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History of Changes for Study: NCT06346067
A Study to Assess Naporafenib (ERAS-254) Administered With Trametinib in Patients With NRAS-mutant Melanoma (SEACRAFT-2)
Latest version (submitted May 8, 2024) on ClinicalTrials.gov
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Study Record Versions
Version A B Submitted Date Changes
1 March 28, 2024 None (earliest Version on record)
2 April 25, 2024 Study Status and Contacts/Locations
3 April 26, 2024 Study Status
4 April 29, 2024 Eligibility and Study Status
5 April 30, 2024 Recruitment Status, Study Status, Contacts/Locations and Oversight
6 May 6, 2024 Study Status and Eligibility
7 May 8, 2024 Study Status and Eligibility
Comparison Format:

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Changes (Side-by-Side) for Study: NCT06346067
March 28, 2024 (v1) -- April 25, 2024 (v2)

Changes in: Study Status and Contacts/Locations

Open or close this module Study Identification
Unique Protocol ID: ERAS-254-02 ERAS-254-02
Brief Title: A Study to Assess Naporafenib (ERAS-254) Administered With Trametinib in Patients With NRAS-mutant Melanoma (SEACRAFT-2) A Study to Assess Naporafenib (ERAS-254) Administered With Trametinib in Patients With NRAS-mutant Melanoma (SEACRAFT-2)
Official Title: A Randomized, Open-label Phase III Study in Patients With Previously Treated Unresectable or Metastatic NRAS Mutant Cutaneous Melanoma Comparing the Combination of Naporafenib + Trametinib to Physician's Choice of Therapy (Dacarbazine, Temozolomide or Trametinib Monotherapy) With a Dose Optimization lead-in [SEACRAFT-2] A Randomized, Open-label Phase III Study in Patients With Previously Treated Unresectable or Metastatic NRAS Mutant Cutaneous Melanoma Comparing the Combination of Naporafenib + Trametinib to Physician's Choice of Therapy (Dacarbazine, Temozolomide or Trametinib Monotherapy) With a Dose Optimization lead-in [SEACRAFT-2]
Secondary IDs:
Open or close this module Study Status
Record Verification: March 2024 April 2024
Overall Status: Not yet recruitingNot yet recruiting
Study Start: May 2024 May 2024
Primary Completion: April 2028 [Anticipated] April 2028 [Anticipated]
Study Completion: December 2028 [Anticipated] December 2028 [Anticipated]
First Submitted: March 17, 2024 March 17, 2024
First Submitted that
Met QC Criteria:
March 28, 2024 March 28, 2024
First Posted: April 3, 2024 [Actual] April 3, 2024 [Actual]
Last Update Submitted that
Met QC Criteria:
March 28, 2024 April 25, 2024
Last Update Posted: April 3, 2024 [Actual] April 26, 2024 [Actual]
Open or close this module Sponsor/Collaborators
Sponsor: Erasca, Inc. Erasca, Inc.
Responsible Party: Sponsor Sponsor
Collaborators:
Open or close this module Oversight
U.S. FDA-regulated Drug: YesYes
U.S. FDA-regulated Device: NoNo
Data Monitoring: Yes Yes
Open or close this module Study Description
Brief Summary:

Stage 1: To select the optimal dose of naporafenib + trametinib to be studied in Stage 2.

Stage 2: To compare progression free survival (PFS) and overall survival (OS) for patients with NRAS-mutant (NRASm) melanoma who are randomized to receive the combination of naporafenib + trametinib to that of patients who are randomized to physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy).

Stage 1: To select the optimal dose of naporafenib + trametinib to be studied in Stage 2.

Stage 2: To compare progression free survival (PFS) and overall survival (OS) for patients with NRAS-mutant (NRASm) melanoma who are randomized to receive the combination of naporafenib + trametinib to that of patients who are randomized to physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy).

Detailed Description:

SEACRAFT-2 is a global, Phase III, open-label, randomized study to assess the efficacy and safety of naporafenib administered with trametinib compared to physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy) in patients with unresectable or metastatic NRAS mutant melanoma who have progressed on, or are intolerant to, an anti-programmed death-1 ligand 1 (PD 1/L1)-based regimen. The study will consist of 2 stages: dose optimization in Stage 1 and the Phase 3 portion in Stage 2.

A total of approximately 470 eligible patients will be randomized to receive study drug(s) in this study across 2 stages.

