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Evaluating Panitumumab (ABX-EGF) in Patients With Metastatic Colorectal Cancer

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Irinotecan
Panitumumab
5-Fluorouracil
Leucovorin
Sponsored by
Amgen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring Immunex, Panitumumab, ABX-EGF, Abgenix

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Able to comprehend and sign an Institutional Review Board (IRB)-approved informed consent form Pathologic diagnosis of colorectal cancer - Metastatic colorectal adenocarcinoma If history of adjuvant chemotherapy for colorectal cancer, must have been free of disease for greater than or equal to 1 year after completion of adjuvant chemotherapy Unidimensionally measurable disease Paraffin-embedded tumor tissue available for immunohistochemistry studies of epidermal growth factor receptor (EGFr) expression (archived tissue is acceptable) Tumor over-expressing EGFr by immunohistochemistry (staining must be the sum of 1+, 2+ and 3+ in greater than or equal to 10% of evaluated tumor cells; staining and evaluation to be conducted at a central laboratory) Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1 Adequate hematologic, renal, and hepatic function Exclusion Criteria: Female (of childbearing potential, post-menopausal for less than 6 months, not surgically sterilized, or not abstinent) not consenting to use adequate contraceptive precautions during the course of the study and for 6 months after the last ABX-EGF infusion Female who is breast-feeding or pregnant Any kind of disorder that compromises the ability of the patient to give written informed consent and/or comply with the study procedures History of any chronic medical or psychiatric condition or laboratory abnormality that, in the opinion of the investigator, may increase the risks associated with study participation or study drug administration or may interfere with compliance or the interpretation of study results Untreated brain metastases Therapy for colorectal cancer other than surgery and 5-FU-based adjuvant therapy Prior treatment for metastatic colorectal cancer Prior irinotecan Prior or concurrent radiation therapy for colorectal cancer, including prior adjuvant radiation therapy to the pelvis Known allergy to irinotecan, 5-fluorouracil, or leucovorin Known Gilbert's disease Known dihydropyrimidine dehydrogenase (DPD) deficiency Prior EGFr-targeting agents Use of investigational therapy used with adjuvant intent within 30 days before the first ABX-EGF infusion If prior history of cancer other than colorectal carcinoma, basal cell carcinoma, or cervical carcinoma in situ, no treatment or active disease within 5 years Active inflammatory bowel disease or other bowel disease (other than colorectal carcinoma) causing chronic diarrhea (defined as greater than 4 stools per day) Partial or complete bowel obstruction, known chronic malabsorption, total colectomy, or other major abdominal surgery that might result in substantial alteration in transit to absorption of oral medication Ascites or pleural effusion requiring therapeutic paracentesis or thoracentesis; subject with small, stable, asymptomatic pleural effusions or ascites may be enrolled; subject who has been rendered asymptomatic by successful sclerosis of an effusion may be enrolled. Active interstitial pneumonia or interstitial fibrosis Left ventricular ejection fraction (LVEF) less than 45%, as measured by multiple-gated acquisition (MUGA) scan - Myocardial infarction within 1 year before the first ABX-EGF infusion Any of the following within 6 months before the first study drug dose: Unstable angina; Symptomatic congestive heart failure; Serious uncontrolled cardiac arrhythmia; Cerebrovascular accident or transient ischemic attack; Pulmonary embolism; Deep vein thrombosis; Other significant thromboembolic event. Subject known to be human immunodeficiency virus (HIV) positive History of any chronic medical or psychiatric condition or laboratory abnormality that, in the opinion of the Investigator, may increase the risks associated with study participation or study drug administration or may interfere with patient compliance or the interpretation of study results Unwilling or unable to comply with study requirements Known allergy to the ingredients of the study drug or to Staphylococcus protein A

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Part 1: Panitumumab + IFL

    Part 2: Panitumumab + FOLFIRI

    Arm Description

    Panitumumab (2.5 mg/kg once weekly for up to 48 weeks or until disease progression, intolerable adverse event or other reason for discontinuation) in combination with irinotecan, 5-fluorouracil (5-FU)and leucovorin (IFL chemotherapy regimen)

