Cabozantinib-S-Malate and Vemurafenib in Treating Patients With Solid Tumors or Melanoma That is Metastatic or That Cannot Be Removed By Surgery
This phase I trial studies the side effects and best dose of cabozantinib-s-malate when given together with vemurafenib in treating patients with solid tumors or melanoma that is metastatic or that cannot be removed by surgery. Cabozantinib-s-malate and vemurafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Stage IIIA Melanoma
Stage IIIB Melanoma
Stage IIIC Melanoma
Stage IV Melanoma
Unspecified Adult Solid Tumor, Protocol Specific
Other: laboratory biomarker analysis
Other: pharmacological study
|Study Design:||Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Phase I Dose Escalation of the MET Inhibitor XL184 and the BRAF Inhibitor Vemurafenib|
- Maximum tolerable dose of cabozantinib-s-malate in combination with vemurafenib [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]Dose limiting toxicity (DLT) is defined as the occurrence of Grade 4 hematologic toxicity, Grade 3 or 4 non-hematologic toxicity including diarrhea, or nausea and vomiting. Graded according to the National Cancer Institute Common Toxicity Criteria, version 3.0.
- ORR (complete response [CR]+partial response [PR]) assessed using RECIST criteria [ Time Frame: Up to 4 weeks after last dose of therapy ] [ Designated as safety issue: No ]Calculated and presented with 90% exact binomial confidence intervals.
- DCR [ Time Frame: Up to 4 weeks after last dose of therapy ] [ Designated as safety issue: No ]Rate will be calculated and presented with 90% exact binomial confidence intervals.
- PFS [ Time Frame: Time from start of treatment to time of progression or death, whichever occurs first, assessed up to 4 weeks after last dose of therapy ] [ Designated as safety issue: No ]Summarized using the method of Kaplan-Meier. Median PFS will be presented with 90% confidence intervals derived using log(-log(survival)) methodology.
- Pre-treatment met proto-oncogene (MET) expression [ Time Frame: Baseline ] [ Designated as safety issue: No ]To investigate the relationship between pre-treatment expressions of MET, phospho-MET, or hepatocyte growth factor (HGF) and measures of response or clinical benefit, pre-treatment ratios of total MET to phospho-MET will be calculated and summarized by response or clinical benefit status using descriptive statistics.
- Clinical benefit (CR, PR, or stable disease [SD]), assessed according to RECIST [ Time Frame: Up to 4 weeks after last dose of therapy ] [ Designated as safety issue: No ]To investigate the relationship between pre-treatment expressions of MET, phospho-MET, or HGF and measures of response or clinical benefit, pre-treatment ratios of total MET to phospho-MET will be calculated and summarized by response or clinical benefit status using descriptive statistics.
- Serum levels of HGF [ Time Frame: Up to 8 weeks ] [ Designated as safety issue: No ]Assay levels of HGF in the serum will be summarized graphically. The status of the assay (+/-) will be shown at each assessment time for each patient while on study therapy. Graphics will note changes in disease status and times of disease progression.
|Study Start Date:||May 2013|
|Estimated Primary Completion Date:||May 2014 (Final data collection date for primary outcome measure)|
Experimental: Treatment (cabozantinib-s-malate, vemurafenib)
Patients receive cabozantinib-s-malate PO QD and vemurafenib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Other Names:Drug: vemurafenib
Other Names:Other: laboratory biomarker analysis
Correlative studiesOther: pharmacological study
Other Name: pharmacological studies
I. To determine a tolerable dose of XL184 (cabozantinib-s-malate) in combination with vemurafenib.
I. To determine the objective response rate (ORR) and disease control rate (DCR) per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
II. To determine the progression-free survival (PFS). III. To determine the response rate according to the molecular phenotype.
OUTLINE: This is a dose-escalation study of cabozantinib-s-malate.
Patients receive cabozantinib-s-malate orally (PO) once daily (QD) and vemurafenib PO twice daily (BID) on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 4 weeks.
|United States, Massachusetts|
|Dana-Farber Cancer Institute||Recruiting|
|Boston, Massachusetts, United States, 02115|
|Contact: Jason J. Luke 617-632-6588 Jason_Luke@DFCI.Harvard.edu|
|Principal Investigator: Jason J. Luke|
|Principal Investigator:||Jason Luke||Dana-Farber Cancer Institute|