A trial of dabrafenib and trametinib for children and young people with a glioma

Cancer type:

Brain (and spinal cord) tumours
Children's cancers

Status:

Open

Phase:

Phase 2
This trial is for children and young people with a glioma that has a change in the BRAF gene called BRAF V600. 
 
It is open to children and young people who are at least 12 months old and haven’t yet had their 18th birthday. And who have a type of brain tumour called a glioma that is either:
  • slow growing (low grade
  • fast growing (high grade) and continued to get worse during treatment or came back after treatment
We use the term ‘you’ in this summary, but if you are a parent we are referring to your child. 

More about this trial

Some gliomas have a change (mutation Open a glossary item) in the BRAF gene Open a glossary item called BRAF V600.  The BRAF gene makes a protein that affects how cancers grow and divide. 
 
Dabrafenib and trametinib are targeted drugs. They work by blocking the action of the BRAF protein so possibly stopping the cancer growing or spreading. 
 
We know that the combination of dabrafenib and trametinib works for other cancers that have the BRAF V600 change. Researchers think it could help children and young people whose glioma has the BRAF V600 change. 
 
In this trial everyone who has a fast growing glioma will have dabrafenib and trametinib. 
 
Everyone who has a slow growing glioma will have either:
  • dabrafenib and trametinib or
  • carboplatin and vincristine (standard treatment Open a glossary item)
The aims of this trial are to find:
  • how well dabrafenib and trametinib works for children and young people with a glioma
  • how dabrafenib and trametinib works in the body of children and young people
  • out about the side effects of having dabrafenib and trametinib together
  • out how tasty and acceptable liquid dabrafenib and liquid trametinib is 

Who can enter

The following bullet points list the entry conditions for this trial. Talk to your doctor or the trial team if you are unsure about any of these. They will be able to advise you. 
 
Who can take part
 
You may be able to join this trial if all of the following apply. You:
  • have a low grade Open a glossary item glioma that has got worse following surgery or can’t be removed by surgery and needs treatment or you have a high grade Open a glossary item glioma that got worse during treatment or came back after treatment 
  • have a glioma with a change (mutation Open a glossary item) in the BRAF V600 gene Open a glossary item
  • have a glioma that can be measured on a scan
  • might need quite a lot of help to look after yourself (Karnofsky performance status 50 or more) or you can get dressed, lie down for most of the day and take part in quiet play (Lansky performance status 50 or more)
  • have satisfactory blood test results
  • are willing to use reliable contraception during treatment and for 6 months after if there is any chance you or your partner could become pregnant  
  • are at least 12 months old and haven’t yet had your 18th birthday
Who can’t take part
 
You cannot join this trial if any of these apply. 
 
Cancer related
You:
  • have another cancer 
  • have already had dabrafenib, trametinib or any other drug that works in a similar way 
  • have had another cancer treatment within 3 weeks of starting treatment, if you are taking steroids you must be taking a stable dose or a reducing dose a week before starting treatment
  • have had radiotherapy to the glioma within 3 months unless a scan shows that the glioma has continued to grow
  • have had an experimental drug as part of a clinical trial within 3 weeks of starting treatment
  • have had another cancer that had a gene change (mutation) in the RAS gene or a combination of genes that included the BRAF gene
  • have ongoing moderate to severe side effects from any previous cancer treatment 
  • have had a stem cell transplant Open a glossary item within 3 months of starting treatment
  • have had graft versus host disease Open a glossary item (GVHD) 
Medical conditions
You can’t take part if you:
  • are taking medication including herbal treatments that affect the CYP enzymes
  • have had a heart attack, unstable angina or heart surgery in the past 6 months 
  • have any other serious heart problem such as congestive heart failure
  • have a problem with your digestive system Open a glossary item that could affect how well you absorb tablets, capsules or liquid medication
  • have hepatitis B or hepatitis C
  • have any other medical or mental health condition that your doctor or the trial team think could affect you taking part
 
Other
You can’t take part if you:
  • are sensitive or allergic to dabrafenib, trametinib or any of their ingredients
  • are pregnant or breastfeeding

Trial design

This is a phase 2 trial
 
There are 2 groups in this trial. Children and young people who have:
  • a fast growing (high grade) glioma
  • a slow growing (low grade) glioma
Fast growing glioma
The trial team need about 40 children and young people to join this group. Everyone will take dabrafenib and trametinib. 
 
Slow growing glioma
The trial team need 102 children and young people to join this group. 
 
