A Study Comparing 3 Study Medicines (Encorafenib, Binimetinib, Pembrolizumab) to 2 Study Medicines (Ipilimumab and Nivolumab) in Patients With Advanced Melanoma

Registration Number
NCT05926960
Lead Sponsor
Pfizer
Brief Summary

The purpose of this study is to learn about the effects of 3 study medicines (encorafenib, binimetinib, pembrolizumab) compared to 2 study medicines (ipilimumab and nivolumab) given for the treatment of melanoma.

Melanoma is a type of cancer that starts in the cells that give color to your skin.

The study is seeking participants who:
...

Detailed Description

The purpose of the study is to compare the efficacy of a triplet therapy (encorafenib, binimetinib, pembrolizumab) versus a doublet/control therapy (nivolumab and ipilimumab). Participants will have metastatic or unresectable locally advanced BRAF V600E/K-mutant melanoma, which progressed during or after prior treatment in the adjuvant or first-line metastat...

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Male or female participants ≥18 years of age at the time of informed consent.
  • Histologically confirmed unresectable (Stage IIIB, IIIC, or IIID) or metastatic (Stage IV) cutaneous melanoma, according to the AJCC 8th edition.
  • Documented evidence of a BRAF V600E or V600K mutation.
  • Availability of adequate tumor tissue (archival or newly obtained; block or slides) to submit to the sponsor central laboratory(ies) during the screening period for central biomarker analyses .
  • Must have received only 1 prior line of systemic therapy for melanoma (either adjuvant therapy or first-line anti-PD-1 monotherapy (ie, nivolumab or pembrolizumab)
  • Must have anti-PD-1 resistant disease (primary or secondary) with confirmed disease progression per RECIST v1.1 either during or after receipt of an approved anti-PD-1 monotherapy (ie, nivolumab or pembrolizumab) for melanoma, defined according to the SITC Immunotherapy Resistance Taskforce (Kluger et al, 2020).
  • Have at least one measurable lesion per RECIST v1.1.
  • ECOG PS of 0-1, and adequate organ and cardiac function, including LVEF ≥50% by cardiac imaging.
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Exclusion Criteria
  • Mucosal or ocular melanoma.
  • Diagnosis of immunodeficiency or an active autoimmune disease that required systemic treatment with chronic systemic steroid therapy or any other form of immunosuppressive therapy within the past 2 years.
  • Clinically significant cardiovascular diseases.
  • History of thromboembolic or cerebrovascular events ≤12 weeks prior to randomization.
  • History or current evidence of RVO or current risk factors for RVO.
  • Concurrent neuromuscular disorder that is associated with the potential of elevated CK.
  • Active bacterial, fungal, or viral infection requiring systemic therapeutic treatment within 2 weeks prior to randomization.
  • Current non-infectious pneumonitis/interstitial lung disease or history of noninfectious pneumonitis/interstitial lung disease requiring steroids.
  • Prior or current symptomatic brain metastasis, leptomeningeal disease or other active CNS metastases.
  • Participants who permanently discontinued prior anti-PD-1 therapy due to toxicity or will be unable to tolerate combination therapy based on investigator judgement are excluded.
  • Prior treatment with ipilimumab; prior combined immunotherapy blockade with anti-PD-1/L-1; prior treatment with a BRAFi and/or MEKi; or previous administration of an investigational anti-cancer agent for the adjuvant or first-line treatment of melanoma prior to randomization.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Tripletencorafenibencorafenib and binimetinib in combination with pembrolizumab
Tripletbinimetinibencorafenib and binimetinib in combination with pembrolizumab
Doubletipilimumabipilimumab and nivolumab
Doubletnivolumabipilimumab and nivolumab
Tripletpembrolizumabencorafenib and binimetinib in combination with pembrolizumab
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR) is defined as the proportion of participants in each treatment arm with a confirmed best overall response of either Complete Response (CR) or Partial Response (PR), as determined by investigator assessment per RECIST v1.1Time from the date of randomization to the earliest date disease progression, or start of subsequent anticancer therapy, or death due to any cause (assessed up to approximately 48 months).
Secondary Outcome Measures
NameTimeMethod
Progression Free Survival in each treatment armTime from the date of randomization to the earliest date of disease progression, as determined by investigator assessment per RECIST v1.1, or death due to any cause, whichever occurs first (assessed up to approximately 48 months)
Overall Survival in each treatment armTime from date of randomization to the date of death due to any cause or the last known alive date (assessed up to approximately 48 months)
Duration of Response (CR or PR) in each treatment armTime from the date of the first documented response (CR or PR) to the earliest date of disease progression, as determined by investigator assessment per RECIST v1.1, or death due to any cause (assessed up to approximately 48 months)
Disease Control Rate (proportion of participants with a confirmed best overall response of CR, PR or SD) in each treatment armTime from the date of randomization to the earliest date of disease progression, or start of subsequent anticancer therapy (assessed up to approximately 48 months)
Time to Response (CR or PR)Time from the date of randomization to the date of first documented response (CR or PR), as determined by investigator assessment per RECIST v1.1 (assessed up to approximately 48 months)
Progression Free Survival 2 in each treatment armTime from date of randomization to date of discontinuation of next-line treatment after 1st disease progression, 2nd disease progression after initiation of next line treatment, or death due to any cause (assessed up to approximately 48 months)
Incidence and severity of Adverse Events (AEs) and changes in clinical laboratory parameters, vital signs, and cardiac assessments.Time from first dose of study intervention through 28 days after the last dose of study intervention

