sites
Novartis Investigative Site
Exeter, EX2 5DW
Novartis Investigative Site
Glasgow, G12 0YN
Novartis Investigative Site
Guildford, GU2 7XX
Novartis Investigative Site
Leeds, LS9 7TF
Novartis Investigative Site
London, NW3 2QG
Novartis Investigative Site
London, SW3 6JJ
Novartis Investigative Site
London, W1G 6AD
Novartis Investigative Site
Manchester, M20 4BX
Novartis Investigative Site
Newcastle upon Tyne, NE7 7DN
Novartis Investigative Site
Northwood, Middlesex, HA6 2RN
Novartis Investigative Site
Norwich, NR4 7UY
Novartis Investigative Site
Preston, PR2 9HT
Novartis Investigative Site
Southampton, SO16 6YD
Spain12 sites
Novartis Investigative Site
Badalona, 08916
Novartis Investigative Site
Barcelona, 08035
Novartis Investigative Site
Barcelona, 08036
Novartis Investigative Site
Donostia / San Sebastian, 20014
Novartis Investigative Site
Las Palmas de Gran Canaria, 35016
Novartis Investigative Site
Madrid, 28034
Novartis Investigative Site
Madrid, 28041
Novartis Investigative Site
Madrid, 28046
Novartis Investigative Site
Palma de Mallorca, 07198
Novartis Investigative Site
Pamplona, 31008
Novartis Investigative Site
Santander, 39008
Novartis Investigative Site
Valencia, 46014
Australia11 sites
Novartis Investigative Site
Adelaide, South Australia, 5000
Novartis Investigative Site
Box Hill, Victoria, 3128
Novartis Investigative Site
Gateshead, New South Wales, 2290
Novartis Investigative Site
Greenslopes, Queensland, 4120
Novartis Investigative Site
Heidelberg, Victoria, 3084
Novartis Investigative Site
Melbourne, Victoria, 3004
Novartis Investigative Site
Nedlands, Western Australia, 6009
Novartis Investigative Site
North Sydney, New South Wales, 2060
Novartis Investigative Site
Tweed Heads, New South Wales, 2485
Novartis Investigative Site
Westmead, New South Wales, 2145
Novartis Investigative Site
Woolloongabba, Queensland, 4102
Italy8 sites
Novartis Investigative Site
Bergamo, Lombardy, 24127
Novartis Investigative Site
Candiolo, Piedmont, 10060
Novartis Investigative Site
Genoa, Liguria, 16132
Novartis Investigative Site
Milan, Lombardy, 20133
Novartis Investigative Site
Milan, Lombardy, 20141
Novartis Investigative Site
Padova, Veneto, 35128
Novartis Investigative Site
Pisa, Tuscany, 56126
Novartis Investigative Site
Rome, Lazio, 00167
Russia8 sites
Novartis Investigative Site
Chelyabinsk, 454087
Novartis Investigative Site
Moscow, 115478
Novartis Investigative Site
Moscow, 143423
Novartis Investigative Site
Ryazan, 390011
Novartis Investigative Site
Saint Petersburg, 191014
Novartis Investigative Site
Saint Petersburg, 197758
Novartis Investigative Site
Saint Petersburg, 198255
Novartis Investigative Site
Volgograd, 400138
Netherlands7 sites
Novartis Investigative Site
Amsterdam, 1066 CX
Novartis Investigative Site
Amsterdam, 1081 HV
Novartis Investigative Site
Groningen, 9713 GZ
Novartis Investigative Site
Leeuwarden, 8934 AD
Novartis Investigative Site
Maastricht, 6229 HX
Novartis Investigative Site
Nijmegen, 6525 GA
Novartis Investigative Site
Rotterdam, 3015 GD
Canada6 sites
Novartis Investigative Site
Edmonton, Alberta, T6G 1Z2
Novartis Investigative Site
Hamilton, Ontario, L8V 5C2
Novartis Investigative Site
Oshawa, Ontario, L1G 2B9
Novartis Investigative Site
Ottawa, Ontario, K1H 8L6
Novartis Investigative Site
Québec, Quebec, G1J 1Z4
Novartis Investigative Site
Toronto, Ontario, M5G 2M9
