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BRAF Inhibitor
Immunotherapy + Targeted Therapy for Melanoma
Phase 3
Waitlist Available
Led By Michael B Atkins
Research Sponsored by National Cancer Institute (NCI)
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
Age >= 18 years. Because no dosing or adverse event data are currently available on the use of dabrafenib or dabrafenib + trametinib or nivolumab or nivolumab + ipilimumab therapy in patients < 18 years of age, children are excluded from this study, but will be eligible for future pediatric trials.
Age >= 18 years
Must not have
History of lymphoproliferative disorder
Other current malignancies, except specified exceptions
Timeline
Screening 3 weeks
Treatment Varies
Follow Up up to 5 years
Awards & highlights
No Placebo-Only Group
Pivotal Trial
Summary
This trial is testing two different treatments for melanoma that cannot be removed by surgery. The first treatment is immunotherapy with monoclonal antibodies, followed by targeted therapy with dabrafenib and trametinib. The second treatment is targeted therapy with dabrafenib and trametinib, followed by immunotherapy with monoclonal antibodies. It is not yet known which treatment is more effective.
Who is the study for?
Adults with stage III-IV melanoma that can't be surgically removed and have the BRAFV600 mutation. They should not have HIV, other cancers within the last 5 years (except certain skin cancers), serious medical conditions, or be pregnant/breastfeeding. Participants must agree to use effective contraception.
What is being tested?
The trial is testing two treatment sequences for advanced melanoma: starting with ipilimumab and nivolumab (immunotherapies) followed by dabrafenib and trametinib (targeting BRAFV600 gene), versus starting with dabrafenib and trametinib followed by immunotherapies, to see which is more effective.
What are the potential side effects?
Possible side effects include immune system reactions affecting organs, infusion-related reactions from antibodies, heart issues due to targeted therapies, liver problems, skin rash, fever, fatigue, eye problems like blurred vision or dry eyes.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
I am 18 years old or older.
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I am 18 years old or older.
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My cancer is at an advanced stage and cannot be removed with surgery.
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My cancer has a BRAF V600 mutation confirmed by an approved test.
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I am fully active or restricted in physically strenuous activity but can do light work.
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My melanoma cannot be removed by surgery and has been confirmed by tests.
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My melanoma has the BRAF V600 mutation.
Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
I have a history of disorders related to lymphocyte proliferation.
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I do not have any other cancers, except for allowed exceptions.
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I have a history of heart problems or risks.
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I am HIV positive.
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I am not using any medications or therapies that are not allowed in the study.
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I don't have issues swallowing or absorbing medications.
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I have had a blockage in the veins of my retina.
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I have an active cancer other than basal or squamous cell skin cancer.
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I have brain metastases that are currently treated and stable.
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I have lung scarring or inflammation.
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I have an autoimmune disease that could come back and affect my organs.
Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ up to 5 years
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~up to 5 years
Treatment Details
Study Objectives
Study objectives can provide a clearer picture of what you can expect from a treatment.Primary study objectives
Overall survival (OS) rate
Secondary study objectives
Progression-free survival (PFS)
Response rate
Toxicity rate for categorized AEs
+2 moreOther study objectives
Change in patient-reported symptoms
Genetic characteristics
Immune-related adverse events (irAE) status
+2 moreAwards & Highlights
No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
Pivotal Trial
The final step before approval, pivotal trials feature drugs that have already shown basic safety & efficacy.
Trial Design
4Treatment groups
Experimental Treatment
Group I: Arm D (immunotherapy)Experimental Treatment7 Interventions
IMMUNOTHERAPY INDUCTION (CYCLES 1-2): Patients receive nivolumab IV over 30-60 minutes and ipilimumab IV over 30-90 minutes on days 1 and 22. Treatment repeats every 6 weeks for 2 cycles in the absence of disease progression or unacceptable toxicity.
IMMUNOTHERAPY MAINTENANCE (CYCLES 3-14): Patients receive nivolumab IV over 30-60 minutes on days 1, 15, and 29. Treatment repeats every 6 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity.
