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Study of the Combination of Binimetinib and Encorafenib in Adolescent Patients With Unresectable or Metastatic BRAF V600-mutant Melanoma

Primary Purpose

Melanoma

Status
Terminated
Phase
Phase 1
Locations
Italy
Study Type
Interventional
Intervention
binimetinib
encorafenib
Sponsored by
Pfizer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring Adolescent, BRAF V600K, BRAF V600E

Eligibility Criteria

12 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

Patients must meet all of the following criteria to be eligible for enrollment in the study.

  • Histologically confirmed diagnosis of locally advanced, unresectable or metastatic cutaneous melanoma or unknown primary melanoma American Joint Committee on Cancer Stage IIIB, IIIC, or IV.
  • Presence of BRAF V600E or V600K mutation in tumor tissue as determined by a local or central laboratory
  • Adequate cardiac function:

    • Left ventricular ejection fraction (LVEF) ≥ 50% as determined by ECHO or multi-gated acquisition (MUGA) scan and above the institutional lower limit of normal (LLN);
    • Triplicate average baseline QTcF value ≤ 450 ms.
  • Adequate bone marrow, organ function, and laboratory parameters:

    • Absolute neutrophil count (ANC) ≥ 1.5 × 10⁹/L;
    • Hemoglobin ≥ 9 g/dL with or without transfusions;
    • Platelets ≥ 75 × 10⁹/L without transfusions;
    • Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) ≤ 2.5 × upper limit of normal (ULN); in patients with liver metastases ≤ 5 × ULN;
    • Total bilirubin ≤ 1.5 × ULN;
    • Creatinine ≤ 1.5 × institutional ULN for age, or calculated creatinine clearance ≥ 70 mL/min/1.73 m² (following Schwartz formula).
  • Adequate performance status at Screening:

    • Patients < 16 years old: Lansky Performance Scale score ≥ 80
    • Patients 16 to 17 years old: Karnofsky Performance Scale score ≥ 80

Key Exclusion Criteria:

Patients meeting any of the following criteria are not eligible for enrollment in the study.

  • Uveal or mucosal melanoma.
  • Brain metastases that are uncontrolled or symptomatic, require steroids, are potentially life-threatening or have required radiation within 28 days prior to starting study drug.
  • History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO
  • Prior therapy with a BRAF inhibitor (e.g., dabrafenib, vemurafenib) and/or a MEK inhibitor (e.g., trametinib, cobimetinib).
  • Impaired cardiovascular function or clinically significant cardiovascular disease, including any of the following:

    • History of acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass grafting, coronary angioplasty or stenting) < 6 months prior to screening,
    • Symptomatic chronic heart failure, history or current evidence of clinically significant cardiac arrhythmia and/or conduction abnormality < 6 months prior to screening except atrial fibrillation and paroxysmal supraventricular tachycardia.
  • Concurrent neuromuscular disorder associated with elevated creatine kinase (CK)
  • Uncontrolled arterial hypertension despite medical treatment
  • Presence of BRAFʷͭ or indeterminate melanoma in tumor tissue.

Sites / Locations

  • Fondazione IRCCS Istituto Nazionale Dei Tumori

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Safety Run-in Phase

Expansion Phase

Arm Description

binimetinib taken twice daily (BID) and encorafenib taken once daily (QD) Dose levels by patient body surface area (BSA) for binimetinib and encorafenib tablets/capsules are specified in the protocol.

binimetinib taken twice daily (BID) and encorafenib taken once daily (QD) Dose levels by patient body surface area (BSA) for binimetinib and encorafenib tablets/capsules and pediatric formulations are specified in the protocol.

