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Malignant MelanomaPhase 3COMBI-APlusNCT03551626

Study of Dabrafenib+Trametinib in the Adjuvant Treatment of Stage III BRAF V600+ Melanoma After Complete Resection to Evaluate the Impact on Pyrexia Related Outcomes

A Phase 3 study testing Dabrafenib and Trametinib in people with Malignant Melanoma, run by Novartis Pharmaceuticals at 100 sites in 23 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The main purpose of this study was to evaluate the impact on pyrexia-related outcomes of an adapted pyrexia adverse event (AE)-management algorithm, as well as safety, efficacy and health-related outcomes. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Malignant Melanoma
What is being tested?
Dabrafenib and Trametinib
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
552 participants
Where
100 sitesin 23 countries
Study dates
29 Aug 2018to 16 Sep 2021
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Completely resected histologically confirmed cutaneous melanoma stage IIIA (LN metastasis >1 mm), IIIB, IIIC, IIID [AJCC (ed 8)] no more than 12 weeks, from last surgery, before Day 1
  • Subjects presenting with initial resectable lymph node recurrence after a diagnosis of Stage I or II melanoma were eligible.
  • Subjects who had previously had Stage III melanoma at any time were not eligible.
  • Recovered from definitive surgery (e.g. no uncontrolled wound infections or indwelling drains).
  • V600E/K mutation positive using a validated local test
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1

Who cannot join

  • Uveal or mucosal melanoma
  • Evidence of metastatic disease including unresectable in-transit metastasis
  • Received any prior adjuvant or neoadjuvant treatment, including but not limited to chemotherapy, checkpoint inhibitors, targeted therapy [e.g., BRAF and/or MEK inhibitors], biologic therapy, vaccine therapy, investigational treatment, or radiotherapy for melanoma
  • Malignant disease, other than that being treated in this study. Exceptions to this exclusion include the following: malignancies that were treated curatively and had not recurred within 2 years prior to study treatment; completely resected basal cell and squamous cell skin cancers and any completely resected carcinoma in situ
  • History or current evidence of cardiovascular risk
  • A history or current evidence/risk of retinal vein occlusion (RVO) or central serous retinopathy

Trial locations and contacts

100 sites in 23 countries.

