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A Study of Picoplatin in Colorectal Cancer

Primary Purpose

Colorectal Cancer

Status
Unknown status
Phase
Phase 1
Locations
Russian Federation
Study Type
Interventional
Intervention
(FOLPI) Picoplatin with 5-FU and Leucovorin
FOLPI
FOLFOX
Sponsored by
Poniard Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring colorectal cancer, picoplatin, FOLFOX, FOLPI, chemotherapy

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed adenocarcinoma of the colon or rectum.
  • Metastatic disease consistent with colorectal adenocarcinoma. Stage M1, and not amenable to curative surgery. Subjects with only locally persistent or only locally recurrent disease are not eligible.
  • No prior systemic therapy for metastatic cancer. Prior adjuvant chemotherapy with a 5-FU-based treatment regimen not containing oxaliplatin or irinotecan is acceptable after a treatment-free interval of at least 6 months.
  • ECOG performance score (PS) of 0 or 1.
  • Life expectancy more than 3 months.
  • Subject must have measurable disease, defined by the RECIST criteria.
  • At least 28 days must have elapsed since prior surgery except venous access device placement.
  • At least 28 days must have elapsed since prior radiotherapy.
  • At least 28 days must have elapsed since a prior investigational agent.
  • Absolute neutrophil count (ANC) equal to or greater than 1.5 x 10^9/L.
  • Platelet count equal to or greater than 100 x 10^9/L.
  • Hemoglobin equal or greater than 10g/dL (must be obtained at least 3 days after any transfusion).
  • Serum AST and ALT levels less than or equal to 2.5 times upper limit of normal (ULN) or less than 5 times ULN if liver involvement is present.
  • Serum bilirubin of less than or equal to 1.5 ULN.
  • Serum creatinine of less than or equal to ULN.
  • Women of childbearing potential must have a negative pregnancy test (serum or urine beta HCG).
  • All subjects must agree to use appropriate birth control methods while on study and for 1 month after completion of study chemotherapy.

Exclusion Criteria:

  • Concurrent use of EGFR inhibitors or anti-VEGF agents.
  • No clinically significant obstructive symptoms or intestinal bleeding.
  • Significant chronic or recent acute gastrointestinal disorder with diarrhea as a major symptom (e.g. Crohn's disease, ulcerative colitis, malabsorption syndrome, Grade 2+ diarrhea of any etiology at baseline).
  • History of serious cardiac disease, defined as myocardial infarction within six months of enrollment, congestive heart failure classified by the New York Heart Association as class III or IV, uncontrolled cardiac arrhythmias, poorly controlled or unstable angina, or electrocardiographic evidence of acute ischemia.
  • Clinical evidence of brain metastases or central nervous system disease.
  • Symptomatic peripheral neuropathy (equivalent to Grade 2 or higher CTCAE toxicity criteria).
  • Uncontrolled intercurrent illness (e.g. active infection).
  • Pregnant or nursing.
  • Serious medical or psychiatric illness that could potentially interfere with the completion of study treatment according to this protocol.
  • Malignancy other than colorectal carcinoma within the past 5 years, except, curatively treated, superficial skin cancer or carcinoma in situ of the cervix or breast.

Sites / Locations

  • Leningrad Regional Oncology Center, Chemotherapy Department - Phase 2
  • Regional Oncology Center - Phase 2
  • Chelyabinsk Regional Oncology Center - Phase 1
  • Regional Oncology Center, Chemotherapy Department - Phase 2
  • Kazan Oncology Center
  • Blokhin Russian Oncology Research Center - Phase 1
  • Semashko Central Clinical Hospital #2 - Phase 1
  • Medical Radiology Research Center of Russian Academy of Medical Sciences- Phase 1
  • Republic Oncology Center of the Ministry of Healthcare of Karelia Republic - Phase 2
  • Rostov Research Institute of Oncology- Phase 2
  • St. Petersburg Academy of Postgraduate Education - Phase 2
  • St. Petersburg Mechnikov State Medical Academy - Phase 2
  • St. Petersburg City Oncology Center - Phase 1
  • Regional Clinical Oncology Center - Phase 2
  • Voronezh Regional Clinical Oncology Center - Phase 2
  • Yaroslavl Regional Oncology Center - Phase 1

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

Picoplatin, 150 mg/m2, 5-FU and leucovorin (q 4 weeks, Schedule B). Leucovorin, 400 mg/m2 in D5W and leucovorin (± picoplatin) will be followed by a 5-FU bolus of 400 mg/m2 and then by 5-FU, 2,400 mg/m2 in D5W administered as a 46-hour continuous infusion.