Outcomes

Primary Outcome Measures

Pharmacokinetic (PK) parameter (time to reach the maximum observed plasma concentration Cmax [Tmax]) for binimetinib
PK parameter (Cmax) for binimetinib
PK parameter (time of last PK sample [Tlast]) for binimetinib
PK parameter (area under the plasma concentration-time curve from time zero to Tlast [AUClast]) for binimetinib
PK parameter (Tmax) for binimetinib's active metabolite (AR00426032)
PK parameter (Cmax) for AR00426032
PK parameter (Tlast) for AR00426032
PK parameter (AUClast) for AR00426032
PK parameter (Tmax) for encorafenib
PK parameter (Cmax) for encorafenib
PK parameter (Tlast) for encorafenib
PK parameter (AUClast) for encorafenib
PK parameter (Tmax) for encorafenib's metabolite (LHY746)
PK parameter (Cmax) for LHY746
PK parameter (Tlast) for LHY746
PK parameter (AUClast) for LHY746
PK parameter (trough concentration [Ctrough]) for binimetinib
PK parameter (trough concentration [Ctrough]) for binimetinib
PK parameter (trough concentration [Ctrough]) for binimetinib
PK parameter (Ctrough) for AR00426032
PK parameter (Ctrough) for AR00426032
PK parameter (Ctrough) for AR00426032
PK parameter (Ctrough) for encorafenib
PK parameter (Ctrough) for encorafenib
PK parameter (Ctrough) for encorafenib
PK parameter (Ctrough) for LHY746
PK parameter (Ctrough) for LHY746
PK parameter (Ctrough) for LHY746

Secondary Outcome Measures

Incidence and severity of adverse events (AEs)
Incidence of dose-limiting toxicities (DLTs)
Palatability score for the pediatric formulations as assessed by an age-appropriate questionnaire for binimetinib
Five-point Hedonic scale from 1 to 5, 5=really good
Palatability score for the pediatric formulations as assessed by an age-appropriate questionnaire for encorafenib
Five-point Hedonic scale from 1 to 5, 5=really good
Objective response rate (ORR) assessed by the investigator, based on Response Criteria Evaluation in Solid Tumors (RECIST) v1.1
Duration of response (DOR)
Time to response
Progression-free survival (PFS)
One-year survival rate
Change from baseline bone age and the difference in bone age and chronological age
Change from Baseline in bone densitometry based on dual energy X-ray absorptiometry (DEXA) scan.
Change from Baseline in calcium-phosphorus product (Ca × P)

Full Information

First Posted
February 20, 2019
Last Updated
March 29, 2023
Sponsor
Pfizer
Collaborators
Pierre Fabre Laboratories
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1. Study Identification

Unique Protocol Identification Number
NCT03878719
Brief Title
Study of the Combination of Binimetinib and Encorafenib in Adolescent Patients With Unresectable or Metastatic BRAF V600-mutant Melanoma
Official Title
A Multicenter, Open-label Phase 1b Study of the Combination of Binimetinib and Encorafenib in Adolescent Patients With Unresectable or Metastatic BRAF V600-mutant Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Terminated
Why Stopped
The trial was terminated early on 05 October 2022 due to non-feasibility and poor recruitment and not based on safety concerns.
Study Start Date
August 3, 2020 (Actual)
Primary Completion Date
August 19, 2022 (Actual)
Study Completion Date
August 19, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pfizer
Collaborators
Pierre Fabre Laboratories

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multicenter Phase 1b, open-label study to evaluate the pharmacokinetic, safety and efficacy of binimetinib and encorafenib co-administered to adolescent patients with BRAF V600-mutant advanced/metastatic melanoma. The study consists of a Safety Run-in Phase to determine the RDE (recommended dose in expansion), followed by an Expansion Phase.
Detailed Description
The study did not recruit the desired number of subjects and as a result does not have sufficient data for quantitative statistical analyses. Additionally, results data cannot be reported because doing so would risk re-identification of the participant.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma
Keywords
Adolescent, BRAF V600K, BRAF V600E