100 sites in 23 countries

France20 sites
  • Novartis Investigative Site

    Besançon, 25030

  • Novartis Investigative Site

    Bobigny, 93009

  • Novartis Investigative Site

    Bordeaux, 33075

  • Novartis Investigative Site

    Boulogne-Billancourt, 92104

  • Novartis Investigative Site

    Clermont-Ferrand, 63003

  • Novartis Investigative Site

    Dijon, 21034

  • Novartis Investigative Site

    Grenoble, 38043

  • Novartis Investigative Site

    Lille, 59037

  • Novartis Investigative Site

    Limoges, Haute Vienne, 87000

  • Novartis Investigative Site

    Lorient, 56322

  • Novartis Investigative Site

    Marseille, 13885

  • Novartis Investigative Site

    Montpellier, 34295

  • Novartis Investigative Site

    Nice, 06202

  • Novartis Investigative Site

    Paris, 75475

  • Novartis Investigative Site

    Pierre-Bénite, Cedex 02, 69495

  • Novartis Investigative Site

    Poitiers, 86021

  • Novartis Investigative Site

    Reims, 51092

  • Novartis Investigative Site

    Rennes, Ille Et Vilaine, 35062

  • Novartis Investigative Site

    Toulouse, 31059

  • Novartis Investigative Site

    Villejuif, 94800

Other trials in France

Italy14 sites
  • Novartis Investigative Site

    Antella - Bagno A Ripoli, FI, 50011

  • Novartis Investigative Site

    Bergamo, BG, 24127

  • Novartis Investigative Site

    Genova, GE, 16132

  • Novartis Investigative Site

    Meldola, FC, 47014

  • Novartis Investigative Site

    Milan, MI, 20133

  • Novartis Investigative Site

    Milan, MI, 20141

  • Novartis Investigative Site

    Modena, MO, 41124

  • Novartis Investigative Site

    Naples, 80131

  • Novartis Investigative Site

    Padova, PD, 35100

  • Novartis Investigative Site

    Palermo, PA, 90127

  • Novartis Investigative Site

    Roma, RM, 00128

  • Novartis Investigative Site

    Roma, RM, 00167

  • Novartis Investigative Site

    Torino, TO, 10126

  • Novartis Investigative Site

    Udine, UD, 33100

Other trials in Italy

Canada9 sites
  • Novartis Investigative Site

    Calgary, Alberta, T2N 4N2

  • Novartis Investigative Site

    Edmonton, Alberta, T6G 1Z2

  • Novartis Investigative Site

    Hamilton, Ontario, L8V 5C2

  • Novartis Investigative Site

    London, Ontario, N6A 4L6

  • Novartis Investigative Site

    Montreal, Quebec, H3T 1E2

  • Novartis Investigative Site

    Ottawa, Ontario, K1H 8L6

  • Novartis Investigative Site

    Québec, Quebec, G1R 2J6

  • Novartis Investigative Site

    Toronto, Ontario, M4N 3M5

  • Novartis Investigative Site

    Toronto, Ontario, M5G 1Z6

Other trials in Canada

Czechia8 sites
  • Novartis Investigative Site

    Brno, Czech Republic, 656 53

  • Novartis Investigative Site

    Hradec Králové, CZE, 500 05

  • Novartis Investigative Site

    Olomouc, 779 00

  • Novartis Investigative Site

    Ostrava, Poruba, 708 52

  • Novartis Investigative Site

    Prague, Czech Republic, 180 00

  • Novartis Investigative Site

    Prague, Prague 1, 11000

  • Novartis Investigative Site

    Prague, 12808

  • Novartis Investigative Site

    Zlín, Czech Republic, 762 75

Other trials in Czechia

United Kingdom7 sites
  • Novartis Investigative Site

    Bristol, Avon, BS2 8ED

  • Novartis Investigative Site

    Cambridge, CB2 2QQ

  • Novartis Investigative Site

    Leeds, LS9 7TF

  • Novartis Investigative Site

    Manchester, M20 4BX

  • Novartis Investigative Site

    Northwood, Middlesex, HA6 2RN

  • Novartis Investigative Site

    Sheffield, South Yorkshire, S10 2JF

  • Novartis Investigative Site

    Southampton, SO16 6YD

Other trials in United Kingdom

Greece4 sites
  • Novartis Investigative Site

    Athens, 115 27

  • Novartis Investigative Site

    Athens, 18547

  • Novartis Investigative Site

    Athens, GR 115 22

  • Novartis Investigative Site

    Thessaloniki, 54622

Other trials in Greece

Russia4 sites
  • Novartis Investigative Site

    Moscow, 115478

  • Novartis Investigative Site

    Moscow Region Istra Village, 143423

  • Novartis Investigative Site

    Omsk, 644013

  • Novartis Investigative Site

    Saint Petersburg, 197758

Other trials in Russia

Sweden4 sites
  • Novartis Investigative Site

    Gothenburg, SE-413 45

  • Novartis Investigative Site

    Örebro, 701 85

  • Novartis Investigative Site

    Stockholm, SE 171 76

  • Novartis Investigative Site

    Umeå, SE 901 85

Other trials in Sweden

Argentina3 sites
  • Novartis Investigative Site

    Buenos Aires, C1125ABE

  • Novartis Investigative Site

    Córdoba, X5004BAL

  • Novartis Investigative Site

    Rosario, Sante Fe, S200KZE

Other trials in Argentina

Brazil3 sites
  • Novartis Investigative Site

    Porto Alegre, Rio Grande do Sul, 90035-003

  • Novartis Investigative Site

    Rio de Janeiro, Rio de Janeiro, 20220410

  • Novartis Investigative Site

    São Paulo, São Paulo, 01246 000

Other trials in Brazil

Finland3 sites
  • Novartis Investigative Site