    Panitumumab (2.5 mg/kg once weekly until disease progression, intolerable adverse event or other reason for discontinuation) in combination with irinotecan/5-FU/leucovorin chemotherapy (the FOLFIRI regimen)

    Outcomes

    Primary Outcome Measures

    Number of Participants With Grade 3 or Grade 4 Diarrhea (Part 2)
    The number of participants with grade 3 or grade 4 diarrhea in Part 2 of the study. Grading of diarrhea followed the grading scale in Version 2.0 of the National Cancer Institute Common Toxicity Criteria (NCI CTC).
    Number of Participants With Grade 3 or Grade 4 Diarrhea (Part 1)
    The number of participants with grade 3 or grade 4 diarrhea in Part 1 of the study. Grading of diarrhea followed the grading scale in Version 2.0 of the National Cancer Institute Common Toxicity Criteria (NCI CTC).

    Secondary Outcome Measures

    Number of Participants With an Objective Tumor Response (Part 2)
    Objective tumor response (complete or partial) in Part 2 of the study, based on Response Evaluation Criteria in Solid Tumors (RECIST), where complete response = disappearance of all target lesions, partial response = ≥30% reduction in lesion size, progressive disease = ≥20% increase in tumor size; otherwise stable disease.
    Time to Disease Progression (Part 2)
    Kaplan-Meier estimate of median time from the first dose of study drug to first observed disease progression or death if the death was due to disease progression (whichever comes first) in Part 2 of the study. Participants who had not progressed or died for reasons other than disease progression were censored at their last disease assessment date.
    Progression-free Survival Time (Part 2)
    Kaplan-Meier estimate of median time from enrollment to death or disease progression in Part 2 of the study. Participants who had not progressed and had not died were censored at their last disease assessment date.
    Survival Time (Part 2)
    Kaplan-Meier estimate of the median time from enrollment to death from any cause. Participants who did not die on study were censored at their last contact date.
    Number of Participants Who Died (Part 2)
    The number of participants in Part 2 who died during the study.
    Number of Participants With Objective Tumor Response (Part 1)
    Objective tumor response (complete or partial) in Part 1 of the study, based on Response Evaluation Criteria in Solid Tumors (RECIST), where complete response = disappearance of all target lesions, partial response = ≥30% reduction in lesion size, progressive disease = ≥20% increase in tumor size; otherwise stable disease.
    Progression-free Survival Time (Part 1)
    Kaplan-Meier estimate of median time from enrollment to death or disease progression in Part 1 of the study. Participants who had not progressed and had not died were censored at their last disease assessment date.
    Time to Disease Progression (Part 1)
    Kaplan-Meier estimate of the median time from the first dose of study drug to disease progression or death if due to disease progression (whichever comes first) in Part 1 of the study. Participants who had not progressed or died for reasons other than disease progression were censored at their last disease assessment date.
    Survival Time (Part 1)
    Kaplan-Meier estimate of the median time from enrollment to death from any cause. Participants who did not die on study were censored at their last contact date.
    Time to Treatment Failure (Part 1)
    Kaplan-Meier estimate of the median time from the date of first dose of panitumumab or chemotherapy to the date the decision was made to end treatment for any reason in Part 1 of the study.
    Time to Initial Objective Tumor Response (Part 1)
    Median time to first observed objective tumor response (complete or partial) among responders in Part 1 of the study.

    Full Information

    First Posted
    May 25, 2005
    Last Updated
    November 15, 2013
    Sponsor
    Amgen
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00111761
    Brief Title
    Evaluating Panitumumab (ABX-EGF) in Patients With Metastatic Colorectal Cancer
    Official Title
    A Clinical Trial of the Safety and Efficacy of ABX-EGF in Combination With Irinotecan, Leucovorin, and 5-Fluorouracil in Subjects With Metastatic Colorectal Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2013
    Overall Recruitment Status
    Completed
    Study Start Date
    July 2002 (undefined)
    Primary Completion Date
    February 2008 (Actual)
    Study Completion Date
    October 2008 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Amgen