Number of participants with treatment emergent Adverse Events as as assessed per National Cancer Institute \[NCI\] Common Terminology Criteria for Adverse Events \[CTCAE\], version 4.03).

Patient Reported Outcomes using EORTC QLQ-C30 questionnaires in each treatment armChange from Baseline until Progressive Disease, death, withdrawal of consent, lost to follow-up, or end of study, whichever occurs first (assessed up to approximately 48 months)

EORTC (European Organization for Research and Treatment of Cancer) QLQ-30 includes 5 functional scales (physical, role, emotional, cognitive and social functioning), 3 symptom scales (fatigue, nausea/vomiting, and pain), 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea and financial impact) and a global health status/Quality of Life s...

Patient Reported Outcomes using EuroQOL EQ-5D-5L questionnaires in each treatment armChange from Baseline until Progressive Disease, death, withdrawal of consent, lost to follow-up, or end of study, whichever occurs first (assessed up to approximately 48 months)

The EQ-5D-5L is a standardized measure of health utility that provides a single index value of health status and contains 1 item for each of 5 dimensions of HRQoL (ie, mobility, self-care, usual activities, pain or discomfort, and anxiety or depression).

BRAF V600E/K Variant Allele Frequency and/or overall mean Variant Allele Frequency from circulating tumour DNA analysis in each treatment armChange from baseline, Day 1 of Cycle 2 (after 3 weeks), and End of Treatment (assessed up to approximately 48 months)

Trial Locations

Locations (63)

Istituto Nazionale Tumori IRCCS Fondazione Pascale

🇮🇹

Napoli, Italy

Istituto Europeo di Oncologia IRCCS

🇮🇹

Milano, Italy

Nemocnica Poprad, a.s.

🇸🇰

Poprad, Slovakia

Hospital Germans Trias i Pujol

🇪🇸

Badalona, Barcelona [barcelona], Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Barcelona [barcelona], Spain

Institut Català d'Oncologia - L'Hospitalet

🇪🇸

L'Hospitalet de Llobregat, Catalunya [cataluña], Spain

Ocne centrum Sokolik, s.r.o.

🇸🇰

Trencin, Slovakia

H.R.U Málaga - Hospital General

🇪🇸

Malaga, Andalucía, Spain

Hospital General Universitario de Valencia

🇪🇸

Valencia, Valenciana, Comunitat, Spain

Hospital General Universitario de Alicante

🇪🇸

Alicante, Spain

Neovizia, s.r.o.

🇸🇰

Bratislava, Slovakia

Institut nuklearnej a molekularnej mediciny

🇸🇰

Kosice, Slovakia

Martinske Biopticke centrum, s.r.o.

🇸🇰

Martin, Slovakia

DERMATOP s.r.o., MUDr. Frantisek Perutka

🇸🇰

Partizanske, Slovakia

Nemocnica na okraji mesta, n.o.

🇸🇰

Partizanske, Slovakia

KARDIO, s.r.o.

🇸🇰

Poprad, Slovakia

MR Poprad s.r.o., Pracovisko magnetickej rezonancie

🇸🇰

Poprad, Slovakia

Nemocnica Poprad, a.s., Dermatovenerolgicka ambulancia

🇸🇰

Poprad, Slovakia

POKO Poprad, s.r.o., Ambulancia klinickej onkologie

🇸🇰

Poprad, Slovakia

Universitaetsklinikum Heidelberg

🇩🇪

Heidelberg, Baden-württemberg, Germany

Fachklinik Hornheide

🇩🇪

Münster, Nordrhein-westfalen, Germany

Euromedix, a.s.

