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Metastatic MelanomaPhase 2EBRAIN-MELNCT03898908

Encorafenib and Binimetinib Before Local Treatment in Patients With BRAF Mutant Melanoma Metastatic to the Brain

A Phase 2 study testing encorafenib, binimetinib and Whole brain radiation therapy in people with Metastatic Melanoma and Brain Metastases, run by Grupo Español Multidisciplinar de Melanoma at 21 sites in Spain.

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

Phase II clinical trial, with two cohorts of patients included in parallel, all with melanoma BRAF mutated and brain metastases without previous local treatment in the brain. Cohort 1 will include patients with asymptomatic brain metastases and cohort 2 will include patients with symptomatic brain metastasis. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Metastatic Melanoma, Brain Metastases
What is being tested?
encorafenib, binimetinib and Whole brain radiation therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
21 sitesSpain
Study dates
18 Jul 2019to 31 Jul 2023
Phase
Phase 2
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

  • Written informed consent of approved by the investigator's Institutional Review Board (IRB)/Independent Ethics Committee (IEC), prior to the performance of any trial activities.
  • Histologically confirmed diagnosis of unresectable metastatic cutaneous melanoma, or unknown primary melanoma with one or more brain metastasis with a diameter of 10 to 50 mm, measured by contrast enhanced MRI.
  • Presence of a BRAF V600E or V600K mutation, or both, in their tumour tissue.
  • Barthel Index of Activities of Daily Living > 10.
  • Subjects aged ≥ 18 years.
  • ECOG 0-1 in asymptomatic patients (cohort 1), 0-2 in symptomatic patients (cohort 2).
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  • Adequate haematological function (Haemoglobin ≥ 9 g/dL, may have been transfused; Platelet count ≥ 100 × 109/L; Absolute neutrophil count (ANC) ≥ 1.5 × 109/L.)
  • Adequate hepatic function defined by a total bilirubin level ≤ 2.0 × the upper limit of normality (ULN) and AST and ALT levels ≤ 2.5 × ULN or AST and ALT levels ≤ 5 x ULN (for subjects with documented metastatic disease to the liver).
  • Serum Creatinine ≤ 2.0 x ULN or estimated creatinine clearance ≥ 30 mL/min according to the Cockcroft-Gault formula (or local institutional standard method).
  • Evidence of at least one measurable lesion as detected by radiological or photographic methods according to guidelines based on Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1.
  • Naïve untreated patients or patients who have progressed on or after prior first line immunotherapy for unresectable locally advanced or metastatic melanoma, but it must have ended at least 6 weeks prior to randomization; prior adjuvant therapy is permitted (e.g. IFN, IL-2 therapy, any other immunotherapy, radiotherapy or chemotherapy), BRAF or MEK inhibitors can be used in the adjuvant setting, providing the relapse does not occur during the adjuvant treatment or within 12 months after the end of it, and providing the adjuvant treatment with targeted therapy did not cause in the patient any grade 3-4 toxicity not including medically serious and reversible/controlled toxicities (ex: GGT elevation, CPK elevation, vomiting).
  • Steroids or anticonvulsants are allowed if clinically needed and are not being administered in an increasing dose.
  • Female subjects must either be of non-reproductive potential (ie, post-menopausal by history: ≥60 years old and no menses for ≥1 year without an alternative medical cause; OR history of hysterectomy, OR history of bilateral tubal ligation, OR history of bilateral oophorectomy) or must have a negative serum pregnancy test upon study entry.
  • Normal functioning of daily living activities.
  • Willingness and ability to attend scheduled visits, follow the treatment schedule and undergo clinical tests and other study procedures.

