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Kinase Inhibitor

Encorafenib + Binimetinib Before Surgery for Melanoma

Phase 2
Waitlist Available
Led By Leslie A Fecher
Research Sponsored by ECOG-ACRIN Cancer Research Group
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status 0-1
Patient must be able to take oral medications
Must not have
Patient must not have any concurrent neuromuscular disorder that is associated with elevated creatine kinase (CK)
Patient must not have any evidence of distant metastases
Timeline
Screening 3 weeks
Treatment Varies
Follow Up up to 5 years
Awards & highlights
No Placebo-Only Group
All Individual Drugs Already Approved
Approved for 5 Other Conditions

Summary

This trial is studying a combination of two drugs, encorafenib and binimetinib, to see how well they work before surgery in treating patients with melanoma that has spread to the lymph nodes and has a BRAF V600 mutation. 18F-FLT PET/CT scans may be used to predict how well the melanoma will respond to the treatment.

Who is the study for?
This trial is for adults with stage IIIB-D melanoma that has spread to lymph nodes and have a BRAF V600 mutation. They must be able to take oral meds, lie still for PET/CT scans, use contraception if of childbearing potential, and not have distant metastases or other serious health issues. HIV-positive patients can join if their condition is stable.
What is being tested?
The effectiveness of Encorafenib and Binimetinib before surgery in treating melanoma with lymph node involvement is being tested. The study also evaluates how well an imaging agent (18F-FLT) used in PET/CT scans predicts the response to these drugs.
What are the potential side effects?
Potential side effects include risk of heart problems, bleeding events, liver function changes, high blood pressure, fatigue, skin rash or disorders, vision changes like retinal vein occlusion (RVO), muscle pain or weakness due to elevated creatine kinase (CK).

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I am fully active or restricted in physically strenuous activity but can do light work.
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I can take pills by mouth.
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My scans show measurable cancer, taken within the last 4 weeks.
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My melanoma is stage III B/C/D and can be seen or felt.
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My melanoma can be entirely removed by surgery, as confirmed by a specialist.
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I have at least one visible lymph node metastasis, but not in the N1c category.
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My cancer has a BRAF V600 mutation.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I do not have a muscle disorder that increases my CK levels.
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My cancer has not spread to distant parts of my body.
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I do not have an infection that needs treatment with IV antibiotics.
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I have no history or current signs of retinal vein occlusion.
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I have never had pancreatitis.
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My heart is healthy and I don't have significant heart disease.
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I have not had radiation on the area where my disease can be measured.
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My digestive system works well enough to absorb medication properly.
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I do not have active hepatitis B or C.
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I have never been treated with BRAF or MEK inhibitors.
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I am not pregnant or breastfeeding.
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I am not allergic to binimetinib or encorafenib.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~up to 5 years
This trial's timeline: 3 weeks for screening, Varies for treatment, and up to 5 years for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Change in fluorothymidine F-18 (18F-FLT) positron emission tomography (PET)/computed tomography (CT) uptake
Pathologic complete response (pCR) rate
Secondary study objectives
Change in 18F-FLT PET/CT uptake
Change in CD8 positive (+) tumor infiltrating lymphocytes
Change in CD8+ T cell infiltration in tumor or tumor bed
+7 more
Other study objectives
Change in Ki-67 status in tumor or tumor bed

