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Study of Trametinib + Ceritinib in Patients With Unresectable Melanoma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03501368
Recruitment Status : Recruiting
First Posted : April 18, 2018
Last Update Posted : January 20, 2022
Sponsor:
Collaborator:
Novartis Pharmaceuticals
Information provided by (Responsible Party):
H. Lee Moffitt Cancer Center and Research Institute

Brief Summary:
The main purpose of this study is to determine the risks and benefits of ceritinib (ZYKADIA) given in combination with trametinib (MEKINIST) in patients who have progressed on prior melanoma therapy.

Condition or disease Intervention/treatment Phase
Melanoma Unresectable Melanoma Advanced Melanoma Drug: Ceritinib Drug: Trametinib Phase 1

Detailed Description:
Ceritinib that has been approved for patients with metastatic non-small cell lung cancer (NSCLC) by the US Food and Drug Administration (FDA). While ceritinib is not currently FDA-approved specifically in melanoma, researchers believe ceritinib may also help keep melanoma cancer cells from growing and therefore potentially help patients with melanoma as well. Trametinib is currently FDA-approved for melanoma with a BRAFV600-mutation.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 27 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase 1 Study of Trametinib + Ceritinib in Patients With Unresectable Melanoma
Actual Study Start Date : June 27, 2018
Estimated Primary Completion Date : June 2022
Estimated Study Completion Date : June 2023

Resource links provided by the National Library of Medicine

MedlinePlus Genetics related topics: Melanoma
MedlinePlus related topics: Melanoma

Arm Intervention/treatment
Experimental: Trametinib + Ceritinib Treatment
Study treatment will be given in cycles. Each cycle will be 4 weeks (28 days). Post-Treatment (follow-up) Period: Participants will return to the study site between 30-40 days after the last dose of trametinib + ceritinib for an end-of-treatment assessment. Additional follow-up will occur for related Adverse Events (AEs) that are not resolved by this time and related Serious Adverse Events (SAEs) that occur after the time of this visit. Participants will be followed for survival every 3 months for the first year following end of treatment, and then every 6 months for up to 5 years after end of treatment.
Drug: Ceritinib
Participants will take ceritinib by mouth (PO) once daily at a dose of up to 450 mg (3 capsules of 150 mg)
Other Name: ZYKADIA

Drug: Trametinib
Participants will take trametinib by mouth at a dose of 2 mg daily
Other Name: MEKINIST




Primary Outcome Measures :
  1. Maximum Tolerated Dose (MTD) and recommended Phase 2 Dose (RP2D) [ Time Frame: Up to 12 months ]
    Maximum Tolerated Dose and recommended phase 2 dose of trametinib + ceritinib, determined by number and frequency of treatment related adverse events

  2. Overall Response Rate (ORR) [ Time Frame: Up to 6 months post treatment ]
    ORR will be defined by proportion of patients who have achieved a complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD.


Secondary Outcome Measures :
  1. Median Progression-free Survival (PFS) [ Time Frame: Up to 5 years post treatment ]
    PFS is defined from the time of on-treatment to time of progression, censoring at last clinical follow up or if no longer followed at Moffitt, then based on date of last medical documentation of no progression. Progressive Disease (PD): At least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started.

  2. Overall Survival (OS) [ Time Frame: Up to 5 years post treatment ]
    OS is defined as from the time of on-treatment to the time of death, censoring at last date known alive.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of advanced/unresectable melanoma (AJCC v.8 Stage 3C/D/4)
  • Measurable disease, defined as per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
  • Must have at least one tumor site accessible for a biopsy
  • Documented disease refractory to at least one PD1/PD-L1 (+/- CTLA-4) inhibitor treatment, or intolerance to these drugs and if BRAFV600-mutant melanoma, refractory disease to at least one BRAF and MEK inhibitor (defined as progression while on treatment), or intolerance to these drugs
  • Last line of treatment prior to study enrollment must not have been BRAF/MEK inhibitor therapy
  • Prior treatment-related toxicity resolved to ≤ Grade 2 or baseline
  • Prior radiation allowed
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤2
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation and for 90 days after completion of trametinib + ceritinib administration.
  • Participants must have normal organ and marrow function.

Exclusion Criteria:

  • Potential participants with known hypersensitivity to any of the excipients of trametinib, ceritinib (microcrystalline cellulose, mannitol, crospovidone, colloidal silicon dioxide and magnesium stearate).
  • An untreated or uncontrolled brain metastases or evidence of leptomeningeal disease. Patients with asymptomatic brain metastases or previously treated brain metastases that are stable (i.e., not requiring corticosteroids) at the time of study start will be eligible.
  • Previous malignancy is not an exclusion provided that the other malignancy is considered under control, patient is not on concomitant anti-cancer drug therapy, and target lesions from melanoma are clearly defined for response assessment.
  • Other severe, acute, or chronic medical conditions including uncontrolled diabetes mellitus or psychiatric conditions or laboratory abnormalities that, in the opinion of the investigator, may increase the risk associated with study participation or may interfere with the interpretation of study results.
  • Clinically significant, uncontrolled heart disease and/or recent cardiac event (within 6 months), such as:

    1. unstable angina within 6 months prior to screening;
    2. myocardial infarction within 6 months prior to screening;
    3. history of documented congestive heart failure (New York Heart Association functional classification III-IV);
    4. cardiac arrhythmias not controlled with medication;
    5. Corrected QT (QTcF) >470 ms at baseline
  • A history of interstitial lung disease or interstitial pneumonitis, including clinically significant radiation pneumonitis (i.e., affecting activities of daily living or requiring therapeutic intervention). (Note, this does NOT include immune-mediated pneumonitis)
  • Impaired gastrointestinal (GI) function or GI disease that may alter absorption of study drugs or inability to swallow
  • Receiving medications that meet one of the following criteria and that cannot be discontinued at least 1 week prior to start of treatment with study drugs and for the duration of participation:

    1. Medication with a known risk of prolonging the QT interval or inducing Torsades de Pointes
    2. Strong inhibitors or strong inducers of CYP3A4/5, and Medications with a low therapeutic index that are primarily metabolized by CYP3A4/5, and/or CYP2C9
    3. Therapeutic doses of warfarin sodium (Coumadin) or any other coumadin-derived anti-coagulant. Anticoagulants not derived from warfarin are allowed (e.g., dabigatran, rivaroxaban, apixaban).
    4. Unstable or increasing doses of corticosteroids in the 5 days before first dose of study treatment.
    5. Enzyme-inducing anticonvulsive agents

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03501368


Locations
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United States, Florida
H. Lee Moffitt Cancer Center and Research Institute Recruiting
Tampa, Florida, United States, 33612
Contact: Deanryan DeAquino    813-745-3998    deanryan.deaquino@moffitt.org   
Contact: Zeynep Eroglu, M.D.    813-745-7488    zeynep.eroglu@moffitt.org   
Principal Investigator: Zeynep Eroglu, M.D.         
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Novartis Pharmaceuticals
Investigators
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Principal Investigator: Zeynep Eroglu, M.D. H. Lee Moffitt Cancer Center and Research Institute
Additional Information:
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Responsible Party: H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov Identifier: NCT03501368    
Other Study ID Numbers: MCC-19475
First Posted: April 18, 2018    Key Record Dates
Last Update Posted: January 20, 2022
Last Verified: January 2022

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
cutaneous
refractory
melanoma
ceritinib
Additional relevant MeSH terms:
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Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas
Trametinib
Ceritinib
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action