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Panitumumab in Combination With Irinotecan Chemotherapy as 2nd-line Therapy in Subjects With mCRC

Primary Purpose

Metastatic Colorectal Cancer

Status
Completed
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Panitumumab and CPT-11
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 Metastatic Colorectal Cancer focused on measuring metastatic colorectal cancer, 2nd-line Therapy, panitumumab, irinotecan

Eligibility Criteria

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

Inclusion Criteria:

  • Man or woman > 18 years of age
  • Competent to comprehend, sign, and date an IEC-approved informed consent form
  • Histologically or cytologically-confirmed metastatic adenocarcinoma of the colon or rectum.
  • Radiographically documented disease progression per modified RECIST criteria either while receiving or ≤ 6 months after the last dose of prior first-line chemotherapy for mCRC
  • At least 1 uni-dimensionally measurable lesion of at least 20 mm per modified RECIST criteria.
  • If subject has prior history of cancer other than colorectal carcinoma, basal cell carcinoma, or cervical carcinoma in situ, then subject must not have had treatment or active disease within 5 years.
  • Prior radiotherapy is acceptable.
  • One and only one prior chemotherapy regimen for mCRC consisting of first-line fluoropyrimidine-based chemotherapy.
  • ECOG performance status of 0, 1 or 2
  • Life expectancy ≥ 3 months
  • Hematologic function:ANC > 1.5 x 109/L, Platelet count > 100 x 109/L, Hemoglobin > 10 g/dL
  • Renal function: Creatinine < 1.5 mg/dL
  • Hepatic function: AST and ALT < 3 x ULN (if liver metastases < 5 x ULN)
  • Bilirubin < 2 x ULN

Exclusion Criteria:

  • No more than one prior chemotherapy regimen for mCRC consisting of first-line fluoropyrimidine-based chemotherapy. (Prior adjuvant fluoropyrimidine-based chemotherapy is allowed)
  • Prior systemic therapy for the treatment of metastatic colorectal carcinoma with the exception of adjuvant fluoropyrimidine-based chemotherapy given at least 6 months prior to enrolment.
  • Systemic chemotherapy, hormonal therapy, immunotherapy or experimental or approved proteins/antibodies (eg, bevacizumab) ≤ 30 days before inclusion
  • Unresolved toxicities from prior systemic therapy that, in the opinion of the investigator, does not qualify the patient for inclusion
  • Central nervous system/brain metastases
  • Significant cardiovascular disease including unstable angina or myocardial infarction within 6 months before initiating study treatment or a history of ventricular arrhythmia
  • Prior anti-EGFr antibody therapy (eg, cetuximab) or treatment small molecule EGFr tyrosine kinase inhibitors (eg, erlotinib)
  • History of interstitial pneumonitis or pulmonary fibrosis or evidence of interstitial pneumonitis or pulmonary fibrosis on baseline chest CT scan
  • Treatment for systemic infection within 14 days before initiating study treatment
  • Radiotherapy ≤ 14 days prior to inclusion. Patients must have recovered from all radiotherapy-related toxicities
  • Active inflammatory bowel disease or other bowel disease causing chronic diarrhoea (defined as > 4 loose stools per day)
  • History of Gilbert's syndrome or dihydropyrimidine deficiency
  • History of any medical condition that may increase the risks associated with study participation or may interfere with the interpretation of the study results
  • Known positive test for human immunodeficiency virus infection, hepatitis C virus, chronic active hepatitis B infection
  • subject allergic to the ingredients of the study medication or to Staphylococcus protein A
  • Any co-morbid disease that would increase risk of toxicity
  • Any kind of disorder that compromises the ability of the subject to give written informed consent and/or comply with the study procedures
  • Any investigational agent within 30 days before enrolment
  • Must not have had a major surgical procedure within 28 days of randomization
  • Subject who is pregnant or breast feeding
  • Woman or man of childbearing potential not consenting to use adequate contraceptive precautions i.e. double barrier contraceptive methods
  • Subject unwilling or unable to comply with study requirements

