Physician

Neil Belman, DO

Study Coordinator

Cynthia Evancho
484-658-2534
Cynthia.Evancho@sluhn.org

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This is a Phase 2 study evaluating the efficacy of a CDK, PI3K, or NTRK/ROS1 inhibitor in patients with progressive brain metastases from solid tumors harboring the alterations predicting sensitivity to each of these inhibitors.

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• Histologically confirmed parenchymal metastatic disease to the brain from any solid tumor

• Tissue must be available for biomarker testing (any brain metastasis tissue and extracranial site from any prior resection or biopsy). If extracranial tissue is not available or there is no evidence of extracrania disease, brain metastasis tissue is sufficient for eligibility

• Measurable CNS disease (≥ 10mm) that is new or progressive after systemic therapy or prior radiotherapy

• Patients must be able to undergo MRI with contrast

• Presence of clinically actionable alteration in NTRK, ROS1, CDK pathway or PI3K pathway in both a brain metastais and extracranial site per central review

• For HER2+ breast cancer, patients must have received prior HER-2 directed therapy in the metastatic setting

• For TNBC, patients must have had at least one chemotherpy in the metastatic setting

• For ER and/or PR+ HER2- breast cancer, patients must have had at least one endocrine therapy in the metastatic setting

• For melanoma, patietnts must have progressed after immunotherapy or after BRAF/MEK inhibitors for BRAF+ disease

• For lung cancer, patients must have failed EGFR therapies for EGFR mutated disease

• No known current diffuse leptomeningeal involvement

• No surgery within 2 weeks prior to or after registration

• No chemotherapy within 14 days prior to registration

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Physician

Melissa Wilson, MD

Study Coordinator

Amy Grossman, RN
484-658-1788
Amy.grossman@sluhn.org

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This phase II trial studies the effect of pembrolizumab alone or in combination with CMP-001 in treating patients with melanoma that can be treated by surgery (operable). Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Immunotherapy with CMP-001 may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. The addition of CMP-001 to pembrolizumab could improve the ability of the immune system to shrink tumors and to prevent them from returning.

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>= 18 years old

Diagnosis of melanoma by AJCC 8th edition:

• T0, TX or T1-4 and
• N2b, N2C, N3b or N3c

Patients may have a presentation with primary melanoma with concurrent regional nodal and/or in-transit metastasis; or patients may have a history of primary melanoma or unknown primary melanoma presenting with clinically detected regional nodal and/or in-transit recurrence; and may belong to any of the following groups:

• Primary cutaneous melanoma with clinically apparent regional lymph node metastases and/or in-transit metastases
• Clinically detected recurrent melanoma at the proximal regional lymph node(s) basin
• Primary cutaneous melanoma with concurrent nodal disease involving a single regional nodal group
• Clinically detected nodal melanoma (if single site) arising from an unknown primary
• In-transit cutaneous metastases with or without regional lymph node involvement permitted if considered potentially surgically resectable at baseline

Mucosal and uveal melanoma are excluded

Patients must be a candidate for definitive surgery and have met with the treating surgical oncologist prior to entry on study

Patients must have injectable and measurable disease

No prior systemic therapy for melanoma including immunotherapy and BRAF/MEK inhibitors and/or TLR-9 agonist

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Physician

Darius Desai, MD

Study Coordinator

Amy Grossman, RN
484-658-1788
Amy.grossman@sluhn.org

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This study will determine whether there is a difference in disease free survival for patients treated with either a 1cm excision margin or 2cm margin for clinical stage II (pT2b-pT4b) primary cutaneous melanoma.

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• Patients must have stage II primary invasive cutaneous melanoma (including head, neck, truck, extremity, scalp, palm or sole) with Breslow thickness >2mm without ulceration, or >1mm with ulceration (pT2b-pT4b, AJCC 8th edition) as determined by diagnostic biopsy and subsequent histopathological analysis
• An uninterrupted 2cm margin must be technically feasible around biopsy scar or primary melanoma
• Surgery (which refers to the staging sentinel node biopsy and wide local excision as these are both to be done on the same day) must be completed within 120 days of the original diagnosis
• Patients must have an ECOG PS of 0 or 1
• Patients may not have uncertain diagnosis of melanoma, i.e. 'melanocytic lesion of unknown malignant potential
• Patients who have undergone WLE at the site of primary index lesion, are unable or ineligible to undergo staging SLNB, or have a history of previous or concurrent invasive melanoma are excluded- Patients must not have physical, clinical, radiographic or pathologic evidence of satellite, in-transit, regional or distant metastatic melanoma
• Subungual, pure desmoplastic or neurotropic, mucosal, uveal melanomas are excluded. The cutaneous lesion may not be located distal to the metacarpophalangeal joint, on the tip of the nose, the eyelids or on the ear
• Planned adjuvant radiotherapy to the primary melanoma after WLE is not permitted

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Physician

Melissa Wilson, MD

Study Coordinator

Amy Grossman, RN
484-658-1788
Amy.grossman@sluhn.org

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The purpose of this study is to determine the most effective dose for nilotinib when combined with trametinib and dabrafenib and to gather information about the safety and effectiveness of this combination of drugs for patients with BRAF V600 mutated metastatic or unresectable melanoma.

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• Histologic diagnosis of metastatic or unresectable melanoma
• BRAF V600 mutation documented via any CLIA-certified mutation testing
• Patients must have failed any BRAFi/MEKi regimen and be off of this regimen for a minimum of 7 days before starting protocol therapy
• Patients may have had prior immunotherapy for metastatic disease (although NOT mandatory). Other prior therapies are not allowed, with the exception of radiation
• ECOG performance status ≤ 1
• Patients with treated brain metastases are eligible if follow-up brain imaging 4 weeks or longer after CNS-directed therapy shows no evidence of progression
• RECIST 1.1 measurable disease
• Patients may not be taking proton pump inhibitors, drugs or substances known to prolong QT interval, or CYP3A inhibitors and inducers, or CYP2C8 inhibitors

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