🇸🇰

Bratislava, Slovakia

HELIOS Klinikum Erfurt

🇩🇪

Erfurt, Thüringen, Germany

Fakultni nemocnice Hradec Kralove

🇨🇿

Hradec Kralove, Hradec Králové, Czechia

Fakultni nemocnice Ostrava

🇨🇿

Ostrava, Moravskoslezský KRAJ, Czechia

Fakultni nemocnice Olomouc

🇨🇿

Olomouc, Olomoucký KRAJ, Czechia

Fakultni nemocnice Bulovka

🇨🇿

Prague, Praha 8, Czechia

Vseobecna fakultni nemocnice v Praze

🇨🇿

Praha 2, Czechia

Universitaetsklinikum Tuebingen

🇩🇪

Tübingen, Baden-württemberg, Germany

Universitätsklinikum Regensburg

🇩🇪

Regensburg, Bayern, Germany

Elbe Kliniken Stade-Buxtehude, Klinikum Buxtehude

🇩🇪

Buxtehude, Niedersachsen, Germany

Medizinische Hochschule Hannover

🇩🇪

Hannover, Niedersachsen, Germany

Universitaetsklinikum Essen

🇩🇪

Essen, Nordrhein-westfalen, Germany

Universitätsmedizin Johannes Gutenberg Universität Mainz

🇩🇪

Mainz, Rheinland-pfalz, Germany

Universitätsklinikum Leipzig

🇩🇪

Leipzig, Sachsen, Germany

Universitätsklinikum Schleswig-Holstein

🇩🇪

Lübeck, Schleswig-holstein, Germany

SRH Wald-Klinikum Gera

🇩🇪

Gera, Thüringen, Germany

Klinikum Bremen-Ost

🇩🇪

Bremen, Germany

Istituto Nazionale Tumori Regina Elena

🇮🇹

Rome, Roma, Italy

A.O.U. Policlinico Paolo Giaccone

🇮🇹

Palermo, Sicilia, Italy

Istituto di Candiolo IRCCS - Fondazione del Piemonte per l'Oncologia

🇮🇹

Candiolo, Torino, Italy

Azienda Ospedaliero Universitaria Senese

🇮🇹

Siena, Toscana, Italy

AO Santa Maria della Misericordia

🇮🇹

Perugia, Umbria, Italy

Istituto Oncologico Veneto IRCCS

🇮🇹

Padova, Veneto, Italy

Ospedale San Martino

🇮🇹

Genova, Italy

Uniwersyteckie Centrum Kliniczne Klinika Chirurgii Onkologicznej, Transplantacyjnej i Ogólnej

🇵🇱

Gdansk, Poland

Pratia MCM Krakow

🇵🇱

Krakow, Poland

Samodzielny Publiczny Zakład Opieki Zdrowotnej MSWiA z Warmińsko - Mazurskim Centrum Onkologii

🇵🇱

Olsztyn, Poland

Uniwersytecki Szpital Kliniczny w Poznaniu

🇵🇱

Poznan, Poland

Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie - Państwowy Instytut Badawczy

🇵🇱

Warszawa, Poland

Fakultna Nemocnica s Poliklinikou F. D. Roosevelta Banska Bystrica

🇸🇰

Banska Bystrica, Slovakia

Fakultna nemocnica s poliklinikou F.D. Roosevelta Banska Bystrica

🇸🇰

Banska Bystrica, Slovakia

Fakultna nemocnica s poliklinikou F.D. Roosevelta

🇸🇰

Banska Bystrica, Slovakia

Narodny onkologicky ustav

🇸🇰

Bratislava, Slovakia

Hospital Clínic de Barcelona

🇪🇸

Barcelona, Spain

Hospital General Universitario Gregorio Marañon

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

Hospital Universitario Miguel Servet

🇪🇸

Zaragoza, Spain

Addenbrooke's Hospital

🇬🇧

Cambridge, Cambridgeshire, United Kingdom

Royal Marsden Hospital (Chelsea)

🇬🇧

London, Kensington AND Chelsea, United Kingdom

Royal Marsden Hospital (Sutton)

🇬🇧

London, Sutton, United Kingdom

City Hospital, Nottingham University Hospitals NHS Trust

🇬🇧

Nottingham, United Kingdom

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