Austria5 sites
Novartis Investigative Site
Graz, 8036
Novartis Investigative Site
Linz, A-4010
Novartis Investigative Site
Salzburg, A-5020
Novartis Investigative Site
Vienna, 1090
Novartis Investigative Site
Wels, A-4600
Belgium4 sites
Novartis Investigative Site
Brussels, 1200
Novartis Investigative Site
Leuven, 3000
Novartis Investigative Site
Liège, 4000
Novartis Investigative Site
Wilrijk, 2610
Czechia4 sites
Novartis Investigative Site
Brno, 656 53
Novartis Investigative Site
Prague, 100 34
Novartis Investigative Site
Prague, 128 08
Novartis Investigative Site
Zlín, 76275
Poland4 sites
Novartis Investigative Site
Gdansk, 80-215
Novartis Investigative Site
Konin, 62-500
Novartis Investigative Site
Poznan, 60-693
Novartis Investigative Site
Warsaw, 02-781
Sweden4 sites
Novartis Investigative Site
Gothenburg, SE-413 45
Novartis Investigative Site
Lund, SE-221 85
Novartis Investigative Site
Stockholm, SE-171 76
Novartis Investigative Site
Uppsala, SE-751 85
Denmark3 sites
Novartis Investigative Site
Arhus C, 8000
Novartis Investigative Site
Herlev, 2730
Novartis Investigative Site
Odense, 5000 C
Greece3 sites
Novartis Investigative Site
Athens, 11527
Novartis Investigative Site
Thessaloniki, 54622
Novartis Investigative Site
Thessaloniki, 56429
Switzerland3 sites
Novartis Investigative Site
Basel, 4031
Novartis Investigative Site
Chur, 7000
Novartis Investigative Site
Zurich, 8091
Argentina2 sites
Novartis Investigative Site
Buenos Aires, C1125ABD
Novartis Investigative Site
Capital Federal, Buenos Aires, C1426ANZ
Brazil2 sites
Novartis Investigative Site
Curitiba, Paraná, 81520-060
Novartis Investigative Site
Ijuí, Rio Grande do Sul, 98700
Japan2 sites
Novartis Investigative Site
Shizuoka, 411-8777
Novartis Investigative Site
Tokyo, 104-0045
Norway2 sites
Novartis Investigative Site
Ålesund, 6026
Novartis Investigative Site
Oslo, 0310
Taiwan2 sites
Novartis Investigative Site
Taipei, 10002
Novartis Investigative Site
Taoyuan, 33305
About this study
Official title: COMBI-AD: A Phase III Randomized Double Blind Study of Dabrafenib (GSK2118436) in COMBInation With Trametinib (GSK1120212) Versus Two Placebos in the ADjuvant Treatment of High-risk BRAF V600 Mutation-positive Melanoma After Surgical Resection
This was a two-arm, randomized, double-blind Phase III study of dabrafenib in combination with trametinib versus 2 placebos in the adjuvant treatment of melanoma after surgical resection. Patients with completely resected, histologically confirmed, BRAF V600E/K mutation-positive, high-risk (Stage IIIa [lymph node metastasis >1 mm], IIIb or IIIc) cutaneous melanoma were screened for eligibility. Approximately 852 patients were planned to be randomized in a 1:1 ratio, stratified by BRAF mutation status (V600E, V600K) and stage of disease (Stage IIIa, IIIb, IIIc). Patients received either dabrafenib (150 milligram (mg) twice daily [BID]) and trametinib (2 mg once daily [QD]) combination therapy or 2 matching placebos (one each for dabrafenib and trametinib) for 12 months or until disease recurrence, death, unacceptable toxicity, or withdrawal of consent. Patients were followed for disease recurrence and survival during and after the treatment period. The study did not permit crossover. Doses of study treatment could be modified and/or interrupted for management of toxicities associated with study treatment.