Side effects data

From 2022 Phase 3 trial • 702 Patients • NCT02928224
78%
Diarrhoea
68%
Dermatitis acneiform
59%
Nausea
54%
Fatigue
51%
Vomiting
51%
Dry Skin
43%
Pyrexia
43%
Anaemia
41%
Decreased appetite
38%
Abdominal pain
38%
Constipation
35%
Dyspnoea
32%
Vision blurred
30%
Blood creatine increased
30%
Blood creatine phosphokinase increased
24%
Arthralgia
24%
Myalgia
24%
Skin fissures
22%
Back Pain
22%
Dizziness
19%
Malaise
19%
Urinary tract infection
19%
Headache
19%
Aspartate aminotransferase increased
16%
Asthenia
16%
Stomatitis
16%
Oedema peripheral
16%
PPE syndrome
16%
Hypomagnesaemia
16%
Rash maculo-papular
16%
Palmar-planar erythrodysaesthesia
16%
Chills
16%
Paronychia
16%
Rash pustular
16%
Alanine aminotransferase increased
16%
Dysgeusia
16%
Peripheral sensory neuropathy
14%
Cough
14%
Abdominal pain upper
14%
Infusion-related reaction
14%
Ejection fraction decreased
14%
Dry eye
11%
Trichiasis
11%
Pollakiuria
11%
Vitreous floaters
11%
Dyspepsia
11%
Hypoalbuminaemia
11%
Hypertension
11%
Tumour Pain
8%
Rhinitis allergic
8%
Hypokalaemia
8%
Visual impairment
8%
Infusion related reaction
8%
Macular oedema
8%
Hypertrichosis
8%
Iron deficiency
8%
Nasopharyngitis
8%
Weight decreased
8%
Flank pain
8%
Proteinuria
8%
Rash
8%
Pruritus
8%
Pain in extremity
8%
Blood bilirubin increased
8%
Rhinnorrhoea
8%
Hypotension
5%
Pleural effusion
5%
Restless legs syndrome
5%
Nervous system disorder
5%
Wound
5%
Trichomegaly
5%
Infection
5%
Hypocalcaemia
5%
Hypophosphataemia
5%
Rectal haemorrhage
5%
Musculoskeletal pain
5%
Anal haemorrhage
5%
Ascites
5%
Colitis
5%
Abdominal pain lower
5%
Nail disorder
5%
Pruritus generalised
5%
Bone pain
5%
Musculoskeletal chest pain
5%
Chorioretinopathy
5%
Urinary incontinence
5%
Insomnia
5%
Gastroesophageal reflux disease
5%
Abdominal distension
5%
Eczema
5%
Cystitis
5%
Renal failure
5%
Conjunctivitis
5%
Syncope
5%
Dehydration
5%
Dry Mouth
5%
Skin hyperpigmentation
5%
Muscle spasms
5%
Erythema
5%
Retinal detachment
5%
Pulmonary embolism
5%
Dysphonia
5%
Haematuria
5%
Blood creatinine increased
5%
Depression
5%
Palpitations
3%
Tumour pain
3%
Urinary tract infection bacterial
3%
Melanocytic naevus
3%
Large intestinal ulcer
3%
Kidney infection
3%
Large intestinal ulcer hemorrhage
3%
Epistaxis
3%
Hyperkeratosis
3%
Rectal hemorrhage
3%
Streptococcal infection
3%
Alopecia
3%
Upper respiratory tract infection
3%
Skin papilloma
3%
Large intestine perforation
3%
Bacterial sepsis
3%
Cholangitis
3%
Urinary tract obstruction
3%
Confusional state
3%
Device occlusion
3%
Back pain
3%
Rhabdomyolysis
3%
Colon cancer
3%
Sepsis
3%
Acute kidney injury
3%
Large intestine ulcer
3%
Neutropenia
3%
Bacteria sepsis
3%
Hydronephrosis
3%
Neuropathy peripheral
3%
Abdominal abscess
3%
Hyperglycaemia
100%
80%
60%
40%
20%
0%
Study treatment Arm
Combined Safety Lead-in
Phase 3: Triplet Arm
Phase 3: Doublet Arm
Phase 3: Control Arm

Awards & Highlights

No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
All Individual Drugs Already Approved
Therapies where all constituent drugs have already been approved are likely to have better-understood side effect profiles.
Approved for 5 Other Conditions
This treatment demonstrated efficacy for 5 other conditions.

Trial Design

1Treatment groups
Experimental Treatment
Group I: Treatment (18F-FLT, PET/CT, encorafenib, binimetinib, surgery)Experimental Treatment6 Interventions
NEOADJUVANT TREATMENT: Patients receive 18F-FLT IV and undergo a PET/CT scan approximately 60 minutes later. Within 2 weeks, patients receive encorafenib PO QD and binimetinib PO BID on days 1-28. Treatment repeats every 28 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive 18F-FLT IV and undergo a second PET/CT scan approximately 60 minutes later. SURGICAL RESECTION: Within 2 weeks of completing therapy with encorafenib and binimetinib, patients undergo surgery. ADJUVANT TREATMENT: Within 2-7 days after surgery, patients resume treatment with encorafenib PO QD and binimetinib PO BID on days 1-28. Treatment repeats every 28 days for up to 11 cycles in the absence of disease progression or unacceptable toxicity.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Binimetinib
FDA approved
Computed Tomography
2017
Completed Phase 2
~2740
Conventional Surgery
2006
Completed Phase 3
~1080
Encorafenib
FDA approved
Positron Emission Tomography
2011
Completed Phase 2
~2200

Find a Location

Who is running the clinical trial?

ECOG-ACRIN Cancer Research GroupLead Sponsor
121 Previous Clinical Trials
180,194 Total Patients Enrolled
National Cancer Institute (NCI)NIH
13,925 Previous Clinical Trials
41,017,998 Total Patients Enrolled
Leslie A FecherPrincipal InvestigatorECOG-ACRIN Cancer Research Group

Media Library

Binimetinib (Kinase Inhibitor) Clinical Trial Eligibility Overview. Trial Name: NCT04221438 — Phase 2
Cancer Research Study Groups: Treatment (18F-FLT, PET/CT, encorafenib, binimetinib, surgery)
Cancer Clinical Trial 2023: Binimetinib Highlights & Side Effects. Trial Name: NCT04221438 — Phase 2
Binimetinib (Kinase Inhibitor) 2023 Treatment Timeline for Medical Study. Trial Name: NCT04221438 — Phase 2
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