MelanomaPhase 2NCT02974803
Concurrent Dabrafenib + Trametinib With Sterotactic Radiation in BRAF Mutation-Positive Malignant Melanoma and Brain Metastases
A Phase 2 study testing Dabrafenib and Trametinib in people with Melanoma and Brain Metastases, run by Canadian Cancer Trials Group at 6 sites in Canada.
Trial summary
Dabrafenib and trametinib are drugs that are usually given for the treatment of melanoma. Combinations of dabrafenib and trametinib have also been studied and when used together have shown to increase tumour shrinkage in animals compared to either drug alone. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Melanoma, Brain Metastases
- What is being tested?
- Dabrafenib and Trametinib
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 6 participants
- Where
- 6 sitesCanada
- Study dates
- 9 Feb 2018to 29 Jul 2020
- Phase
- Phase 2
- 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
- Histologically confirmed melanoma metastatic to brain and determined to be BRAF V600 mutated.
- Age ≥ 18 years.
- Karnofsky Performance Status of 70-100 (Appendix I).
- Patients must have a life expectancy of at least 12 weeks.
- Presence of measurable disease (i.e. present with at least one measurable CNS lesion per RECIST 1.1).
- Presence of 1-10 brain metastases as confirmed on a thin slice axial T1 post-gadolinium MRI sequence. The maximum diameter of a single brain lesion should be ≤ 4 cm and presence of a measurable lesion ≥ 1cm based on baseline MRI of brain.
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- All CNS metastases amenable to single fraction SRS and or fractionated SRS. Hemorrhagic lesions are allowed if the treating radiation oncologist deems the lesion amenable to focal SRS.
- Able to swallow and retain oral medication and must not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels.
- Laboratory requirements (within 14 days prior to registration):
- ANC ≥ 1.2 x 10^9/L
- Hemoglobin ≥ 90 g/L
- Platelet count ≥ 100 x 10^9/L
- PT/INR \& PTT ≤ 1.3 x ULN
- Total bilirubin ≤ 1.5 x ULN
- AST and ALT ≤ 2.5 x ULN
- Serum creatinine or ≤ 1.5 x ULN or Creatinine Clearance ≥ 50 ml/min (calculated by Cockcroft and Gault)
- LVEF ≥ LLN (within 28 days prior to registration)
- No prior treatment with a BRAF inhibitor or MEK inhibitor.
- No known ocular or primary mucosal melanoma.
- No prior systemic anti-cancer treatment within the last 2 weeks preceding the frist dose of dabrafenib and trametinib. Patients must have recoved from clinical manifestations of toxicity related to prior systemic therapy and have adequate washout as follows: Longest of one of the following:
- two weeks
- 5 half-lives for investigational agents
- Standard cycle length of standard therapies
- Prior systemic treatment in the adjuvant setting is allowed.
- No current use of a prohibited medication as described in section 7.2.
- No history of malignancy with confirmed activating RAS mutation at any time.
- No history of malignancy other than disease under study within 3 years of study enrollment.
- No leptomeningeal metastases or metastases causing spinal cord compression that are symptomatic or untreated or not stable for ≥ 3 months. Subjects on stable dose of corticosteroids > 2 weeks or who have been off of corticosteroids for at least 2 weeks can be enrolled with approval of CCTG.
- No serious or unstable pre-existing medical conditions, psychiatric disorders or other conditions that could interfere with the subject's safety, obtaining informed consent or compliance with study procedures.
- No history of Hepatitis B Virus or Hepatitis C Virus infection
- No history or evidence of cardiovascular risk No history or current eveidence/risk of retinal vein occlusion or central serous retinopathy
- No known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the study treatments, their excipients, and/or dimethyl sulfoxide.
- No pregnant or lactating women.
- No hisotry of interstitial lung disease or active pneumonitis.
- Presence of any one brain metastases >4cm in maximal diameter, and/or presence of brain metastase of less than 1cm.
