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).
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
470
Naporafenib (ERAS-254) is an experimental Pan-Raf inhibitor
Dacarbazine IV - Day 1
Temozolomide 200 mg/m2/day PO on Day 1 to Day 5 of each 28-day cycle
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
Incidence and severity of treatment-emergent AEs and serious AEs
Time frame: Assessed up to 6 months from time of first dose
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
Objective response rate (ORR) based on assessment of radiographic imaging RECIST v1.1
Time frame: Assessed up to 6 months from time of first dose
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
Maximum plasma concentration of ERAS-254 and trametinib
Time frame: Study Day 1 up to Day 29
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
Time to achieve maximum plasma concentration of ERAS-254 and trametinib
Time frame: Study Day 1 up to Day 29
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
Area under the plasma concentration-time curve
Time frame: Study Day 1 up to Day 29
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)
* Progression free survival (PFS) based on assessment of radiographic imaging per RECIST v1.1 * Survival status
Time frame: Assessed up to 24 months from time of first dose
Adverse Events
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Trametinib is an FDA approved anticancer medication that targets MEK1 and MEK2.
Mayo Clinic - Arizona
Phoenix, Arizona, United States
RECRUITINGUniversity of California, San Francisco
San Francisco, California, United States
RECRUITINGThe Melanoma and Skin Care Institute
Englewood, Colorado, United States
RECRUITINGMayo Clinic - Florida
Jacksonville, Florida, United States
RECRUITINGUniversity of Miami Sylvester Cancer
Miami, Florida, United States
RECRUITINGUniversity of Kansas Cancer Center
Kansas City, Kansas, United States
RECRUITINGOchsner Clinic Foundation
Jefferson, Louisiana, United States
ACTIVE_NOT_RECRUITINGMassachusetts General Hospital
Boston, Massachusetts, United States
RECRUITINGBarbara Ann Karmanos Cancer Institute
Detroit, Michigan, United States
RECRUITINGMayo Clinic
Rochester, Minnesota, United States
RECRUITING...and 49 more locations
Incidence and severity of treatment-emergent AEs and serious AEs
Time frame: Assessed up to 24 months from time of first dose
Duration of Response (DOR)
Based on assessment of radiographic imaging per RECIST version 1.1
Time frame: Assessed up to 24 months from time of first dose]
Time to Response (TTR)
Based on assessment of radiographic imaging per RECIST version 1.1
Time frame: Assessed up to 24 months from time of first dose]
Disease Control Rate (DCR)
Based on assessment of radiographic imaging per RECIST version 1.1
Time frame: Assessed up to 24 months from time of first dose]
Overall Response Rate (ORR)
Based on the assessment of radiographic imaging per RECIST version 1.1
Time frame: Assessed up to 24 months from time of first dose
Plasma concentration (Cmax):Stage 1 only
Maximum plasma concentration of ERAS-254 and trametinib
Time frame: Study Day 1 up to Day 29
Area under the curve (AUC):Stage 1 only
Area under the plasma concentration-time curve
Time frame: Study Day 1 up to Day 29
Quality of Life: To assess disease and treatment-related QOL in patients with NRASm melanoma.
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.
Time frame: Assessed up to 24 months from time of first dose