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Brief Title: Testing the Addition of Nivolumab to Standard Treatment for Patients With Metastatic or Unresectable Colorectal Cancer That Have a BRAF Mutation
Official Title: Randomized Phase II Trial of Encorafenib and Cetuximab With or Without Nivolumab (NSC #748726) for Patients With Previously Treated, Microsatellite Stable, BRAFV600E Metastatic and/or Unresectable Colorectal Cancer
Study ID: NCT05308446
Brief Summary: This phase II trial tests whether adding nivolumab to the usual treatment (encorafenib and cetuximab) works better than the usual treatment alone to shrink tumors in patients with colorectal cancer that has spread to other places in the body (metastatic) or that cannot be removed by surgery (unresectable) and whose tumor has a mutation in a gene called BRAF. Encorafenib is in a class of medications called kinase inhibitors. It is used in patients whose cancer has a certain mutation (change) in the BRAF gene. It works by blocking the action of mutated BRAF that signals cancer cells to multiply. This helps to stop or slow the spread of cancer cells. Cetuximab is in a class of medications called monoclonal antibodies. It binds to a protein called EGFR, which is found on some types of cancer cells. This may help keep cancer cells from growing. Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving nivolumab in combination with encorafenib and cetuximab may be more effective than encorafenib and cetuximab alone at stopping tumor growth and spreading in patients with metastatic or unresectable BRAF-mutant colorectal cancer.
Detailed Description: PRIMARY OBJECTIVE: I. To compare progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 in patients with microsatellite stable (MSS), BRAF\^V600E metastatic and/or unresectable colorectal cancer (CRC) randomized to treatment with nivolumab + encorafenib + cetuximab compared to encorafenib + cetuximab. SECONDARY OBJECTIVES: I. To compare overall response rate (ORR), including confirmed and unconfirmed, complete and partial response, according to RECIST 1.1 criteria between the two arms. II. To compare overall survival (OS) between the two arms. III. To compare duration of response between the two arms. IV. To compare safety and tolerability between the two arms. V. To assess immune-related PFS using modified response criteria adapted for immunotherapy (irRC-PFS) in patients treated with nivolumab + encorafenib + cetuximab. BANKING OBJECTIVE: I. To bank tissue and blood specimens for future correlative studies. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive encorafenib orally (PO) once daily (QD) on days 1-28, cetuximab intravenously (IV) on days 1 and 15, and nivolumab IV on day 1. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive encorafenib PO QD on days 1-28 and cetuximab IV on days 1 and 15. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed until death or 3 years after registration, whichever occurs first.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
CTCA at Western Regional Medical Center, Goodyear, Arizona, United States
Mercy Cancer Center - Carmichael, Carmichael, California, United States
Mercy San Juan Medical Center, Carmichael, California, United States
Kaiser Permanente Dublin, Dublin, California, United States
Mercy Cancer Center - Elk Grove, Elk Grove, California, United States
Kaiser Permanente-Fremont, Fremont, California, United States
Kaiser Permanente-Fresno, Fresno, California, United States
Kaiser Permanente-Modesto, Modesto, California, United States
Kaiser Permanente-Oakland, Oakland, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center, Orange, California, United States
Mercy Cancer Center - Rocklin, Rocklin, California, United States
Kaiser Permanente-Roseville, Roseville, California, United States
Kaiser Permanente Downtown Commons, Sacramento, California, United States
Mercy Cancer Center - Sacramento, Sacramento, California, United States
Kaiser Permanente-South Sacramento, Sacramento, California, United States
Kaiser Permanente-San Francisco, San Francisco, California, United States
Kaiser Permanente-Santa Teresa-San Jose, San Jose, California, United States
Kaiser Permanente San Leandro, San Leandro, California, United States
Kaiser Permanente Medical Center - Santa Clara, Santa Clara, California, United States
