TY - JOUR
T1 - Nilotinib in KIT-driven advanced melanoma
T2 - Results from the phase II single-arm NICAM trial
AU - Larkin, James
AU - Marais, Richard
AU - Porta, Nuria
AU - Gonzalez de Castro, David
AU - Parsons, Lisa
AU - Messiou, Christina
AU - Stamp, Gordon
AU - Thompson, Lisa
AU - Edmonds, Kim
AU - Sarker, Sarah
AU - Banerji, Jane
AU - Lorigan, Paul
AU - Evans, Thomas R Jeffry
AU - Corrie, Pippa
AU - Marshall, Ernest
AU - Middleton, Mark R
AU - Nathan, Paul
AU - Nicholson, Steve
AU - Ottensmeier, Christian
AU - Plummer, Ruth
AU - Bliss, Judith
AU - Valpione, Sara
AU - Turajlic, Samra
N1 - Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2024/3/19
Y1 - 2024/3/19
N2 - Mucosal (MM) and acral melanomas (AM) are rare melanoma subtypes of unmet clinical need; 15%-20% harbor KIT mutations potentially targeted by small-molecule inhibitors, but none yet approved in melanoma. This multicenter, single-arm Phase II trial (NICAM) investigates nilotinib safety and activity in KIT mutated metastatic MM and AM. KIT mutations are identified in 39/219 screened patients (18%); of 29/39 treated, 26 are evaluable for primary analysis. Six patients were alive and progression free at 6 months (local radiology review, 25%); 5/26 (19%) had objective response at 12 weeks; median OS was 7.7 months; ddPCR assay correctly identifies KIT alterations in circulating tumor DNA (ctDNA) in 16/17 patients. Nilotinib is active in KIT-mutant AM and MM, comparable to other KIT inhibitors, with demonstrable activity in nonhotspot KIT mutations, supporting broadening of KIT evaluation in AM and MM. Our results endorse further investigations of nilotinib for the treatment of KIT-mutated melanoma. This clinical trial was registered with ISRCTN (ISRCTN39058880) and EudraCT (2009-012945-49).
AB - Mucosal (MM) and acral melanomas (AM) are rare melanoma subtypes of unmet clinical need; 15%-20% harbor KIT mutations potentially targeted by small-molecule inhibitors, but none yet approved in melanoma. This multicenter, single-arm Phase II trial (NICAM) investigates nilotinib safety and activity in KIT mutated metastatic MM and AM. KIT mutations are identified in 39/219 screened patients (18%); of 29/39 treated, 26 are evaluable for primary analysis. Six patients were alive and progression free at 6 months (local radiology review, 25%); 5/26 (19%) had objective response at 12 weeks; median OS was 7.7 months; ddPCR assay correctly identifies KIT alterations in circulating tumor DNA (ctDNA) in 16/17 patients. Nilotinib is active in KIT-mutant AM and MM, comparable to other KIT inhibitors, with demonstrable activity in nonhotspot KIT mutations, supporting broadening of KIT evaluation in AM and MM. Our results endorse further investigations of nilotinib for the treatment of KIT-mutated melanoma. This clinical trial was registered with ISRCTN (ISRCTN39058880) and EudraCT (2009-012945-49).
KW - KIT mutation
KW - acral
KW - liquid biopsy
KW - melanoma
KW - mucosal
KW - tyrosine kinase inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85187660035&partnerID=8YFLogxK
U2 - 10.1016/j.xcrm.2024.101435
DO - 10.1016/j.xcrm.2024.101435
M3 - Article
C2 - 38417447
SN - 2666-3791
VL - 5
JO - Cell reports. Medicine
JF - Cell reports. Medicine
IS - 3
M1 - 101435
ER -