Study to Evaluate Mechanisms of Acquired Resistance to Panitumumab

This is an interventional treatment trial for Metastatic Colorectal Cancer focused on measuring wild-type KRAS, panitumumab, biomarker, mechanisms of acquired resistance, metastatic colorectal cancer Read More

Inclusion Criteria:

• Histologically or cytologically confirmed metastatic adenocarcinoma of the colon or rectum;
• Subjects with wild-type KRAS tumor status confirmed by an Amgen approved central laboratory assessment or an experienced local laboratory assessment of archival tumor tissue (preferably from the primary tumor);
• Radiographic evidence of disease progression while on or ≤ 6 months after completion of treatment with irinotecan- and oxaliplatin- or oxaliplatin-based chemotherapy for mCRC;
• Radiographic measurement of tumor burden done within 28 days prior to Day 1 (start of treatment with investigational product);
• At least 1 uni-dimensionally measurable lesion ≥ 20 mm using conventional computed tomography (CT) or magnetic resonance imaging (MRI) or ≥ 10 mm by spiral CT scan per modified RECIST v1.0. Lesion must not be chosen from a previously irradiated field, unless there has been documented disease progression in that field after irradiation and prior to enrollment. All sites of disease must be evaluated;
• At least 1 tumor (preferably a metastasis or unresected primary tumour) that is amenable to core biopsy, as determined by the clinician who will perform the biopsy;
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
• A life expectancy estimate of ≥ 3 months;
• Willing to undergo two serial core biopsy procedures of tumors (metastasis or unresected primary);
• other criteria may apply

Exclusion Criteria:

• History of other primary cancer, unless:

  • Malignancy treated with curative intent and with no known active disease present for ≥ 3 years before enrollment and felt to be at low risk for recurrence by the treating physician,

• Adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease,

  • Adequately treated cervical carcinoma in situ without evidence of disease,
  • Prostatic intraepithelial neoplasia without evidence of prostate cancer;
• History of prior or concurrent central nervous system (CNS) metastases;
• Prior treatment with anti-EGFR (eg, panitumumab, cetuximab or small molecule inhibitors (eg, erlotinib, gefitinib);
• Prior treatment with monoclonal antibodies directed against insulin-like growth factor-1 receptor (IGF-1R) or small molecule inhibitors directed against IGF-1R;
• Use of systemic chemotherapy or radiotherapy ≤ 21 days before enrollment. Subjects must have recovered from acute toxicities related to radiotherapy;
• Use of any antibody therapy (eg, bevacizumab) ≤ 42 days before enrolment;
• Use of anti-tumor therapies including prior experimental agents or approved anti-tumor small molecules ≤ 30 days before enrolment;
• Known allergy or hypersensitivity to any component of panitumumab, irinotecan, or AMG 479;
• Known uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) polymorphisms predisposing to increased irinotecan toxicity;
• History of irinotecan intolerance that may interfere with planned treatment;
• History of interstitial lung disease (eg, pneumonitis, pulmonary fibrosis) or evidence of interstitial lung disease on baseline chest CT scan;
• Clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) ≤ 1 year before enrolment;
• Active inflammatory bowel disease or other active bowel disease causing chronic diarrhea (defined as ≥ grade 2 per Common Terminology Criteria for Adverse Events (CTCAE) version 3.0);
• Known positive test(s) for human immunodeficiency virus (HIV) infection, hepatitis C virus, acute or chronic active hepatitis B infection;
• Major surgical procedure ≤ 28 days before enrollment or minor surgical procedure ≤ 14 days before enrollment. Subjects must have recovered from surgery related toxicities. Core biopsy, central venous catheter placement, fine needle aspiration, thoracentesis, or paracentesis is not considered a major or minor surgical procedure; - Other investigational procedures or drugs (ie, participation in another clinical study) ≤ 30 days before enrolment;
• other criteria may apply