Read the detailed description
The study periods were follows:
- Screening: Assessments were to be completed within 28 days of randomization.
- Treatment: The treatment period was 12 months. Discontinuation of study treatment could occur earlier than 12 months for disease recurrence, death, unacceptable toxicity or withdrawal of consent.
- Post treatment follow-up (before recurrence): Patients were to be followed for disease recurrence every 3 months after the end of treatment until Month 24, every 6 months after Month 24 and annually after Month 60 (365 days +/- 14 days from last visit).
- Post treatment follow-up (after recurrence): After disease recurrence patients remained on study for follow-up assessments every 3 months until Month 24, every 6 months after Month 24, and annually after Month 60 (365 days +/- 14 days from last visit).
- Conditions
- Melanoma
- Being tested
- Dabrafenib, Trametinib, Placebos
- Keywords
- MEK inhibitor, trametinib, Oncology, adjuvant melanoma, dabrafenib, dabrafenib and trametinib combination therapy, BRAF mutation-positive melanoma, BRAF inhibitor
- Medical subject headings
- Melanoma, Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DabrafenibDrug
Also called GSK2118436
Each capsule contained 50 mg or 75 mg of free base (present as the mesylate salt)
TrametinibDrug
Also called GSK1120212
Each tablet contained 0.5 mg or 2.0 mg of trametinib parent (present as the DMSO solvate)
PlacebosDrug
The placebo capsules and tablets contained the same inactive ingredients and film coatings as the dabrafenib and trametinib study treatment
| Study group | Role | What they receive |
|---|---|---|
| Dabrafenib and trametinib | Experimental | Subjects received dabrafenib (150 mg twice daily) and trametinib (2 mg once daily) orally for 12 months. Receives: Drug: Dabrafenib; Drug: Trametinib |
| Dabrafenib and trametinib placebos | Placebo comparator | Subjects received matching placebos orally for 12 months Receives: Drug: Placebos |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With Relapse-free Survival (RFS) Events
Relapse-Free Survival (RFS) was defined as the time from randomization to disease recurrence or death from any cause. RFS events included loco-regional recurrence, distant metastases, new primary melanoma, and death without prior documented recurrence; such deaths were counted as events and not censored.
Patients without an event at the analysis cut-off (30-Jun-2017) were censored at the date of the last radiological or non-radiological efficacy assessment. Patients lost to follow-up before recurrence or who initiated subsequent anti-cancer therapy prior to recurrence were censored at the last efficacy assessment before loss to follow-up or therapy initiation. Events after prolonged loss to follow-up were handled per the analysis plan.
Malignancies other than new primary melanoma were not considered RFS events and, except for basal cell carcinoma, were reported as serious adverse events. Tumor tissue from any new primary cancer was collected for biomarker analyses.
Measured: Approximately 4 years
Relapse-free Survival (RFS)
Relapse-Free Survival (RFS) was defined as the time from randomization to disease recurrence or death from any cause. RFS events included loco-regional recurrence, distant metastases, new primary melanoma, and death without prior documented recurrence; such deaths were counted as events and not censored.
Patients without an event at the analysis cut-off (30-Jun-2017) were censored at the date of the last radiological or non-radiological efficacy assessment. Patients lost to follow-up before recurrence or who initiated subsequent anti-cancer therapy prior to recurrence were censored at the last efficacy assessment before loss to follow-up or therapy initiation. Events after prolonged loss to follow-up were handled per the analysis plan.
Malignancies other than new primary melanoma were not considered RFS events and, except for basal cell carcinoma, were reported as serious adverse events. Tumor tissue from any new primary cancer was collected for biomarker analyses.
Measured: Approximately 4 years
Secondary outcomes (6)
Percentage of Participants With Overall Survival (OS) Events
Censoring was performed using the date of last known contact for those who were alive at the time of analysis.
Measured: Approximately 10 years
Overall Survival (OS)
Overall Survival (OS) was defined as the interval from randomization to the date of death, irrespective of the cause of death. Censoring was performed using the date of last known contact for those who were alive at the time of analysis.