SEACRAFT-2 is a global, Phase III, open-label, randomized study to assess the efficacy and safety of naporafenib administered with trametinib compared to physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy) in patients with unresectable or metastatic NRAS mutant melanoma who have progressed on, or are intolerant to, an anti-programmed death-1 ligand 1 (PD 1/L1)-based regimen. The study will consist of 2 stages: dose optimization in Stage 1 and the Phase 3 portion in Stage 2.

A total of approximately 470 eligible patients will be randomized to receive study drug(s) in this study across 2 stages.

Open or close this module Conditions
Conditions: Advanced or Metastatic NRAS-mutant Melanoma Advanced or Metastatic NRAS-mutant Melanoma
Keywords: Melanoma
NRAS Mutant
Cutaneous Melanoma
Melanoma
NRAS Mutant
Cutaneous Melanoma
Open or close this module Study Design
Study Type: InterventionalInterventional
Primary Purpose: TreatmentTreatment
Study Phase: Phase 3Phase 3
Interventional Study Model: Parallel Assignment Parallel Assignment
Number of Arms: 55
Masking: None (Open Label)None (Open Label)
Allocation: RandomizedRandomized
Enrollment: 470 [Anticipated] 470 [Anticipated]
Open or close this module Arms and Interventions
Arms Assigned Interventions
Experimental: Stage 1 Dose selection Lead-in Arm 1
Naporafenib + Trametinib Naporafenib (ERAS-254) 100 mg administered orally twice daily (BID) Trametinib 1 mg once daily (QD)
Drug: Naporafenib
Naporafenib (ERAS-254) is an experimental Pan-Raf inhibitor
Other Names:
  • ERAS-254
  • LXH254
Drug: Trametinib
Trametinib is an FDA approved anticancer medication that targets MEK1 and MEK2.
Other Names:
  • Mekinist
Experimental: Stage 1 Dose selection Lead-in Arm 2
Naporafenib + Trametinib Naporafenib (ERAS-254) 400 mg administered orally twice daily (BID) Trametinib 0.5 mg once daily (QD)
Drug: Naporafenib
Naporafenib (ERAS-254) is an experimental Pan-Raf inhibitor
Other Names:
  • ERAS-254
  • LXH254
Drug: Trametinib
Trametinib is an FDA approved anticancer medication that targets MEK1 and MEK2.
Other Names:
  • Mekinist
Active Comparator: Stage 1 Dose selection Lead-in Arm 3 Trametinib monotherapy
Trametinib 2 mg once daily (QD)
Drug: Trametinib
Trametinib is an FDA approved anticancer medication that targets MEK1 and MEK2.
Other Names:
  • Mekinist
Experimental: Stage 2 Arm A
Naporafenib + Trametinib Naporafenib (ERAS-254) BID oral administration with Trametinib QD at the dose selected in Stage 1
Drug: Naporafenib
Naporafenib (ERAS-254) is an experimental Pan-Raf inhibitor
Other Names:
  • ERAS-254
  • LXH254
Drug: Trametinib
Trametinib is an FDA approved anticancer medication that targets MEK1 and MEK2.
Other Names:
  • Mekinist
Active Comparator: Stage 2 Arm B - Physician's Choice
  • Dacarbazine 1000 mg/m2 intravenously (IV) on Day 1 of each 21-day cycle OR
  • Temozolomide 200 mg/m2/day PO on Day 1 to Day 5 of each 28-day cycle OR
  • Trametinib monotherapy, 2 mg PO QD
Drug: Dacarbazine
Dacarbazine IV - Day 1
Other Names:
  • DTIC
Drug: Temozolomide
Temozolomide 200 mg/m2/day PO on Day 1 to Day 5 of each 28-day cycle
Other Names:
  • Temodar
  • TMZ
Drug: Trametinib
Trametinib is an FDA approved anticancer medication that targets MEK1 and MEK2.
Other Names:
  • Mekinist
Open or close this module Outcome Measures
Primary Outcome Measures:
1. Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Assessed up to 6 months from time of first dose ]

Incidence and severity of treatment-emergent AEs and serious AEs
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Assessed up to 6 months from time of first dose ]

Incidence and severity of treatment-emergent AEs and serious AEs
2. Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Assessed up to 6 months from time of first dose ]

Objective response rate (ORR) based on assessment of radiographic imaging RECIST v1.1
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Assessed up to 6 months from time of first dose ]

Objective response rate (ORR) based on assessment of radiographic imaging RECIST v1.1
3. Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Study Day 1 up to Day 29 ]

Maximum plasma concentration of ERAS-254 and trametinib
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Study Day 1 up to Day 29 ]

Maximum plasma concentration of ERAS-254 and trametinib
4. Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Study Day 1 up to Day 29 ]