Who cannot join

  • Uveal or mucosal melanoma.
  • History of leptomeningeal metastases, with the exception that they are only seen in brain MRI and the patient has ECOG 0-1 and no neurological symptoms (except for cohort 2, where symptomatic patients will be allowed if ECOG is 0-2).
  • Another cancer in the last five years, except for in situ carcinoma of the cervix or squamous cell carcinoma of the skin adequately treated or limited basal cell skin cancer adequately controlled.
  • History of or current evidence of central serous retinopathy (CSR), retinal vein occlusion (RVO) or history of retinal degenerative disease (RDD).
  • Any previous systemic chemotherapy treatment, extensive brain radiotherapy, targeted therapy for locally advanced unresectable or metastatic melanoma; Immunotherapy treatment is allowed but must have ended at least 6 weeks prior to randomization.
  • History of Gilbert's syndrome.
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  • Previous treatment with a BRAF or MEK inhibitor in metastatic setting. This treatment will be allowed in the adjuvant setting (see above). Previous treatments with immunotherapy will be allowed in both the metastatic and adjuvant setting.
  • Known positive serology for human immunodeficiency virus, or an active hepatitis B or hepatitis C infection, or both.
  • Impaired cardiovascular function or clinically significant cardiovascular diseases "Clinically significant (i.e., active) cardiovascular disease: cerebrovascular accident/stroke (< 6 months prior to enrolment), myocardial infarction (< 6 months prior to enrolment), unstable angina, congestive heart failure (≥ New York Heart Association Classification Class II), a LVEF < 50% evaluated by MUGA or echocardiography, or serious cardiac arrhythmia requiring medication or a triplicate average baseline QTc interval > 500 ms."
  • Uncontrolled arterial hypertension despite medical treatment.
  • Moderate (Child Pugh Class B) or severe (Child Pugh Class C) hepatic impairment.
  • Impairment of gastrointestinal function.
  • Neuromuscular disorders associated with high concentrations of creatine kinase.
  • Pregnant or nursing (lactating) women.
  • Medical, psychiatric, cognitive or other conditions that may compromise the patient's ability to understand the patient information, give informed consent, comply with the study protocol or complete the study.
  • Known hypersensitivity to encorafenib, binimetinib or their components.
  • Persisting toxicity related to prior therapy of Grade >1 NCI-CTCAE v 4.03; however, alopecia and sensory neuropathy Grade ≤ 2 is acceptable.
  • Female patients who are pregnant or breastfeeding or male or female patients of reproductive potential who are not willing to employ highly effective birth control from screening to 180 days after the last dose of study treatment.
  • Known alcohol or drug abuse.
  • Inability to swallow tablets or capsules.
  • Total lactase deficiency or glucose-galactose malabsorption.

Trial locations and contacts

21 sites in 1 country.

21 sites in 1 country

Spain21 sites
  • Institut Català d'Oncología Hospitalet

    Barcelona, Barcelona, Spain, 08908

  • Hospital Universitario Quirón Dexeus

    Barcelona, Catalonia

  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

  • Hospital Clínic de Barcelona

    Barcelona

  • Hospital del Mar

    Barcelona

  • Hospital Universitario Reina Sofía

    Córdoba

  • Hospital Clínico Universitario Virgen de la Arrixaca

    El Palmar, Murcia, 30120

  • Complejo Hospitalario Universitario Insular de Canarias

    Las Palmas de Gran Canaria, Las Palmas

  • Hospital Lucus Augusti

    Lugo, 27003

  • Hospital Universitario Ramón y Cajal

    Madrid, 28034

  • H. U. Gregorio Marañón

    Madrid

  • Hospital Clínico San Carlos

    Madrid

  • Hospital Universitario La Paz

    Madrid

  • Hospital Regional Universitario de Málaga

    Málaga

  • Hospital Universitario Son Espases

    Palma de Mallorca, Balearic Islands

  • Clínica Universidad de Navarra

    Pamplona

  • Hospital Universitario Marqués de Valdecilla

    Santander, Cantabria

  • Hospital Universitario Virgen Macarena

    Seville

  • Hospital General Universitario de Valencia

    Valencia

  • Hospital Universitario y Politécnico La Fe

    Valencia

  • Hospital Miguel Servet

    Zaragoza

Other trials in Spain

About this study

Official title: Phase II, Multicentre Clinical Trial to Evaluate the Activity of Encorafenib and Binimetinib Administered Before Local Treatment in Patients With BRAF Mutant Melanoma Metastatic to the Brain

Phase II clinical trial, with two cohorts of patients included in parallel, all with melanoma BRAF mutated and brain metastases without previous local treatment in the brain. Cohort 1 will include patients with asymptomatic brain metastases and cohort 2 will include patients with symptomatic brain metastasis.