FOLFOX Oxaliplatin 85 mg/m2, as a 2-hour infusion Leucovorin (400 mg/m2 in D5W) and Oxaliplatin. Leucovorin + oxaliplatin will be followed by a 5-FU bolus of 400 mg/m2 and then by 5-FU, 2400 mg/m2 in D5W administered as a 46-hour continuous infusion.

Outcomes

Primary Outcome Measures

dose-limiting toxicity
maximum tolerated dose

Secondary Outcome Measures

safety and efficacy

Full Information

First Posted
May 23, 2007
Last Updated
January 20, 2009
Sponsor
Poniard Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00478946
Brief Title
A Study of Picoplatin in Colorectal Cancer
Official Title
A Phase I Open-Label Study of Picoplatin in Combination With 5-Fluorouracil and Leucovorin as Initial Therapy in Subjects With Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2009
Overall Recruitment Status
Unknown status
Study Start Date
April 2006 (undefined)
Primary Completion Date
December 2009 (Anticipated)
Study Completion Date
June 2010 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Poniard Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Colorectal cancer is a type of cancer that begins in the large intestine (colon) or the rectum (end of the colon). Several drugs are often given in combination to treat colorectal cancer. One of the most active treatment combinations is known as FOLFOX, which is a combination of 5-fluorouracil (5-FU), leucovorin, and oxaliplatin. Oxaliplatin is a type of platinum drug and was approved by the FDA in 2004. While generally well-tolerated, oxaliplatin may cause toxicity to the nerves, such as sensory loss or cold sensitivity. Picoplatin is a new type of platinum drug that has shown activity with 5-FU in pre-clinical studies and has undergone extensive Phase 1 and Phase 2 testing in a variety of cancers. No significant nerve toxicity has been seen in previous studies of picoplatin. This study will review the safety and effectiveness of FOLPI, which is the combination of 5-FU and leucovorin with picoplatin in participants with colorectal cancer.
Detailed Description
Subjects will be randomized centrally to treatment with picoplatin administered either every two or every four weeks and will be assigned a dose of picoplatin dependent on the study results to date. Each patient will also receive therapy every two weeks with 5-FU and leucovorin. In each schedule, the cohort size will be 3 subjects, to be expanded to 6 subjects if a dose-limiting toxicity is observed. If not dose-limiting toxicity observed among the 3 subjects within a cohort, picoplatin dose escalation may proceed, until the maximum tolerated dose is established.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
colorectal cancer, picoplatin, FOLFOX, FOLPI, chemotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
43 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Picoplatin, 150 mg/m2, 5-FU and leucovorin (q 4 weeks, Schedule B). Leucovorin, 400 mg/m2 in D5W and leucovorin (± picoplatin) will be followed by a 5-FU bolus of 400 mg/m2 and then by 5-FU, 2,400 mg/m2 in D5W administered as a 46-hour continuous infusion.
Arm Title
2
Arm Type
Active Comparator
Arm Description
FOLFOX Oxaliplatin 85 mg/m2, as a 2-hour infusion Leucovorin (400 mg/m2 in D5W) and Oxaliplatin. Leucovorin + oxaliplatin will be followed by a 5-FU bolus of 400 mg/m2 and then by 5-FU, 2400 mg/m2 in D5W administered as a 46-hour continuous infusion.
Intervention Type
Drug
Intervention Name(s)
(FOLPI) Picoplatin with 5-FU and Leucovorin
Intervention Description
Picoplatin, 150 mg/m2, 5-FU and leucovorin (q 4 weeks, Schedule B). Leucovorin, 400 mg/m2 in D5W and leucovorin (± picoplatin) will be followed by a 5-FU bolus of 400 mg/m2 and then by 5-FU, 2,400 mg/m2 in D5W administered as a 46-hour continuous infusion.
Intervention Type
Drug
Intervention Name(s)
FOLPI
Intervention Description
Picoplatin, 150 mg/m2 to be administered with every alternate cycle of 5-FU and leucovorin (q 4 weeks, Schedule B). Leucovorin, 400 mg/m2 in D5W, will be administered as a 2-hour infusion, either alone or, if the patient is to receive picoplatin that cycle, at the same time as picoplatin, in separate bags using a Y-line. The leucovorin (± picoplatin) will be followed by a 5-FU bolus of 400 mg/m2 and then by 5-FU, 2,400 mg/m2 in D5W administered as a 46-hour continuous infusion.
Intervention Type
Drug
Intervention Name(s)
FOLFOX
Intervention Description
Oxaliplatin 85 mg/m. Leucovorin (400 mg/m2 in D5W). Oxaliplatin and leucovorin Leucovorin + oxaliplatin 5-FU bolus of 400 mg/m2 and then by 5-FU, 2400 mg/m2 in D5W administered as a 46-hour continuous infusion.
Primary Outcome Measure Information:
Title
dose-limiting toxicity
Time Frame
within the first four weeks of treatment
Title
maximum tolerated dose
Time Frame
within the first two cycles of treatment
Secondary Outcome Measure Information:
Title
safety and efficacy
Time Frame
