A Phase 2 Study of Dabrafenib (NSC# 763760) With Trametinib (NSC# 763093) After Local Irradiation in Newly-Diagnosed BRAF V600-Mutant High-Grade Glioma (HGG)

Who is this study for? Patients with Glioma
What treatments are being studied? Dabrafenib Mesylate+Radiation Therapy+Trametinib Dimethyl Sulfoxide
Status: Active_not_recruiting
Location: See all (131) locations...
Intervention Type: Procedure, Radiation, Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

This phase II trial studies how well the combination of dabrafenib and trametinib works after radiation therapy in children and young adults with high grade glioma who have a genetic change called BRAF V600 mutation. Radiation therapy uses high energy rays to kill tumor cells and reduce the size of tumors. Dabrafenib and trametinib may stop the growth of tumor cells by blocking BRAF and MEK, respectively, which are enzymes that tumor cells need for their growth. Giving dabrafenib with trametinib after radiation therapy may work better than treatments used in the past in patients with newly-diagnosed BRAF V600-mutant high-grade glioma.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 3
Maximum Age: 25
Healthy Volunteers: f
View:

• PRE-ENROLLMENT ELIGIBILITY SCREENING: Patients must be =\< 25 years of age at the time of enrollment on APEC14B1 Part A CNS/HGG pre-enrollment eligibility screening.

‣ Note: This required age range applies to the pre-enrollment eligibility screening for all HGG patients. Individual treatment protocols may have different age criteria.

• PRE-ENROLLMENT ELIGIBILITY SCREENING: Patient is suspected of having localized newly-diagnosed HGG, excluding metastatic disease.

• PRE-ENROLLMENT ELIGIBILITY SCREENING: Patient and/or their parents or legal guardians have signed informed consent for eligibility screening on APEC14B1 Part A.

• PRE-ENROLLMENT ELIGIBILITY SCREENING: The specimens obtained at the time of diagnostic biopsy or surgery must be submitted through APEC14B1 as soon as possible (ASAP), preferably within 5 calendar days of the procedure.

‣ Please note: See the APEC14B1 Manual of Procedures for a full list of detailed instructions for submitting required materials and for shipping details.

• Patients must be \>= 3 years and =\< 25 years of age at the time of enrollment.

• Patients must have eligibility confirmed by Rapid Central Pathology and Molecular Screening Reviews performed on APEC14B1

‣ Newly diagnosed high-grade glioma with BRAF\^V600-mutation

⁃ Results for H3 K27M by immunohistochemistry (IHC) or sequencing

⁃ Histologically confirmed high-grade glioma (World Health Organization \[WHO\] grade III or IV) including but not limited to: anaplastic astrocytoma (AA), anaplastic pleomorphic xanthoastrocytoma (aPXA), anaplastic gangliogliomas (aGG), glioblastoma (GB), and high-grade astrocytoma, not otherwise specified (NOS).

• Patients must have had histologic verification of a high-grade glioma diagnosis. CSF cytology by lumbar puncture must be done if clinically indicated and determined to be safe prior to study enrollment. If cytology proves positive, the patient would be considered to have metastatic disease and would, therefore, be ineligible.

• A pre- and post-operative brain MRI with and without contrast and a baseline spine MRI with contrast must be obtained prior to enrollment. The requirement for a post-operative MRI is waived for patients who undergo biopsy only. If the spine MRI is positive, the patient would be considered to have metastatic disease and would be ineligible.

• Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, or 2. Use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age.

• Peripheral absolute neutrophil count (ANC) \>= 1000/uL (within 7 days prior to enrollment).

• Platelet count \>= 100,000/uL (transfusion independent) (within 7 days prior to enrollment).

• Hemoglobin \>= 8.0 g/dL (may receive red blood cell \[RBC\] transfusions) (within 7 days prior to enrollment).

• Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 (within 7 days prior to enrollment) or

• A serum creatinine based on age/gender as follows (within 7 days prior to enrollment):

‣ Age 3 to \< 6 years (Male 0.8 mg/dL, Female 0.8 mg/dL)

⁃ Age \>= 16 years (Male 1.7 mg/dL, Female 1.4 mg/dL)

• Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment), and

• Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 135 U/L (within 7 days prior to enrollment). For the purpose of this study, the ULN for SGPT is 45 U/L.

• Patients with a seizure disorder may be enrolled if their seizures are well controlled while on non-enzyme inducing anticonvulsants permitted on this study.

• All patients and/or their parents or legal guardians must sign a written informed consent

• Patients must be enrolled and protocol therapy must be projected to begin no later than 31 days after definitive surgery (day 0). If a biopsy only was performed, the biopsy date will be considered the date of definitive surgery. For patients who have a biopsy or incomplete resection at diagnosis followed by additional surgery, the date of the last resection will be considered the date of definitive surgery.

Locations
United States
Alabama
Children's Hospital of Alabama
Birmingham
Arkansas
Arkansas Children's Hospital
Little Rock
Arizona
Banner Children's at Desert
Mesa
Phoenix Childrens Hospital
Phoenix
California
Kaiser Permanente Downey Medical Center
Downey
Loma Linda University Medical Center
Loma Linda
Miller Children's and Women's Hospital Long Beach
Long Beach
Cedars Sinai Medical Center
Los Angeles
Children's Hospital Los Angeles
Los Angeles
Kaiser Permanente-Oakland
Oakland
Children's Hospital of Orange County
Orange
Lucile Packard Children's Hospital Stanford University
Palo Alto
University of California Davis Comprehensive Cancer Center
Sacramento
UCSF Medical Center-Mission Bay
San Francisco
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
Torrance
Colorado
Children's Hospital Colorado
Aurora
Connecticut
Connecticut Children's Medical Center
Hartford
Yale University
New Haven
Washington, D.c.
Children's National Medical Center
Washington
MedStar Georgetown University Hospital
Washington
Delaware
Alfred I duPont Hospital for Children
Wilmington
Florida
Golisano Children's Hospital of Southwest Florida
Fort Myers
University of Florida Health Science Center - Gainesville
Gainesville
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood
Nemours Children's Clinic-Jacksonville
Jacksonville
Nicklaus Children's Hospital
Miami
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami
AdventHealth Orlando
Orlando
Arnold Palmer Hospital for Children
Orlando
Nemours Children's Hospital
Orlando
Sacred Heart Hospital
Pensacola
Johns Hopkins All Children's Hospital
Saint Petersburg
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa
Tampa General Hospital
Tampa
Saint Mary's Medical Center
West Palm Beach
Georgia
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta
Memorial Health University Medical Center
Savannah
Hawaii
Kapiolani Medical Center for Women and Children
Honolulu
Iowa
University of Iowa/Holden Comprehensive Cancer Center
Iowa City
Idaho
Saint Luke's Cancer Institute - Boise
Boise
Illinois
Lurie Children's Hospital-Chicago
Chicago
University of Chicago Comprehensive Cancer Center
Chicago
University of Illinois
Chicago
Saint Jude Midwest Affiliate
Peoria
Indiana
Ascension Saint Vincent Indianapolis Hospital
Indianapolis
Riley Hospital for Children
Indianapolis
Kentucky
University of Kentucky/Markey Cancer Center
Lexington
Norton Children's Hospital
Louisville
Louisiana
Children's Hospital New Orleans
New Orleans
