- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03843853
Pemetrexed and S-1 in Combination With Bevacizumab in Refractory Colorectal Cancer
July 20, 2022 updated by: The First Affiliated Hospital with Nanjing Medical University
A Single Arm, Open Label, Exploratory Study of Pemetrexed and S-1 in Combination With Bevacizumab in Patients Who Have Progressed After Standard Second Line Therapy
Limited agents are optional after standard first and second line treatment for mCRC.
Only Regorafenib and Fruquintinib are approved in China.
PFS of these targeted drugs are not very long.
Pemetrexed has shown significant efficacy in advanced lung cancer regarding PFS and OS with controllable toxicity.
S-1 has been used in colorectal cancer with promising outcomes.
Bevacizumab is also an important monoclonal antibody which could make benefits in treated patients.
This study is aimed to explore the efficacy, safety in advanced colorectal cancer failed to standard therapy in Chinese population.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Study Type
Interventional
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Jiangsu
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Nanjing, Jiangsu, China, 210029
- The First Affiliated Hospital of Nanjing Medical University
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Histological or cytological documentation of adenocarcinoma of the colon or rectum. All other histological types are excluded.
- Subjects with metastatic colorectal cancer(CRC) (Stage IV).
- Subjects must have failed at least two lines of prior treatment, which must include a fluoropyrimidine, oxaliplatin and irinotecan.
- Subjects have failed or refused third-line treatment with regorafenib or fruquintinib.
- Subjects treated with oxaliplatin in an adjuvant setting should have progressed during or within 6 months of completion of adjuvant therapy.
- Subjects who have withdrawn from standard treatment due to unacceptable toxicity and precluding retreatment with the same agent prior to progression of disease will also be allowed.
- Prior treatment with bevacizumab and/or cetuximab will be allowed, but the use of bevacizumab should be no more than one single line treatment.
- Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria, version 1.1.is necessary.
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1.
- Life expectancy of at least 3 months.
- Adequate bone marrow, liver, cardiac and renal function as assessed by the laboratory required by protocol.
- Assigned informed consent.
Exclusion Criteria:
- Previous or concurrent cancer that is distinct in primary site or histology from colorectal cancer EXCEPT for curatively treated cervical cancer in situ, non-melanoma skin cancer and superficial bladder tumors [Ta (non-invasive tumor), Tis (carcinoma in situ) and T1 (tumor invades lamina propria)].
- Participants of other clinical trial within 4 weeks.
- Diseases which will impact the absorption of S-1, eg. dysphagia, chronic diarrhea, bowl obstruction
- Hemorrhage events of ≥grade 3 within 4 weeks.
- Known central nervous system metastasis.
- Uncontrolled hypertension. (Systolic blood pressure 140 mmHg or diastolic pressure 90 mmHg despite optimal medical management). Unstable angina,congestive heart failure,Myocardial infarction, Cardiac arrhythmias requiring anti-arrhythmic therapy.
- Urine protein ≥++ and 24h urine protein more than 1.0g.
- Chronically green wound or bone fracture.
- Arterial or venous thrombotic or embolic events.
- Tumor invading important blood vessel with high risk of severe hemorrhage.
- Current active bleeding or any surgery taken within 2 months.
- Abnormal coagulation function.
- Thromboemboli events within 6 months.
- Immune diseases or organ transplantation history.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Pemetrexed + S-1 + Bevacizumab
Pemetrexed 500 mg/m2 d1+ S-1 (20mg、25mg), capsule, 40~60mg, Bid,p.o,
d1~14 + Bevacizumab 7.5 mg/kg d1; Repeated every 3 weeks
|
Pemetrexed 500 mg/m2 d1
S-1 (20mg、25mg), capsule, 40~60mg, Bid,p.o,
d1~14
Bevacizumab 7.5 mg/kg d1
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression-free Survival(PFS)
Time Frame: From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
|
PFS was defined as the time from assignment to disease progression radiological/clinical or death due to any cause, whichever occurs first.
Subjects without progression or death at the time of analysis were censored at their last date of tumor evaluation.
|
From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall Survival (OS)
Time Frame: From assignment of the first subject until 40 death events observed, up to 2 years.
|
OS is defined as the time from date of assignment to death due to any cause.
Subjects still alive at the time of analysis were censored at their last date of last contact.
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From assignment of the first subject until 40 death events observed, up to 2 years.
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Disease control rate (DCR)
Time Frame: From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
|
DCR is defined as the percentage of subjects whose best response was not Progressive Disease (PD) according to Response Evaluation Criteria in Solid Tumors (RECIST) (= total number of Complete Response (CR) + total number of Partial Response (PR) + total number of Stable Disease (SD)
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From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
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Objective response rate(ORR)
Time Frame: From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
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The percentage of subjects with total number of Complete Response (CR) + total number of Partial Response (PR)
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From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
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Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
|
adverse events will be assessed according to CTCAE v4.0, including hematological and non-hematological adverse events.
Non-hematological adverse events will be collected by patients reported outcomes questionaire.
The adverse events of interest include hypertension,hand-foot syndrome,proteinuria,hoarseness,rash,etc.The dose reduction and drug discontinuance due to adverse events will also be recorded.
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From assignment of the first subject to 3 months later after the last participant is recruited.The last participant will be recruited before November 1,2021
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Wu XY, Huang XE, You SX, Lu YY, Cao J, Liu J. Phase II study of pemetrexed as second or third line combined chemotherapy in patients with colorectal cancer. Asian Pac J Cancer Prev. 2013;14(3):2019-22. doi: 10.7314/apjcp.2013.14.3.2019.
- Passardi A, Fanini F, Turci L, Foca F, Rosetti P, Ruscelli S, Casadei Gardini A, Valgiusti M, Dazzi C, Marangolo M. Prolonged Pemetrexed Infusion Plus Gemcitabine in Refractory Metastatic Colorectal Cancer: Preclinical Rationale and Phase II Study Results. Oncologist. 2017 Aug;22(8):886-e79. doi: 10.1634/theoncologist.2017-0206. Epub 2017 Jun 7.
- Lim SW, Lee S, Lee J, Park SH, Park JO, Park YS, Lim HY, Kang WK, Kim ST. Pemetrexed Monotherapy as Salvage Treatment in Patients with Metastatic Colorectal Cancer Refractory to Standard Chemotherapy: A Phase II Single-arm Prospective Trial. J Cancer. 2018 Jul 30;9(16):2910-2915. doi: 10.7150/jca.24948. eCollection 2018.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
May 1, 2019
Primary Completion (Anticipated)
November 1, 2021
Study Completion (Anticipated)
May 1, 2022
Study Registration Dates
First Submitted
February 14, 2019
First Submitted That Met QC Criteria
February 14, 2019
First Posted (Actual)
February 18, 2019
Study Record Updates
Last Update Posted (Actual)
July 25, 2022
Last Update Submitted That Met QC Criteria
July 20, 2022
Last Verified
July 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Colonic Diseases
- Intestinal Diseases
- Intestinal Neoplasms
- Rectal Diseases
- Colorectal Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Folic Acid Antagonists
- Bevacizumab
- Pemetrexed
Other Study ID Numbers
- KEEP-G 02
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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