Clinical Trial 19310

Cancer Type: Cutaneous
Interventions:Atezolizumab (Tecentriq); Cobimetinib; Pembrolizumab (Keytruda)

Study Type: Treatment
Phase of Study: Phase III
Investigators:

  • Zeynep Eroglu

Overview

Study Title

A Phase III, Open-Label, Multicenter,Two-Arm, Randomized Study To Investigate The Efficacy And Safety Of Cobimetinib Plus Atezolizumab Versus Pembrolizumab In Patients With Previously Untreated Advanced Brafv600 Wild-Type Melanoma

Summary

The purpose of this study is to compare the efficacy and safety of cobimetinib plus atezolizumab with the efficacy and safety of pembrolizumab in participants with a type of skin cancer called melanoma that has spread to other parts of the body (metastatic) that cannot be removed by surgery (unresectable), and who have not received any prior treatment.

Objective

To evaluate the efficacy of cobimetinib plus atezolizumab compared with pembrolizumab, as measured by the primary endpoint of PFS by independent review

Inclusion Criteria

  • Histologically confirmed Stage IV (metastatic) or unresectable Stage IIIc (locally advanced) melanoma
  • Naive to prior systemic anti-cancer therapy for melanoma
  • Documentation of BRAFV600 wild-type status in melanoma tumor tissue through use of a clinical mutation test approved by the local health authority
  • A representative, formalin-fixed, paraffin-embedded (FFPE) tumor specimen in a paraffin block (preferred) or 20 slides containing unstained, freshly cut, serial sections must be submitted along with an associated pathology report prior to study entry. If 20 slides are not available or the tissue block is not of sufficient size, the patient may still be eligible for the study, after discussion with and approval by the Medical Monitor
  • Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
  • Age >=18 years at time of signing Informed Consent Form
  • Ability to comply with the study protocol, in the investigator's judgment
  • Histologically or cytologically confirmed BRAFV600 wild-type melanoma
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
  • Life expectancy >=3 months
  • Adequate hematologic and end-organ function
  • Women of childbearing potential and Men must agree to follow study contraception guidelines.
  • Willingness and ability of participants to use an electronic device to report selected study outcomes

  • Exclusion Criteria

  • Inability to swallow medications
  • Malabsorption condition that would alter the absorption of orally administered medications
  • Pregnancy, breastfeeding, or intention of becoming pregnant during the study
  • History of severe hypersensitivity reactions to components of the cobimetinib, atezolizumab, or pembrolizumab formulations
  • Current or recent treatment with therapeutic antibiotics, live attenuated vaccines or systemic immunostimulatory/immunosuppresive medication
  • Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes the patient's safe participation in and completion of the study
  • Ocular melanoma
  • Major surgery or radiotherapy within 21 days prior to Day 1 of Cycle 1 or anticipation of needing such procedure while receiving study treatment
  • Uncontrolled tumor-related pain
  • Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage more than once every 28 days
  • Active or untreated central nervous system (CNS) metastases Exclusions Related to Cardiovascular Disease
  • Unstable angina, new-onset angina within last 3 months, myocardial infarction within the last 6 months prior to Day 1 of Cycle 1, or current congestive heart failure classified as New York Heart Association Class II or higher
  • Left ventricular ejection fraction (LVEF) below institutional lower limit of normal or less than 50%, whichever is lower
  • Poorly controlled hypertension, defined as sustained, uncontrolled, non-episodic baseline hypertension consistently above 159/99 mmHg despite optimal medical management
  • History or presence of an abnormal electrocardiogram (ECG) that is clinically significant in the investigator's opinion
  • HIV infection
  • Active tuberculosis infection
  • Severe infections within 4 weeks prior to Day 1 of Cycle 1
  • Signs or symptoms of clinically relevant infection within 2 weeks prior to Day 1 of Cycle 1
  • Treatment with oral or IV antibiotics within 2 weeks prior to Day 1 of Cycle 1
  • Active or chronic viral hepatitis B or C infection Exclusions Related to Ocular Disease
  • Known risk factors for ocular toxicity
  • Active or history of autoimmune disease or immune deficiency
  • Prior allogeneic stem cell or solid organ transplantation
  • History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan
  • Treatment with systemic immunosuppressive medications within 2 weeks prior to Day 1, Cycle 1 Exclusions > Related to Other Medical Conditions or Medications
  • Active malignancy (other than melanoma) or a prior malignancy within the past 3 years
  • Any Grade >=3 hemorrhage or bleeding event within 28 days of Day 1 of Cycle 1
  • History of stroke, reversible ischemic neurological defect, or transient ischemic attack within 6 months prior to Day 1
  • Proteinuria >3.5 gm/24 hr
  • Consumption of foods, supplements, or drugs that are strong or moderate CYP3A4 enzyme inducers or inhibitors at least 7 days prior to Day 1 of Cycle 1 and during study treatment