Kaiser Permanente-Santa Rosa, Santa Rosa, California, United States
Kaiser Permanente-South San Francisco, South San Francisco, California, United States
Kaiser Permanente-Vallejo, Vallejo, California, United States
Kaiser Permanente-Walnut Creek, Walnut Creek, California, United States
Woodland Memorial Hospital, Woodland, California, United States
UCHealth University of Colorado Hospital, Aurora, Colorado, United States
Rocky Mountain Cancer Centers-Penrose, Colorado Springs, Colorado, United States
UCHealth Memorial Hospital Central, Colorado Springs, Colorado, United States
Memorial Hospital North, Colorado Springs, Colorado, United States
Poudre Valley Hospital, Fort Collins, Colorado, United States
Cancer Care and Hematology-Fort Collins, Fort Collins, Colorado, United States
UCHealth Greeley Hospital, Greeley, Colorado, United States
UCHealth Highlands Ranch Hospital, Highlands Ranch, Colorado, United States
Medical Center of the Rockies, Loveland, Colorado, United States
CTCA at Southeastern Regional Medical Center, Newnan, Georgia, United States
Kaiser Permanente Moanalua Medical Center, Honolulu, Hawaii, United States
Saint Alphonsus Cancer Care Center-Boise, Boise, Idaho, United States
Saint Luke's Cancer Institute - Boise, Boise, Idaho, United States
Saint Alphonsus Cancer Care Center-Caldwell, Caldwell, Idaho, United States
Kootenai Health - Coeur d'Alene, Coeur d'Alene, Idaho, United States
Saint Luke's Cancer Institute - Fruitland, Fruitland, Idaho, United States
Saint Luke's Cancer Institute - Meridian, Meridian, Idaho, United States
Saint Luke's Cancer Institute - Nampa, Nampa, Idaho, United States
Saint Alphonsus Cancer Care Center-Nampa, Nampa, Idaho, United States
Kootenai Clinic Cancer Services - Post Falls, Post Falls, Idaho, United States
Kootenai Cancer Clinic, Sandpoint, Idaho, United States
Saint Luke's Cancer Institute - Twin Falls, Twin Falls, Idaho, United States
Rush - Copley Medical Center, Aurora, Illinois, United States
Advocate Good Shepherd Hospital, Barrington, Illinois, United States
Illinois CancerCare-Bloomington, Bloomington, Illinois, United States
Illinois CancerCare-Canton, Canton, Illinois, United States
Illinois CancerCare-Carthage, Carthage, Illinois, United States
Centralia Oncology Clinic, Centralia, Illinois, United States
University of Illinois, Chicago, Illinois, United States
Advocate Illinois Masonic Medical Center, Chicago, Illinois, United States
AMG Crystal Lake - Oncology, Crystal Lake, Illinois, United States
Carle at The Riverfront, Danville, Illinois, United States
Cancer Care Specialists of Illinois - Decatur, Decatur, Illinois, United States
Decatur Memorial Hospital, Decatur, Illinois, United States
Illinois CancerCare-Dixon, Dixon, Illinois, United States
Advocate Good Samaritan Hospital, Downers Grove, Illinois, United States
Carle Physician Group-Effingham, Effingham, Illinois, United States
Crossroads Cancer Center, Effingham, Illinois, United States
Advocate Sherman Hospital, Elgin, Illinois, United States
Illinois CancerCare-Eureka, Eureka, Illinois, United States
Illinois CancerCare-Galesburg, Galesburg, Illinois, United States
Advocate South Suburban Hospital, Hazel Crest, Illinois, United States
Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois, United States
AMG Libertyville - Oncology, Libertyville, Illinois, United States
Condell Memorial Hospital, Libertyville, Illinois, United States
Illinois CancerCare-Macomb, Macomb, Illinois, United States
Carle Physician Group-Mattoon/Charleston, Mattoon, Illinois, United States
Cancer Care Center of O'Fallon, O'Fallon, Illinois, United States
Advocate Christ Medical Center, Oak Lawn, Illinois, United States
Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois, United States
Advocate Lutheran General Hospital, Park Ridge, Illinois, United States
Illinois CancerCare-Pekin, Pekin, Illinois, United States
Illinois CancerCare-Peoria, Peoria, Illinois, United States
Illinois CancerCare-Peru, Peru, Illinois, United States
Illinois CancerCare-Princeton, Princeton, Illinois, United States
Southern Illinois University School of Medicine, Springfield, Illinois, United States
Springfield Clinic, Springfield, Illinois, United States
Memorial Medical Center, Springfield, Illinois, United States
Carle Cancer Center, Urbana, Illinois, United States
Illinois CancerCare - Washington, Washington, Illinois, United States
