This phase I tests the safety, side effects, and best dose of E6201 in combination with dabrafenib in treating patients with BRAF V600 mutated melanoma that has spread to the central nervous system (central nervous system metastases). E6201 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Dabrafenib is used in patients whose cancer has a mutated (changed) form of a gene called BRAF. It is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals tumor cells to multiply. This helps stop the spread of tumor cells. Giving E6201 and dabrafenib together may work better in treating patients with BRAF V600 mutated melanoma that has spread to the central nervous system than either drug alone.
PRIMARY OBJECTIVE: I. To determine the maximum tolerated dose of MEK-1/MEKK-1 inhibitor E6201 (E6201) in combination with dabrafenib in patients with central nervous system (CNS) metastases from BRAF V600- mutated metastatic melanoma. (Phase I) II. To assess the response rates treated at the maximum tolerated dose of E6201 in combination with dabrafenib in patients with central nervous system (CNS) metastases from BRAF V600- mutated metastatic melanoma. (maximum tolerated dose \[MTD\] + Expansion Cohort) SECONDARY OBJECTIVES: I. To assess the time to first progression in subjects with CNS metastases due to metastatic melanoma with a BRAF V600 mutation treated with E6201 + dabrafenib. II. To assess overall survival (OS) in subjects with CNS metastases due to metastatic melanoma with a BRAF V600 mutation treated with E6201 + dabrafenib. III. To assess the adverse events profile of E6201 in combination with dabrafenib in subjects with CNS metastases due to metastatic melanoma with a BRAF V600 mutation treated with E6201 + dabrafenib. CORRELATIVE RESEARCH OBJECTIVE: I. To assess the impact of BRAF mutational status (e.g., type, heterozygosity or homozygosity) in archival tissue with clinical outcome. OUTLINE: This is a dose-escalation study of MEK-1/MEKK-1 inhibitor E6201 followed by a dose-expansion study. Patients receive MEK-1/MEKK-1 inhibitor E6201 intravenously (IV) over 2 hours on days 1, 4, 8, 11, 15, and 18, and dabrafenib orally (PO) twice daily (BID) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo blood sample collection, computed tomography (CT) or magnetic resonance imaging (MRI) throughout study. After completion of study treatment, patients are followed up every 6 months for up to 2 years from time of registration.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
13
Given PO
Given IV
Undergo blood sample collection
Undergo CT
Undergo MRI
Mayo Clinic in Arizona
Scottsdale, Arizona, United States
Mayo Clinic in Florida
Jacksonville, Florida, United States
Mayo Clinic in Rochester
Rochester, Minnesota, United States
Maximum tolerated dose
Time frame: Up to end of cycle 1 (1 cycle = 28 days)
Overall intracranial response rate
Defined as the number of patients who have achieved CR or PR per Response Assessment in Neuro-oncology (RANO) for brain metastases criteria during treatment with E6201 plus dabrafenib divided by total number of evaluable patients. Responses will be summarized by simple descriptive summary statistics delineating complete and partial responses as well as stable and progressive disease in this patient population.
Time frame: Up to 2 years
Overall extracranial response rate
Defined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Systemic response by RECIST 1.1 criteria for extracranial disease will be estimated using systemic response rate (SRR) - where SRR is defined as the number of evaluable patients achieving a response (partial response or complete response per RECIST 1.1) during treatment with study therapy divided by the total number of evaluable patients. Responses will be summarized by simple descriptive summary statistics delineating complete and partial responses as well as stable and progressive disease in this patient population.
Time frame: Up to 2 years
Incidence of adverse events
The maximum grade for each type of adverse event will be recorded for each patient, and frequency tables will be reviewed to determine patterns. Additionally, the relationship of the adverse event(s) to the study treatment will be taken into consideration.
Time frame: Up to 2 years
Time to first progression
Will be summarized descriptively.
Time frame: Up to 2 years
Overall survival
Will be summarized descriptively.
Time frame: Up to 2 years
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