Patients also undergo CT, ECHO or MUGA, and collection of blood samples throughout the trial.
Group II: Arm C (BRAF inhibitor therapy)Experimental Treatment7 Interventions
Patients receive dabrafenib mesylate PO BID and trametinib dimethyl sulfoxide PO daily on days 1-42. Cycles repeat every 6 weeks in the absence of disease progression or unacceptable toxicity.
Patients also undergo CT, ECHO or MUGA, and collection of blood samples throughout the trial.
Group III: Arm B (BRAF inhibitor therapy)Experimental Treatment7 Interventions
Patients receive dabrafenib mesylate PO BID and trametinib dimethyl sulfoxide PO daily on days 1-42. Cycles repeat every 6 weeks in the absence of disease progression or unacceptable toxicity. Upon disease progression (or before), patients re-register and cross over to Arm D.
Patients also undergo CT, ECHO or MUGA, and collection of blood samples throughout the trial.
Group IV: Arm A (immunotherapy)Experimental Treatment7 Interventions
IMMUNOTHERAPY INDUCTION (CYCLES 1-2): Patients receive nivolumab IV over 30-60 minutes and ipilimumab IV over 30-90 minutes on days 1 and 22. Treatment repeats every 6 weeks for 2 cycles in the absence of disease progression or unacceptable toxicity.
IMMUNOTHERAPY MAINTENANCE (CYCLES 3-14): Patients receive nivolumab IV over 30-60 minutes on days 1, 15, and 29. Treatment repeats every 6 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Upon disease progression (or before), patients re-register and cross over to Arm C.
Patients also undergo CT, ECHO or MUGA, and collection of blood samples throughout the trial.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Dabrafenib Mesylate
2014
Completed Phase 2
~10
Biospecimen Collection
2004
Completed Phase 3
~2030
Multigated Acquisition Scan
2015
Completed Phase 3
~270
Nivolumab
2015
Completed Phase 3
~4010
Echocardiography
2013
Completed Phase 4
~11580
Computed Tomography
2017
Completed Phase 2
~2790
Ipilimumab
2015
Completed Phase 3
~3420
Trametinib Dimethyl Sulfoxide
2014
Completed Phase 2
~10
Find a Location
Who is running the clinical trial?
National Cancer Institute (NCI)Lead Sponsor
13,956 Previous Clinical Trials
41,111,797 Total Patients Enrolled
5 Trials studying Cutaneous Melanoma
146 Patients Enrolled for Cutaneous Melanoma
Michael B AtkinsPrincipal InvestigatorECOG-ACRIN Cancer Research Group
Media Library
Eligibility Criteria:
This trial includes the following eligibility criteria:- This information is not applicable to my condition.I am 18 years old or older.I agree to use effective birth control or abstain from sex during and after the trial as required.I have a history of disorders related to lymphocyte proliferation.I am 18 years old or older.My cancer has a BRAF V600 mutation confirmed by an approved test.I haven't had any cancer except for skin cancer in the last 5 years.I do not have any other cancers, except for allowed exceptions.I have a history of heart problems or risks.I am HIV positive.I am not using any medications or therapies that are not allowed in the study.I don't have issues swallowing or absorbing medications.My cancer is at an advanced stage and cannot be removed with surgery.My cancer has a BRAF V600 mutation confirmed by an approved test.I do not have any serious health issues or social situations that would prevent me from following the study's requirements.My cancer can be measured and has been checked within the last month.I am fully active or restricted in physically strenuous activity but can do light work.I have had a blockage in the veins of my retina.I have an active cancer other than basal or squamous cell skin cancer.I have brain metastases that are currently treated and stable.My melanoma cannot be removed by surgery and has been confirmed by tests.I have lung scarring or inflammation.I have an autoimmune disease that could come back and affect my organs.Your lab test results must be within a certain range.I have stopped any previous treatments and recovered from their side effects.My melanoma has the BRAF V600 mutation.I've had cancer treatment before, but not with CTLA4, PD1 inhibitors, or BRAF/MEK inhibitors.