Measured: Approximately 10 years
Percentage of Participants With Distant Metastasis-free Survival (DMFS) Events
Distant metastasis-free survival (DMFS) was defined as the time from randomization to the first occurrence of distant metastasis or death, whichever occurred first, if death preceded documented recurrence. Patients who remained alive and free of distant metastasis were censored at the date of their last assessment.
Measured: Approximately 4 years
Distant Metastasis-free Survival (DMFS)
Distant metastasis-free survival (DMFS) was defined as the time from randomization to the first occurrence of distant metastasis or death, whichever occurred first, if death preceded documented recurrence. Patients who remained alive and free of distant metastasis were censored at the date of their last assessment.
Measured: Approximately 4 years
Percentage of Participants With Freedom From Relapse (FFR) Events
The first appearance of local/distant metastasis or mortality due to disease recurrence or toxicity were used as events. Censoring was performed using the date of last assessment for those who were alive without local/distant metastasis or new primary melanoma at the time of analysis. FFR was censored if patients died from causes other than melanoma or treatment-related toxicity at the date of death.
Measured: Approximately 4 years
Freedom From Relapse (FFR)
Freedom from relapse (FFR) was defined as the interval from randomization to local or distant recurrence with censoring of patients dying from causes other than melanoma or treatment -related toxicity at the date of death. The first appearance of local/distant metastasis or mortality due to disease recurrence or toxicity were used as events. Censoring was performed using the date of last assessment for those who were alive without local/distant metastasis or new primary melanoma at the time of analysis. FFR was censored if patients died from causes other than melanoma or treatment-related toxicity at the date of death.
Measured: Approximately 4 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Sep 2012 (estimated)
- Study start8 Jan 2013
- Primary completion30 Jun 2017
- Study completion31 Jul 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for MelanomaStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 870 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01682083
- Sponsor's protocol ID
- 115532
- Other IDs
- 2012-001266-15, CDRB436F2301, BRF115532
- Acronym
- COMBI-AD
- Status last verified
- Apr 2026
- First submitted
- 6 Sep 2012
- Last updated
- 21 Apr 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Publications
Syeda MM, Long GV, Garrett J, Atkinson V, Santinami M, Schadendorf D, Hauschild A, Millward M, Mandala M, Chiarion-Sileni V, Smylie M, Manikhas GM, Dummer R, Wiggins JM, Ali S, Adnaik SB, Tan M, Dajee M, Polsky D. Clinical validation of droplet digital PCR assays in detecting BRAFV600-mutant circulating tumour DNA as a prognostic biomarker in patients with resected stage III melanoma receiving adjuvant therapy (COMBI-AD): a biomarker analysis from a double-blind, randomised phase 3 trial. Lancet Oncol. 2025 May;26(5):641-653. doi: 10.1016/S1470-2045(25)00139-1. Epub 2025 Apr 15.
PubMed 40250457Long GV, Hauschild A, Santinami M, Kirkwood JM, Atkinson V, Mandala M, Merelli B, Sileni VC, Nyakas M, Haydon A, Dutriaux C, Robert C, Mortier L, Schachter J, Schadendorf D, Lesimple T, Plummer R, Larkin J, Tan M, Adnaik SB, Burgess P, Jandoo T, Dummer R. Final Results for Adjuvant Dabrafenib plus Trametinib in Stage III Melanoma. N Engl J Med. 2024 Nov 7;391(18):1709-1720. doi: 10.1056/NEJMoa2404139. Epub 2024 Jun 19.
PubMed 38899716Li SN, Wan X, Peng LB, Li YM, Li JH. Cost-effectiveness of immune checkpoint inhibition and targeted treatment in combination as adjuvant treatment of patient with BRAF-mutant advanced melanoma. BMC Health Serv Res. 2023 Jan 18;23(1):49. doi: 10.1186/s12913-023-09058-7.