This part of the trial is randomised. You are put into 1 of 2 groups by a computer. Neither you or your doctor can choose which group you are in. 
  • dabrafenib and trametinib 
  • carboplatin and vincristine
2 out of every 3 children and young people will be in the dabrafenib and trametinib group.
 
Dabrafenib and trametinib 
You have dabrafenib as a capsule or a liquid. You take it twice a day. Your doctor will tell you how many capsules or how much liquid to take. 
 
You have trametinib as a tablet or a liquid. You take it twice a day. Your doctor will tell you how many tablets or how much liquid to take.
 
You continue taking dabrafenib and trametinib as long as it is helping and the side effects aren’t too bad.  
 
Carboplatin and vincristine
You have carboplatin and vincristine as a drip into a vein. You have treatment:
  • once a week for 10 weeks
  • followed by no treatment for 2 weeks
  • followed by maintenance treatment 
You have maintenance treatment:
  • once a week for 4 weeks 
  • followed by no treatment for 2 weeks
Each 6 week period is called a cycle of treatment. You have 8 cycles of maintenance treatment. 
 
 
After you finish chemotherapy, or if your glioma gets worse, you might be able to start taking dabrafenib and trametinib. Your doctor or a member of the trial team will talk to you about this. 
 
Questionnaires
Children and young people taking dabrafenib and trametinib as a liquid fill in a questionnaire during the 1st week and 5th week of treatment. This questionnaire is about the taste of the liquid. 
 
Everyone who has a slow growing (low grade) glioma will fill in a questionnaire:
  • every month for 3 months
  • then every 8 weeks for about 9 months
  • then every 16 weeks while you are having treatment 
The questions are about your general health, wellbeing and any side effects you might have. This is a quality of life questionnaire
 
Samples
When you agree to join the trial, the team will ask for a small piece of glioma tissue from when you had your surgery. If this isn’t available, you must agree to have a small piece of glioma tissue (biopsy Open a glossary item) taken. They use this sample to confirm your glioma has the change (mutation) in the BRAF V600 gene. 
 
During the trial if your glioma gets worse and you have surgery to remove it the team will ask for a small piece of the glioma tissue. They will use this to learn:
  • why the treatment has stopped working
  • more about how dabrafenib and trametinib works
  • why dabrafenib and trametinib works better for some people and not others 
The trial team will take extra blood samples from those who are taking dabrafenib and trametinib. They will use these to find out what happens to these 2 drugs in the body. 
 
They will also ask for extra blood samples at the start of treatment and if your glioma gets worse. You don’t have to agree to these samples being taken. You can still take part in the trial.
 
Researchers will use the blood samples to look for substances (biomarkers Open a glossary item) in them that could help identify who might benefit from this treatment in the future. 

Hospital visits

You see the doctor to have some tests before taking part. These tests include:
  • a physical examination
  • blood tests
  • heart trace (ECG Open a glossary item)
  • CT scan
  • MRI scan or x-ray of your shin bone or wrist
  • heart scan (ECHO Open a glossary item)
  • eye examination
During treatment you see the doctor:
  • every week for 5 weeks
  • at 2 months
  • then every 2 months for about 9 months
  • then every 3 to 4 months until you start a new treatment for your glioma
You have your eyes examined every 4 months. 
 
You have a CT scan:
  • every 2 months for about 9 months
  • then every 16 weeks until your glioma starts to grow or you are no longer in the trial
You have an MRI scan or x-ray of your shin bone or wrist at:
  • 16 weeks
  • 48 weeks
  • then every year until the end of treatment
After you start a new treatment a member of the trial team will phone you to see how you are. They might ask you to have a CT scan every 4 months. 

Side effects

Your doctor and nurse will monitor you closely for any side effects. Let your doctor or nurse know as soon as possible if:
  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse
Dabrafenib can cause men to lose the ability to have children (fertility). And this might be permanent. If you have been through puberty you might be able to bank your sperm. This is a way of storing your sperm to be used later in a fertility treatment. Your doctor will be able to tell you more about this. 
 
The most common side effects of taking dabrafenib only or dabrafenib and trametinib together include:
We have information about the side effects of carboplatin and the side effects of vincristine
 
Your doctor or a member of the trial team will talk to you about the possible side effects of dabrafenib, trametinib, carboplatin and vincristine before you agree to join the trial. 

Location

Leeds
Liverpool
London

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Darren Hargrave

Supported by

Novartis

 

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

15821

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Cara took part in a clinical trial

A picture of Cara

"I am glad that taking part in a trial might help others on their own cancer journey.”

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