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Study of Efficacy and Safety of Dabrafenib in Combination With Trametinib in Pediatric Patients With BRAF V600 Mutation Positive LGG or Relapsed or Refractory HGG Tumors

Study Purpose

The purpose of this study was to investigate the activity of dabrafenib in combination with trametinib in children and adolescent patients with BRAF V600 mutation positive low grade glioma (LGG) or relapsed or refractory high grade glioma (HGG)

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 12 Months - 17 Years
Gender All
More Inclusion & Exclusion Criteria

Key

Inclusion Criteria:

  • - Diagnosis of BRAF V600 mutant High Grade glioma that had relapsed, progressed or failed to respond to frontline therapy.
  • - Diagnosis of BRAF V600 mutant Low Grade glioma with progressive disease following surgical excision, or non-surgical candidates with necessity to begin first systemic treatment because of a risk of neurological impairment with progression.
  • - Confirmed measurable disease.
Key

Exclusion Criteria:

  • - Previous treatment with dabrafenib, trametinib, other RAF inhibitor, other MEK or ERK inhibitor.
  • - HGG patient: Cancer treatment within the past 3 weeks.
LGG patient: Any systemic therapy or radiotherapy prior to enrollment.
  • - LGG patients: history of allergic reaction or contraindications to the use of carboplatin or vincristine.
  • - Stem cell transplant within the past 3 months.
  • - History of heart disease.
- Pregnant or lactating females

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT02684058
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Novartis Pharmaceuticals
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Novartis Pharmaceuticals
Principal Investigator Affiliation Novartis Pharmaceuticals
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Completed
Countries Argentina, Australia, Belgium, Brazil, Canada, Czechia, Denmark, Finland, France, Germany, Israel, Italy, Japan, Netherlands, Russian Federation, Spain, Sweden, Switzerland, United Kingdom, United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Diffuse Astrocytoma, Anaplastic Astrocytoma, Astrocytoma, Oligodendroglioma, Childhood, Anaplastic Oligodendroglioma, Glioblastoma, Pilocytic Astrocytoma, Giant Cell Astrocytoma, Pleomorphic Xanthoastrocytoma, Anaplastic Pleomorphic Xanthoastrocytoma, Angiocentric Glioma, Chordoid Glioma of Third Ventricle, Gangliocytoma, Ganglioglioma, Anaplastic Ganglioglioma, Dysplastic Gangliocytoma of Cerebrellum, Desmoplastic Infantile Astrocytoma and Ganglioglioma, Papillary Glioneuronal Tumor, Rosette-forming Glioneurona Tumor, Central Neurocytoma, Extraventricular Neurocytoma, Cerebellar Iponeurocytoma
Additional Details

This study combines two pediatric glioma cohorts (LGG and HGG cohorts) into a multi-center, open-label, Phase II study:

  • - The LGG cohort is a multi-center, randomized, open-label part of this Phase II study conducted in children and adolescent patients with BRAF V600 mutation-positive LGG whose tumor was unresectable and who required first systemic treatment.
Participants in the LGG cohort were randomized in a 2:1 ratio to either dabrafenib plus trametinib or carboplatin with vincristine.
  • - The HGG cohort is a multi-center, single-arm, open-label part of this Phase II study conducted in children and adolescent patients with BRAF V600 mutation-positive, refractory or relapsed HGG tumors after having received at least one previous standard therapy.
The duration of treatment for participants on dabrafenib plus trametinib in LGG and for all patients in the HGG cohort was continued until the loss of clinical benefit in the opinion of the Investigator, unacceptable toxicity, start of a new anti-neoplastic therapy, discontinuation at the discretion of the investigator or patient/legal guardian, lost to follow-up, death, study termination by the sponsor, or until disease progression. The duration of treatment for patients in the carboplatin with vincristine arm in LGG cohort was continued for the prescribed number of cycles, as tolerated or until unacceptable toxicity, start of a new anti-neoplastic therapy, discontinuation at the discretion of the investigator or patient/legal guardian, lost to follow-up, death, study is terminated by the sponsor or until disease progression. Participants randomized to the carboplatin with vincristine treatment arm were allowed to cross over to receive dabrafenib in combination with trametinib after centrally confirmed RANO-defined disease progression. Crossover was allowed during the treatment period or the post-treatment period. After discontinuation of study treatment, all participants (LGG and HGG cohorts) were followed for safety for at least 30 days after the last dose of study treatment. All participants who discontinued study treatment for reasons other than disease progression, death, loss to follow up, or withdrawal of consent moved into the post-treatment efficacy follow-up phase. Finally, all participants were followed for survival once they discontinued study treatment for at least 2 years after the last patient first study treatment (except if consent was withdrawn, death, or the patient was lost to follow-up or discontinued study)