    Helsinki, 9

  • Novartis Investigative Site

    Tampere, FIN-33521

  • Novartis Investigative Site

    Turku, 20520

Other trials in Finland

Hungary3 sites
  • Novartis Investigative Site

    Budapest, H 1122

  • Novartis Investigative Site

    Pécs, 7623

  • Novartis Investigative Site

    Szeged, H 6725

Other trials in Hungary

Poland3 sites
  • Novartis Investigative Site

    Gdansk, 80 952

  • Novartis Investigative Site

    Warsaw, 02 781

  • Novartis Investigative Site

    Wroclaw, 53 413

Other trials in Poland

Australia2 sites
  • Novartis Investigative Site

    Cairns, QLD 4870

  • Novartis Investigative Site

    Woolloongabba, Queensland, 4102

Other trials in Australia

Israel2 sites
  • Novartis Investigative Site

    Jerusalem, 9112001

  • Novartis Investigative Site

    Ramat Gan, 52621

Other trials in Israel

Japan2 sites
  • Novartis Investigative Site

    Chuo Ku, Tokyo, 104 0045

  • Novartis Investigative Site

    Sapporo, Hokkaido, 060-8543

Other trials in Japan

Norway2 sites
  • Novartis Investigative Site

    Ålesund, NO-6026

  • Novartis Investigative Site

    Oslo, 0379

Other trials in Norway

Slovakia2 sites
  • Novartis Investigative Site

    Bratislava, 812 50

  • Novartis Investigative Site

    Košice, 04191

Other trials in Slovakia

Latvia1 site
  • Novartis Investigative Site

    Riga, LV 1079

Other trials in Latvia

Lithuania1 site
  • Novartis Investigative Site

    Vilnius, LT-08660

Other trials in Lithuania

Portugal1 site
  • Novartis Investigative Site

    Porto, 4200-072

Other trials in Portugal

Slovenia1 site
  • Novartis Investigative Site

    Ljubljana, 1000

Other trials in Slovenia

Turkey (Türkiye)1 site
  • Novartis Investigative Site

    Izmir, 35040

Other trials in Turkey (Türkiye)

About this study

Official title: COMBI-APlus: Open-label, Phase IIIb Study of Dabrafenib in COMBInation With Trametinib in the Adjuvant Treatment of Stage III BRAF V600 Mutation-positive Melanoma After Complete Resection to Evaluate the Impact on Pyrexia Related Outcomes of an Adapted Pyrexia AE-management Algorithm (Plus)

The main purpose of this study was to evaluate the impact on pyrexia-related outcomes of an adapted pyrexia adverse event (AE)-management algorithm, as well as safety, efficacy and health-related outcomes.

Read the detailed description

This was an open-label Phase IIIb study of dabrafenib in combination with trametinib in the adjuvant treatment of melanoma after complete resection. Patients with completely resected, histologically confirmed, BRAF V600E/K mutation-positive, high-risk cutaneous melanoma were screened for eligibility.

This study consisted of two periods:

  1. Treatment Period - patients received up to 12 months of dabrafenib (150 mg twice daily) and trametinib (2 mg once daily). In the adapted pyrexia management algorithm, dabrafenib and trametinib were interrupted promptly at the onset of pyrexia (≥38°C) and were restarted upon the improvement of symptoms at the same dose if patients remained symptom free (temperature <38°C) for at least 24 hours. In addition, dabrafenib and trametinib could be interrupted in the presence of pyrexia syndrome (i.e. chills, rigours, night sweats, or influenza-like symptoms) without documented temperature ≥38°C for cases of suspected recurrent pyrexia, at the investigators' discretion.
  2. Follow-up Period - patients were followed for disease relapse through 24 months from first dose date. Moreover, patients were followed for overall survival through withdrawal, lost to follow-up, death, or the end of study, whichever occurs first. The follow-up period started once treatment was completed or treatment was prematurely discontinued.
Being tested
Dabrafenib, Trametinib
Keywords
dabrafenib, trametinib, adjuvant, Stage III melanoma, combination treatment, pyrexia
Medical subject headings
Melanoma, Fever

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DabrafenibDrug

    Also called DRB436

    Supplied as dabrafenib 50 mg and 75 mg capsules for oral administration

  • TrametinibDrug

    Also called TMT212

    Supplied as trametinib 0.5mg, and 2.0mg tablets for oral administration

Study groups in NCT03551626
Study groupRoleWhat they receive
Dabrafenib and trametinib combination therapyExperimentalSubjects received dabrafenib (150 mg twice daily) and trametinib (2 mg once daily) orally for up to 12 months.
Receives: Drug: Dabrafenib; Drug: Trametinib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Composite Rate of Pyrexia Related Events

    The composite rate of pyrexia related events was calculated as the total number of participants experiencing at least one of the three components of the composite endpoint (i.e., grade 3/4 pyrexia, hospitalization due to pyrexia, or permanent treatment discontinuation due to pyrexia), divided by the total number of participants treated in the study and multiplied by 100. Pyrexia is defined as fever ≥ 38 °C.