- No prior whole brain radiation
- No brainstem metastses
- No contrindications to MRI and/or Gadolinimum contrast or sterotactic brain radiation therapy.
Who cannot join
None listed.
Trial locations and contacts
6 sites in 1 country.
6 sites in 1 country
Canada6 sites
QEII Health Sciences Centre
Halifax, Nova Scotia, B3H 1V7
Juravinski Cancer Centre at Hamilton Health Sciences
Hamilton, Ontario, L8V 5C2
Saskatoon Cancer Centre
Saskatoon, Saskatchewan, S7N 4H4
Centre hospitalier universitaire de Sherbrooke
Sherbrooke, Quebec, J1H 5N4
Odette Cancer Centre
Toronto, Ontario, M4N 3M5
University Health Network
Toronto, Ontario, M5G 2M9
About this study
Official title: A Phase II Study of Concurrent Dabrafenib and Trametinib With Stereotactic Radiation in the Management of Patients With BRAF Mutation-Positive Malignant Melanoma and Brain Metastases
Dabrafenib and trametinib are drugs that are usually given for the treatment of melanoma. Combinations of dabrafenib and trametinib have also been studied and when used together have shown to increase tumour shrinkage in animals compared to either drug alone. Dabrafenib and trametinib have also shown potential to penetrate the blood-brain-barrier when given together and have an effect on brain metastases. Giving these drugs at the same time and then giving brain stereotactic radiosurgery (SRS) may also be preferred in patients with brain metastases
Read the detailed description
The purpose of this study is to find out the effects of giving dabrafenib in combination with trametinib continuously with stereotactic radiotherapy (SRS) has on melanoma and brain metastases.
Stereotactic Radiosurgery (SRS) is a non-surgical radiation therapy used to treat tumours of the brain. It can deliver precisely targeted radiation. Currently SRS alone is the usual treatment for patients with up to 4 brain lesions. This study will include 2 groups 1) patients with 1-4 brain lesions treated with SRS concurrently with dabrafenib and trametinib and 2) patients with 5-10 brain lesions treated with SRS concurrently with dabrafenib and trametinib.
- Conditions
- Melanoma, Brain Metastases
- Being tested
- Dabrafenib, Trametinib
- Medical subject headings
- Melanoma, Brain Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DabrafenibDrug
Dabrafenib 150 mg twice a day until progression or unaccepted toxicity.
TrametinibDrug
Trametinib 2 mg once daily until progression or unaccepted toxicity.
| Study group | Role | What they receive |
|---|---|---|
| Dabrafenib and Trametinib | Experimental | Dabrafenib, PO, 150mg BID Continuously Trameteinib, PO 2mg OD Continuously Receives: Drug: Dabrafenib; Drug: Trametinib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Intracranial Objective Response Rate
Measured: 24 months
Secondary outcomes (4)
Extra-cranial Objective Response Rate
Response will be assessed using RECIST v1.1
Measured: 24 months
Duration of Response
Response will be assessed using RECIST v1.1
Measured: 24 months
Intracranial Progression Free Survival
Response will be assessed using RECIST v1.1
Measured: 24 months
Overall Progression Free Survival
Response will be assessed using RECIST v1.1
Measured: 24 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Nov 2016 (estimated)
- Study start9 Feb 2018
- Primary completion29 Jul 2020
- Study completion29 Jul 2020
Why it stopped: Very slow accrual
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.
- Other trials for MelanomaStudies of the same condition, open and under way.