Rush-Copley Healthcare Center, Yorkville, Illinois, United States
Northwest Cancer Center - Main Campus, Crown Point, Indiana, United States
Northwest Oncology LLC, Dyer, Indiana, United States
Northwest Cancer Center - Hobart, Hobart, Indiana, United States
Saint Mary Medical Center, Hobart, Indiana, United States
Franciscan Health Indianapolis, Indianapolis, Indiana, United States
Saint Catherine Hospital, Indianapolis, Indiana, United States
Franciscan Saint Elizabeth Health - Lafayette East, Lafayette, Indiana, United States
Woodland Cancer Care Center, Michigan City, Indiana, United States
Franciscan Health Mooresville, Mooresville, Indiana, United States
The Community Hospital, Munster, Indiana, United States
Women's Diagnostic Center - Munster, Munster, Indiana, United States
Northwest Cancer Center - Valparaiso, Valparaiso, Indiana, United States
Mary Greeley Medical Center, Ames, Iowa, United States
McFarland Clinic - Ames, Ames, Iowa, United States
McFarland Clinic - Boone, Boone, Iowa, United States
Mercy Medical Center - Des Moines, Des Moines, Iowa, United States
McFarland Clinic - Trinity Cancer Center, Fort Dodge, Iowa, United States
McFarland Clinic - Jefferson, Jefferson, Iowa, United States
McFarland Clinic - Marshalltown, Marshalltown, Iowa, United States
LSU Health Baton Rouge-North Clinic, Baton Rouge, Louisiana, United States
Our Lady of the Lake Physician Group, Baton Rouge, Louisiana, United States
Ochsner Hematology Oncology North Shore - Covington (West Region), Covington, Louisiana, United States
Ochsner Medical Center Jefferson, New Orleans, Louisiana, United States
Trinity Health Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor, Michigan, United States
Bronson Battle Creek, Battle Creek, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - Brighton, Brighton, Michigan, United States
Trinity Health Medical Center - Brighton, Brighton, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - Canton, Canton, Michigan, United States
Trinity Health Medical Center - Canton, Canton, Michigan, United States
Saint Joseph Mercy Chelsea, Chelsea, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital, Chelsea, Michigan, United States
Henry Ford Hospital, Detroit, Michigan, United States
Ascension Saint John Hospital, Detroit, Michigan, United States
Great Lakes Cancer Management Specialists-Doctors Park, East China Township, Michigan, United States
Genesee Cancer and Blood Disease Treatment Center, Flint, Michigan, United States
Genesee Hematology Oncology PC, Flint, Michigan, United States
Genesys Hurley Cancer Institute, Flint, Michigan, United States
Hurley Medical Center, Flint, Michigan, United States
Corewell Health Grand Rapids Hospitals - Butterworth Hospital, Grand Rapids, Michigan, United States
Trinity Health Grand Rapids Hospital, Grand Rapids, Michigan, United States
Academic Hematology Oncology Specialists, Grosse Pointe Woods, Michigan, United States
Great Lakes Cancer Management Specialists-Van Elslander Cancer Center, Grosse Pointe Woods, Michigan, United States
Bronson Methodist Hospital, Kalamazoo, Michigan, United States
West Michigan Cancer Center, Kalamazoo, Michigan, United States
Ascension Borgess Cancer Center, Kalamazoo, Michigan, United States
University of Michigan Health - Sparrow Lansing, Lansing, Michigan, United States
Trinity Health Saint Mary Mercy Livonia Hospital, Livonia, Michigan, United States
Great Lakes Cancer Management Specialists-Macomb Medical Campus, Macomb, Michigan, United States
Trinity Health Muskegon Hospital, Muskegon, Michigan, United States
Cancer and Hematology Centers of Western Michigan - Norton Shores, Norton Shores, Michigan, United States
Ascension Providence Hospitals - Novi, Novi, Michigan, United States
Corewell Health Reed City Hospital, Reed City, Michigan, United States
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center, Saint Joseph, Michigan, United States
Ascension Providence Hospitals - Southfield, Southfield, Michigan, United States
Bhadresh Nayak MD PC-Sterling Heights, Sterling Heights, Michigan, United States
Munson Medical Center, Traverse City, Michigan, United States
Great Lakes Cancer Management Specialists-Macomb Professional Building, Warren, Michigan, United States
Macomb Hematology Oncology PC, Warren, Michigan, United States
Saint John Macomb-Oakland Hospital, Warren, Michigan, United States