PubMed 36653848Schadendorf D, Robert C, Dummer R, Flaherty KT, Tawbi HA, Menzies AM, Banerjee H, Lau M, Long GV. Pyrexia in patients treated with dabrafenib plus trametinib across clinical trials in BRAF-mutant cancers. Eur J Cancer. 2021 Aug;153:234-241. doi: 10.1016/j.ejca.2021.05.005. Epub 2021 Jul 2.
PubMed 34225229Dummer R, Hauschild A, Santinami M, Atkinson V, Mandala M, Kirkwood JM, Chiarion Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Schachter J, Lesimple T, Plummer R, Dasgupta K, Gasal E, Tan M, Long GV, Schadendorf D. Five-Year Analysis of Adjuvant Dabrafenib plus Trametinib in Stage III Melanoma. N Engl J Med. 2020 Sep 17;383(12):1139-1148. doi: 10.1056/NEJMoa2005493. Epub 2020 Sep 2.
PubMed 32877599Dummer R, Brase JC, Garrett J, Campbell CD, Gasal E, Squires M, Gusenleitner D, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Flaherty K, Larkin J, Robert C, Kefford R, Kirkwood JM, Hauschild A, Schadendorf D, Long GV. Adjuvant dabrafenib plus trametinib versus placebo in patients with resected, BRAFV600-mutant, stage III melanoma (COMBI-AD): exploratory biomarker analyses from a randomised, phase 3 trial. Lancet Oncol. 2020 Mar;21(3):358-372. doi: 10.1016/S1470-2045(20)30062-0. Epub 2020 Jan 30.
PubMed 32007138Schadendorf D, Hauschild A, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Lesimple T, Plummer R, Schachter J, Dasgupta K, Manson S, Koruth R, Mookerjee B, Kefford R, Dummer R, Kirkwood JM, Long GV. Patient-reported outcomes in patients with resected, high-risk melanoma with BRAFV600E or BRAFV600K mutations treated with adjuvant dabrafenib plus trametinib (COMBI-AD): a randomised, placebo-controlled, phase 3 trial. Lancet Oncol. 2019 May;20(5):701-710. doi: 10.1016/S1470-2045(18)30940-9. Epub 2019 Mar 27.
PubMed 30928620Hauschild A, Dummer R, Schadendorf D, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Schachter J, Lesimple T, Plummer R, Dasgupta K, Haas T, Shilkrut M, Gasal E, Kefford R, Kirkwood JM, Long GV. Longer Follow-Up Confirms Relapse-Free Survival Benefit With Adjuvant Dabrafenib Plus Trametinib in Patients With Resected BRAF V600-Mutant Stage III Melanoma. J Clin Oncol. 2018 Dec 10;36(35):3441-3449. doi: 10.1200/JCO.18.01219. Epub 2018 Oct 22.
PubMed 30343620Long GV, Hauschild A, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Schachter J, Schadendorf D, Lesimple T, Plummer R, Ji R, Zhang P, Mookerjee B, Legos J, Kefford R, Dummer R, Kirkwood JM. Adjuvant Dabrafenib plus Trametinib in Stage III BRAF-Mutated Melanoma. N Engl J Med. 2017 Nov 9;377(19):1813-1823. doi: 10.1056/NEJMoa1708539. Epub 2017 Sep 10.