- More trials run by Canadian Cancer Trials GroupThe 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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 6 participants (actual)
Sponsor and investigators
- Lead sponsor
- Canadian Cancer Trials Group
- Sponsor type
- Research network
- Collaborators
- Novartis
- Responsible party
- Sponsor
- Investigators
- Arjun Sahgal, Study chair, Odette Cancer Centre, Toronto, ON CanadaTeresa Petrella, Study chair, Odette Cancer Centre, Toronto, ON Canada
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02974803
- Sponsor's protocol ID
- I224
- Status last verified
- Jul 2021
- First submitted
- 23 Nov 2016
- Last updated
- 20 Aug 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Aug 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II Study of Concurrent Dabrafenib and Trametinib With Stereotactic Radiation in the Management of Patients With BRAF Mutation-Positive Malignant Melanoma and Brain Metastases
- ClinicalTrials.gov ID
- NCT02974803
- Acronym / sponsor ID
- I224
- Conditions
- Melanoma, Brain Metastases
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Very slow accrual
- Enrolment
- 6 participants (actual)
- Lead sponsor
- Canadian Cancer Trials GroupResearch network
- Collaborators
- Novartis
- Study start
- 9 Feb 2018 (actual)
- Primary completion
- 29 Jul 2020 (actual)
- Study completion
- 29 Jul 2020 (actual)
- First posted
- 28 Nov 2016 (estimated)
- Results
- Posted 17 Aug 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Dabrafenib and trametinib are drugs that are usually given for the treatment of melanoma. Combinations of dabrafenib and trametinib have also been studied and when used together have shown to increase tumour shrinkage in animals compared to either drug alone. Dabrafenib and trametinib have also shown potential to penetrate the blood-brain-barrier when given together and have an effect on brain metastases. Giving these drugs at the same time and then giving brain stereotactic radiosurgery (SRS) may also be preferred in patients with brain metastases
Detailed description
The purpose of this study is to find out the effects of giving dabrafenib in combination with trametinib continuously with stereotactic radiotherapy (SRS) has on melanoma and brain metastases.
Stereotactic Radiosurgery (SRS) is a non-surgical radiation therapy used to treat tumours of the brain. It can deliver precisely targeted radiation. Currently SRS alone is the usual treatment for patients with up to 4 brain lesions. This study will include 2 groups 1) patients with 1-4 brain lesions treated with SRS concurrently with dabrafenib and trametinib and 2) patients with 5-10 brain lesions treated with SRS concurrently with dabrafenib and trametinib.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Dabrafenib and Trametinib | Experimental | Drug: Dabrafenib, Drug: TrametinibDabrafenib, PO, 150mg BID Continuously Trameteinib, PO 2mg OD Continuously |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (38 listed)
- Histologically confirmed melanoma metastatic to brain and determined to be BRAF V600 mutated.
- Age ≥ 18 years.
- Karnofsky Performance Status of 70-100 (Appendix I).
- Patients must have a life expectancy of at least 12 weeks.
- Presence of measurable disease (i.e. present with at least one measurable CNS lesion per RECIST 1.1).
Key exclusion criteria (0 listed)
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 |
|---|---|---|
| DabrafenibDabrafenib 150 mg twice a day until progression or unaccepted toxicity. | Drug | Dabrafenib and Trametinib |
| TrametinibTrametinib 2 mg once daily until progression or unaccepted toxicity. | Drug | Dabrafenib and Trametinib |
Primary outcome
Intracranial Objective Response Rate
Time frame: 24 months
4 secondary outcomes
Extra-cranial Objective Response Rate
Time frame: 24 months
Duration of Response
Time frame: 24 months
Intracranial Progression Free Survival
Time frame: 24 months
Overall Progression Free Survival
Time frame: 24 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Aug 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No
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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.
Arjun Sahgal study chair
Odette Cancer Centre, Toronto, ON Canada
Teresa Petrella study chair
Odette Cancer Centre, Toronto, ON Canada
6 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Dabrafenib and Trametinib in people with Melanoma and Brain Metastases, run by Canadian Cancer Trials Group at 6 sites in Canada.
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 38 inclusion and 0 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: stopped early, as of the sponsor's last update on 20 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 6 sites in Canada. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 17 Aug 2021). 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?
Intracranial Objective Response Rate (time frame: 24 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 20 Aug 2021.