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FOLFOXIRI Plus Panitumumab Patients With Metastatic KRAS Wild-Type Colorectal Cancer With Liver Metastases Only

7 de mayo de 2015 actualizado por: SCRI Development Innovations, LLC

A Phase II Study of FOLFOXIRI Plus Panitumumab Followed by Evaluation for Resection, in Patients With Metastatic KRAS Wild-Type Colorectal Cancer With Liver Metastases Only

In this Phase II study the investigators plan to determine the overall response rate (ORR) of the combination of FOLFOXIRI plus panitumumab as first-line treatment of patients with liver-only metastatic KRAS wild-type colorectal cancer.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

Further data has emerged showing a consistent lack of efficacy using EGFR inhibitor panitumumab in combination with chemotherapy in the treatment of patients with KRAS mutant colorectal cancer. For patients with liver-only metastatic colorectal cancer, improvement in response rates with newer chemotherapy regimens has led to a larger percentage of patients eligible for surgical resection. Treatment with FOLFOXIRI improves response rates when compared to FOLFIRI. Similarly, the addition of an EGFR inhibitor improves the response rate of FOLFIRI in patients with wild-type KRAS. In this trial, we will attempt to maximize the response rate and the surgical resection rate by using FOLFOXIRI and panitumumab.

Tipo de estudio

Intervencionista

Inscripción (Actual)

15

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Estados Unidos
    • Arkansas
      • Jonesboro, Arkansas, Estados Unidos, 72401
        • NEA Baptist Clinic
    • Florida
      • Ft. Myers, Florida, Estados Unidos, 33916
        • Florida Cancer Specialists
      • Orlando, Florida, Estados Unidos, 32804
        • Florida Hospital Cancer Institute
      • St. Petersburg, Florida, Estados Unidos, 33705
        • Florida Cancer Specialists
    • Georgia
      • Gainesville, Georgia, Estados Unidos, 30501
        • Northeast Georgia Medical Center
    • Indiana
      • Terre Haute, Indiana, Estados Unidos, 47802
        • Providence Medical Group
      • Terre Haute, Indiana, Estados Unidos, 47802
        • Hope Cancer Center
    • Maryland
      • Bethesda, Maryland, Estados Unidos, 20817
        • Center for Cancer and Blood Disorders
    • New Hampshire
      • Portsmouth, New Hampshire, Estados Unidos, 03801
        • Portsmouth Regional Hospital
    • New Jersey
      • Morristown, New Jersey, Estados Unidos, 07960
        • Hematology-Oncology Associates of Northern NJ
    • Ohio
      • Cincinnati, Ohio, Estados Unidos, 45242
        • Oncology Hematology Care, Inc
    • Tennessee
      • Chattanooga, Tennessee, Estados Unidos, 37404
        • Chattanooga Oncology Hematology Associates
      • Collierville, Tennessee, Estados Unidos, 38017
        • Family Cancer Center
      • Nashville, Tennessee, Estados Unidos, 37203
        • Tennessee Oncology, PLLC
    • Texas
      • Fort Worth, Texas, Estados Unidos, 76104
        • The Center for Cancer and Blood Disorders

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  1. Patient must have a biopsy confirmed adenocarcinoma of the colon or rectum with stage IV (metastatic) liver-only disease, as defined by staging with CT scans.
  2. Patients must have a baseline evaluation to determine whether liver metastases are resectable (e.g. a single liver metastasis in a resectable location)or unresectable (surgical consultation is recommended). Both groups are eligible for this study.
  3. Tumor tissue must reveal wild-type KRAS expression (i.e. no KRAS mutation) prior to study entry (see Section 7.4.4.).
  4. Patients must have at least one unidimensional measurable lesion definable by CT scan. Disease must be measurable per RECIST version 1.1 criteria (see Section 9).
  5. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 (see Appendix A).

  6. Laboratory values as follows:

    ANC greater than 1500/μL

    Hgb greater than9 g/dL

    Platelets greater than 100,000/μL

    AST/SGOT less than 5.0 x ULN

    ALT/SGPT less than or equal to 5.0 x ULN

    Alk Phos less than or equal to 5.0 x ULN

    Bilirubin less than or equal to 1.5 x ULN

    Creatinine 1.5 mg/dL or calculated creatinine clearance 50 ml/min

    Magnesium LLN

  7. Patient must have a life expectancy of greater than 12 weeks.
  8. Patient must be greater than or equal to 18 years of age.
  9. Patient must be accessible for treatment and follow-up.
  10. Women of childbearing potential must have a negative serum or urine pregnancy test performed less than or equal to 7 days prior to start of treatment. Women of childbearing potential or men with partners of childbearing potential must use effective birth control measures during treatment and during the 6 months following completion of study treatment. If a woman becomes pregnant or suspects she is pregnant while participating in this study, she must agree to inform her treating physician immediately.
  11. Patient must be able to understand the nature of the study and give written informed consent prior to study entry.

