E6201 and Dabrafenib for the Treatment of Central Nervous System Metastases From BRAF V600 Mutated Metastatic Melanoma

Inclusion Criteria

• •Age \>= 18 years
• •Histologically or cytologically confirmed stage IV metastatic BRAF V600-mutated melanoma
• •Documented metastasis of the primary tumor to the CNS
• •BRAF-mutation melanoma tumor status will be established prior to entry based on previous BRAF-gene analysis reports from a Clinical Laboratory Improvement Act (CLIA) qualified laboratory. If a report is not available, the mutation analysis will be performed at screening on archival tissue
• •At least one brain metastasis, as assessed by magnetic resonance imaging (MRI) or computed tomography (CT) with contrast =\< 3 weeks prior to registration and does not require immediate local intervention (surgery or radiosurgery)
• •Asymptomatic or symptomatic CNS metastasis
• •Systemic, measurable metastatic melanoma disease is allowed; leptomeningeal disease is allowed.
• •Prior stereotactic radiosurgery and/or excision of brain metastases is allowed \> 3 weeks before initiation of study treatment
• •Prior immunotherapy for adjuvant or metastatic disease is allowed provided there is documented progression of disease following treatment
• •Prior melanoma adjuvant BRAF/MEK inhibitor treatment is allowed if \>= 12 months has elapsed between the end of therapy and initiation of study treatment
• •Able to swallow and retain oral medication with no clinically significant gastrointestinal abnormalities that may alter absorption, such as malabsorption syndrome or major resection of the stomach or bowels
• •Stable dose of corticosteroids for CNS metastasis is allowed if \>= 7 days
• •Seizures due to CNS metastases must be controlled with stable anti-epileptic treatment for \>= 14 days
• •Bisphosphonates and/or denosumab are allowed
• •Life expectancy \>= 3 months
• •Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2
• •Hemoglobin (Hb) \>= 9 g/dL without ongoing transfusional support (obtained =\< 15 days prior to registration)
• •Absolute neutrophil count (ANC) \>= 1.0 x 10\^9 cells/L without ongoing transfusional support (obtained =\< 15 days prior to registration)
• •Platelets \>= 75 x 10\^9 cells/L without ongoing transfusional support (obtained =\< 15 days prior to registration)
• •Creatinine =\< 1.5 x the upper limit of normal (ULN), or calculated creatinine clearance \>= 50 mL/minute per the Cockcroft-Gault formula (obtained =\< 15 days prior to registration)
• •Total bilirubin =\< 2 times the upper limit of normal (ULN) unless due to Gilbert's disease (obtained =\< 15 days prior to registration)
• •Alanine aminotransferase (ALT)/aspartate aminotransferase (AST) =\< 2.5 times ULN, or \< 5 times ULN for subjects with liver metastases (obtained =\< 15 days prior to registration)
• •Negative serum pregnancy test done =\< 14 days prior to registration, for persons of childbearing potential only, defined as a female who has not undergone a hysterectomy or who has not been naturally post-menopausal for at least 24 consecutive months (i.e., who has had menses any time in the preceding 24 consecutive months)
• •Willing to use contraception
• •Sexually active persons of childbearing potential (PCBP) and persons able to father a child must agree to use adequate methods to avoid pregnancy throughout the study and for 28 days after the completion of study treatment
• •Provide written informed consent
• •Willing to return to enrolling institution for follow-up (during the Active Monitoring Phase of the study)
• •Ability to complete Patient Medication Diaries by themselves or with assistance
• •Willingness to have institution procure previous BRAF-gene analysis report(s) from a CLIA qualified laboratory, or if a report is not available, willingness to have institution procure archived tumor sample to establish BRAF-mutational melanoma tumor status prior to study
• •Ability to swallow