Time to achieve maximum plasma concentration of ERAS-254 and trametinib
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Study Day 1 up to Day 29 ]

Time to achieve maximum plasma concentration of ERAS-254 and trametinib
5. Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Study Day 1 up to Day 29 ]

Area under the plasma concentration-time curve
Stage 1:To select the optimal dose of naporafenib + trametinib to be studied in Stage 2
[ Time Frame: Study Day 1 up to Day 29 ]

Area under the plasma concentration-time curve
6. Stage 2: To compare PFS and OS for patients who are randomized to receive the combination of naporafenib + trametinib to that of patients who receive physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy)
[ Time Frame: Assessed up to 24 months from time of first dose ]

  • Progression free survival (PFS) based on assessment of radiographic imaging per RECIST v1.1
  • Survival status
Stage 2: To compare PFS and OS for patients who are randomized to receive the combination of naporafenib + trametinib to that of patients who receive physician's choice of therapy (dacarbazine, temozolomide, or trametinib monotherapy)
[ Time Frame: Assessed up to 24 months from time of first dose ]

  • Progression free survival (PFS) based on assessment of radiographic imaging per RECIST v1.1
  • Survival status
Secondary Outcome Measures:
1. Adverse Events
[ Time Frame: Assessed up to 24 months from time of first dose ]

Incidence and severity of treatment-emergent AEs and serious AEs
Adverse Events
[ Time Frame: Assessed up to 24 months from time of first dose ]

Incidence and severity of treatment-emergent AEs and serious AEs
2. Duration of Response (DOR)
[ Time Frame: Assessed up to 24 months from time of first dose] ]

Based on assessment of radiographic imaging per RECIST version 1.1
Duration of Response (DOR)
[ Time Frame: Assessed up to 24 months from time of first dose] ]

Based on assessment of radiographic imaging per RECIST version 1.1
3. Time to Response (TTR)
[ Time Frame: Assessed up to 24 months from time of first dose] ]

Based on assessment of radiographic imaging per RECIST version 1.1
Time to Response (TTR)
[ Time Frame: Assessed up to 24 months from time of first dose] ]

Based on assessment of radiographic imaging per RECIST version 1.1
4. Disease Control Rate (DCR)
[ Time Frame: Assessed up to 24 months from time of first dose] ]

Based on assessment of radiographic imaging per RECIST version 1.1
Disease Control Rate (DCR)
[ Time Frame: Assessed up to 24 months from time of first dose] ]

Based on assessment of radiographic imaging per RECIST version 1.1
5. Overall Response Rate (ORR)
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on the assessment of radiographic imaging per RECIST version 1.1
Overall Response Rate (ORR)
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on the assessment of radiographic imaging per RECIST version 1.1
6. Plasma concentration (Cmax):Stage 1 only
[ Time Frame: Study Day 1 up to Day 29 ]

Maximum plasma concentration of ERAS-254 and trametinib
Plasma concentration (Cmax):Stage 1 only
[ Time Frame: Study Day 1 up to Day 29 ]

Maximum plasma concentration of ERAS-254 and trametinib
7. Area under the curve (AUC):Stage 1 only
[ Time Frame: Study Day 1 up to Day 29 ]

Area under the plasma concentration-time curve
Area under the curve (AUC):Stage 1 only
[ Time Frame: Study Day 1 up to Day 29 ]

Area under the plasma concentration-time curve
8. Quality of Life: To assess disease and treatment-related QOL in patients with NRASm melanoma.
[ Time Frame: Assessed up to 24 months from time of first dose ]

Using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire [QLQ]-C30 subscales and PRO CTCAE® symptom items specific to the potential cutaneous toxicities.
Quality of Life: To assess disease and treatment-related QOL in patients with NRASm melanoma.
[ Time Frame: Assessed up to 24 months from time of first dose ]

Using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire [QLQ]-C30 subscales and PRO CTCAE® symptom items specific to the potential cutaneous toxicities.
Other Outcome Measures:
1. Duration of Response (DOR) for CNS disease in participants
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM)
Duration of Response (DOR) for CNS disease in participants
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM)
2. Overall Response Rate (ORR) for CNS disease in participants
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM)
Overall Response Rate (ORR) for CNS disease in participants
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM)
3. Disease Control Rate (DCR) for CNS disease in participants
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM)
Disease Control Rate (DCR) for CNS disease in participants
[ Time Frame: Assessed up to 24 months from time of first dose ]