University of Michigan Health - West, Wyoming, Michigan, United States
Huron Gastroenterology PC, Ypsilanti, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus, Ypsilanti, Michigan, United States
Mercy Hospital, Coon Rapids, Minnesota, United States
Essentia Health - Deer River Clinic, Deer River, Minnesota, United States
Essentia Health Cancer Center, Duluth, Minnesota, United States
Fairview Southdale Hospital, Edina, Minnesota, United States
Essentia Health Hibbing Clinic, Hibbing, Minnesota, United States
Abbott-Northwestern Hospital, Minneapolis, Minnesota, United States
North Memorial Medical Health Center, Robbinsdale, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park, Saint Louis Park, Minnesota, United States
Regions Hospital, Saint Paul, Minnesota, United States
United Hospital, Saint Paul, Minnesota, United States
Essentia Health Sandstone, Sandstone, Minnesota, United States
Essentia Health Virginia Clinic, Virginia, Minnesota, United States
Saint Francis Medical Center, Cape Girardeau, Missouri, United States
Community Hospital of Anaconda, Anaconda, Montana, United States
Billings Clinic Cancer Center, Billings, Montana, United States
Bozeman Health Deaconess Hospital, Bozeman, Montana, United States
Benefis Sletten Cancer Institute, Great Falls, Montana, United States
Kalispell Regional Medical Center, Kalispell, Montana, United States
Community Medical Center, Missoula, Montana, United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center, Lebanon, New Hampshire, United States
Hunterdon Medical Center, Flemington, New Jersey, United States
Roswell Park Cancer Institute, Buffalo, New York, United States
Southeastern Medical Oncology Center-Clinton, Clinton, North Carolina, United States
Southeastern Medical Oncology Center-Goldsboro, Goldsboro, North Carolina, United States
Southeastern Medical Oncology Center-Jacksonville, Jacksonville, North Carolina, United States
FirstHealth of the Carolinas-Moore Regional Hospital, Pinehurst, North Carolina, United States
Strecker Cancer Center-Belpre, Belpre, Ohio, United States
Miami Valley Hospital South, Centerville, Ohio, United States
Adena Regional Medical Center, Chillicothe, Ohio, United States
Mount Carmel East Hospital, Columbus, Ohio, United States
Columbus Oncology and Hematology Associates Inc, Columbus, Ohio, United States
Riverside Methodist Hospital, Columbus, Ohio, United States
Grant Medical Center, Columbus, Ohio, United States
The Mark H Zangmeister Center, Columbus, Ohio, United States
Doctors Hospital, Columbus, Ohio, United States
Miami Valley Hospital, Dayton, Ohio, United States
Premier Blood and Cancer Center, Dayton, Ohio, United States
Dayton Physician LLC - Englewood, Dayton, Ohio, United States
Miami Valley Hospital North, Dayton, Ohio, United States
Delaware Health Center-Grady Cancer Center, Delaware, Ohio, United States
Grady Memorial Hospital, Delaware, Ohio, United States
Columbus Oncology and Hematology Associates, Dublin, Ohio, United States
Atrium Medical Center-Middletown Regional Hospital, Franklin, Ohio, United States
Dayton Physicians LLC-Atrium, Franklin, Ohio, United States
Miami Valley Cancer Care and Infusion, Greenville, Ohio, United States
Mount Carmel Grove City Hospital, Grove City, Ohio, United States
Kettering Medical Center, Kettering, Ohio, United States
Fairfield Medical Center, Lancaster, Ohio, United States
OhioHealth Mansfield Hospital, Mansfield, Ohio, United States
OhioHealth Marion General Hospital, Marion, Ohio, United States
Memorial Hospital, Marysville, Ohio, United States
Knox Community Hospital, Mount Vernon, Ohio, United States
Licking Memorial Hospital, Newark, Ohio, United States
Southern Ohio Medical Center, Portsmouth, Ohio, United States
Springfield Regional Cancer Center, Springfield, Ohio, United States
Springfield Regional Medical Center, Springfield, Ohio, United States
Toledo Clinic Cancer Centers-Toledo, Toledo, Ohio, United States
Upper Valley Medical Center, Troy, Ohio, United States
Saint Ann's Hospital, Westerville, Ohio, United States
Genesis Healthcare System Cancer Care Center, Zanesville, Ohio, United States
Cancer Centers of Southwest Oklahoma Research, Lawton, Oklahoma, United States
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
Mercy Hospital Oklahoma City, Oklahoma City, Oklahoma, United States
Clackamas Radiation Oncology Center, Clackamas, Oregon, United States
