Study of Neoadjuvant Vemurafenib for BRAF Mutant Melanoma and Palpable Lymph Node Metastasis

Official Title

A Pilot Study of the Neo-adjuvant Use of Vemurafenib in Patients With BRAF Mutant Melanoma With Palpable Lymph Node Metastasis.


This study will evaluate the clinical and pathological response to vemurafenib and cobimetinib in the neoadjuvant treatment of patients with histologically confirmed, BRAF V600 mutation-positive Stage IIIB and C melanoma. 20 patients will be treated with vemurafenib and cobimetinib for 2 months. Then they will be assessed for surgery. Patients will undergo surgery and subsequently resume taking vemurafenib and cobimetinib after recovery from surgery. Patients will undergo radiation therapy if appropriate then continue vemurafenib and cobimetinib. The maximum treatment period is 12 months. After 12 months of treatment, patients will be followed for disease recurrence and survival during for a total of 5 years.

Trial Description

Primary Outcome:

  • The feasibility of treating patients with unresectable melanoma and palpable lymph node metastases that harbor the BRAF mutation with neoadjuvant vemurafenib.
Secondary Outcome:
  • Resectability rates post vemurafenib therapy
  • Local-regional recurrence rates after treatment with neo-adjuvant vemurafenib.
  • Time to distant metastases and Distant Metastatic Free Survival (DMFS).
  • Disease Free Survival (DFS) and Overall Survival (OS).
  • Immunohistochemical correlates of tumour response.
  • Safety and tolerability of vemurafenib in the neoadjuvant setting
At Screening: Assessments will include CT or MRI of the brain, CT of chest, abdomen and pelvis, dermatology assessment, head and neck exam, pelvic and anal exam, ophthalmology exam, electrocardiogram (ECG), echocardiogram (ECHO) or multigated acquisition (MUGA) scan, a history and physical exam. A core biopsy will be performed within 14 days of study entry. During Treatment: The maximum treatment period is 12 months. Patients will be assessed monthly while on treatment. Assessments performed will include vital signs assessment and physical exam, dermatology exam, ophthalmology exam, echocardiogram (ECHO) or multigated acquisition (MUGA) scan, electrocardiogram (ECG), safety blood tests, pelvic and anal exam. Follow-up after treatment: Patients will be followed for 5 years. Radiology exams will be done to assess for disease. Other assessments performed include vital signs assessment and physical exam, dermatology exam, include echogram (ECHO) or multigated acquisition (MUGA) scans.

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Canadian Cancer Society

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