duration of the study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed adenocarcinoma of the colon or rectum. Metastatic disease consistent with colorectal adenocarcinoma. Stage M1, and not amenable to curative surgery. Subjects with only locally persistent or only locally recurrent disease are not eligible. No prior systemic therapy for metastatic cancer. Prior adjuvant chemotherapy with a 5-FU-based treatment regimen not containing oxaliplatin or irinotecan is acceptable after a treatment-free interval of at least 6 months. ECOG performance score (PS) of 0 or 1. Life expectancy more than 3 months. Subject must have measurable disease, defined by the RECIST criteria. At least 28 days must have elapsed since prior surgery except venous access device placement. At least 28 days must have elapsed since prior radiotherapy. At least 28 days must have elapsed since a prior investigational agent. Absolute neutrophil count (ANC) equal to or greater than 1.5 x 10^9/L. Platelet count equal to or greater than 100 x 10^9/L. Hemoglobin equal or greater than 10g/dL (must be obtained at least 3 days after any transfusion). Serum AST and ALT levels less than or equal to 2.5 times upper limit of normal (ULN) or less than 5 times ULN if liver involvement is present. Serum bilirubin of less than or equal to 1.5 ULN. Serum creatinine of less than or equal to ULN. Women of childbearing potential must have a negative pregnancy test (serum or urine beta HCG). All subjects must agree to use appropriate birth control methods while on study and for 1 month after completion of study chemotherapy. Exclusion Criteria: Concurrent use of EGFR inhibitors or anti-VEGF agents. No clinically significant obstructive symptoms or intestinal bleeding. Significant chronic or recent acute gastrointestinal disorder with diarrhea as a major symptom (e.g. Crohn's disease, ulcerative colitis, malabsorption syndrome, Grade 2+ diarrhea of any etiology at baseline). History of serious cardiac disease, defined as myocardial infarction within six months of enrollment, congestive heart failure classified by the New York Heart Association as class III or IV, uncontrolled cardiac arrhythmias, poorly controlled or unstable angina, or electrocardiographic evidence of acute ischemia. Clinical evidence of brain metastases or central nervous system disease. Symptomatic peripheral neuropathy (equivalent to Grade 2 or higher CTCAE toxicity criteria). Uncontrolled intercurrent illness (e.g. active infection). Pregnant or nursing. Serious medical or psychiatric illness that could potentially interfere with the completion of study treatment according to this protocol. Malignancy other than colorectal carcinoma within the past 5 years, except, curatively treated, superficial skin cancer or carcinoma in situ of the cervix or breast.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Earhart, MD, PhD
Organizational Affiliation
Poniard Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Leningrad Regional Oncology Center, Chemotherapy Department - Phase 2
City
Kuzmolovsky Village
State/Province
Vsevolozhsk
ZIP/Postal Code
188663
Country
Russian Federation
Facility Name
Regional Oncology Center - Phase 2
City
Astrakhan
ZIP/Postal Code
414041
Country
Russian Federation
Facility Name
Chelyabinsk Regional Oncology Center - Phase 1
City
Chelyabinsk
ZIP/Postal Code
454087
Country
Russian Federation
Facility Name
Regional Oncology Center, Chemotherapy Department - Phase 2
City
Engels
ZIP/Postal Code
413115
Country
Russian Federation
Facility Name
Kazan Oncology Center
City
Kazan
ZIP/Postal Code
420111
Country
Russian Federation
Facility Name
Blokhin Russian Oncology Research Center - Phase 1
City
Moscow
ZIP/Postal Code
115478
Country
Russian Federation
Facility Name
Semashko Central Clinical Hospital #2 - Phase 1
City
Moscow
ZIP/Postal Code
129128
Country
Russian Federation
Facility Name
Medical Radiology Research Center of Russian Academy of Medical Sciences- Phase 1
City
Obninsk
ZIP/Postal Code
249036
Country
Russian Federation
Facility Name
Republic Oncology Center of the Ministry of Healthcare of Karelia Republic - Phase 2
City
Petrozavodsk
ZIP/Postal Code
185007
Country
Russian Federation
Facility Name
Rostov Research Institute of Oncology- Phase 2
City
Rostov-na-Dony
ZIP/Postal Code
350086
Country
Russian Federation
Facility Name
St. Petersburg Academy of Postgraduate Education - Phase 2
City
St. Petersburg
ZIP/Postal Code
194291
Country
Russian Federation
Facility Name
St. Petersburg Mechnikov State Medical Academy - Phase 2
City
St. Petersburg
ZIP/Postal Code
195067
Country
Russian Federation
Facility Name
St. Petersburg City Oncology Center - Phase 1
City
St. Petersburg
ZIP/Postal Code
198255
Country
Russian Federation
Facility Name
Regional Clinical Oncology Center - Phase 2
City
Ulyanovsk
ZIP/Postal Code
432063
Country
Russian Federation
Facility Name
Voronezh Regional Clinical Oncology Center - Phase 2
City
Voronezh
ZIP/Postal Code
394000
Country
Russian Federation
Facility Name
Yaroslavl Regional Oncology Center - Phase 1
City
Yaroslavl
ZIP/Postal Code
150054
Country
Russian Federation

