A Phase I/II, multi-center, open label study of DYP688 in patients with metastatic uveal melanoma (MUM) and other GNAQ/11 mutant melanomas

This is a FIH, phase I/II, open label, multi-center study of DYP688 as a single agent. The
purpose of this study is to characterize the safety, tolerability, and anti-tumor activity of
DYP688 as a single agent in patients with metastatic uveal melanoma (MUM) and other melanomas
harboring GNAQ/11 mutations.

Inclusion Criteria:

- Patients in the dose escalation part must be ≥ 18 years of age at the time of informed
consent (ICF) signature. In the phase II part, patients ≥ 12 years of age at the time
of informed consent may be eligible for enrollment (not applicable in countries where
enrollment is restricted by the local health authority to patients ≥ 18 years of age).
Patients must have a minimum weight of 40 kg.

- ECOG performance status ≤ 1 for patients ≥ 18 years of age; Karnofsky performance
status ≥ 70 for patients ≥ 16 and < 18 years of age; Lansky performance status ≥ 70
for patients ≥ 12 and < 16 years of age

- Patients must be suitable and willing to undergo study required biopsies according to
the treating institution's own guidelines and requirements. If a biopsy is not
medically feasible, exceptions may be considered after documented discussion with
Novartis.

For all patients in Dose Escalation

- MUM: uveal melanoma with histologically or cytologically confirmed metastatic disease.
Patient must be either treatment naive or have received any number of prior lines and
progressed on most recent therapy

- Non-MUM: advanced cutaneous or mucosal melanoma with histologically or cytologically
confirmed metastatic disease that has progressed following all standard therapies or
that has no satisfactory alternative therapies and has evidence of GNAQ/11 mutation
based on local data

For patients in Phase II

- Tebentafusp naïve group: Diagnosis of uveal melanoma with histologically or
cytologically confirmed metastatic disease that has progressed following standard
therapies or that has no satisfactory alternative therapies

- Tebentafusp pre-treated group: Diagnosis of uveal melanoma with histologically or
cytologically confirmed metastatic disease. Patients must be previously treated with
tebentafusp and have progressed

- Non-MUM: patients with diagnosis of cutaneous or mucosal melanomas harboring GNAQ/11
mutations based on local data, with histologically or cytologically confirmed
metastatic disease that has progressed following all standard therapies or that has no
satisfactory alternative therapies

Exclusion Criteria:

- Malignant disease, other than that being treated in this study.

- Active brain metastases, i.e. symptomatic brain metastases or known leptomeningeal
disease.

- Evidence of active bleeding or bleeding diathesis or significant coagulopathy
(including familial) or a medical condition requiring long term systemic
anticoagulation that would interfere with biopsies.

- History of anaphylactic or other severe hypersensitivity / infusion reactions to ADCs
or monoclonal antibodies, which in the opinion of the investigator may pose an
increased risk of serious infusion reaction.

- Treatment with any of the following anti-cancer therapies prior to the first dose of
study treatment within the stated timeframes:

- 2 weeks for fluoropyrimidine therapy

- 4 weeks for radiation therapy or limited field radiation for palliation within ≤
2 weeks prior to the first dose of study treatment.

- 4 weeks or ≤ 5 half-lives (whichever is shorter) for chemotherapy or biological
therapy (including monoclonal antibodies) or continuous or intermittent small
molecule therapeutics or any other investigational agent.

- 6 weeks for cytotoxic agents with major delayed toxicities, such as nitrosoureas
and mitomycin C.

- 4 weeks for immuno-oncologic therapy, such as CTLA-4, PD-1, or PD-L1 antagonists.

- Clinically significant and / or uncontrolled heart disease such as congestive heart
failure requiring treatment (NYHA grade ≥ 2) or clinically significant arrhythmia
despite medical treatment.

Other protocol-defined inclusion/exclusion criteria may apply.