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study is to determine if panitumumab, in combination with irinotecan, leucovorin, and 5-fluorouracil (5-FU) is safe and efficacious in patients with metastatic colorectal cancer.
    Detailed Description
    Indication Metastatic Colorectal Cancer Primary Objective To assess the safety of ABX-EGF in combination with the FOLFIRI regimen in subjects with metastatic colorectal cancer. (The primary objective in the original protocol was to assess progression free survival after treatment with ABX-EGF in combination with the Saltz regimen in subjects with metastatic colorectal cancer). Secondary Objective(s) To assess the clinical efficacy of ABX-EGF in combination with the FOLFIRI regimen in subjects with metastatic colorectal cancer. (Secondary objectives in the original protocol were to assess safety and additional measures of the clinical efficacy of ABX-EGF in combination with the Saltz regimen in subjects with metastatic colorectal cancer). To assess the pharmacokinetics (PK) of ABX-EGF in combination with the FOLFIRI regimen in subjects with metastatic colorectal cancer. (Secondary objectives in the original protocol were to assess the PK of ABX-EGF in combination with the Saltz regimen, and the PK of irinotecan (IR) and its active metabolite SN-38 when IR is given in combination with ABX-EGF, leucovorin (LV), and 5-fluorouracil (5-FU) in subjects with metastatic colorectal cancer)

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Colorectal Cancer
    Keywords
    Immunex, Panitumumab, ABX-EGF, Abgenix