12. IPD Sharing Statement

Citations:
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12645909
Citation
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Results Reference
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Results Reference
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PubMed Identifier
9815598
Citation
Raynaud FI, Boxall FE, Goddard PM, Valenti M, Jones M, Murrer BA, Abrams M, Kelland LR. cis-Amminedichloro(2-methylpyridine) platinum(II) (AMD473), a novel sterically hindered platinum complex: in vivo activity, toxicology, and pharmacokinetics in mice. Clin Cancer Res. 1997 Nov;3(11):2063-74.
Results Reference
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PubMed Identifier
9474239
Citation
Holford J, Raynaud F, Murrer BA, Grimaldi K, Hartley JA, Abrams M, Kelland LR. Chemical, biochemical and pharmacological activity of the novel sterically hindered platinum co-ordination complex, cis-[amminedichloro(2-methylpyridine)] platinum(II) (AMD473). Anticancer Drug Des. 1998 Jan;13(1):1-18.
Results Reference
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PubMed Identifier
9472630
Citation
Holford J, Sharp SY, Murrer BA, Abrams M, Kelland LR. In vitro circumvention of cisplatin resistance by the novel sterically hindered platinum complex AMD473. Br J Cancer. 1998;77(3):366-73. doi: 10.1038/bjc.1998.59.
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PubMed Identifier
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Rogers P, Boxall FE, Allott CP, Stephens TC, Kelland LR. Sequence-dependent synergism between the new generation platinum agent ZD0473 and paclitaxel in cisplatin-sensitive and -resistant human ovarian carcinoma cell lines. Eur J Cancer. 2002 Aug;38(12):1653-60. doi: 10.1016/s0959-8049(02)00107-7.
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PubMed Identifier
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Citation
Sharp SY, O'Neill CF, Rogers P, Boxall FE, Kelland LR. Retention of activity by the new generation platinum agent AMD0473 in four human tumour cell lines possessing acquired resistance to oxaliplatin. Eur J Cancer. 2002 Nov;38(17):2309-15. doi: 10.1016/s0959-8049(02)00244-7.
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Plasencia C, Abad A, Martinez-Balibrea E, Taron M. Antiproliferative effects of ZD0473 (AMD473) in combination with 5-fluorouracil or SN38 in human colorectal cancer cell lines. Invest New Drugs. 2004 Nov;22(4):399-409. doi: 10.1023/B:DRUG.0000036682.99818.71.
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A Study of Picoplatin in Colorectal Cancer

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