A Phase II Study to Evaluate the Use of the MEK Inhibitor Mirdametinib to Reduce the Size of Large/Giant Congenital Melanocytic Nevi in Children, Adolescents and Young Adults

Summary

Background: Large and giant congenital melanocytic nevi (LGCMN) are dark birthmarks (moles). They can grow to 8 inches or more across. People with LGCMN have an increased risk of getting skin cancer or problems with the nervous system. Researchers want to find out if a drug approved for a different use (mirdametinib) can shrink the size of LGCMN. Objective: To test mirdametinib in people with LGCMN. Eligibility: People aged 3 to 40 years with LGCMN. Design: Participants will be screened. Their LGCMN sites will be measured and photographed. They will have blood tests, an eye exam, and tests of their heart function. They will also have: * An exam of their nervous system: Their muscle strength, ability to feel and touch, balance, alertness, and other skills will be tested. * Magnetic resonance imaging (MRI) scan: They will lie on a bed that slides into a tube; the scan will use large magnets to create images of their brain and spinal cord. * Skin biopsy: A small sample of their skin may be taken. * VECTRA scan: This is a 3-dimensional imaging system that takes pictures of all of the skin all at once. Mirdametinib will be either pills or capsules that are taken by mouth. Participants will take the drug in 4-week cycles. They will take the pills 2 times a day for 3 weeks with 1 week off. Participants may continue taking the drug for 2 years. They will have clinic visits 12 times while taking the drug. Imaging scans and other tests will be repeated. Participants will continue to have checkups every 6 months for 3 more years.

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