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

7 mai 2015 mis à jour par: 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.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

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.

Type d'étude

Interventionnel

Inscription (Réel)

15

Phase

  • Phase 2

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

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

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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 d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: FOLFOXIRI+panitumumab regimen

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

  • Panitumumab
  • Oxaliplatin
  • Irinotecan
  • Leucovorin
  • 5-Fluorouracil
Médicament: Panitumumab
6 mg/kg, 60-90 minute IV infusion every 2 weeks
Autres noms:
  • Traitement à modalités combinées
Médicament: Oxaliplatin
85 mg/m2, 2-hour IV infusion every 2 weeks
Autres noms:
  • Traitement à modalités combinées
Médicament: Irinotecan
125 mg/m2, 1-hour IV infusion every 2 weeks
Autres noms:
  • Traitement à modalités combinées
Médicament: Leucovorin
200 mg/m2, 2-hour IV infusion every 2 weeks
Autres noms:
  • Traitement à modalités combinées
Médicament: 5-Fluorouracil
3200 mg/m2 IV, 48-hour continuous infusion every two weeks
Autres noms:
  • Traitement à modalités combinées

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Overall Response Rate (ORR)
Délai: 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

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Survie globale (OS)
Délai: 18 mois
La durée, en mois, pendant laquelle les patients étaient en vie depuis leur première date de traitement du protocole jusqu'à leur décès
18 mois
Progression-free Survival (PFS)
Délai: 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
Délai: 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.
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

SCRI Development Innovations, LLC

Collaborateurs

Amgen

Les enquêteurs

  • Chaise d'étude: Johanna Bendell, MD, SCRI Development Innovations, LLC

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 décembre 2010

Achèvement primaire (Réel)

1 mars 2014

Achèvement de l'étude (Réel)

1 mars 2014

Dates d'inscription aux études

Première soumission

15 octobre 2010

Première soumission répondant aux critères de contrôle qualité

20 octobre 2010

Première publication (Estimation)

22 octobre 2010

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

27 mai 2015

Dernière mise à jour soumise répondant aux critères de contrôle qualité

7 mai 2015

Dernière vérification

1 mai 2015

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • SCRI GI 134

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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