Being tested
encorafenib, binimetinib, Whole brain radiation therapy, Radiosurgery/stereotactic radiosurgery
Keywords
metastases, melanoma, encorafenib, binimetinib
Medical subject headings
Melanoma, Brain Neoplasms, Neoplasm Metastasis

What participants receive

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

  • encorafenibDrug

    Also called Braftovi

    Encorafenib 75mg and 50mg (capsules) for a 450mg daily for oral administration during 56 days and after local radiation treatment.

    If no progression of disease progression (PD) is reported, treatment will continue until PD, unacceptable toxicity or death.

  • binimetinibDrug

    Also called Mektovi

    Binimetinib 15mg (tablets) for a 45mg/12 hours for oral administration during 56 days and after local radiation treatment.

  • Whole brain radiation therapyRadiation

    The whole brain planning target volume (PTV) will receive 30 Gy in 10 fractions.

    Treatment will be delivered once daily, 5 fractions per week, over 2 to 2.5 weeks.

  • Radiosurgery/stereotactic radiosurgeryRadiation

    Dose selection must be based on previously published Radiation Therapy Oncology Group (RTOG) data, with dose modification left up to the treating physician. The total dose will depend on the size of the metastatic lesion(s) and proximity to critical structures.

    Suggested doses are as follow: 1 fraction x 15-25 Gy; 3 fractions x 9-11 Gy; 5 fractions x 6-7 Gy; or 6 fractions x 5-6 Gy.

    For GTV > 20 mm hypofractionated stereotactic radiotherapy could be preferred. Treatment will be delivered once daily, alternate-day, 3 fractions per week.

Study groups in NCT03898908
Study groupRoleWhat they receive
COMBO450ExperimentalEncorafenib - Orally, 75 mg and 50 mg capsules Binimetinib - Orally, 15 mg tablets In each cohort, patients will be treated with encorafenib 450 mg once daily and binimetinib 45 mg twice daily until PD or death.
Receives: Drug: encorafenib; Drug: binimetinib; Radiation: Whole brain radiation therapy; Radiation: Radiosurgery/stereotactic radiosurgery

What is being measured

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

  1. Intracranial Objective Response (iORR) by Modified RECIST 1.1 Before Local Radiotherapy Treatment in Full Dataset

    iORR calculated as the proportion of patient with a best overall intracranial response of complete response (CR) or partial response (PR) before local treatment according to modified RECIST 1.1.

    Modified RECIST 1.1 consists of:

    Up to 5 intracranial lesions could be selected as target lesions Target lesions might have a longest diameter ≥ 5 mm when evaluated by contrast-enhanced MRI

    This endpoint was also independently reported in patients with symptomatic and asymptomatic brain metastasis.

    Measured: 24 months after start of treatment

Secondary outcomes (10)
  1. Duration of Intracranial Response

    Calculated as the time from the date of first documented CR or PR to the first documented intracranial progression or death due to underlying cancer accoridng to modified RECIST 1.1, in patients with documented intracranial CR or PR before local treatment.

    Measured: Throughout the study period, up to approximately 24 months

  2. Intracranial Progression-free Survival (iPFS) by RECIST 1.1

    Defined as the time from the date of inclusion to the date of the first documented intracranial disease progression or death due to any cause, whichever occurs first. PFS was determined based on tumor assessment (modified RECIST version 1.1 criteria). The local Investigator's assessments was used for analyses. Those patients who were alive and had not progressed at the last follow-up, date of progression was censored at the date of the last follow-up. Patients with no additional image test other than baseline were censored the day after inclusion.

    Measured: Throughout the study period, up to approximately 24 months

  3. Extracranial Progression-free Survival (ePFS) in Both Cohorts

    Defined as the time from the date of inclusion to the date of the first documented extracranial disease progression or death due to any cause, whichever occurs first. PFS was determined based on tumor assessment (RECIST version 1.1 criteria). The local Investigator's assessments was used for analyses. Those patients who were alive and had not progressed at the last follow-up, date of progression was censored at the date of the last follow-up. Patients with no additional image test other than baseline were censored the day after inclusion.

    Measured: Throughout the study period, up to approximately 24 months

  4. Intracranial Progression-free Rates

    Proportion of patients free of intracranial progression assessed by modified RECIST at 6 months (week 24), 12 months (week 48) and 24-month (week 96) considering date of inclusion estimated through Kaplan-Meier method

    Measured: at 6 months (week 24), 12 months (week 48) and 24-month (week 96)

  5. Overall Survival

    Calculated as the time from date of inclusion to date of death due to any cause.

