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Nilotinib in KIT-driven advanced melanoma: Results from the phase II single-arm NICAM trial.

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posted on 2024-03-21, 11:37 authored by James Larkin, Richard Marais, Nuria Porta, David Gonzalez de Castro, Lisa Parsons, Christina Messiou, Gordon Stamp, Lisa Thompson, Kim Edmonds, Sarah Sarker, Jane Banerji, Paul Lorigan, Thomas R Jeffry Evans, Pippa Corrie, Ernest Marshall, Mark R Middleton, Paul Nathan, Steve Nicholson, Christian Ottensmeier, Ruth Plummer, Judith Bliss, Sara Valpione, Samra Turajlic
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).


Crick (Grant ID: CC2044, Grant title: Turajlic CC2044) Cancer Research UK (Grant ID: 29911, Grant title: CRUK C50947/A29911)


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