A trial of selumetinib for plexiform neurofibromas (KOMET)

Please note - this trial is no longer recruiting patients. We hope to add results when they are available.

Cancer type:

Neurofibroma

Status:

Closed

Phase:

Phase 3

This trial is looking at how well selumetinib might work for plexiform neurofibromas.

Plexiform neurofibromas are not cancer but are a benign Open a glossary item growth on the nerves.

This trial is open to people with neurofibromatosis Open a glossary item type 1 (NF1) who have plexiform neurofibromas that are causing symptoms. And you can’t have surgery to remove them. 

More about this trial

NF1 is a rare genetic (inherited Open a glossary item) disease. It can affect many parts of the body including the nervous system. This system is made up of:

  • the brain and spinal cord, called the central nervous system
  • the nerves that run throughout the body, called the peripheral nervous system

When NF1 affects the peripheral nervous system this is plexiform neurofibroma (PN).

PN can continue to grow throughout your life. It grows on and along the nerves. This can cause a lot of pain and affect your daily living. PN can also lead to cancer but this is rare.

Doctors treat PN with surgery. However, this is not always possible. Researchers are looking for other treatments for PN.

Selumetinib is a targeted drug Open a glossary item called a growth blocker. It works by stopping an enzyme that PN cells need to grow. Selumetinib is already used to treat some types of cancer. 

Researchers think that selumetinib might help people whose PN can’t be removed by surgery. In this trial half the people have selumetinib and the other half have a dummy drug (placebo Open a glossary item). 

The aims of this trial are to find out:

  • how well selumetinib works for plexiform neurofibroma
  • more about plexiform neurofibroma
  • what happens to selumetinib in the body
  • how the body affects selumetinib
  • how it affects quality of life Open a glossary item

Who can enter

The following bullet points are a summary of 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 neurofibromatosis type 1 (NF1)
  • have a plexiform neurofibroma (PN) that is causing symptoms. And you can’t have surgery to remove it.
  • have filled in a pain diary for a certain time. Your doctor can tell you more about this.
  • have at least 1 area of PN that the doctor can measure and is a certain size. Your doctor knows what size it must be.
  • have satisfactory blood test results
  • can look after yourself but might not be able to do heavy physical work (performance status 0 or 1)
  • are able to swallow capsules whole
  • are willing to use contraception during the trial and for a certain time after. This is if there is any chance you or your partner could become pregnant.
  • are at least 18 years old

If you are taking painkilling medication the dose needs to have been the same for the past 28 days before going into the trial.  

Who can’t take part

Medical conditions
You cannot join this trial if any of these apply. You:

  • might have a malignant glioma or malignant peripheral nerve sheath tumour (MPNST)
  • had treatment for PN within 4 weeks of starting the trial treatment. For radiotherapy it is 6 weeks.
  • have ongoing moderate to severe side effects from previous treatment. This is apart from hair thinning, hair lightening or other side effects that your doctor thinks won’t get worse during treatment. 
  • have or had a cancer. This is apart from successfully treated non melanoma skin cancer Open a glossary item. You might be able to join if you had a cancer that has been treated with the aim to cure and there has been no sign of it for 5 years or more.
  • have had a targeted drug called a MEK inhibitor before. Your doctor will know if you have. 
  • are not able to have an MRI scan Open a glossary item. This could be because you have a pacemaker, metal in your body for example surgical clips. It could also be because something such as an artificial limb or dental braces is near the tumour.
  • have a problem with the digestive system Open a glossary item that affects how well medication is absorbed into the body
  • have hepatitis B, hepatitis C or HIV
  • have an eye problem or a heart problem Open a glossary item that could affect you taking part
  • have high blood pressure that isn’t controlled
  • have a problem with bleeding
  • have had a kidney transplant
  • have moderate to severe liver disease
  • have major surgery or a major injury within 4 weeks of starting treatment
  • are taking vitamin E or anything that contains vitamin E. This is unless you are able to stop taking it at least 7 days before starting treatment.
  • are taking medication that affects the CYP enzymes. This is unless you can stop taking the medication within a certain time before starting treatment. Your doctor will know how long this is. 
  • have taken part in another clinical trial within a certain time before starting treatment. Your doctor will know how long this is. 
  • have any other medical condition or mental health problem that could affect you taking part

Other 
You cannot join this trial if any of these apply. You are:

  • sensitive or allergic to selumetinib or any of its ingredients
  • pregnant or breastfeeding

Trial design

This is an international phase 3 trial. The team need 146 people worldwide to take part with 10 people in the UK. 

It is a randomised double blind trial. A computer puts you into 1 of 2 groups. Neither you nor your doctor can choose which group you go into. And neither you nor your doctor will know which group you are in. 

The trial team will be able to tell your doctor which group you are in if this becomes necessary. 

The groups are:

  • people having selumetinib
  • people having the dummy drug (placebo)

Selumetinib is a capsule. You take the capsules twice a day. You must take them on an empty stomach. That means you can’t have any food or drink, apart from water, for 2 hours before taking the capsules and for 1 hour after. Your doctor tells you how many to take. 

The dummy drug is a capsule. You take it twice a day. You must take them on an empty stomach. Your doctor tells you how many to take. 

You take the dummy drug for a year. After the year you can start taking selumetinib. During the year if your scans show that your PN is getting worse you might be able to start taking selumetinib sooner.

You should not have certain foods and drinks for 7 days before starting treatment and during. As they can affect how well the body absorbs selumetinib. Your doctor will tell more about this. 

You continue treatment as long as it is helping and the side effects aren’t too bad. 

e-Diary
You have an e-diary to fill in before starting treatment and during treatment. You fill it in everyday and record any pain you have from the PN and what painkillers you take. During treatment you will also record when and how much of selumetinib or the dummy drug you take. 

There are also questions in the e-diary about:

  • your general health and wellbeing
  • what you are able to do
  • side effects and symptoms

This is a quality of life questionnaire

You must bring this e-diary with you to every clinic visit. 

Optional Interview sub study
A member of the team will phone 3 times during the trial:

  • before starting treatment (takes about 30 minutes)
  • a year after starting treatment (takes about an hour) 
  • about 2 years after starting treatment (takes about an hour)

They will arrange to phone you at a time that is convenient to you. The questions are about:

  • symptoms
  • how these symptoms affect your daily life
  • your experiences during the trial

The interviewer records the interview and keeps it in a safe and confidential place. 

You don’t have to take part in this sub study.

Samples for research
You give several blood samples and urine samples during the trial. Your doctor will tell when and how often. 

Researchers use these samples to find out:

  • what happens to selumetinib in the body
  • how selumetinib affects the body
  • more about plexiform neurofibroma

Hospital visits

You see the doctor for tests before taking part. These include:

  • a physical examination Open a glossary item
  • blood tests
  • urine test
  • heart trace (ECG Open a glossary item)
  • heart scan (ECHO) Open a glossary item
  • eye examination
  • MRI scan

You see the doctor:

  • at regular times during treatment
  • at the end of treatment
  • a month after stopping treatment

This is to see how you are and to have the same tests you had at the start.

Side effects

The trial team monitor you during treatment and afterwards. Contact your advice line or tell your doctor or nurse if any side effects are bad or not getting better. 

The most common side effects of selumetinib are:

Your doctor will talk to you about the possible side effects before you agree to take part.

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 Angela Swampillai

Supported by

AstraZeneca

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

18241

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

Wendy took part in a new trial studying the possible side effect of hearing loss

A picture of Wendy

"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”

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