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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stage 1 Dose selection Lead-in Arm 1 | Experimental | 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 | Experimental | Naporafenib + Trametinib Naporafenib (ERAS-254) 400 mg administered orally twice daily (BID) Trametinib 0.5 mg once daily (QD) |
|
| Stage 1 Dose selection Lead-in Arm 3 Trametinib monotherapy | Active Comparator | Trametinib 2 mg once daily (QD) |
|
| Stage 2 Arm A | Experimental | 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 | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Naporafenib | Drug | Naporafenib (ERAS-254) is an experimental Pan-Raf inhibitor |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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 | 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 | 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 | 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 | 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 | 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) |
| Assessed up to 24 months from time of first dose |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Events | Incidence and severity of treatment-emergent AEs and serious AEs | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of Response (DOR) for CNS disease in participants | Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) | Assessed up to 24 months from time of first dose |
| Overall Response Rate (ORR) for CNS disease in participants |
Key Inclusion Criteria:
Key Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joyce Antal | Clinical Development | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic - Arizona | Phoenix | Arizona | 85054 | United States | ||
| University of California, San Francisco |
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|
| Dacarbazine | Drug | Dacarbazine IV - Day 1 |
|
|
| Temozolomide | Drug | Temozolomide 200 mg/m2/day PO on Day 1 to Day 5 of each 28-day cycle |
|
|
| Trametinib | Drug | Trametinib is an FDA approved anticancer medication that targets MEK1 and MEK2. |
|
|
| 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 | 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 | 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 | Assessed up to 24 months from time of first dose |
| Plasma concentration (Cmax):Stage 1 only | Maximum plasma concentration of ERAS-254 and trametinib | Study Day 1 up to Day 29 |
| Area under the curve (AUC):Stage 1 only | Area under the plasma concentration-time curve | 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. | Assessed up to 24 months from time of first dose |
Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM)
| Assessed up to 24 months from time of first dose |
| Disease Control Rate (DCR) for CNS disease in participants | Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) | Assessed up to 24 months from time of first dose |
| San Francisco |
| California |
| 94143 |
| United States |
| The Melanoma and Skin Care Institute | Englewood | Colorado | 80113 | United States |
| Mayo Clinic - Florida | Jacksonville | Florida | 70121 | United States |
| University of Miami Sylvester Cancer | Miami | Florida | 33136 | United States |
| University of Kansas Cancer Center | Kansas City | Kansas | 66205 | United States |
| Ochsner Clinic Foundation | Jefferson | Louisiana | 70121 | United States |
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| Barbara Ann Karmanos Cancer Institute | Detroit | Michigan | 48201 | United States |
| Mayo Clinic | Rochester | Minnesota | 70121 | United States |
| Washington University School of Medicine | St Louis | Missouri | 63110 | United States |
| Memorial Sloan Kettering Cancer Center | New York | New York | 10065 | United States |
| Cleveland Clinic Foundation | Cleveland | Ohio | 44195 | United States |
| SCRI Oncology Partners (formerly Tennessee Oncology) | Nashville | Tennessee | 37203 | United States |
| Texas Oncology- Austin Midtown | Austin | Texas | 78705 | United States |
| Texas Oncology - Baylor Charles A. Sammons Cancer Center | Dallas | Texas | 75246 | United States |
| The University of Texas MD Anderson Cancer Center | Houston | Texas | 77030 | United States |
| The University of Utah - Huntsman Cancer Institute (HCI) | Salt Lake City | Utah | 84112 | United States |
| Virginia Oncology Associates | Norfolk | Virginia | 23502-1871 | United States |
| Fred Hutchinson Cancer Center | Seattle | Washington | 98109 | United States |
| University of Wisconsin | Madison | Wisconsin | 53792 | United States |
| Calvary Mater Newcastle | Waratah | New South Wales | 2298 | Australia |
| Tasman Health Care | Southport | Queensland | 4215 | Australia |
| Princess Alexandra Hospital | Woolloongabba | Queensland | 4102 | Australia |
| Peter MacCallum Cancer Institute | Melbourne | Victoria | 3000 | Australia |
| Hollywood Private Hospital | Nedlands | Western Australia | 6009 | Australia |
| Alfred Hospital | Melbourne | 3004 | Australia |
| Queen Elizabeth II Health Sciences Centre | Halifax | Nova Scotia | B3J 3R4 | Canada |
| McGill University Health Centre | Montreal | Quebec | H4A3J1 | Canada |
| Masarykuv Onkologicky Ustav-MOU | Brno | 65653 | Czechia |
| Fakultni nemocnice Hradec Kralove | Nový Hradec Králové | 50005 | Czechia |
| Sanatorium Profesora Arenbergera | Prague | 1502 | Czechia |
| Centre Hospitalier Universitaire (CHU) de Bordeaux - Hospitalier Saint-Andre | Bordeaux | 33075 | France |
| CHU Dijon Bourgogne - Hopital Francois Mitterand (Hopital du Bocage) | Dijon | 21079 | France |
| Centre Hospitalier du Mans | Le Mans | 72000 | France |
| CHRU de Lille - Hôpital Claude Huriez | Lille | 59000 | France |
| Centre Hospitalier Lyon-Sud | Lyon | 69310 | France |
| Assistance Publique Hopitaux de Marseille (AP-HM) - Hopital de la Timone | Marseille | 13005 | France |
| Hospital Ambroise Pairs | Paris | 75010 | France |
| APHP - Hopital Saint Louis | Paris | 9001 | France |
| CLCC Institute Gustave Roussy | Villejuif | 94805 | France |
| Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) - Ospedale San Raffaele (HSR) (Istituto Scientifico Universitario Sa | Milan | 20132 | Italy |
| IRCCS Istituto Nazionale Tumori Regina Elena | Roma | 00144 | Italy |
| Istituto Dermopatico dell Immacolata IDI-IRCCS | Roma | 00167 | Italy |
| Azienda Sanitaria Universitaria del Friuli Centrale | Udine | 33100 | Italy |
| Isala Ziekenhuis | Amsterdam | 8025 | Netherlands |
| Leids Universitair Medisch Centrum | Leiden | 2333 ZC | Netherlands |
| Radboud University | Nijmegen | 6525 GA | Netherlands |
| Hospital Universitari Vall d'Hebron - Vall d'Hebron Institut d'Oncologia (VHIO) | Barcelona | 08035 | Spain |
| Hospital Clinic de Barcelona | Barcelona | 08036 | Spain |
| Hospital General Universitario Gregorio Marañón | Madrid | 28007 | Spain |
| Hospital Universitario Ramon y Cajal | Madrid | 28034 | Spain |
| Hospital HM Sanchinarro | Madrid | 28050 | Spain |
| Hospital Universitario Central de Asturias | Oviedo | 33011 | Spain |
| Royal Preston Hospital | Preston | Lancashire | PR29H | United Kingdom |
| Sarah Cannon Research Institute - HCA Healthcare | City of London | London | W1G 6AD | United Kingdom |
| Royal Devon and Exeter Hospital | Exeter | EX25DW | United Kingdom |
| The Royal Marsden NHS Foundation Trust | London | SM2 5PT | United Kingdom |
| Christie Hospital | Manchester | M20 4GJ | United Kingdom |
| ID | Term |
|---|---|
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D012878 | Skin Neoplasms |
| D009371 | Neoplasms by Site |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C000723373 | naporafenib |
| D003606 | Dacarbazine |
| D000077204 | Temozolomide |
| C560077 | trametinib |
| ID | Term |
|---|---|
| D014226 | Triazenes |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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