Ochsner Medical Center Jefferson
New Orleans
Massachusetts
Dana-Farber Cancer Institute
Boston
Massachusetts General Hospital Cancer Center
Boston
Maryland
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore
Walter Reed National Military Medical Center
Bethesda
Maine
Eastern Maine Medical Center
Bangor
Michigan
C S Mott Children's Hospital
Ann Arbor
Children's Hospital of Michigan
Detroit
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids
Bronson Methodist Hospital
Kalamazoo
Corewell Health Children's
Royal Oak
Minnesota
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis
Mayo Clinic in Rochester
Rochester
Missouri
Children's Mercy Hospitals and Clinics
Kansas City
Cardinal Glennon Children's Medical Center
Saint Louis
Mercy Hospital Saint Louis
Saint Louis
Washington University School of Medicine
Saint Louis
Mississippi
University of Mississippi Medical Center
Jackson
North Carolina
Mission Hospital
Asheville
UNC Lineberger Comprehensive Cancer Center
Chapel Hill
Carolinas Medical Center/Levine Cancer Institute
Charlotte
Novant Health Presbyterian Medical Center
Charlotte
East Carolina University
Greenville
Wake Forest University Health Sciences
Winston-salem
North Dakota
Sanford Broadway Medical Center
Fargo
Nebraska
Children's Hospital and Medical Center of Omaha
Omaha
University of Nebraska Medical Center
Omaha
New Jersey
Hackensack University Medical Center
Hackensack
Morristown Medical Center
Morristown
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick
Newark Beth Israel Medical Center
Newark
Saint Joseph's Regional Medical Center
Paterson
New Mexico
University of New Mexico Cancer Center
Albuquerque
New York
Albany Medical Center
Albany
Montefiore Medical Center - Moses Campus
Bronx
Roswell Park Cancer Institute
Buffalo
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park
Memorial Sloan Kettering Cancer Center
New York
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York
State University of New York Upstate Medical University
Syracuse
Ohio
Children's Hospital Medical Center of Akron
Akron
Cincinnati Children's Hospital Medical Center
Cincinnati
Cleveland Clinic Foundation
Cleveland
Rainbow Babies and Childrens Hospital
Cleveland
Nationwide Children's Hospital
Columbus
Dayton Children's Hospital
Dayton
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo
Oklahoma
University of Oklahoma Health Sciences Center
Oklahoma City
Oregon
Legacy Emanuel Children's Hospital
Portland
Oregon Health and Science University
Portland
Pennsylvania
Lehigh Valley Hospital-Cedar Crest
Allentown
Penn State Children's Hospital
Hershey
Children's Hospital of Philadelphia
Philadelphia
Children's Hospital of Pittsburgh of UPMC
Pittsburgh
Rhode Island
Rhode Island Hospital
Providence
South Carolina
Medical University of South Carolina
Charleston
Prisma Health Richland Hospital
Columbia
BI-LO Charities Children's Cancer Center
Greenville
Tennessee
East Tennessee Childrens Hospital
Knoxville
Saint Jude Children's Research Hospital
Memphis
The Children's Hospital at TriStar Centennial
Nashville
Vanderbilt University/Ingram Cancer Center
Nashville
Texas
Dell Children's Medical Center of Central Texas
Austin
Medical City Dallas Hospital
Dallas
UT Southwestern/Simmons Cancer Center-Dallas
Dallas
Cook Children's Medical Center
Fort Worth
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston
Children's Hospital of San Antonio
San Antonio
University of Texas Health Science Center at San Antonio
San Antonio
Scott and White Memorial Hospital
Temple
Utah
Primary Children's Hospital
Salt Lake City
Virginia
University of Virginia Cancer Center
Charlottesville
Children's Hospital of The King's Daughters