    Pyrexia events were graded by the investigator using Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03 as Grade 1 (mild), Grade 2 (moderate), Grade 3 (severe), Grade 4 (Life-threatening) and Grade 5 (Death)

    Measured: Baseline up to 12 months

Secondary outcomes (5)
  1. Relapse Free Survival (RFS) Rate

    RFS is defined as the time from the date of first dose of the study treatment to the date of the first documented disease recurrence or death due to any cause whichever comes first. Treatment emergent malignancies other than second melanomas were not considered as events.

    RFS rate is the estimated percent probability that a patient will remain event-free up to the specified time point. RFS rate was obtained from the Kaplan-Meier survival estimates. RFS was censored if no RFS event was observed before the first to occur between: (i) the analysis cut-off date, and (ii) the date when a new anti-cancer therapy is started. The censoring date was the date of the last adequate tumor assessment prior to data cut-off date/start of new anti-cancer therapy date.

    Measured: At 12 and 24 months

  2. Overall Survival (OS) Rate

    OS is defined as the time from date of the first dose of study medication to date of death due to any cause, whichever comes first. If a patient was not known to have died, then OS rate is the estimated probability that a patient will remain event-free up to the specified time point. OS rate was obtained from the Kaplan-Meier survival estimates. OS was censored at the last contact date when the patient was known to be alive (on or before the cut-off date).

    Measured: At 12 and 24 months

  3. Percentage of Participants Who Required Management of Pyrexia

    Percentage of patients who experienced pyrexia and required intervention including hospitalizations, concomitant medications, and study treatment modifications (dose reductions, permanent discontinuations and/or interruptions) due to pyrexia. Pyrexia is defined as fever ≥ 38 °C

    Measured: Baseline up to 12 months

  4. Percentage of Participants Who Permanently Discontinued Treatment Due to Any Adverse Event (AE)

    Percentage of participants who permanently discontinued treatment due to any AE during treatment. An AE is any untoward medical occurrence (e.g., any unfavorable and unintended sign, symptom or disease) in a subject or clinical investigation subject after providing written informed consent for participation in the study.

    Measured: Baseline up to 12 months

  5. Change From Baseline in Subject-reported Quality of Life (QoL) Assessed by Functional Assessment Cancer Therapy - Melanoma Subscale Score (FACT-M MS)

    The FACT-M is a questionnaire that assesses participant health-related quality of life. It includes a melanoma specific (FACT-M MS) subscale that consists in 16 items related to signs, symptoms, physical/social activities most relevant to participants with advanced-stage melanoma. Each item ranges from 0 (not at all) to 4 (very much). FACT-M MS score ranges from 0 to 64, with higher score indicating better quality of life. If a patient discontinued the study treatment at Month 1 or Month 2, then the follow-up assessments started at Month 3 follow-up and continued until Month 24 follow-up or at withdrawal, lost to follow-up, death, or end of study. If a patient discontinued the study treatment from Month 3 through Month 5, the follow-up assessments started at Month 6 follow-up. If a patient discontinued from Month 6 through Month 11, the follow-up assessments started from Month 12 follow-up. For patients who completed treatment, the follow-up assessments started from Month 15 follow-up

    Measured: Baseline up to 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2018
  2. Study start29 Aug 2018
  3. Primary completion5 Oct 2020
  4. Study completion16 Sep 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
552 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03551626
Sponsor's protocol ID
CDRB436F2410
Other IDs
2018-000168-27, 2018
Acronym
COMBI-APlus
Status last verified
Apr 2025
First submitted
30 Apr 2018
Last updated
29 Apr 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Atkinson V, Robert C, Grob JJ, Gogas H, Dutriaux C, Demidov L, Gupta A, Menzies AM, Ryll B, Miranda F, Banerjee H, Lau M, Del Vecchio M. Improved pyrexia-related outcomes associated with an adapted pyrexia adverse event management algorithm in patients treated with adjuvant dabrafenib plus trametinib: Primary results of COMBI-APlus. Eur J Cancer. 2022 Mar;163:79-87. doi: 10.1016/j.ejca.2021.12.015. Epub 2022 Jan 14.

    PubMed 35042070

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Dabrafenib and Trametinib in people with Malignant Melanoma, run by Novartis Pharmaceuticals at 100 sites in 23 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 100 sites in France, Italy, Canada, Czechia, United Kingdom and 18 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Mar 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Composite Rate of Pyrexia Related Events (time frame: Baseline up to 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03551626, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Apr 2025.

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