Based on Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM)
Open or close this module Eligibility
Minimum Age: 18 Years 18 Years
Maximum Age: 99 Years 99 Years
Sex: All All
Gender Based:
Accepts Healthy Volunteers: NoNo
Criteria:

Key Inclusion Criteria:

  1. Willing and able to provide written informed consent
  2. Age ≥ 18 years
  3. Histologically or cytologically confirmed unresectable or metastatic cutaneous (includes acral) melanoma.
  4. Documentation of an NRAS mutation (tumor tissue or blood) prior to first dose of study drug(s) as determined locally with an analytically validated assay in a certified testing laboratory.
  5. Archival tumor tissue collected within 5 years prior to enrollment must be confirmed to be available at the time of Screening, which may be submitted before or after enrollment for exploratory biomarker analysis.
  6. Must have received an anti-PD-1/L1 based regimen (monotherapy or combination). Patient must have documented disease progression either while receiving therapy or within 6 months of last dose of the most recent anti-PD-1/L1 based regimen; the patient is eligible if they have received other therapies between the most recent anti-PD-1/L1 based regimen and enrollment.
  7. ECOG performance status 0, 1 or 2
  8. Presence of at least 1 measurable lesion according to RECIST v1.1
  9. Able to swallow oral medication.

Key Exclusion Criteria:

1. Patients with uveal or mucosal melanoma 2. Prior therapy with an ERK-, MEK-, RAF-, or RAS-inhibitor 3. Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug(s) (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, small bowel resection) 4. History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndrome) 3. Corrected QT interval using Fridericia's formula (QTcF) at Screening >450 ms based on triplicate average NOTE: criterion does not apply to patients with a right or left bundle branch block 4. LVEF <50% 5. Symptomatic CNS metastases that are neurologically unstable. Patients with controlled CNS metastases are eligible.

6. Patients receiving treatment with medications that are known to be strong inhibitors and/or inducers of cytochrome P450 (CYP)3A; substrates of CYP2C8, CYP2C9, and CYP3A with a narrow therapeutic index and sensitive substrates of CYP3A; 7. Are pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial

Key Inclusion Criteria:

  1. Willing and able to provide written informed consent
  2. Age ≥ 18 years
  3. Histologically or cytologically confirmed unresectable or metastatic cutaneous (includes acral) melanoma.
  4. Documentation of an NRAS mutation (tumor tissue or blood) prior to first dose of study drug(s) as determined locally with an analytically validated assay in a certified testing laboratory.
  5. Archival tumor tissue collected within 5 years prior to enrollment must be confirmed to be available at the time of Screening, which may be submitted before or after enrollment for exploratory biomarker analysis.
  6. Must have received an anti-PD-1/L1 based regimen (monotherapy or combination). Patient must have documented disease progression either while receiving therapy or within 6 months of last dose of the most recent anti-PD-1/L1 based regimen; the patient is eligible if they have received other therapies between the most recent anti-PD-1/L1 based regimen and enrollment.
  7. ECOG performance status 0, 1 or 2
  8. Presence of at least 1 measurable lesion according to RECIST v1.1
  9. Able to swallow oral medication.

Key Exclusion Criteria:

1. Patients with uveal or mucosal melanoma 2. Prior therapy with an ERK-, MEK-, RAF-, or RAS-inhibitor 3. Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug(s) (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, small bowel resection) 4. History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndrome) 3. Corrected QT interval using Fridericia's formula (QTcF) at Screening >450 ms based on triplicate average NOTE: criterion does not apply to patients with a right or left bundle branch block 4. LVEF <50% 5. Symptomatic CNS metastases that are neurologically unstable. Patients with controlled CNS metastases are eligible.

6. Patients receiving treatment with medications that are known to be strong inhibitors and/or inducers of cytochrome P450 (CYP)3A; substrates of CYP2C8, CYP2C9, and CYP3A with a narrow therapeutic index and sensitive substrates of CYP3A; 7. Are pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial

Open or close this module Contacts/Locations
Central Contact Person: Erasca Clinical Team
Telephone: 1-858-465-6511
Email: clinicaltrials@erasca.com
Erasca Clinical Team
Telephone: 1-858-465-6511
Email: clinicaltrials@erasca.com
Study Officials: Joyce Antal
Study Director
Clinical Development
Joyce Antal
Study Director
Clinical Development
Locations: United States, Tennessee
SCRI Oncology Partners (formerly Tennessee Oncology)
Nashville, Tennessee, United States, 37203
Open or close this module IPDSharing
Plan to Share IPD: No No
Open or close this module References
Citations:
Links:
Available IPD/Information:

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