MedPath

Vemurafenib and Cobimetinib in Treating Patients with BRAF V600E Mutation Positive Craniopharyngioma

Phase 2
Active, not recruiting
Conditions
BRAF V600E Mutation Present
Papillary Craniopharyngioma
Interventions
Other: Laboratory Biomarker Analysis
Other: Quality-of-Life Assessment
Registration Number
NCT03224767
Lead Sponsor
Alliance for Clinical Trials in Oncology
Brief Summary

This phase II trial studies how well vemurafenib and cobimetinib work in treating patients with BRAF V600E mutation positive craniopharyngioma. Vemurafenib and cobimetinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Detailed Description

PRIMARY OBJECTIVES:

I. To determine the activity of BRAF and MEK inhibitor combination in untreated papillary craniopharyngiomas as measured by best response at any time during the first four cycles of BRAF and MEK inhibitor treatment.

II. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas that have progressed after prior radiation treatment with or without surgical resection as measured by best response at any time during the first four cycles of BRAF and MEK inhibitor treatment.

SECONDARY OBJECTIVES:

I. To determine the progression-free survival of patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.

II. To determine the toxicity of BRAF/MEK inhibitors in patients with papillary craniopharyngiomas.

III. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas as measured by response of enhancing volume of craniopharyngioma.

IV. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas as measured by response of nonenhancing volume of craniopharyngioma.

V. To determine the overall survival of patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.

VI. To determine the duration of response in patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.

TERTIARY OBJECTIVES:

I. To evaluate visual fields in patients with papillary craniopharyngiomas who have received BRAF/MEK inhibitors.

II. To evaluate pituitary hormone replacement over time in patients with papillary craniopharyngiomas who have received BRAF/MEK inhibitors.

III. To evaluate the time to response in patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.

IV. To assess toxicity that may be associated with radiotherapy in patients with papillary craniopharyngiomas who have received BRAF/MEK inhibitors.

V. To evaluate molecular biomarkers of response in papillary craniopharyngiomas.

VI. To evaluate circulating tumor cells and cell-free circulating deoxyribonucleic acid (DNA) in patients with papillary craniopharyngiomas.

OUTLINE:

Patients receive vemurafenib orally (PO) twice daily (BID) on day 1-28 and cobimetinib PO once daily (QD) on days 1-21. Treatment repeats every 28 days for up to 5 courses in the absence of disease progression or unacceptable toxicity. Patients may then receive radiation therapy, surgery, or continued treatment with vemurafenib and cobimetinib at the discretion of the treating physician.

After completion of study treatment, patients with disease progression are followed up every 16 weeks for 2 years and all other patients are followed up every 6 months for 5 years.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
24
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment (vemurafenib, cobimetinib)Laboratory Biomarker AnalysisPatients receive vemurafenib PO BID on day 1-28 and cobimetinib PO QD on days 1-21. Treatment repeats every 28 days for up to 5 courses in the absence of disease progression or unacceptable toxicity. Patients may then receive radiation therapy, surgery, or continued treatment with vemurafenib and cobimetinib at the discretion of the treating physician.
Treatment (vemurafenib, cobimetinib)Quality-of-Life AssessmentPatients receive vemurafenib PO BID on day 1-28 and cobimetinib PO QD on days 1-21. Treatment repeats every 28 days for up to 5 courses in the absence of disease progression or unacceptable toxicity. Patients may then receive radiation therapy, surgery, or continued treatment with vemurafenib and cobimetinib at the discretion of the treating physician.
Treatment (vemurafenib, cobimetinib)VemurafenibPatients receive vemurafenib PO BID on day 1-28 and cobimetinib PO QD on days 1-21. Treatment repeats every 28 days for up to 5 courses in the absence of disease progression or unacceptable toxicity. Patients may then receive radiation therapy, surgery, or continued treatment with vemurafenib and cobimetinib at the discretion of the treating physician.
Treatment (vemurafenib, cobimetinib)CobimetinibPatients receive vemurafenib PO BID on day 1-28 and cobimetinib PO QD on days 1-21. Treatment repeats every 28 days for up to 5 courses in the absence of disease progression or unacceptable toxicity. Patients may then receive radiation therapy, surgery, or continued treatment with vemurafenib and cobimetinib at the discretion of the treating physician.
Primary Outcome Measures
NameTimeMethod
Response rateUp to 5 years

Defined as the number of responses achieved during treatment with BRAF and MEK inhibitors divided by the total number of evaluable patients and assessed by contrast-enhanced magnetic resonance imaging or computed tomography. Point estimates will be generated for response rates within each cohort with corresponding 95% binomial confidence intervals. Simon's two-stage design with one interim analysis for futility will be applied to evaluate response rate within each cohort.