Sites / Locations

  • Spanish Cooperative Group for Gastrointestinal Tumour Therapy

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1

Arm Description

Outcomes

Primary Outcome Measures

objective response rate

Secondary Outcome Measures

disease control rate, duration of response, time to response, progression-free survival, time to progression,time to treatment failure,duration of stable disease
adverse events

Full Information

First Posted
May 17, 2007
Last Updated
September 12, 2013
Sponsor
Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD)
Collaborators
Amgen
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1. Study Identification

Unique Protocol Identification Number
NCT00475293
Brief Title
Panitumumab in Combination With Irinotecan Chemotherapy as 2nd-line Therapy in Subjects With mCRC
Official Title
A Phase 2 Clinical Trial of Panitumumab in Combination With Irinotecan Chemotherapy as 2nd-line Therapy in Subjects With Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Completed
Study Start Date
May 2007 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
March 2010 (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
Amgen

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the objective response rate (ORR) when panitumumab is administered in combination with irinotecan as 2nd-line therapy in subjects with previously treated metastatic colorectal cancer (mCRC).
Detailed Description
Aside from limited cases of resectable metastatic disease, mCRC cannot be cured with the currently available chemotherapy regimens, and there is a continued need to improve the current treatment. Panitumumab has demonstrated objective tumour response, increase in progression free survival and has an acceptable safety profile in clinical studies in patients with metastatic colorectal cancer when used as a monotherapy or in combination with irinotecan (Meropol et al, 2003; Berlin et al, 2004; Hecht et al, 2004; Malik et al, 2005). The addition of panitumumab to chemotherapy is expected to enhance the treatment effect of chemotherapy. This is a Phase II, single-arm, multi-centre study. Eligible subjects will be enrolled and treated with second-line combination therapy consisting of panitumumab and irinotecan. Prior to study entry and in order to confirm eligibility, the investigator or designee will review existing radiological images in addition to any other relevant clinical documents (reports, notes, etc.) to ensure the subject has failed or relapsed while on or after one prior chemotherapy regimen. Panitumumab will be administered by intravenous (IV) infusion at a dose of 9 mg/kg once Q3W. Irinotecan chemotherapy (350 mg/m2) will be administered after the administration of panitumumab. Subjects will be permitted to receive panitumumab and chemotherapy until he or she develops disease progression (PD) or experiences unacceptable toxicities. Subjects who discontinue irinotecan, for example due to toxicity, will be permitted to receive panitumumab monotherapy. After discontinuation of panitumumab, the treatment period will end and subjects will attend a safety follow-up visit 56 ±3 days later. Tumour response assessment will be performed by the investigator per the modified Response Evaluation Criteria in Solid Tumours (m-RECIST). Subjects will be evaluated for tumour response every 9 weeks ± 1 week until PD or withdrawal from the trial. Responding disease will be confirmed no less than 28 days after the criteria for response are first met. Subjects with symptoms suggestive of PD should be evaluated for tumour progression at the time the symptoms occur. Subjects will complete an EQ-5D PRO questionnaire every 6 weeks ± 1 week, from baseline through to the end of the treatment period and at the safety follow-up visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer
Keywords
metastatic colorectal cancer, 2nd-line Therapy, panitumumab, irinotecan

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
85 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Panitumumab and CPT-11
Intervention Description
Panitumumab will be administered by IV infusion on day 1 of each cycle just prior to the administration of chemotherapy. The starting panitumumab dose is 9 mg/kg Irinotecan: 350 or 300 mg/m2. day 1 One treatment cycle is defined as the 21 day period following the commencement of treatment with panitumumab + irinotecan plus additional time, as needed, for the resolution of irinotecan-related toxicities
Primary Outcome Measure Information:
Title
objective response rate
Time Frame
2007-2010
Secondary Outcome Measure Information:
Title
disease control rate, duration of response, time to response, progression-free survival, time to progression,time to treatment failure,duration of stable disease
Time Frame
2007-2010
Title
adverse events
Time Frame
2007-2010

