A Study to Assess Naporafenib (ERAS-254) Administered With Trametinib in Patients With NRAS-mutant Melanoma (SEACRAFT-2)
- Conditions
- Advanced or Metastatic NRAS-mutant Melanoma
- Interventions
- Registration Number
- NCT06346067
- Lead Sponsor
- Erasca, Inc.
- Brief Summary
Stage 1: To select the optimal dose of naporafenib + trametinib to be studied in Stage 2.
Stage 2: To compare progression free survival (PFS) and overall survival (OS) for patients with NRAS-mutant (NRASm) melanoma who are randomized to receive the combination of naporafenib + trametinib to that of patients who are randomized to physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy).
- Detailed Description
SEACRAFT-2 is a global, Phase III, open-label, randomized study to assess the efficacy and safety of naporafenib administered with trametinib compared to physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy) in patients with unresectable or metastatic NRAS mutant melanoma who have progressed on, or are intolerant to, an anti-programmed death-1 ligand 1 (PD 1/L1)-based regimen. The study will consist of 2 stages: dose optimization in Stage 1 and the Phase 3 portion in Stage 2.
A total of approximately 470 eligible patients will be randomized to receive study drug(s) in this study across 2 stages.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 470
- Willing and able to provide written informed consent
- Age ≥ 18 years
- Histologically or cytologically confirmed unresectable or metastatic cutaneous (includes acral) melanoma.
- Documentation of an NRAS mutation (tumor tissue or blood) prior to first dose of study drug(s) as determined locally with an analytically validated assay in a certified testing laboratory.
- Archival tumor tissue collected within 5 years prior to enrollment must be confirmed to be available at the time of Screening, which may be submitted before or after enrollment for exploratory biomarker analysis.
- Must have received an anti-PD-1/L1 based regimen (monotherapy or combination). Patient must have documented disease progression either while receiving therapy or within 12 weeks of last dose of the most recent anti-PD-1/L1 based regimen; the patient is eligible if they have received other therapies between the most recent anti-PD-1/L1 based regimen and enrollment.
- ECOG performance status 0, 1 or 2
- Presence of at least 1 measurable lesion according to RECIST v1.1
- Able to swallow oral medication.
Key
- Patients with uveal or mucosal melanoma
- Prior therapy with an ERK-, MEK-, RAF-, or RAS-inhibitor
- Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug(s) (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, small bowel resection)
- History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndrome)
- LVEF <50%
- Symptomatic CNS metastases that are neurologically unstable. Patients with controlled CNS metastases are eligible.
- Patients receiving treatment with herbal medicine known to cause liver toxicity, which cannot be discontinued 7 days prior to first dose of study drug(s) and for the duration of the study.
- Are pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Stage 1 Dose selection Lead-in Arm 1 Trametinib Naporafenib + Trametinib Naporafenib (ERAS-254) 100 mg administered orally twice daily (BID) Trametinib 1 mg once daily (QD) Stage 1 Dose selection Lead-in Arm 2 Naporafenib Naporafenib + Trametinib Naporafenib (ERAS-254) 400 mg administered orally twice daily (BID) Trametinib 0.5 mg once daily (QD) Stage 2 Arm A Naporafenib Naporafenib + Trametinib Naporafenib (ERAS-254) BID oral administration with Trametinib QD at the dose selected in Stage 1 Stage 1 Dose selection Lead-in Arm 1 Naporafenib Naporafenib + Trametinib Naporafenib (ERAS-254) 100 mg administered orally twice daily (BID) Trametinib 1 mg once daily (QD) Stage 1 Dose selection Lead-in Arm 3 Trametinib monotherapy Trametinib Trametinib 2 mg once daily (QD) Stage 2 Arm B - Physician's Choice Dacarbazine * Dacarbazine 1000 mg/m2 intravenously (IV) on Day 1 of each 21-day cycle OR * Temozolomide 200 mg/m2/day PO on Day 1 to Day 5 of each 28-day cycle OR * Trametinib monotherapy, 2 mg PO QD Stage 1 Dose selection Lead-in Arm 2 Trametinib Naporafenib + Trametinib Naporafenib (ERAS-254) 400 mg administered orally twice daily (BID) Trametinib 0.5 mg once daily (QD) Stage 2 Arm B - Physician's Choice Temozolomide * Dacarbazine 1000 mg/m2 intravenously (IV) on Day 1 of each 21-day cycle OR * Temozolomide 200 mg/m2/day PO on Day 1 to Day 5 of each 28-day cycle OR * Trametinib monotherapy, 2 mg PO QD Stage 2 Arm A Trametinib Naporafenib + Trametinib Naporafenib (ERAS-254) BID oral administration with Trametinib QD at the dose selected in Stage 1 Stage 2 Arm B - Physician's Choice Trametinib * Dacarbazine 1000 mg/m2 intravenously (IV) on Day 1 of each 21-day cycle OR * Temozolomide 200 mg/m2/day PO on Day 1 to Day 5 of each 28-day cycle OR * Trametinib monotherapy, 2 mg PO QD
- Primary Outcome Measures
Name Time Method Stage 2: To compare PFS and OS for patients who are randomized to receive the combination of naporafenib + trametinib to that of patients who receive physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy) Assessed up to 24 months from time of first dose * Progression free survival (PFS) based on assessment of radiographic imaging per RECIST v1.1
* Survival statusStage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2 Study Day 1 up to Day 29 Area under the plasma concentration-time curve
- Secondary Outcome Measures
Name Time Method Duration of Response (DOR) Assessed up to 24 months from time of first dose] Based on assessment of radiographic imaging per RECIST version 1.1
Time to Response (TTR) Assessed up to 24 months from time of first dose] Based on assessment of radiographic imaging per RECIST version 1.1
Adverse Events Assessed up to 24 months from time of first dose Incidence and severity of treatment-emergent AEs and serious AEs
Disease Control Rate (DCR) Assessed up to 24 months from time of first dose] Based on assessment of radiographic imaging per RECIST version 1.1
Overall Response Rate (ORR) Assessed up to 24 months from time of first dose Based on the assessment of radiographic imaging per RECIST version 1.1
Plasma concentration (Cmax):Stage 1 only Study Day 1 up to Day 29 Maximum plasma concentration of ERAS-254 and trametinib
Area under the curve (AUC):Stage 1 only Study Day 1 up to Day 29 Area under the plasma concentration-time curve
Quality of Life: To assess disease and treatment-related QOL in patients with NRASm melanoma. Assessed up to 24 months from time of first dose Using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire \[QLQ\]-C30 subscales and PRO CTCAE® symptom items specific to the potential cutaneous toxicities.