Arms & Interventions

Arms

Experimental: LGG cohort: dabrafenib and trametinib

Participants in the LGG cohort randomized to receive dabrafenib (orally, twice daily and dosed based on weight and age) in combination with trametinib (orally, once daily in combination with the first daily dose of dabrafenib and was dosed based on weight)

Active Comparator: LGG cohort: carboplatin and vincristine

Participants in the LGG cohort randomized to receive active comparator chemotherapy (carboplatin and vincristine). Participants received one course of induction (10 weeks of chemotherapy with 2 weeks of rest), followed by 8 cycles of maintenance chemotherapy.

Experimental: HGG cohort: dabrafenib and trametinib

Participants in the HGG cohort received dabrafenib (orally, twice daily and dosed based on weight and age) and trametinib (orally, once daily in combination with the first daily dose of dabrafenib and dosed based on weight)

Interventions

Drug: - Dabrafenib

Dabrafenib was available as 50 mg and 75 mg hard capsules and as 10 mg dispersible tablets for oral suspension. Dabrafenib was administered orally, twice daily, and was dosed based on age and weight Patients < 12 years old and ≥ 16 kg were to be administered either the dabrafenib capsules or dabrafenib dispersible tablets for oral suspension (dose: 5.25 mg/kg/day) Patients ≥ 12 years old and ≥ 19 kg were to be administered either the dabrafenib capsules or dabrafenib dispersible tablets for oral suspension (dose: 4.5 mg/kg/day) Patients < 12 years old and < 16 kg were to be administered dabrafenib dispersible tablets for oral suspension (dose: 5.25 mg/kg/day) Patients ≥12 years old and <19 kg were to be administered dabrafenib dispersible tablets for oral suspension (dose: 4.5 mg/kg/day)

Drug: - trametinib

Trametinib was available as 0.5 mg and 2 mg film-coated tablets and as 5.0 mg powder in bottle for oral solution (0.05 mg/ml after reconstitution with 90 ml water).Trametinib was administered orally, once daily in combination with the first daily dose of dabrafenib and was dosed based on age and weight. Patients <6 years old and <26 kg were to be administered the trametinib oral solution (dose: 0.032 mg/kg/day) Patients <6 years old and ≥26 kg were to be administered either the trametinib oral solution or trametinib tablets (dose: 0.032 mg/kg/day) Patients ≥6 years old and ≥10 kg < 33 kg were to be administered the trametinib oral solution (dose: 0.025 mg/kg/day) Patients ≥6 years old and ≥33 kg were to be administered either the trametinib oral solution or the trametinib tablets (dose: 0.025 mg/kg/day)

Drug: - Carboplatin

Carboplatin was supplied locally as commercially available and labelled accordingly to comply with legal requirements of each country. Carboplatin was administered as one course of induction (10 weeks of chemotherapy with 2 weeks of rest), followed by 8 cycles of maintenance chemotherapy. Each maintenance cycle was 6 weeks, and consisted of 4 weeks of chemotherapy with 2 weeks of rest. Induction: 175 mg/m^2 as weekly intravenous (IV) infusion on weeks 1 to 4, and on weeks 7 to 10, on the same day as vincristine dosing Maintenance: 175 mg/m^2 as weekly IV infusion over 60 minutes on weeks 1 to 4 of each cycle.