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Man or woman > 18 years of age Competent to comprehend, sign, and date an IEC-approved informed consent form Histologically or cytologically-confirmed metastatic adenocarcinoma of the colon or rectum. Radiographically documented disease progression per modified RECIST criteria either while receiving or ≤ 6 months after the last dose of prior first-line chemotherapy for mCRC At least 1 uni-dimensionally measurable lesion of at least 20 mm per modified RECIST criteria. If subject has prior history of cancer other than colorectal carcinoma, basal cell carcinoma, or cervical carcinoma in situ, then subject must not have had treatment or active disease within 5 years. Prior radiotherapy is acceptable. One and only one prior chemotherapy regimen for mCRC consisting of first-line fluoropyrimidine-based chemotherapy. ECOG performance status of 0, 1 or 2 Life expectancy ≥ 3 months Hematologic function:ANC > 1.5 x 109/L, Platelet count > 100 x 109/L, Hemoglobin > 10 g/dL Renal function: Creatinine < 1.5 mg/dL Hepatic function: AST and ALT < 3 x ULN (if liver metastases < 5 x ULN) Bilirubin < 2 x ULN Exclusion Criteria: No more than one prior chemotherapy regimen for mCRC consisting of first-line fluoropyrimidine-based chemotherapy. (Prior adjuvant fluoropyrimidine-based chemotherapy is allowed) Prior systemic therapy for the treatment of metastatic colorectal carcinoma with the exception of adjuvant fluoropyrimidine-based chemotherapy given at least 6 months prior to enrolment. Systemic chemotherapy, hormonal therapy, immunotherapy or experimental or approved proteins/antibodies (eg, bevacizumab) ≤ 30 days before inclusion Unresolved toxicities from prior systemic therapy that, in the opinion of the investigator, does not qualify the patient for inclusion Central nervous system/brain metastases Significant cardiovascular disease including unstable angina or myocardial infarction within 6 months before initiating study treatment or a history of ventricular arrhythmia Prior anti-EGFr antibody therapy (eg, cetuximab) or treatment small molecule EGFr tyrosine kinase inhibitors (eg, erlotinib) History of interstitial pneumonitis or pulmonary fibrosis or evidence of interstitial pneumonitis or pulmonary fibrosis on baseline chest CT scan Treatment for systemic infection within 14 days before initiating study treatment Radiotherapy ≤ 14 days prior to inclusion. Patients must have recovered from all radiotherapy-related toxicities Active inflammatory bowel disease or other bowel disease causing chronic diarrhoea (defined as > 4 loose stools per day) History of Gilbert's syndrome or dihydropyrimidine deficiency History of any medical condition that may increase the risks associated with study participation or may interfere with the interpretation of the study results Known positive test for human immunodeficiency virus infection, hepatitis C virus, chronic active hepatitis B infection subject allergic to the ingredients of the study medication or to Staphylococcus protein A Any co-morbid disease that would increase risk of toxicity Any kind of disorder that compromises the ability of the subject to give written informed consent and/or comply with the study procedures Any investigational agent within 30 days before enrolment Must not have had a major surgical procedure within 28 days of randomization Subject who is pregnant or breast feeding Woman or man of childbearing potential not consenting to use adequate contraceptive precautions i.e. double barrier contraceptive methods Subject unwilling or unable to comply with study requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alfredo Carrato, MD
Organizational Affiliation
Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD)
Official's Role
Study Chair
Facility Information:
Facility Name
Spanish Cooperative Group for Gastrointestinal Tumour Therapy
City
Madrid
ZIP/Postal Code
28046
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
23359181
Citation
Carrato A, Gomez A, Escudero P, Chaves M, Rivera F, Marcuello E, Gonzalez E, Gravalos C, Constenla M, Manzano JL, Losa F, Maurel J, Duenas R, Massuti B, Gallego J, Aparicio J, Anton A, Aranda E. Panitumumab and irinotecan every 3 weeks is an active and convenient regimen for second-line treatment of patients with wild-type K-RAS metastatic colorectal cancer. Clin Transl Oncol. 2013 Sep;15(9):705-11. doi: 10.1007/s12094-012-0993-x. Epub 2013 Jan 29.
Results Reference
result
Links:
URL
http://www.ttdgroup.org
Description
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Panitumumab in Combination With Irinotecan Chemotherapy as 2nd-line Therapy in Subjects With mCRC

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