Secondary Outcome Measures
NameTimeMethod
Progression-free survivalUp to 5 years

Will be summarized for each cohort within each cohort with Kaplan-Meier curves and estimates.

Overall survivalUp to 5 years

Will be summarized for each cohort within each cohort with Kaplan-Meier curves and estimates.

Trial Locations

Locations (106)

Alta Bates Summit Medical Center-Herrick Campus

🇺🇸

Berkeley, California, United States

Palo Alto Medical Foundation-Camino Division

🇺🇸

Mountain View, California, United States

UC Irvine Health/Chao Family Comprehensive Cancer Center

🇺🇸

Orange, California, United States

Mills-Peninsula Medical Center

🇺🇸

Burlingame, California, United States

Sutter Cancer Centers Radiation Oncology Services-Cameron Park

🇺🇸

Cameron Park, California, United States

Eden Hospital Medical Center

🇺🇸

Castro Valley, California, United States

Kaiser Permanente Los Angeles Medical Center

🇺🇸

Los Angeles, California, United States

Memorial Medical Center

🇺🇸

Modesto, California, United States

Palo Alto Medical Foundation Health Care

🇺🇸

Palo Alto, California, United States

Sutter Cancer Centers Radiation Oncology Services-Roseville

🇺🇸

Roseville, California, United States

Sutter Medical Center Sacramento

🇺🇸

Sacramento, California, United States

Sutter Roseville Medical Center

🇺🇸

Roseville, California, United States

California Pacific Medical Center-Pacific Campus

🇺🇸

San Francisco, California, United States

Palo Alto Medical Foundation-Sunnyvale

🇺🇸

Sunnyvale, California, United States

Sutter Cancer Centers Radiation Oncology Services-Vacaville

🇺🇸

Vacaville, California, United States

Sutter Solano Medical Center/Cancer Center

🇺🇸

Vallejo, California, United States

Smilow Cancer Center/Yale-New Haven Hospital

🇺🇸

New Haven, Connecticut, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

Tampa General Hospital

🇺🇸

Tampa, Florida, United States

Saint Alphonsus Cancer Care Center-Boise

🇺🇸

Boise, Idaho, United States

Kootenai Clinic Cancer Services - Post Falls

🇺🇸

Post Falls, Idaho, United States

Smilow Cancer Hospital Care Center-Trumbull

🇺🇸

Trumbull, Connecticut, United States

Mayo Clinic in Florida

🇺🇸

Jacksonville, Florida, United States

University of Miami Miller School of Medicine-Sylvester Cancer Center

🇺🇸

Miami, Florida, United States

Saint Alphonsus Cancer Care Center-Caldwell

🇺🇸

Caldwell, Idaho, United States

Kootenai Health - Coeur d'Alene

🇺🇸

Coeur D'Alene, Idaho, United States

Idaho Urologic Institute-Meridian

🇺🇸

Meridian, Idaho, United States

Saint Alphonsus Cancer Care Center-Nampa

🇺🇸

Nampa, Idaho, United States

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

Central Care Cancer Center - Garden City

🇺🇸

Garden City, Kansas, United States

Central Care Cancer Center - Great Bend

🇺🇸

Great Bend, Kansas, United States

Johns Hopkins University/Sidney Kimmel Cancer Center

🇺🇸

Baltimore, Maryland, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Massachusetts General Hospital Cancer Center

🇺🇸

Boston, Massachusetts, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Corewell Health Grand Rapids Hospitals - Butterworth Hospital

🇺🇸

Grand Rapids, Michigan, United States

Trinity Health Grand Rapids Hospital

🇺🇸

Grand Rapids, Michigan, United States

University of Michigan Health - West

🇺🇸

Wyoming, Michigan, United States

University of Michigan Comprehensive Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Bronson Battle Creek