PubMed 28891408
Study at a glance
From the registry record, last updated by the sponsor on 21 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- COMBI-AD: A Phase III Randomized Double Blind Study of Dabrafenib (GSK2118436) in COMBInation With Trametinib (GSK1120212) Versus Two Placebos in the ADjuvant Treatment of High-risk BRAF V600 Mutation-positive Melanoma After Surgical Resection
- ClinicalTrials.gov ID
- NCT01682083
- Acronym / sponsor ID
- COMBI-AD / 115532
- Conditions
- Melanoma
- Keywords
- MEK inhibitor, trametinib, Oncology, adjuvant melanoma, dabrafenib, dabrafenib and trametinib combination therapy, BRAF mutation-positive melanoma, BRAF inhibitor
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 870 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 8 Jan 2013 (actual)
- Primary completion
- 30 Jun 2017 (actual)
- Study completion
- 31 Jul 2023 (actual)
- First posted
- 10 Sep 2012 (estimated)
- Results
- Posted 26 Sep 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This was a two-arm, randomized, double-blind Phase III study of dabrafenib in combination with trametinib versus 2 placebos in the adjuvant treatment of melanoma after surgical resection. Patients with completely resected, histologically confirmed, BRAF V600E/K mutation-positive, high-risk (Stage IIIa [lymph node metastasis >1 mm], IIIb or IIIc) cutaneous melanoma were screened for eligibility. Approximately 852 patients were planned to be randomized in a 1:1 ratio, stratified by BRAF mutation status (V600E, V600K) and stage of disease (Stage IIIa, IIIb, IIIc). Patients received either dabrafenib (150 milligram (mg) twice daily [BID]) and trametinib (2 mg once daily [QD]) combination therapy or 2 matching placebos (one each for dabrafenib and trametinib) for 12 months or until disease recurrence, death, unacceptable toxicity, or withdrawal of consent. Patients were followed for disease recurrence and survival during and after the treatment period. The study did not permit crossover. Doses of study treatment could be modified and/or interrupted for management of toxicities associated with study treatment.
Detailed description
The study periods were follows:
- Screening: Assessments were to be completed within 28 days of randomization.
- Treatment: The treatment period was 12 months. Discontinuation of study treatment could occur earlier than 12 months for disease recurrence, death, unacceptable toxicity or withdrawal of consent.
- Post treatment follow-up (before recurrence): Patients were to be followed for disease recurrence every 3 months after the end of treatment until Month 24, every 6 months after Month 24 and annually after Month 60 (365 days +/- 14 days from last visit).
- Post treatment follow-up (after recurrence): After disease recurrence patients remained on study for follow-up assessments every 3 months until Month 24, every 6 months after Month 24, and annually after Month 60 (365 days +/- 14 days from last visit).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Dabrafenib and trametinib | Experimental | Drug: Dabrafenib, Drug: TrametinibSubjects received dabrafenib (150 mg twice daily) and trametinib (2 mg once daily) orally for 12 months. |
| Dabrafenib and trametinib placebos | Placebo comparator | Drug: PlacebosSubjects received matching placebos orally for 12 months |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- At least 18 years of age
- Completely resected histologically confirmed high-risk (Stage IIIa [lymph node metastasis > 1 mm], IIIb or IIIc) cutaneous melanoma determined to be V600E/K mutation positive using the bioMerieux (bMX) THxID BRAF Assay by a central laboratory. Patients presenting with initial resectable lymph node recurrence after a diagnosis of Stage I or II melanoma were eligible
- Must be surgically rendered free of disease (defined as the date of the most recent surgery) no more than 12 weeks before randomization
- Recovered from definitive surgery (e.g., no uncontrolled wound infections or indwelling drains)
- ECOG Performance Status of 0-1
Key exclusion criteria (8 listed)
- Known mucosal or ocular melanoma or the presence of unresectable in-transit metastases
- Evidence of distant metastatic disease on Screening evaluation
- Prior anti-cancer treatment (chemotherapy, immunotherapy, biologic therapy, vaccine therapy, or investigational treatment) including radiotherapy for melanoma. Prior surgery for melanoma was allowed
- History of another malignancy including melanoma or a concurrent malignancy. Patients who previously had Stage III melanoma or any malignancy with confirmed activating RAS mutation at any time were not eligible. Exceptions to this include:
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| DabrafenibAlso: GSK2118436Each capsule contained 50 mg or 75 mg of free base (present as the mesylate salt) | Drug | Dabrafenib and trametinib |
| TrametinibAlso: GSK1120212Each tablet contained 0.5 mg or 2.0 mg of trametinib parent (present as the DMSO solvate) | Drug | Dabrafenib and trametinib |
| PlacebosThe placebo capsules and tablets contained the same inactive ingredients and film coatings as the dabrafenib and trametinib study treatment | Drug | Dabrafenib and trametinib placebos |
Primary outcome
Percentage of Participants With Relapse-free Survival (RFS) Events
Time frame: Approximately 4 years
Relapse-Free Survival (RFS) was defined as the time from randomization to disease recurrence or death from any cause. RFS events included loco-regional recurrence, distant metastases, new primary melanoma, and death without prior documented recurrence; such deaths were counted as events and not censored. Patients without an event at the analysis cut-off (30-Jun-2017) were censored at the date of the last radiological or non-radiological efficacy assessment. Patients lost to follow-up before recurrence or who initiated subsequent anti-cancer therapy prior to recurrence were censored at the last efficacy assessment before loss to follow-up or therapy initiation. Events after prolonged loss to follow-up were handled per the analysis plan. Malignancies other than new primary melanoma were not considered RFS events and, except for basal cell carcinoma, were reported as serious adverse events. Tumor tissue from any new primary cancer was collected for biomarker analyses.