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    43 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Part 1: Panitumumab + IFL
    Arm Type
    Experimental
    Arm Description
    Panitumumab (2.5 mg/kg once weekly for up to 48 weeks or until disease progression, intolerable adverse event or other reason for discontinuation) in combination with irinotecan, 5-fluorouracil (5-FU)and leucovorin (IFL chemotherapy regimen)
    Arm Title
    Part 2: Panitumumab + FOLFIRI
    Arm Type
    Experimental
    Arm Description
    Panitumumab (2.5 mg/kg once weekly until disease progression, intolerable adverse event or other reason for discontinuation) in combination with irinotecan/5-FU/leucovorin chemotherapy (the FOLFIRI regimen)
    Intervention Type
    Drug
    Intervention Name(s)
    Irinotecan
    Intervention Description
    Part 1: 125 mg/m^2 IV infusion once a week on weeks 1 through 4 of each 6-week treatment cycle. Part 2: 180 mg/m^2 IV infusion every other week until disease progression or unable to tolerate.
    Intervention Type
    Biological
    Intervention Name(s)
    Panitumumab
    Other Intervention Name(s)
    ABX-EGF
    Intervention Description
    Intravenous (IV) infusions of panitumumab 2.5 mg/kg once a week delivered in 6-week cycles.
    Intervention Type
    Drug
    Intervention Name(s)
    5-Fluorouracil
    Intervention Description
    Part 1: IV bolus 500 mg/m^2 on weeks 1 through 4 of each 6-week cycle. Part 2: IV bolus 400 mg/m^2 and infusional 2400-3000 mg/m^2 over 46 hours once every other week until disease progression or unable to tolerate.
    Intervention Type
    Drug
    Intervention Name(s)
    Leucovorin
    Intervention Description
    Part 1: IV bolus 20 mg/m^2 on weeks 1 through 4 of each 6-week cycle. Part 2: 400 mg/m^2 every other week until disease progression or unable to tolerate.
    Primary Outcome Measure Information:
    Title
    Number of Participants With Grade 3 or Grade 4 Diarrhea (Part 2)
    Description
    The number of participants with grade 3 or grade 4 diarrhea in Part 2 of the study. Grading of diarrhea followed the grading scale in Version 2.0 of the National Cancer Institute Common Toxicity Criteria (NCI CTC).
    Time Frame
    Until disease progression (median 47 weeks)
    Title
    Number of Participants With Grade 3 or Grade 4 Diarrhea (Part 1)
    Description
    The number of participants with grade 3 or grade 4 diarrhea in Part 1 of the study. Grading of diarrhea followed the grading scale in Version 2.0 of the National Cancer Institute Common Toxicity Criteria (NCI CTC).
    Time Frame
    Until disease progression (median 35 weeks) or 48 weeks, whichever occurred first
    Secondary Outcome Measure Information:
    Title
    Number of Participants With an Objective Tumor Response (Part 2)
    Description
    Objective tumor response (complete or partial) in Part 2 of the study, based on Response Evaluation Criteria in Solid Tumors (RECIST), where complete response = disappearance of all target lesions, partial response = ≥30% reduction in lesion size, progressive disease = ≥20% increase in tumor size; otherwise stable disease.
    Time Frame
    Until disease progression (median 47 weeks)
    Title
    Time to Disease Progression (Part 2)
    Description
    Kaplan-Meier estimate of median time from the first dose of study drug to first observed disease progression or death if the death was due to disease progression (whichever comes first) in Part 2 of the study. Participants who had not progressed or died for reasons other than disease progression were censored at their last disease assessment date.
    Time Frame
    From enrollment until death or diease progression. Maximum follow-up time was 16 months.
    Title
    Progression-free Survival Time (Part 2)
    Description
    Kaplan-Meier estimate of median time from enrollment to death or disease progression in Part 2 of the study. Participants who had not progressed and had not died were censored at their last disease assessment date.
    Time Frame
    From enrollment until disease progression or death. Maximum follow-up time was 16 months.
    Title
    Survival Time (Part 2)
    Description
    Kaplan-Meier estimate of the median time from enrollment to death from any cause. Participants who did not die on study were censored at their last contact date.
    Time Frame
    From enrollment until death. Maximum follow-up time was 16 months.
    Title
    Number of Participants Who Died (Part 2)
    Description
    The number of participants in Part 2 who died during the study.
    Time Frame
    From enrollment until last contact. Maximum follow-up was 16 months.
    Title
    Number of Participants With Objective Tumor Response (Part 1)
    Description
    Objective tumor response (complete or partial) in Part 1 of the study, based on Response Evaluation Criteria in Solid Tumors (RECIST), where complete response = disappearance of all target lesions, partial response = ≥30% reduction in lesion size, progressive disease = ≥20% increase in tumor size; otherwise stable disease.
    Time Frame
    Until disease progression (median 35 weeks) or 48 weeks, whichever occurred first
    Title
    Progression-free Survival Time (Part 1)
    Description
    Kaplan-Meier estimate of median time from enrollment to death or disease progression in Part 1 of the study. Participants who had not progressed and had not died were censored at their last disease assessment date.
    Time Frame
    From enrollment until disease progression or death. Maximum follow-up time was 25 months.
    Title
    Time to Disease Progression (Part 1)
    Description
    Kaplan-Meier estimate of the median time from the first dose of study drug to disease progression or death if due to disease progression (whichever comes first) in Part 1 of the study. Participants who had not progressed or died for reasons other than disease progression were censored at their last disease assessment date.
    Time Frame
    From enrollment until disease progression or death. Maximum follow-up time was 25 months.
    Title
    Survival Time (Part 1)
    Description
    Kaplan-Meier estimate of the median time from enrollment to death from any cause. Participants who did not die on study were censored at their last contact date.
    Time Frame
    From enrollment until death. Maximum follow-up time was 25 months.
    Title
    Time to Treatment Failure (Part 1)
    Description
    Kaplan-Meier estimate of the median time from the date of first dose of panitumumab or chemotherapy to the date the decision was made to end treatment for any reason in Part 1 of the study.
    Time Frame
    Until disease progression (median 35 weeks) or 48 weeks, whichever occurred first
    Title
    Time to Initial Objective Tumor Response (Part 1)
    Description
    Median time to first observed objective tumor response (complete or partial) among responders in Part 1 of the study.
    Time Frame
    Until disease progression (median 35 weeks) or 48 weeks, whichever occurred first