Drug: - Vincristine

Vincristine was supplied locally as commercially available and labelled accordingly to comply with legal requirements of each country. Vincristine was administered as one course of induction (10 weeks of chemotherapy with 2 weeks of rest), followed by 8 cycles of maintenance chemotherapy. Induction: 1.5 mg/m^2 as weekly IV bolus infusion (0.05 mg/kg if child is <12 kg) (maximum dose of 2.0 mg) for 10 weeks. Maintenance: 1.5 mg/m^2 as weekly IV bolus infusion (0.05 mg/kg if child is <12 kg) (maximum dose of 2.0 mg) on weeks 1 to 3 of each cycle, on the same day as carboplatin dosing.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Children's Hospital of Orange County, Orange, California

Status

Address

Children's Hospital of Orange County

Orange, California, 92868

Childrens National Hospital, Washington, District of Columbia

Status

Address

Childrens National Hospital

Washington, District of Columbia, 20010

Nicklaus Childrens Hospital, Miami, Florida

Status

Address

Nicklaus Childrens Hospital

Miami, Florida, 33155

Chicago, Illinois

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Address

Ann and Robert H Lurie Childrens Hospital of Chicago .

Chicago, Illinois, 60611

Indiana University School of Medicine ., Indianapolis, Indiana

Status

Address

Indiana University School of Medicine .

Indianapolis, Indiana, 46202-2810

Baltimore, Maryland

Status

Address

Johns Hopkins University IDS Pharmacy John Hopkins Hospital

Baltimore, Maryland, 21287

Saint Louis, Missouri

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Address

Washington University School of Medicine SC

Saint Louis, Missouri, 63110

Cincinnati, Ohio

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Address

Cincinnati Childrens Hospital Medical Center Cancer & Blood Disease Inst.