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Safety Run-in Phase
Arm Type
Experimental
Arm Description
binimetinib taken twice daily (BID) and encorafenib taken once daily (QD) Dose levels by patient body surface area (BSA) for binimetinib and encorafenib tablets/capsules are specified in the protocol.
Arm Title
Expansion Phase
Arm Type
Experimental
Arm Description
binimetinib taken twice daily (BID) and encorafenib taken once daily (QD) Dose levels by patient body surface area (BSA) for binimetinib and encorafenib tablets/capsules and pediatric formulations are specified in the protocol.
Intervention Type
Drug
Intervention Name(s)
binimetinib
Intervention Description
taken orally
Intervention Type
Drug
Intervention Name(s)
encorafenib
Intervention Description
taken orally
Primary Outcome Measure Information:
Title
Pharmacokinetic (PK) parameter (time to reach the maximum observed plasma concentration Cmax [Tmax]) for binimetinib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Cmax) for binimetinib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (time of last PK sample [Tlast]) for binimetinib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (area under the plasma concentration-time curve from time zero to Tlast [AUClast]) for binimetinib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Tmax) for binimetinib's active metabolite (AR00426032)
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Cmax) for AR00426032
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Tlast) for AR00426032
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (AUClast) for AR00426032
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Tmax) for encorafenib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Cmax) for encorafenib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Tlast) for encorafenib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (AUClast) for encorafenib
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Tmax) for encorafenib's metabolite (LHY746)
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Cmax) for LHY746
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Tlast) for LHY746
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (AUClast) for LHY746
Time Frame
Day 1 and Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (trough concentration [Ctrough]) for binimetinib
Time Frame
at time zero Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (trough concentration [Ctrough]) for binimetinib
Time Frame
at time zero Day 1 of Cycle 2, 28 day cycles
Title
PK parameter (trough concentration [Ctrough]) for binimetinib
Time Frame
at time zero Day 1 of Cycle 3, 28 day cycles
Title
PK parameter (Ctrough) for AR00426032
Time Frame
at time zero Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Ctrough) for AR00426032
Time Frame
at time zero Day 1 of Cycle 2, 28 day cycles
Title
PK parameter (Ctrough) for AR00426032
Time Frame
at time zero Day 1 of Cycle 3, 28 day cycles
Title
PK parameter (Ctrough) for encorafenib
Time Frame
at time zero Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Ctrough) for encorafenib
Time Frame
at time zero Day 1 of Cycle 2, 28 day cycles
Title
PK parameter (Ctrough) for encorafenib
Time Frame
at time zero Day 1 of Cycle 3, 28 day cycles
Title
PK parameter (Ctrough) for LHY746
Time Frame
at time zero Day 15 of Cycle 1, 28 day cycles
Title
PK parameter (Ctrough) for LHY746
Time Frame
at time zero Day 1 of Cycle 2, 28 day cycles
Title
PK parameter (Ctrough) for LHY746
Time Frame
at time zero Day 1 of Cycle 3, 28 day cycles
Secondary Outcome Measure Information:
Title
Incidence and severity of adverse events (AEs)
Time Frame
From informed consent up to 30 days following last dose of study drug
Title
Incidence of dose-limiting toxicities (DLTs)
Time Frame
Duration of treatment for safety run-in phase, approximately 6 months, 28 day cycles
Title
Palatability score for the pediatric formulations as assessed by an age-appropriate questionnaire for binimetinib
Description
Five-point Hedonic scale from 1 to 5, 5=really good
Time Frame
Through Cycle 3 Day 1 in patients receiving the pediatric formulations in the Expansion Phase, 28 day cycles
Title
Palatability score for the pediatric formulations as assessed by an age-appropriate questionnaire for encorafenib
Description
Five-point Hedonic scale from 1 to 5, 5=really good
Time Frame
Through Cycle 3 Day 1 in patients receiving the pediatric formulations in the Expansion Phase, 28 day cycles
Title
Objective response rate (ORR) assessed by the investigator, based on Response Criteria Evaluation in Solid Tumors (RECIST) v1.1
Time Frame
Duration of treatment, approximately 6 months, 28 day cycles
Title
Duration of response (DOR)
Time Frame
Duration of treatment, approximately 6 months, 28 day cycles
Title
Time to response
Time Frame
Duration of treatment, approximately 6 months, 28 day cycles
Title
Progression-free survival (PFS)
Time Frame
Duration of treatment, approximately 6 months, 28 day cycles
Title
One-year survival rate
Time Frame
From first dose up to 1 year after treatment initiation
Title
Change from baseline bone age and the difference in bone age and chronological age
Time Frame
Duration of treatment, approximately 6 months, 28 day cycles
Title
Change from Baseline in bone densitometry based on dual energy X-ray absorptiometry (DEXA) scan.
Time Frame
Duration of treatment, approximately 6 months, 28 day cycles
Title
Change from Baseline in calcium-phosphorus product (Ca × P)
Time Frame
Duration of treatment, approximately 6 months, 28 day cycles