Relapse-free Survival (RFS)
Time frame: Approximately 4 years
Relapse-Free Survival (RFS) was defined as the time from randomization to disease recurrence or death from any cause. RFS events included loco-regional recurrence, distant metastases, new primary melanoma, and death without prior documented recurrence; such deaths were counted as events and not censored. Patients without an event at the analysis cut-off (30-Jun-2017) were censored at the date of the last radiological or non-radiological efficacy assessment. Patients lost to follow-up before recurrence or who initiated subsequent anti-cancer therapy prior to recurrence were censored at the last efficacy assessment before loss to follow-up or therapy initiation. Events after prolonged loss to follow-up were handled per the analysis plan. Malignancies other than new primary melanoma were not considered RFS events and, except for basal cell carcinoma, were reported as serious adverse events. Tumor tissue from any new primary cancer was collected for biomarker analyses.
6 secondary outcomes
Percentage of Participants With Overall Survival (OS) Events
Time frame: Approximately 10 years
Overall Survival (OS)
Time frame: Approximately 10 years
Percentage of Participants With Distant Metastasis-free Survival (DMFS) Events
Time frame: Approximately 4 years
Distant Metastasis-free Survival (DMFS)
Time frame: Approximately 4 years
Percentage of Participants With Freedom From Relapse (FFR) Events
Time frame: Approximately 4 years
Freedom From Relapse (FFR)
Time frame: Approximately 4 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Apr 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40250457Syeda MM, Long GV, Garrett J, Atkinson V, Santinami M, Schadendorf D, Hauschild A, Millward M, Mandala M, Chiarion-Sileni V, Smylie M, Manikhas GM, Dummer R, Wiggins JM, Ali S, Adnaik SB, Tan M, Dajee M, Polsky D. Clinical validation of droplet digital PCR assays in detecting BRAFV600-mutant circulating tumour DNA as a prognostic biomarker in patients with resected stage III melanoma receiving adjuvant therapy (COMBI-AD): a biomarker analysis from a double-blind, randomised phase 3 trial. Lancet Oncol. 2025 May;26(5):641-653. doi: 10.1016/S1470-2045(25)00139-1. Epub 2025 Apr 15.
- Derived from this study: PubMed 38899716Long GV, Hauschild A, Santinami M, Kirkwood JM, Atkinson V, Mandala M, Merelli B, Sileni VC, Nyakas M, Haydon A, Dutriaux C, Robert C, Mortier L, Schachter J, Schadendorf D, Lesimple T, Plummer R, Larkin J, Tan M, Adnaik SB, Burgess P, Jandoo T, Dummer R. Final Results for Adjuvant Dabrafenib plus Trametinib in Stage III Melanoma. N Engl J Med. 2024 Nov 7;391(18):1709-1720. doi: 10.1056/NEJMoa2404139. Epub 2024 Jun 19.
- Derived from this study: PubMed 36653848Li SN, Wan X, Peng LB, Li YM, Li JH. Cost-effectiveness of immune checkpoint inhibition and targeted treatment in combination as adjuvant treatment of patient with BRAF-mutant advanced melanoma. BMC Health Serv Res. 2023 Jan 18;23(1):49. doi: 10.1186/s12913-023-09058-7.