Cincinnati, Ohio, 45229-3039

St Jude Children's Research Hospital, Memphis, Tennessee

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Address

St Jude Children's Research Hospital

Memphis, Tennessee, 38105

Houston, Texas

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Address

Texas Children s Hospital Baylor College of Medicine

Houston, Texas, 77030

International Sites

Novartis Investigative Site, Caba, Buenos Aires, Argentina

Status

Address

Novartis Investigative Site

Caba, Buenos Aires, C1428AQK

Novartis Investigative Site, Randwick, New South Wales, Australia

Status

Address

Novartis Investigative Site

Randwick, New South Wales, 2130

Novartis Investigative Site, Parkville, Victoria, Australia

Status

Address

Novartis Investigative Site

Parkville, Victoria, 3052

Novartis Investigative Site, Brussels, Belgium

Status

Address

Novartis Investigative Site

Brussels, , BE-B-1200

Novartis Investigative Site, Barretos, SP, Brazil

Status

Address

Novartis Investigative Site

Barretos, SP, 14784 400

Novartis Investigative Site, Sao Paulo, SP, Brazil

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Address

Novartis Investigative Site

Sao Paulo, SP, 04829-310

Novartis Investigative Site, Sao Paulo, SP, Brazil

Status

Address

Novartis Investigative Site

Sao Paulo, SP, 08270-070

Novartis Investigative Site, Vancouver, British Columbia, Canada

Status

Address

Novartis Investigative Site

Vancouver, British Columbia, V6H 3V4

Novartis Investigative Site, Toronto, Ontario, Canada

Status

Address

Novartis Investigative Site

Toronto, Ontario, M5G 1X8

Novartis Investigative Site, Montreal, Quebec, Canada

Status

Address

Novartis Investigative Site

Montreal, Quebec, H3T 1C5

Novartis Investigative Site, Brno, Czechia

Status

Address

Novartis Investigative Site

Brno, , 613 00

Novartis Investigative Site, Praha 5, Czechia

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Address

Novartis Investigative Site

Praha 5, , 150 06

Novartis Investigative Site, Copenhagen, Denmark

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Address

Novartis Investigative Site

Copenhagen, , 2100 O

Novartis Investigative Site, Tampere, Finland

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Address

Novartis Investigative Site

Tampere, , 33521

Novartis Investigative Site, Lille Cedex, France

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Address

Novartis Investigative Site

Lille Cedex, , 59020

Novartis Investigative Site, Lyon, France

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Address

Novartis Investigative Site

Lyon, , 69373

Novartis Investigative Site, Paris, France

Status

Address

Novartis Investigative Site

Paris, , 75231

Novartis Investigative Site, Strasbourg, France

Status

Address

Novartis Investigative Site

Strasbourg, , 67000

Novartis Investigative Site, Toulouse Cedex, France

Status

Address

Novartis Investigative Site

Toulouse Cedex, , 31059

Novartis Investigative Site, Villejuif, France

Status

Address

Novartis Investigative Site

Villejuif, , 94800

Novartis Investigative Site, Augsburg, Germany

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Address

Novartis Investigative Site

Augsburg, , 86179

Novartis Investigative Site, Berlin, Germany

Status

Address

Novartis Investigative Site

Berlin, , 13353

Novartis Investigative Site, Essen, Germany

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Address

Novartis Investigative Site

Essen, , 45147

Novartis Investigative Site, Gottingen, Germany

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Address

Novartis Investigative Site

Gottingen, , 37075

Novartis Investigative Site, Hamburg, Germany

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Address

Novartis Investigative Site

Hamburg, , 20246

Novartis Investigative Site, Heidelberg, Germany

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Address

Novartis Investigative Site

Heidelberg, , 69120

Novartis Investigative Site, Koeln, Germany

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Address

Novartis Investigative Site

Koeln, , 50937

Novartis Investigative Site, Petach-Tikva, Israel

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Address

Novartis Investigative Site

Petach-Tikva, , 49202

Novartis Investigative Site, Tel-Hashomer, Israel

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Address

Novartis Investigative Site

Tel-Hashomer, , 52621

Novartis Investigative Site, Firenze, FI, Italy

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Address

Novartis Investigative Site

Firenze, FI, 50139

Novartis Investigative Site, Genova, GE, Italy

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Address

Novartis Investigative Site

Genova, GE, 16147

Novartis Investigative Site, Milano, MI, Italy

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Address

Novartis Investigative Site

Milano, MI, 20133

Novartis Investigative Site, Roma, RM, Italy

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Address

Novartis Investigative Site

Roma, RM, 00165

Novartis Investigative Site, Torino, TO, Italy

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Address

Novartis Investigative Site

Torino, TO, 10126

Novartis Investigative Site, Fukuoka city, Fukuoka, Japan

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Address

Novartis Investigative Site

Fukuoka city, Fukuoka, 812-8582

Novartis Investigative Site, Setagaya-ku, Tokyo, Japan

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Address

Novartis Investigative Site

Setagaya-ku, Tokyo, 157-8535

Novartis Investigative Site, Osaka, Japan

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Address

Novartis Investigative Site

Osaka, , 534-0021

Novartis Investigative Site, Utrecht, CS, Netherlands

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Address

Novartis Investigative Site

Utrecht, CS, 3584

Novartis Investigative Site, Moscow, Russian Federation

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Address

Novartis Investigative Site

Moscow, , 117198

Novartis Investigative Site, Barcelona, Catalunya, Spain

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Address

Novartis Investigative Site

Barcelona, Catalunya, 08035

Novartis Investigative Site, Madrid, Spain

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Address

Novartis Investigative Site

Madrid, , 28009

Novartis Investigative Site, Valencia, Spain

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Address

Novartis Investigative Site

Valencia, , 46026

Novartis Investigative Site, Stockholm, Sweden

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Address

Novartis Investigative Site

Stockholm, , 17176

Novartis Investigative Site, Zuerich, Switzerland

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Address

Novartis Investigative Site

Zuerich, , 8032

Novartis Investigative Site, Leeds, United Kingdom

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Address

Novartis Investigative Site

Leeds, , LS1 3EX

Novartis Investigative Site, Liverpool, United Kingdom

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Address

Novartis Investigative Site

Liverpool, , L12 2AP

Novartis Investigative Site, London, United Kingdom

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Address

Novartis Investigative Site

London, , WC1N 3JH