Efficacy and safety of dabrafenib in pediatric patients with BRAF V600 mutation–positive relapsed or refractory low-grade glioma: Results from a phase I/IIa study Journal Article


Authors: Hargrave, D. R.; Bouffet, E.; Tabori, U.; Broniscer, A.; Cohen, K. J.; Hansford, J. R.; Geoerger, B.; Hingorani, P.; Dunkel, I. J.; Russo, M. W.; Tseng, L.; Dasgupta, K.; Gasal, E.; Whitlock, J. A.; Kieran, M. W.
Article Title: Efficacy and safety of dabrafenib in pediatric patients with BRAF V600 mutation–positive relapsed or refractory low-grade glioma: Results from a phase I/IIa study
Abstract: Purpose: Pediatric low-grade glioma (pLGG) is the most prevalent childhood brain tumor. Patients with BRAF V600 mutation–positive pLGG may benefit from treatment with dabrafenib. Part 2 of a phase I/IIa study, open-label study (NCT01677741) explores the activity and safety of dabrafenib treatment in these patients. Patients and Methods: Patients ages 1 to <18 years who had BRAF V600–mutant solid tumors (≥1 evaluable lesion) with recurrent, refractory, or progressive disease after ≥1 standard therapy were treated with oral dabrafenib 3.0 to 5.25 mg/kg/ day (part 1) or at the recommended phase II dose (RP2D; part 2). Primary objectives were to determine the RP2D (part 1, results presented in a companion paper) and assess clinical activity (part 2). Here, we report the clinical activity, including objective response rates (ORRs) using Response Assessment in Neuro-Oncology criteria and safety across parts 1 and 2. Results: Overall, 32 patients with pLGG were enrolled (part 1, n 1⁄4 15; part 2, n 1⁄4 17). Minimum follow-up was 26.2 months. Among all patients, the ORR was 44% [95% confidence interval (CI), 26–62] by independent review. The 1-year progression-free survival rate was 85% (95% CI, 64–94). Treatment-related adverse events (AE) were reported in 29 patients (91%); the most common was fatigue (34%). Grade 3/4 treatment-related AEs were reported in 9 patients (28%). Conclusions: Dabrafenib demonstrated meaningful clinical activity and acceptable tolerability in patients with BRAF V600–mutant pLGG. © 2019 American Association for Cancer Research.
Keywords: adolescent; adult; cancer survival; child; survival rate; major clinical study; fatigue; cancer recurrence; drug efficacy; drug safety; drug withdrawal; follow up; glioma; cancer grading; progression free survival; phase 2 clinical trial; vomiting; arthralgia; febrile neutropenia; fever; rash; hypotension; maculopapular rash; heart failure; multicenter study; headache; phase 1 clinical trial; dry skin; b raf kinase; pediatrics; braf gene; adverse event; dabrafenib; disseminated intravascular clotting; human; male; female; priority journal; article
Journal Title: Clinical Cancer Research
Volume: 25
Issue: 24
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2019-12-15
Start Page: 7303
End Page: 7311
Language: English
DOI: 10.1158/1078-0432.Ccr-19-2177
PUBMED: 31811016
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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  1. Ira J Dunkel
    371 Dunkel