Exclusion Criteria:

  1. Prior systemic therapy for metastatic colorectal cancer (including chemotherapy, bevacizumab, cetuximab, panitumumab, and other targeted agents).
  2. Adjuvant chemotherapy (and/or chemoradiation) for colorectal carcinoma ending less than or equal to 12 months prior to the diagnosis of metastatic cancer. Prior radiation therapy (in the metastatic setting) may be allowed if it was completed greater than or equal to 4 weeks prior to enrollment and measurable lesions are outside the radiation portal site.
  3. Any detectable metastases in areas other than the liver.
  4. Known liver disease or other significant medical illness that would exclude the patient as a candidate for resection of liver metastases.
  5. Patients requiring therapeutic coumadin or heparin (for a history of pulmonary emboli or deep vein thrombosis [DVT]) will be excluded.
  6. Patients who have had a major surgical procedure (not including mediastinoscopy), open biopsy, or significant traumatic injury less than or equal to 4 weeks prior to beginning treatment.
  7. History of Gilbert's disease.
  8. History of hypersensitivity to active or inactive excipients of any component of treatment (5 fluorouracil, irinotecan, panitumumab, and/or oxaliplatin), or known dipyrimidine dehydrogenase (DPD) deficiency
  9. Serious cardiac arrhythmia requiring medication.
  10. Concurrent severe, intercurrent illness including, but not limited to, ongoing or active infection, an infection requiring IV antibiotics, or psychiatric illness/social situations that would limit compliance with study requirements.
  11. Patient with known diagnosis of human immunodeficiency virus (HIV), hepatitis C virus or acute or chronic hepatitis B infection.
  12. Mental condition that would prevent patient comprehension of the nature of, and risk associated with, the study.
  13. Use of any non-approved or investigational agent less than or equal to 28 days prior to administration of the first dose of study drug.
  14. Past or current history of neoplasm other than the entry diagnosis with the exception of treated non melanoma skin cancer or carcinoma in situ of the cervix, or other cancers cured by local therapy alone and a DFS greater than or equal to 5 years.
  15. Patients with National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 (NCI CTCAE) Grade 2 peripheral neuropathy.
  16. Female patients who are pregnant or lactating.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: FOLFOXIRI+panitumumab regimen

All patients will receive the FOLFOXIRI/panitumumab regimen, with drugs administered in the following order:

  • Panitumumab
  • Oxaliplatin
  • Irinotecan
  • Leucovorin
  • 5-Fluorouracil
Droga: Panitumumab
6 mg/kg, 60-90 minute IV infusion every 2 weeks
Otros nombres:
  • Tratamiento Modalidad Combinada
Droga: Oxaliplatin
85 mg/m2, 2-hour IV infusion every 2 weeks
Otros nombres:
  • Tratamiento Modalidad Combinada
Droga: Irinotecan
125 mg/m2, 1-hour IV infusion every 2 weeks
Otros nombres:
  • Tratamiento Modalidad Combinada
Droga: Leucovorin
200 mg/m2, 2-hour IV infusion every 2 weeks
Otros nombres:
  • Tratamiento Modalidad Combinada
Droga: 5-Fluorouracil
3200 mg/m2 IV, 48-hour continuous infusion every two weeks
Otros nombres:
  • Tratamiento Modalidad Combinada

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Overall Response Rate (ORR)
Periodo de tiempo: 18 months
The Percentage of Patients Who Experience an Objective Benefit From Treatment. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI or CT: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
18 months

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Supervivencia general (SG)
Periodo de tiempo: 18 meses
La cantidad de tiempo, en meses, que los pacientes estuvieron vivos desde su primera fecha de tratamiento de protocolo hasta la muerte
18 meses
Progression-free Survival (PFS)
Periodo de tiempo: 18 months
The Length of Time, in Months, That Patients Were Alive From Their First Date of Protocol Treatment Until Worsening of Their Disease. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
18 months
R0 Resection Rate
Periodo de tiempo: 18 months
To determine the rate of complete (R0) resection for patients treated with this regimen.
18 months
To Determine the Acute Toxicity Produced by This Regimen.
Periodo de tiempo: 18 months
The analyses of safety will be based on the frequency of adverse events and their severity for patients who received at least one dose of study treatment.
18 months

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

SCRI Development Innovations, LLC

Colaboradores

Amgen

Investigadores

  • Silla de estudio: Johanna Bendell, MD, SCRI Development Innovations, LLC

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de diciembre de 2010

Finalización primaria (Actual)

1 de marzo de 2014

Finalización del estudio (Actual)

1 de marzo de 2014

Fechas de registro del estudio

Enviado por primera vez

15 de octubre de 2010

Primero enviado que cumplió con los criterios de control de calidad

20 de octubre de 2010

Publicado por primera vez (Estimar)

22 de octubre de 2010

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

27 de mayo de 2015

Última actualización enviada que cumplió con los criterios de control de calidad

7 de mayo de 2015

Última verificación

1 de mayo de 2015

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • SCRI GI 134

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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