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Patients must meet all of the following criteria to be eligible for enrollment in the study. Histologically confirmed diagnosis of locally advanced, unresectable or metastatic cutaneous melanoma or unknown primary melanoma American Joint Committee on Cancer Stage IIIB, IIIC, or IV. Presence of BRAF V600E or V600K mutation in tumor tissue as determined by a local or central laboratory Adequate cardiac function: Left ventricular ejection fraction (LVEF) ≥ 50% as determined by ECHO or multi-gated acquisition (MUGA) scan and above the institutional lower limit of normal (LLN); Triplicate average baseline QTcF value ≤ 450 ms. Adequate bone marrow, organ function, and laboratory parameters: Absolute neutrophil count (ANC) ≥ 1.5 × 10⁹/L; Hemoglobin ≥ 9 g/dL with or without transfusions; Platelets ≥ 75 × 10⁹/L without transfusions; Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) ≤ 2.5 × upper limit of normal (ULN); in patients with liver metastases ≤ 5 × ULN; Total bilirubin ≤ 1.5 × ULN; Creatinine ≤ 1.5 × institutional ULN for age, or calculated creatinine clearance ≥ 70 mL/min/1.73 m² (following Schwartz formula). Adequate performance status at Screening: Patients < 16 years old: Lansky Performance Scale score ≥ 80 Patients 16 to 17 years old: Karnofsky Performance Scale score ≥ 80 Key Exclusion Criteria: Patients meeting any of the following criteria are not eligible for enrollment in the study. Uveal or mucosal melanoma. Brain metastases that are uncontrolled or symptomatic, require steroids, are potentially life-threatening or have required radiation within 28 days prior to starting study drug. History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO Prior therapy with a BRAF inhibitor (e.g., dabrafenib, vemurafenib) and/or a MEK inhibitor (e.g., trametinib, cobimetinib). Impaired cardiovascular function or clinically significant cardiovascular disease, including any of the following: History of acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass grafting, coronary angioplasty or stenting) < 6 months prior to screening, Symptomatic chronic heart failure, history or current evidence of clinically significant cardiac arrhythmia and/or conduction abnormality < 6 months prior to screening except atrial fibrillation and paroxysmal supraventricular tachycardia. Concurrent neuromuscular disorder associated with elevated creatine kinase (CK) Uncontrolled arterial hypertension despite medical treatment Presence of BRAFʷͭ or indeterminate melanoma in tumor tissue.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pfizer Pfizer CT.gov Call Center
Organizational Affiliation
Pfizer
Official's Role
Study Director
Facility Information:
Facility Name
Fondazione IRCCS Istituto Nazionale Dei Tumori
City
Milan
State/Province
Lombardy
ZIP/Postal Code
20133
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
Links:
URL
https://pmiform.com/clinical-trial-info-request?StudyID=ARRAY-162-115
Description
To obtain contact information for a study center near you, click here.

Learn more about this trial

Study of the Combination of Binimetinib and Encorafenib in Adolescent Patients With Unresectable or Metastatic BRAF V600-mutant Melanoma

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