🇺🇸

Battle Creek, Michigan, United States

Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital

🇺🇸

Grand Rapids, Michigan, United States

Bronson Methodist Hospital

🇺🇸

Kalamazoo, Michigan, United States

West Michigan Cancer Center

🇺🇸

Kalamazoo, Michigan, United States

Borgess Medical Center

🇺🇸

Kalamazoo, Michigan, United States

Trinity Health Muskegon Hospital

🇺🇸

Muskegon, Michigan, United States

Corewell Health Lakeland Hospitals - Niles Hospital

🇺🇸

Niles, Michigan, United States

Cancer and Hematology Centers of Western Michigan - Norton Shores

🇺🇸

Norton Shores, Michigan, United States

Corewell Health Reed City Hospital

🇺🇸

Reed City, Michigan, United States

Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center

🇺🇸

Saint Joseph, Michigan, United States

Corewell Health Lakeland Hospitals - Saint Joseph Hospital

🇺🇸

Saint Joseph, Michigan, United States

Munson Medical Center

🇺🇸

Traverse City, Michigan, United States

Fairview Ridges Hospital

🇺🇸

Burnsville, Minnesota, United States

Minnesota Oncology - Burnsville

🇺🇸

Burnsville, Minnesota, United States

Mercy Hospital

🇺🇸

Coon Rapids, Minnesota, United States

Fairview Southdale Hospital

🇺🇸

Edina, Minnesota, United States

Unity Hospital

🇺🇸

Fridley, Minnesota, United States

Fairview Clinics and Surgery Center Maple Grove

🇺🇸

Maple Grove, Minnesota, United States

Minnesota Oncology Hematology PA-Maplewood

🇺🇸

Maplewood, Minnesota, United States

Saint John's Hospital - Healtheast

🇺🇸

Maplewood, Minnesota, United States

Monticello Cancer Center

🇺🇸

Monticello, Minnesota, United States

Mayo Clinic in Rochester

🇺🇸

Rochester, Minnesota, United States

Rice Memorial Hospital

🇺🇸

Willmar, Minnesota, United States

Abbott-Northwestern Hospital

🇺🇸

Minneapolis, Minnesota, United States

Hennepin County Medical Center

🇺🇸

Minneapolis, Minnesota, United States

Health Partners Inc

🇺🇸

Minneapolis, Minnesota, United States

North Memorial Medical Health Center

🇺🇸

Robbinsdale, Minnesota, United States

Regions Hospital

🇺🇸

Saint Paul, Minnesota, United States

Park Nicollet Clinic - Saint Louis Park

🇺🇸

Saint Louis Park, Minnesota, United States

United Hospital

🇺🇸

Saint Paul, Minnesota, United States

Saint Francis Regional Medical Center

🇺🇸

Shakopee, Minnesota, United States

Lakeview Hospital

🇺🇸

Stillwater, Minnesota, United States

Central Care Cancer Center - Bolivar

🇺🇸

Bolivar, Missouri, United States

Ridgeview Medical Center

🇺🇸

Waconia, Minnesota, United States

Minnesota Oncology Hematology PA-Woodbury

🇺🇸

Woodbury, Minnesota, United States

Research Medical Center

🇺🇸

Kansas City, Missouri, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Billings Clinic Cancer Center

🇺🇸

Billings, Montana, United States

Bozeman Health Deaconess Hospital

🇺🇸

Bozeman, Montana, United States

Benefis Sletten Cancer Institute

🇺🇸

Great Falls, Montana, United States

Great Falls Clinic

🇺🇸

Great Falls, Montana, United States

Kalispell Regional Medical Center

🇺🇸

Kalispell, Montana, United States

Community Medical Center

🇺🇸

Missoula, Montana, United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

🇺🇸

Lebanon, New Hampshire, United States

Rutgers New Jersey Medical School

🇺🇸

Newark, New Jersey, United States

NYP/Weill Cornell Medical Center

🇺🇸

New York, New York, United States

Laura and Isaac Perlmutter Cancer Center at NYU Langone

🇺🇸

New York, New York, United States

UNC Lineberger Comprehensive Cancer Center

🇺🇸

Chapel Hill, North Carolina, United States

Wake Forest University Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

Cancer Centers of Southwest Oklahoma Research

🇺🇸

Lawton, Oklahoma, United States

M D Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Huntsman Cancer Institute/University of Utah

🇺🇸

Salt Lake City, Utah, United States

Inova Schar Cancer Institute

🇺🇸

Fairfax, Virginia, United States

University of Washington Medical Center - Montlake

🇺🇸

Seattle, Washington, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Farmington Health Center

🇺🇸

Farmington, Utah, United States

South Jordan Health Center

🇺🇸

South Jordan, Utah, United States

FHCC South Lake Union

🇺🇸

Seattle, Washington, United States

Fred Hutchinson Cancer Center

🇺🇸

Seattle, Washington, United States

Aurora Saint Luke's Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Welch Cancer Center

🇺🇸

Sheridan, Wyoming, United States

United Hospital Center

🇺🇸

Bridgeport, West Virginia, United States

West Virginia University Healthcare

🇺🇸

Morgantown, West Virginia, United States

Cancer Center of Western Wisconsin

🇺🇸

New Richmond, Wisconsin, United States

Camden Clark Medical Center

🇺🇸

Parkersburg, West Virginia, United States

University of Alabama at Birmingham Cancer Center

🇺🇸

Birmingham, Alabama, United States

Sutter Cancer Centers Radiation Oncology Services-Auburn

🇺🇸

Auburn, California, United States

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