Adjuvant Therapy Based on Pathologic Response After Neoadjuvant Encorafenib Binimetinib in Melanoma

NCT04741997 | Recruiting Early Phase 1 DMC FDA Drug

• 1 other identifier: MCC-20641
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to assess rate of disease relapse and hazard rate of disease relapse after neoadjuvant therapy based on the statuses of pathologic complete response or non-pathologic complete response, and postoperative adjuvant therapy.

Conditions

Melanoma Stage III; Melanoma Stage IV; BRAF V600 Mutation

Keywords

Skin

Outcome Measures

Primary Outcomes (1)

• Rate of Disease Relapse

  Investigators will estimate the rate of disease relapse after neoadjuvant therapy based on pathologic complete response status and postoperative adjuvant therapy within each arm.

  After surgery up to 24 weeks

Secondary Outcomes (5)

• Relapse Free Survival

  After surgery up to 24 weeks

• Rate of Pathologic Complete Response

  At 26 weeks

• Rate of Non-Pathologic Complete Response

  At 26 weeks

• Overall Response Rate

  Up to 26 weeks

• Overall Survival

  After surgery, up to 5 years

Study Arms (4)

Surveillance

ACTIVE COMPARATOR

Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have pathologic complete response they will receive adjuvant treatment for 24 weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.

Drug: Encorafenib Pill; Drug: Binimetinib Pill

Encorafenib and Binimetinib after Pathologic Complete Response

EXPERIMENTAL

Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have pathologic complete response they will continue to receive encorafenib and binimetinib for 24 more weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.

Drug: Encorafenib Pill; Drug: Binimetinib Pill

Encorafenib and Binimetinib after Non-Pathologic Complete Response

EXPERIMENTAL

Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have non-pathologic complete response they will continue to receive encorafenib and binimetinib for 24 more weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.

Drug: Encorafenib Pill; Drug: Binimetinib Pill

Nivolumab after Non-Pathologic Complete Response

EXPERIMENTAL

Participants will receive 24 weeks of neoadjuvant encorafenib and binimetinib and then proceed to planned resection. If participants have non-pathologic complete response they will receive nivolumab for 24 weeks. Imaging will be conducted every 12 weeks for at least one year after surgery, and every 24 weeks for at least two years post-surgery.

Drug: Encorafenib Pill; Drug: Binimetinib Pill; Drug: Nivolumab

Interventions

Encorafenib Pill DRUG

Encorafenib 450 mg will be administered orally once per day in continuous 28-day cycles

Encorafenib and Binimetinib after Non-Pathologic Complete Response; Encorafenib and Binimetinib after Pathologic Complete Response; Nivolumab after Non-Pathologic Complete Response; Surveillance

Binimetinib Pill DRUG

Binimetinib 45 mg will be administered orally twice per day in continuous 28-day cycles

Encorafenib and Binimetinib after Non-Pathologic Complete Response; Encorafenib and Binimetinib after Pathologic Complete Response; Nivolumab after Non-Pathologic Complete Response; Surveillance

Nivolumab DRUG

Nivolumab will be administered at a dose of 480 mg IV infusion over 30 minutes every 4 weeks.

Nivolumab after Non-Pathologic Complete Response

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 18 years at the time of informed consent
• Histologically confirmed diagnosis of melanoma. Any primary or unknown origin is permitted.
• Melanoma must have a BRAFV600 mutation (using a CLIA-validated assay), either stage III (B/C/D) or Stage IV (AJCC 8th edition).
• ECOG performance status ≤ 2
• Adequate laboratory parameters as well:
• a. Hemoglobin ≥ 8 g/dL.
• b. Platelets ≥ 75 × 109/L;
• c. AST and ALT ≤ 2.5 × ULN; in participants with liver metastases ≤ 5 × ULN;
• d. Total bilirubin ≤ 1.5 × ULN and \< 2 mg/dL; OR total bilirubin \>1.5 × ULN with indirect bilirubin \< 1.5 × ULN;
• e. Serum creatinine ≤ 2.0 × ULN
• Female participants of childbearing potential as described in protocol, must have a negative serum or urine β-HCG test result. Female participants of childbearing potential must agree to use methods of contraception that are highly effective or acceptable, as described in Section 4.3.1. Participants must agree to not use hormonal contraceptives, as encorafenib can result in decreased concentration and loss of efficacy. Male participants must agree to use methods of contraception that are highly effective or acceptable per protocol.

You may not qualify if:

• Participants may have received prior therapy with BRAF and/or a MEK inhibitor if it was completed at least 6 months prior to study enrollment. Patients who had prior disease progression while on BRAF/MEK inhibitor therapy are not eligible. (Progression after stopping treatment is permitted.) Participants may have received prior therapy an anti-PD-1/PD-L1 or CTLA-4 inhibitor.
• Participants must not have had adverse events related to encorafenib and/or binimetinib specifically, that required discontinuation of one or both drugs due to toxicity.
• Participants who have had major surgery or radiotherapy ≤ 14 days prior to start of study treatment or who have not recovered from side effects of such procedure.
• Participants must be willing to avoid consuming grapefruit, pomegranates, star fruits, Seville oranges or products containing the juice during the study while they are taking encorafenib/binimetinib.
• Uncontrolled or symptomatic brain metastases or leptomeningeal carcinomatosis that are not stable, require steroids, are potentially life-threatening or have required radiation within 28 days prior to starting study drug. Patients with previously treated brain metastases may participate provided they are stable (e.g.,without evidence of progression by radiographic imaging for at least 28 days before the first dose of study treatment and neurologic symptoms have returned to baseline).
• Impaired cardiovascular function as below:
• a. Congestive heart failure requiring treatment (New York Heart Association Grade ≥ 3);
• b. presence of uncontrolled atrial fibrillation or uncontrolled paroxysmal supraventricular tachycardia
• c. Baseline QTcF interval ≥ 500 ms.
• Known history of retinal vein occlusion (RVO)
• Current use of a prohibited medication (including herbal medications, supplements, or foods), as described in protocol, or use of a prohibited medication ≤ 1 week prior to the start of study treatment.
• Participants with a prior or concurrent malignancy whose natural history or treatment (in the opinion of the treating physician) does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.
• Participants with known human immunodeficiency virus (HIV)-infection are eligible providing they are on effective anti-retroviral therapy and have undetectable viral load at their most recent viral load test and within 90 days prior to randomization.
• Participants with a known history of hepatitis C virus (HCV) infection must have been treated and cured. Participants with HCV infection who are currently on treatment must have an undetectable HCV viral load prior to randomization.
• Pregnancy or breast feeding.

Sponsors & Collaborators

• H. Lee Moffitt Cancer Center and Research Institute: lead
• Pfizer: collaborator

Study Sites (1)

Moffitt Cancer Center

Tampa, Florida, 33612, United States

RECRUITING

MeSH Terms

Conditions

Melanoma

Interventions

encorafenib; binimetinib; Nivolumab

Condition Hierarchy (Ancestors)

Neuroendocrine Tumors; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Nerve Tissue; Nevi and Melanomas; Skin Neoplasms; Neoplasms by Site; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins

Study Officials

• Zeynep Eroglu, MD

  Moffitt Cancer Center

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Arnay Marshall

CONTACT

813-745-5938; Arnay.Marshall@moffitt.org

Study Design

• Study Type: interventional
• Phase: early phase 1
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 2, 2021
• First Posted: February 5, 2021
• Study Start: May 24, 2021
• Primary Completion (Estimated): July 22, 2026
• Study Completion (Estimated): July 1, 2027
• Last Updated: March 2, 2026

Record last verified: 2026-02

Locations

US (1)