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Safety and Efficacy Study of Combination Therapy With Cetuximab and FOLFOX4 in Patients With Colorectal Cancer

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
FOLFOX-4+cetuximab
FOLFOX-4
Sponsored by
Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring colorectal cancer, cetuximab, FOLFOX4

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Written informed consent. Men and women < 75 years Histologically confirmed diagnosis of CRC Metastatic colorectal carcinoma with exclusive non-resectable hepatic metastases, due to fulfillment of one of the following criteria: Number of hepatic metastases > or= 4; Size of one or more hepatic metastases > 5 cm diameter; Vascular involvement and/or poor site that prevent complete resection of hepatic disease and/or require resection with the remaining liver mass less than 25-30% of functional liver. Presence of at least one lesion detectable by two-dimensional measurement. Karnofsky functional status >or=70% at the time of enrollment in study Life expectancy greater than 3 months. Patients must not have received chemotherapy for advanced/metastatic disease. Patients with the following characteristics will be enrolled: Recurrence after adjuvant treatment with 5-fluorouracil/folinic acid or capecitabine +/- radiotherapy with disease-free period > 6 months following conclusion of treatment. Recurrence after surgical and/or radiotherapy treatment without adjuvant systemic treatment. De novo diagnosis of disease. Proper liver function, defined by aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) < or = 2.5 x ULN (< or = 5 x ULN if there are hepatic metastases) and total bilirubin count < 1.5 x ULN. Proper kidney function, defined as serum creatinine < 1.5 x ULN. Proper hematological function, defined as neutrophil count > or = 1.5 x 109/l , platelets > or = 100 X 109/l and hemoglobin > or = 9 g/dl. Effective birth control method for men as well as women if there is possibility of pregnancy Exclusion Criteria: Documented or suspected cerebral and/or leptomeningeal metastases. Metastasis in any other non-hepatic site, including extrahepatic lymph node metastases. Surgery (excluding biopsy for diagnosis) and/or radiotherapy within 4 weeks prior to enrollment in the study. Participation in another clinical trial with medication in the past 30 days. Chronic, concomitant administration of systemic immunotherapy, chemotherapy, hormone therapy or any other investigational drug. Prior malignant tumour in past 5 years, except history of basal cell skin carcinoma or pre-invasive cervical carcinoma. Any investigational drug during the 4 weeks prior to enrolment. Prior administration of monoclonal antibodies, EGFR signal transduction inhibitors or EGFR-targeted treatment. Prior participation in study in which treatment with cetuximab can be assigned (whether or not treatment with cetuximab is received) Acute or subacute intestinal occlusion or history of inflammatory intestinal disease. Evidence of grade 3 or 4 allergic reaction to any of the treatment components. Clinically relevant peripheral neuropathy. Clinically relevant myocardial disease or history of myocardial infarction in the past 12 months. Known abuse of alcohol / drugs, Legal incapacity or limited legal capacity. Any medical or psychological disorder which, in the opinion of the investigator, does not allow the patient to conclude the study or sign the informed consent. Pregnant or nursing woman

Sites / Locations

  • Spanish Cooperative Group for Gastrointestinal Tumour Therapy (TTD)

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

FOLFOX-4+cetuximab

FOLFOX-4

Outcomes

Primary Outcome Measures

Determine confirmed objective response rate

Secondary Outcome Measures

Determine safety of combination, surgical resectability and R0 resections, clinical benefit, time to disease progression, time to onset of response, duration of response, time to treatment failure, overall survival time
determination of polymorphisms of the intron 1 of the EGFR gene, TS, XRCC1, XPD, serum levels of EGFR and ATP7A and ATP7B, nº of copies of EGFR gene, the levels of PTEN, EGFR, AKT y MAPK proteins, and mutations at EGFR, PI3KCA, K-RAS y B-RAF genes

Full Information

First Posted
September 12, 2005
Last Updated
February 19, 2013
Sponsor
Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD)
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT00202787
Brief Title
Safety and Efficacy Study of Combination Therapy With Cetuximab and FOLFOX4 in Patients With Colorectal Cancer
Official Title
Open-label, Phase II, Randomised, Pilot Study to Evaluate the Safety and Efficacy of Combination Therapy With Cetuximab and FOLFOX4 or FOLFOX4 Alone in Patients Colorectal Cancer and Initially Non-resectable
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Completed
Study Start Date
February 2005 (undefined)
Primary Completion Date
February 2009 (Actual)
Study Completion Date
February 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD)
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine confirmed objective response rate to combination therapy with cetuximab and FOLFOX4 or FOLFOX4 alone in patients with CRC and non-resectable hepatic metastases

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
colorectal cancer, cetuximab, FOLFOX4