Norfolk
Virginia Commonwealth University/Massey Cancer Center
Richmond
Carilion Children's
Roanoke
Washington
Seattle Children's Hospital
Seattle
Providence Sacred Heart Medical Center and Children's Hospital
Spokane
Mary Bridge Children's Hospital and Health Center
Tacoma
Wisconsin
University of Wisconsin Carbone Cancer Center - University Hospital
Madison
Marshfield Medical Center-Marshfield
Marshfield
Children's Hospital of Wisconsin
Milwaukee
Other Locations
Puerto Rico
HIMA San Pablo Oncologic Hospital
Caguas
Time Frame
Start Date: 2020-02-20
Completion Date: 2027-09-30
Participants
Target number of participants: 58
Treatments
Experimental: Treatment (radiation therapy, dabrafenib, trametinib)
Patients undergo standardized local RT 5 days a week (Monday-Friday) for 6-7 weeks. Four weeks after completion of RT, patients receive dabrafenib mesylate PO BID and trametinib dimethyl sulfoxide PO QD on days 1-28 of each cycle. Treatment repeats every 28 days for up to 24 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo MRI at baseline, on day 1 of cycles 1, 3, 5, 7, 11, 14, 17, 20, and 23 while on treatment, then at time of relapse, every 3 months for year 1, every 4 months for year 2, every 6 months for year 3, and annually for years 4-5. Patients may also undergo lumbar puncture for CSF testing during treatment. Patients also undergo collection of blood on study.
Authors
Thomas W. McLean, Kathleen J. Yost, John F. Kuttesch, Kenneth J. Cohen, Elyssa M. Rubin, Nina S. Kadan-Lottick, Alissa Kahn, Kathryn L. Laurie, Marcio H. Malogolowkin, Devang J. Pastakia, Douglas S. Hawkins, Eduard H. Panosyan, Julio C. Barredo, Matthew A. Kutny, Rene Y. McNall-Knapp, Eric J. Lowe, Ryuma Tanaka, Nadine P. SantaCruz, Mariko Sato, Ashok B. Raj, Lindsey M. Hoffman, Daniel C. Bowers, Keith J. August, Susan N. Chi, Stacie L. Stapleton, Lisa Gennarini, Michael S. Isakoff, Justine M. Kahn, Ziad A. Khatib, Mukund G. Dole, Andrew S. Cluster, Adit L. Tal, Phillip E. Barnette, David H. Ebb, Cynthia Wetmore, Rabi Hanna, Timothy C. Griffin, Rebecca O. Clark, Juan F. Rico, Don E. Eslin, Lolie C. Yu, David E. Kram, Iftikhar Hanif, Mark A. Ranalli, Jane E. Minturn, Felipe S. Bautista-Otanez, Ray C. Pais, Jamie L. Dargart, Santhosh A. Upadhyaya, Duncan S. Stearns, Andrew L. Pendleton, Gregory K. Friedman, Narayana Gowda, Jhon A. Guerra, Aarati V. Rao, Linda C. Stork, Tobey J. MacDonald, Michelle A. Manalang, Clare J. Twist, Craig Lotterman, Aniket Saha, Sandeep Batra, Robert M. Cooper, Luke D. Maese, Nicholas W. McGregor, Jacqueline M. Kraveka, Robert G. Irwin, Susan E. Spiller, Douglas J. Scothorn, James T. Badgett, Fouad M. Hajjar, Judy L. Felgenhauer, Jacob A. Troutman, Jessica F. Goodman, Minnie Abromowitch, James T. Felker, William S. Ferguson, Shannon M. Cohn, Scott M. Bradfield, Lisa M. McGregor, Nichole L. Bryant, Philip M. Monteleone, Stuart L. Cramer, Jeffrey A. Toretsky, Angela J. Waanders, Jay Michael S. Balagtas, Joel A. Kaplan, Sibo Zhao, Maryam Fouladi, Stewart Goldman, Enrique A. Escalon, Carl J. Koschmann, Stephen W. Gilheeney, Amber M. D'Souza, Janice F. Olson, Laura K. Gowans, Michael K. Richards, Steven J. Kuerbitz, Wendy S. Darlington, Kellie J. Nazemi, Lauren R. Weintraub, Jill C. Beck, Albert Kheradpour, Jeffrey S. Dome, Jonathan D. Schwartz, Kathleen M. Dorris, Farzana Pashankar, Nathan J. Robison, John J. Gregory, Emad K. Salman, David L. Becton, Eugenia Chang, William B. Slayton, Samuel J. Milanovich, Robin D. Hanson, David S. Dickens, Wade T. Kyono, Alyssa T. Reddy, Alice Lee
Sponsors
Leads: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov

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