    Measured: Throughout the study period, up to approximately 24 months

  6. Overall Survival Rates

    Proportion of of patients alive at 6 months, 12 month and 24-month considering date of inclusion estimated using Kaplan-Meier.

    Patients alive at the moment of the analysis were censored on the date of their last follow-up.

    Measured: at 6 months, 12 month and 24-month

  7. Number of Participants With Treatment-related Adverse Events as Assessed by CTCAE v4.0

    Number of patients experiencing treatment related adverse events. These events were graded accrding to CTCAE, a scale that ranges from 0 (less intense; no event) to 5 (death) .

    Here we report the number of patients experiencing any grade toxicities and the number of patients experiencing high grade (grade 3-5) toxicities.

    Measured: Throughout the study period, up to approximately 24 months

  8. Change on Quality of Life at Week 8 in Both Cohorts Based on the EORTC QLQ 30 Scale

    The EORTC QLQ-C30 questionnaire is validated for cancer. It is composed of 30 questions or items that assess QoL. The questionnaire is structured in 5 functional scales physical functioning, daily activities, emotional functioning, cognitive functioning and social functioning), 3 symptom scales (fatigue, pain and nausea, vomiting), 1 global health status scale, and 6 independent items (dyspnea, insomnia, anorexia, constipation, diarrhea and economic impact). Values between 1 and 4 (1: not at all, 2: a little, 3: quite, 4: a lot) are assigned according to the patient's responses to the item, only in items 29 and 30 are they evaluated with a score of 1 to 7 (1: dreadful, 7: excellent).

    The scores obtained are standardized and a score between 0 and 100 is obtained, which determines the level of impact of the cancer on the patient on each of the scales. Higher values indicate better performance

    Measured: 8 weeks

  9. Change on Quality of Life at Week 24 in Both Cohorts Based on the EORTC QLQ 30 Scale

    The EORTC QLQ-C30 questionnaire is validated for cancer. It is composed of 30 questions or items that assess QoL. The questionnaire is structured in 5 functional scales physical functioning, daily activities, emotional functioning, cognitive functioning and social functioning), 3 symptom scales (fatigue, pain and nausea, vomiting), 1 global health status scale, and 6 independent items (dyspnea, insomnia, anorexia, constipation, diarrhea and economic impact). Values between 1 and 4 (1: not at all, 2: a little, 3: quite, 4: a lot) are assigned according to the patient's responses to the item, only in items 29 and 30 are they evaluated with a score of 1 to 7 (1: dreadful, 7: excellent).

    The scores obtained are standardized and a score between 0 and 100 is obtained, which determines the level of impact of the cancer on the patient on each of the scales. Higher values indicate better performance

    Measured: 24 weeks

  10. Extracranial Progression-free Rates

    Proportion of patients free of extracranial progression assessed by modified RECIST at 6 months (week 24), 12 months (week 48) and 24-month (week 96) considering date of inclusion estimated through Kaplan-Meier method

    Measured: at 6 months (week 24), 12 months (week 48) and 24-month (week 96)

Timeline

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

  1. First posted2 Apr 2019
  2. Study start18 Jul 2019
  3. Primary completion10 Oct 2022
  4. Study completion31 Jul 2023

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Cohort 1 will include patients with asymptomatic brain metastases and without previous local treatment in the brain (N=48), while cohort 2 will include patients with symptomatic brain metastasis and without previous local treatment in the brain (N=15).
Masking
None (open label)
Enrolment
48 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03898908
Sponsor's protocol ID
GEM-1802
Other IDs
2018-002530-20, 2018
Acronym
EBRAIN-MEL
Status last verified
May 2025
First submitted
27 Mar 2019
Last updated
21 May 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing encorafenib, binimetinib and Whole brain radiation therapy in people with Metastatic Melanoma and Brain Metastases, run by Grupo Español Multidisciplinar de Melanoma at 21 sites in Spain.

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 15 inclusion and 21 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 21 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in Spain. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 13 May 2025). 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?

Intracranial Objective Response (iORR) by Modified RECIST 1.1 Before Local Radiotherapy Treatment in Full Dataset (time frame: 24 months after start of treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 21 May 2025.

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