Trial Locations
- Locations (59)
Mayo Clinic - Arizona
🇺🇸Phoenix, Arizona, United States
University of California, San Francisco
🇺🇸San Francisco, California, United States
The Melanoma and Skin Care Institute
🇺🇸Englewood, Colorado, United States
Mayo Clinic - Florida
🇺🇸Jacksonville, Florida, United States
University of Miami Sylvester Cancer
🇺🇸Miami, Florida, United States
University of Kansas Cancer Center
🇺🇸Kansas City, Kansas, United States
Ochsner Clinic Foundation
🇺🇸Jefferson, Louisiana, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Barbara Ann Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Memorial Sloan Kettering Cancer Center
🇺🇸New York, New York, United States
Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
SCRI Oncology Partners (formerly Tennessee Oncology)
🇺🇸Nashville, Tennessee, United States
Texas Oncology- Austin Midtown
🇺🇸Austin, Texas, United States
Texas Oncology - Baylor Charles A. Sammons Cancer Center
🇺🇸Dallas, Texas, United States
The University of Texas MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
The University of Utah - Huntsman Cancer Institute (HCI)
🇺🇸Salt Lake City, Utah, United States
Virginia Oncology Associates
🇺🇸Norfolk, Virginia, United States
Fred Hutchinson Cancer Center
🇺🇸Seattle, Washington, United States
University of Wisconsin
🇺🇸Madison, Wisconsin, United States
Calvary Mater Newcastle
🇦🇺Waratah, New South Wales, Australia
Tasman Health Care
🇦🇺Southport, Queensland, Australia
Princess Alexandra Hospital
🇦🇺Woolloongabba, Queensland, Australia
Peter MacCallum Cancer Institute
🇦🇺Melbourne, Victoria, Australia
Hollywood Private Hospital
🇦🇺Nedlands, Western Australia, Australia
Alfred Hospital
🇦🇺Melbourne, Australia
Queen Elizabeth II Health Sciences Centre
🇨🇦Halifax, Nova Scotia, Canada
McGill University Health Centre
🇨🇦Montréal, Quebec, Canada
Masarykuv Onkologicky Ustav-MOU
🇨🇿Brno, Czechia
Fakultni nemocnice Hradec Kralove
🇨🇿Nový Hradec Králové, Czechia
Sanatorium Profesora Arenbergera
🇨🇿Prague, Czechia
Centre Hospitalier Universitaire (CHU) de Bordeaux - Hospitalier Saint-Andre
🇫🇷Bordeaux, France
CHU Dijon Bourgogne - Hopital Francois Mitterand (Hopital du Bocage)
🇫🇷Dijon, France
Centre Hospitalier du Mans
🇫🇷Le Mans, France
CHRU de Lille - Hôpital Claude Huriez
🇫🇷Lille, France
Centre Hospitalier Lyon-Sud
🇫🇷Lyon, France
Assistance Publique Hopitaux de Marseille (AP-HM) - Hopital de la Timone
🇫🇷Marseille, France
Hospital Ambroise Pairs
🇫🇷Paris, France
APHP - Hopital Saint Louis
🇫🇷Paris, France
CLCC Institute Gustave Roussy
🇫🇷Villejuif, France
Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) - Ospedale San Raffaele (HSR) (Istituto Scientifico Universitario Sa
🇮🇹Milan, Italy
IRCCS Istituto Nazionale Tumori Regina Elena
🇮🇹Roma, Italy
Istituto Dermopatico dell Immacolata IDI-IRCCS
🇮🇹Roma, Italy
Azienda Sanitaria Universitaria del Friuli Centrale
🇮🇹Udine, Italy
Isala Ziekenhuis
🇳🇱Amsterdam, Netherlands
Leids Universitair Medisch Centrum
🇳🇱Leiden, Netherlands
Radboud University
🇳🇱Nijmegen, Netherlands
Hospital Universitari Vall d'Hebron - Vall d'Hebron Institut d'Oncologia (VHIO)
🇪🇸Barcelona, Spain
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Hospital General Universitario Gregorio Marañón
🇪🇸Madrid, Spain
Hospital Universitario Ramon y Cajal
🇪🇸Madrid, Spain
Hospital HM Sanchinarro
🇪🇸Madrid, Spain
Hospital Universitario Central de Asturias
🇪🇸Oviedo, Spain
Royal Preston Hospital
🇬🇧Preston, Lancashire, United Kingdom
Sarah Cannon Research Institute - HCA Healthcare
🇬🇧City of London, London, United Kingdom
Royal Devon and Exeter Hospital
🇬🇧Exeter, United Kingdom
The Royal Marsden NHS Foundation Trust
🇬🇧London, United Kingdom
Christie Hospital
🇬🇧Manchester, United Kingdom