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Able to comprehend and sign an Institutional Review Board (IRB)-approved informed consent form Pathologic diagnosis of colorectal cancer - Metastatic colorectal adenocarcinoma If history of adjuvant chemotherapy for colorectal cancer, must have been free of disease for greater than or equal to 1 year after completion of adjuvant chemotherapy Unidimensionally measurable disease Paraffin-embedded tumor tissue available for immunohistochemistry studies of epidermal growth factor receptor (EGFr) expression (archived tissue is acceptable) Tumor over-expressing EGFr by immunohistochemistry (staining must be the sum of 1+, 2+ and 3+ in greater than or equal to 10% of evaluated tumor cells; staining and evaluation to be conducted at a central laboratory) Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1 Adequate hematologic, renal, and hepatic function Exclusion Criteria: Female (of childbearing potential, post-menopausal for less than 6 months, not surgically sterilized, or not abstinent) not consenting to use adequate contraceptive precautions during the course of the study and for 6 months after the last ABX-EGF infusion Female who is breast-feeding or pregnant Any kind of disorder that compromises the ability of the patient to give written informed consent and/or comply with the study procedures History of any chronic medical or psychiatric condition or laboratory abnormality that, in the opinion of the investigator, may increase the risks associated with study participation or study drug administration or may interfere with compliance or the interpretation of study results Untreated brain metastases Therapy for colorectal cancer other than surgery and 5-FU-based adjuvant therapy Prior treatment for metastatic colorectal cancer Prior irinotecan Prior or concurrent radiation therapy for colorectal cancer, including prior adjuvant radiation therapy to the pelvis Known allergy to irinotecan, 5-fluorouracil, or leucovorin Known Gilbert's disease Known dihydropyrimidine dehydrogenase (DPD) deficiency Prior EGFr-targeting agents Use of investigational therapy used with adjuvant intent within 30 days before the first ABX-EGF infusion If prior history of cancer other than colorectal carcinoma, basal cell carcinoma, or cervical carcinoma in situ, no treatment or active disease within 5 years Active inflammatory bowel disease or other bowel disease (other than colorectal carcinoma) causing chronic diarrhea (defined as greater than 4 stools per day) Partial or complete bowel obstruction, known chronic malabsorption, total colectomy, or other major abdominal surgery that might result in substantial alteration in transit to absorption of oral medication Ascites or pleural effusion requiring therapeutic paracentesis or thoracentesis; subject with small, stable, asymptomatic pleural effusions or ascites may be enrolled; subject who has been rendered asymptomatic by successful sclerosis of an effusion may be enrolled. Active interstitial pneumonia or interstitial fibrosis Left ventricular ejection fraction (LVEF) less than 45%, as measured by multiple-gated acquisition (MUGA) scan - Myocardial infarction within 1 year before the first ABX-EGF infusion Any of the following within 6 months before the first study drug dose: Unstable angina; Symptomatic congestive heart failure; Serious uncontrolled cardiac arrhythmia; Cerebrovascular accident or transient ischemic attack; Pulmonary embolism; Deep vein thrombosis; Other significant thromboembolic event. Subject known to be human immunodeficiency virus (HIV) positive History of any chronic medical or psychiatric condition or laboratory abnormality that, in the opinion of the Investigator, may increase the risks associated with study participation or study drug administration or may interfere with patient compliance or the interpretation of study results Unwilling or unable to comply with study requirements Known allergy to the ingredients of the study drug or to Staphylococcus protein A
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    MD
    Organizational Affiliation
    Amgen
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    17531105
    Citation
    Berlin J, Posey J, Tchekmedyian S, Hu E, Chan D, Malik I, Yang L, Amado RG, Hecht JR. Panitumumab with irinotecan/leucovorin/5-fluorouracil for first-line treatment of metastatic colorectal cancer. Clin Colorectal Cancer. 2007 Mar;6(6):427-32. doi: 10.3816/CCC.2007.n.011.
    Results Reference
    background
    Links:
    URL
    http://www.amgentrials.com
    Description
    AmgenTrials clinical trials website
    URL
    http://www.vectibix.com/
    Description
    FDA-approved Drug Labeling

    Learn more about this trial

    Evaluating Panitumumab (ABX-EGF) in Patients With Metastatic Colorectal Cancer

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