- Derived from this study: PubMed 34225229Schadendorf D, Robert C, Dummer R, Flaherty KT, Tawbi HA, Menzies AM, Banerjee H, Lau M, Long GV. Pyrexia in patients treated with dabrafenib plus trametinib across clinical trials in BRAF-mutant cancers. Eur J Cancer. 2021 Aug;153:234-241. doi: 10.1016/j.ejca.2021.05.005. Epub 2021 Jul 2.
- Derived from this study: PubMed 32877599Dummer R, Hauschild A, Santinami M, Atkinson V, Mandala M, Kirkwood JM, Chiarion Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Schachter J, Lesimple T, Plummer R, Dasgupta K, Gasal E, Tan M, Long GV, Schadendorf D. Five-Year Analysis of Adjuvant Dabrafenib plus Trametinib in Stage III Melanoma. N Engl J Med. 2020 Sep 17;383(12):1139-1148. doi: 10.1056/NEJMoa2005493. Epub 2020 Sep 2.
- Derived from this study: PubMed 32007138Dummer R, Brase JC, Garrett J, Campbell CD, Gasal E, Squires M, Gusenleitner D, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Flaherty K, Larkin J, Robert C, Kefford R, Kirkwood JM, Hauschild A, Schadendorf D, Long GV. Adjuvant dabrafenib plus trametinib versus placebo in patients with resected, BRAFV600-mutant, stage III melanoma (COMBI-AD): exploratory biomarker analyses from a randomised, phase 3 trial. Lancet Oncol. 2020 Mar;21(3):358-372. doi: 10.1016/S1470-2045(20)30062-0. Epub 2020 Jan 30.
- Derived from this study: PubMed 30928620Schadendorf D, Hauschild A, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Lesimple T, Plummer R, Schachter J, Dasgupta K, Manson S, Koruth R, Mookerjee B, Kefford R, Dummer R, Kirkwood JM, Long GV. Patient-reported outcomes in patients with resected, high-risk melanoma with BRAFV600E or BRAFV600K mutations treated with adjuvant dabrafenib plus trametinib (COMBI-AD): a randomised, placebo-controlled, phase 3 trial. Lancet Oncol. 2019 May;20(5):701-710. doi: 10.1016/S1470-2045(18)30940-9. Epub 2019 Mar 27.
- Derived from this study: PubMed 30343620Hauschild A, Dummer R, Schadendorf D, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Schachter J, Lesimple T, Plummer R, Dasgupta K, Haas T, Shilkrut M, Gasal E, Kefford R, Kirkwood JM, Long GV. Longer Follow-Up Confirms Relapse-Free Survival Benefit With Adjuvant Dabrafenib Plus Trametinib in Patients With Resected BRAF V600-Mutant Stage III Melanoma. J Clin Oncol. 2018 Dec 10;36(35):3441-3449. doi: 10.1200/JCO.18.01219. Epub 2018 Oct 22.
- Derived from this study: PubMed 28891408Long GV, Hauschild A, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, Larkin J, Nyakas M, Dutriaux C, Haydon A, Robert C, Mortier L, Schachter J, Schadendorf D, Lesimple T, Plummer R, Ji R, Zhang P, Mookerjee B, Legos J, Kefford R, Dummer R, Kirkwood JM. Adjuvant Dabrafenib plus Trametinib in Stage III BRAF-Mutated Melanoma. N Engl J Med. 2017 Nov 9;377(19):1813-1823. doi: 10.1056/NEJMoa1708539. Epub 2017 Sep 10.
- Individual participant dataSharing planned: Yes. Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Novartis Pharmaceuticals study director
Novartis Pharmaceuticals
168 sites in 25 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Dabrafenib and Trametinib in people with Melanoma, run by Novartis Pharmaceuticals at 168 sites in 25 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 168 sites in Germany, United States, France, United Kingdom, Spain and 20 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 26 Sep 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of Participants With Relapse-free Survival (RFS) Events (time frame: Approximately 4 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01682083, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Apr 2026.