Adjuvant Encorafenib and Binimetinib in High-risk Stage II Melanoma With a BRAF Mutation.

Inclusion Criteria:

Pre-Screening

1. Male or female ≥ 18 years of age;
2. Surgically resected, with tumour free margins, and histologically/pathologically confirmed new diagnosis of stage II (pT3b-pT4bN0) cutaneous melanomaa;
3. Sentinel node (SN) biopsy within 14 weeks from initial diagnosis of melanoma.
4. Sentinel node (SN) staged node negative (pN0);
5. Available tumour sample for central determination of the BRAF V600E/K mutation.

Screening

1. Melanoma confirmed centrally to be BRAF V600E/K mutation-positive;
2. Participant still free of disease as evidenced by the required baseline imaging and physical/dermatological assessments performed respectively within 6 weeks and 2 weeks before randomization (Day 1);
3. No more than 12 weeks elapsed between full surgical resection (including SLNB) and randomization;
4. Recovered from definitive surgery (e.g., complete wound healing, no uncontrolled wound infections or indwelling drains);
5. ECOG performance status of 0 or 1;

Adequate haematological function as defined as Absolute neutrophil count (ANC) ≥ 1.5 x 109/L, Platelets ≥ 100 x 109/L and Hemoglobin

≥ 9.0 g/dL;

1. Adequate renal function as defined as Serum creatinine ≤ 1.5 × ULN; or calculated creatinine clearance ≥ 50 mL/min;
2. Adequate electrolytes, defined as serum potassium and magnesium levels within institutional normal limits;
3. Adequate hepatic function as defined as Serum total bilirubin ≤ 1.5 x ULN and < 2 mg/dL, Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤ 2.5 x ULN;
4. Adequate cardiac function as defined as LVEF ≥ 50% as determined by MUGA scan or echocardiogram and Mean triplicate QTcF value ≤ 480 msec and no history of QT syndrome;
5. Adequate coagulation function, defined as INR ≤1.5× ULN unless the patient is receiving anticoagulant therapy as long as PT or aPTT is within the therapeutic range;
6. Negative serum β-HCG test (female patient of childbearing potential only) performed within 3 days prior to Day 1;
7. Female patients of child-bearing potential and male patients must agree to follow the protocol's contraception guidance during the treatment period and for ≥30 days after last administration.

Exclusion Criteria:

Pre-screening

1. Unknown ulceration status;
2. Uveal and mucosal melanoma;
3. Clinically apparent metastases (N+/M1);
4. Microsatellites, satellites and/or in-transit metastases,
5. Local (scar) recurrences.

Screening

1. Breast feeding women;
2. Pregnant women;
3. History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO;
4. History of thromboembolic or cerebrovascular events ≤ 12 weeks prior to randomization;
5. History of previous or concurrent malignancy within preceding 3 years or any condition with a life expectancy of less than 5 years;
6. Participants with a prior cancer associated with RAS mutation;
7. Prior systemic anticancer therapy for melanoma or radiotherapy for melanoma;
8. Hypersensitivity to the study drugs or to any of the excipients;
9. Participants with severe lactose intolerance (e.g., Rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption);
10. Impaired cardiovascular function or clinically significant cardiovascular diseases;
11. Neuromuscular disorders that are associated with CK > ULN (e.g., inflammatory myopathies, muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy);
12. Non-infectious pneumonitis and Interstitial Lung Disease;
13. Positive SARs-CoV-2 or variants of SARs-CoV2 RT-PCR test at screening or suspected to be infected with SARs-CoV2 or variants of SARsCoV2 with confirmation pending;
14. Active bacterial, fungal, or viral infection, including, but not limited to HBV, HCV, and known HIV or AIDS-related illness, or an infection requiring systemic therapeutic treatment within 2 weeks prior to randomization.