Providence Cancer Institute Clackamas Clinic, Clackamas, Oregon, United States
Providence Newberg Medical Center, Newberg, Oregon, United States
Saint Alphonsus Medical Center-Ontario, Ontario, Oregon, United States
Providence Willamette Falls Medical Center, Oregon City, Oregon, United States
Providence Portland Medical Center, Portland, Oregon, United States
Providence Saint Vincent Medical Center, Portland, Oregon, United States
Lehigh Valley Hospital-Cedar Crest, Allentown, Pennsylvania, United States
Lehigh Valley Hospital - Muhlenberg, Bethlehem, Pennsylvania, United States
University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania, United States
Reading Hospital, West Reading, Pennsylvania, United States
Rhode Island Hospital, Providence, Rhode Island, United States
Prisma Health Cancer Institute - Spartanburg, Boiling Springs, South Carolina, United States
Medical University of South Carolina, Charleston, South Carolina, United States
Prisma Health Cancer Institute - Easley, Easley, South Carolina, United States
Prisma Health Cancer Institute - Butternut, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Faris, Greenville, South Carolina, United States
Prisma Health Greenville Memorial Hospital, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Eastside, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Greer, Greer, South Carolina, United States
Prisma Health Cancer Institute - Seneca, Seneca, South Carolina, United States
Vanderbilt University/Ingram Cancer Center, Nashville, Tennessee, United States
The Don and Sybil Harrington Cancer Center, Amarillo, Texas, United States
UT Southwestern Simmons Cancer Center - RedBird, Dallas, Texas, United States
UT Southwestern/Simmons Cancer Center-Dallas, Dallas, Texas, United States
UT Southwestern/Simmons Cancer Center-Fort Worth, Fort Worth, Texas, United States
M D Anderson Cancer Center, Houston, Texas, United States
UT Southwestern Clinical Center at Richardson/Plano, Richardson, Texas, United States
Huntsman Cancer Institute/University of Utah, Salt Lake City, Utah, United States
Dartmouth Cancer Center - North, Saint Johnsbury, Vermont, United States
Swedish Cancer Institute-Issaquah, Issaquah, Washington, United States
Swedish Medical Center-First Hill, Seattle, Washington, United States
United Hospital Center, Bridgeport, West Virginia, United States
West Virginia University Healthcare, Morgantown, West Virginia, United States
ThedaCare Regional Cancer Center, Appleton, Wisconsin, United States
Duluth Clinic Ashland, Ashland, Wisconsin, United States
Aurora Cancer Care-Southern Lakes VLCC, Burlington, Wisconsin, United States
Aurora Saint Luke's South Shore, Cudahy, Wisconsin, United States
Marshfield Medical Center-EC Cancer Center, Eau Claire, Wisconsin, United States
Aurora Health Care Germantown Health Center, Germantown, Wisconsin, United States
Aurora BayCare Medical Center, Green Bay, Wisconsin, United States
Aurora Cancer Care-Kenosha South, Kenosha, Wisconsin, United States
Aurora Bay Area Medical Group-Marinette, Marinette, Wisconsin, United States
Marshfield Medical Center-Marshfield, Marshfield, Wisconsin, United States
Aurora Cancer Care-Milwaukee, Milwaukee, Wisconsin, United States
Marshfield Clinic-Minocqua Center, Minocqua, Wisconsin, United States
ProHealth D N Greenwald Center, Mukwonago, Wisconsin, United States
Cancer Center of Western Wisconsin, New Richmond, Wisconsin, United States
ProHealth Oconomowoc Memorial Hospital, Oconomowoc, Wisconsin, United States
Vince Lombardi Cancer Clinic - Oshkosh, Oshkosh, Wisconsin, United States
Aurora Cancer Care-Racine, Racine, Wisconsin, United States
Marshfield Medical Center-Rice Lake, Rice Lake, Wisconsin, United States
Vince Lombardi Cancer Clinic-Sheboygan, Sheboygan, Wisconsin, United States
Marshfield Medical Center-River Region at Stevens Point, Stevens Point, Wisconsin, United States
Vince Lombardi Cancer Clinic-Two Rivers, Two Rivers, Wisconsin, United States
UW Cancer Center at ProHealth Care, Waukesha, Wisconsin, United States
Marshfield Medical Center - Weston, Weston, Wisconsin, United States
Centro Comprensivo de Cancer de UPR, San Juan, , Puerto Rico
PROncology, San Juan, , Puerto Rico
San Juan City Hospital, San Juan, , Puerto Rico
Name: Van K Morris
Affiliation: SWOG Cancer Research Network
Role: PRINCIPAL_INVESTIGATOR