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
FOLFOX-4+cetuximab
Arm Title
2
Arm Type
Active Comparator
Arm Description
FOLFOX-4
Intervention Type
Drug
Intervention Name(s)
FOLFOX-4+cetuximab
Intervention Description
Cetuximab; Weekly administration of Cetuximab IV (initial infusion of 400 mg/m2 for 120 minutes followed by subsequent maintenance doses of 250 mg/m2 for 60 minutes); FOLFOX-4: Every two week Oxaliplatin; 85 mg/m2 ; day 1 Folinic acid; 200 mg/m2 ; day 1 and 2 5-FU ; Bolus 400 mg/m2 + CI 600 mg/m2 22 h day 1 and 2
Intervention Type
Drug
Intervention Name(s)
FOLFOX-4
Intervention Description
FOLFOX-4: Every two week Oxaliplatin; 85 mg/m2 ; day 1 Folinic acid; 200 mg/m2 ; day 1 and 2 5-FU ; Bolus 400 mg/m2 + CI 600 mg/m2 22 h day 1 and 2
Primary Outcome Measure Information:
Title
Determine confirmed objective response rate
Time Frame
2005-2009
Secondary Outcome Measure Information:
Title
Determine safety of combination, surgical resectability and R0 resections, clinical benefit, time to disease progression, time to onset of response, duration of response, time to treatment failure, overall survival time
Time Frame
2005-2009
Title
determination of polymorphisms of the intron 1 of the EGFR gene, TS, XRCC1, XPD, serum levels of EGFR and ATP7A and ATP7B, nº of copies of EGFR gene, the levels of PTEN, EGFR, AKT y MAPK proteins, and mutations at EGFR, PI3KCA, K-RAS y B-RAF genes
Time Frame
2005-2009

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent. Men and women < 75 years Histologically confirmed diagnosis of CRC Metastatic colorectal carcinoma with exclusive non-resectable hepatic metastases, due to fulfillment of one of the following criteria: Number of hepatic metastases > or= 4; Size of one or more hepatic metastases > 5 cm diameter; Vascular involvement and/or poor site that prevent complete resection of hepatic disease and/or require resection with the remaining liver mass less than 25-30% of functional liver. Presence of at least one lesion detectable by two-dimensional measurement. Karnofsky functional status >or=70% at the time of enrollment in study Life expectancy greater than 3 months. Patients must not have received chemotherapy for advanced/metastatic disease. Patients with the following characteristics will be enrolled: Recurrence after adjuvant treatment with 5-fluorouracil/folinic acid or capecitabine +/- radiotherapy with disease-free period > 6 months following conclusion of treatment. Recurrence after surgical and/or radiotherapy treatment without adjuvant systemic treatment. De novo diagnosis of disease. Proper liver function, defined by aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) < or = 2.5 x ULN (< or = 5 x ULN if there are hepatic metastases) and total bilirubin count < 1.5 x ULN. Proper kidney function, defined as serum creatinine < 1.5 x ULN. Proper hematological function, defined as neutrophil count > or = 1.5 x 109/l , platelets > or = 100 X 109/l and hemoglobin > or = 9 g/dl. Effective birth control method for men as well as women if there is possibility of pregnancy Exclusion Criteria: Documented or suspected cerebral and/or leptomeningeal metastases. Metastasis in any other non-hepatic site, including extrahepatic lymph node metastases. Surgery (excluding biopsy for diagnosis) and/or radiotherapy within 4 weeks prior to enrollment in the study. Participation in another clinical trial with medication in the past 30 days. Chronic, concomitant administration of systemic immunotherapy, chemotherapy, hormone therapy or any other investigational drug. Prior malignant tumour in past 5 years, except history of basal cell skin carcinoma or pre-invasive cervical carcinoma. Any investigational drug during the 4 weeks prior to enrolment. Prior administration of monoclonal antibodies, EGFR signal transduction inhibitors or EGFR-targeted treatment. Prior participation in study in which treatment with cetuximab can be assigned (whether or not treatment with cetuximab is received) Acute or subacute intestinal occlusion or history of inflammatory intestinal disease. Evidence of grade 3 or 4 allergic reaction to any of the treatment components. Clinically relevant peripheral neuropathy. Clinically relevant myocardial disease or history of myocardial infarction in the past 12 months. Known abuse of alcohol / drugs, Legal incapacity or limited legal capacity. Any medical or psychological disorder which, in the opinion of the investigator, does not allow the patient to conclude the study or sign the informed consent. Pregnant or nursing woman
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Albert Abad
Organizational Affiliation
Spanish Cooperative Group for Gastrointestinal Tumour Therapy (TTD)
Official's Role
Study Chair
Facility Information:
Facility Name
Spanish Cooperative Group for Gastrointestinal Tumour Therapy (TTD)
City
Madrid
ZIP/Postal Code
28046
Country
Spain

12. IPD Sharing Statement

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Safety and Efficacy Study of Combination Therapy With Cetuximab and FOLFOX4 in Patients With Colorectal Cancer

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