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FOLFIRI in Combination With Cetuximab in the First-line Treatment of Metastatic Colorectal Cancer Including a Regular Dermal Prophylaxis to Prevent Acneiforme Follicular Exanthema (DERMATUX)

Primary Purpose

Colorectal Cancer Metastatic

Status
Unknown status
Phase
Phase 4
Locations
Germany
Study Type
Interventional
Intervention
FOLFIRI + Cetuximab
Sponsored by
Dr. Carl Schimanski
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer Metastatic focused on measuring Phase IV Study, Metastatic Colorectal Cancer (mCRC, Cetuximab (Erbitux), first-line treatment, acneiform follicular exanthema, rash, vitamin K1

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically-confirmed metastatic colorectal cancer (primary tumor or metastasis)
  • Confirmation of KRAS wildtype status
  • Confirmation of EGFR-Expression in the tumor
  • Stadium IV
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Qualified for an application of FOLFIRI + Cetuximab treatment
  • Signed patient informed consent form
  • Of either gender and aged 18 years or more
  • Estimated lifespan more than 3 months
  • Measurable disease according to RECIST 1.1 guidelines. The evaluation has to be max. 4 weeks
  • Effective and adequate contraceptive precautions of man or woman in a childbearing potential age (double barrier method)
  • Leucocytes ≥ 3,0 x 10^9/L with neutrophils ≥ 1,5 x 10^9/L, thrombocytes ≥ 100 x 10^9/L, haemoglobin ≥ 5,6 mmol/L
  • Serum bilirubin ≤ 1,5 x ULN (upper limit of normal)
  • ALAT and ASAT ≤ 2,5 x ULN; if metastasis in liver, than ALAT and ASAT ≤ 5 x ULN
  • Serum creatinin ≤ 1,5 x ULN
  • If applicable a prior operation has to be min. 4 weeks ago, biopsy more than 1 week until initiation of treatment. Wounds of operations had to be completely cured
  • No toxicity of prior treatments

Exclusion Criteria:

  • KRAS-gene mutation
  • Confirmation of non-EGFR-Expression
  • Prior treatment with an EGRF-receptor inhibitor
  • Prior chemotherapy of the mCRC, except (neo-)adjuvant therapy, which had to be ended min. 6 months before recruitment
  • Experimental treatment medication within 30 days before recruitment
  • Known hypersensitivity against components of the chemotherapy, cetuximab, doxycycline, Reconval K1 or Dermatop
  • Rosacea
  • Other chronic dermal diseases with development of papula or pustule
  • Known lung fibrosis or interstitial pneumonitis or interstitial lung diseases
  • keratitis, ulcerative keratitis or severe form of dry eye
  • Pregnancy or breast feeding
  • Brain metastasis
  • Clinical relevant coronary heart disease, myocardial infarction within the last 12 months or high risk of uncontrollable arrhythmia
  • Acute or subacute ileus or chronic colon-inflammation or chronic diarrhea
  • Symptomatic peritoneal carcinomatosis
  • Serious, non-healing wounds, ulcera or bone fractures
  • Uncontrollable arterial hypertension
  • Therapeutic anticoagulation (e.g. therapy with marcumar)
  • Known dihydropyrimidine dehydrogenase deficiency
  • Gilbert-Meulengracht-syndrome
  • Other malignant tumours less than five years old. Exceptions include basocellular carcinoma or an in situ cancer of the cervix uteri if they are curative treated as well as an untreated, locally confined, asymptotic "low risk" (indolent) prostata carcinoma (Stage T ≤ T1-2a, PSA < 15 ng/ml, Gleason-Score ≤ 6 ).
  • Known abuse of narcotic drugs or alcohol
  • Any kind of disorder that compromises the ability of the subject to give written informed consent and/or comply with the study procedures
  • Any significant concomitant disease that excludes the participation to the study
  • Missing or limited juristic contractual capability

Sites / Locations

  • Universitätsmedizin Mainz

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

FOLFIRI + Cetuximab

Arm Description

Outcomes

Primary Outcome Measures

Progression-free survival
Progression-free survival rate at 12 months

Secondary Outcome Measures

Progression-free survival
ORR
Objective response rate over the entire treatment period
OS
Overall survival time
Duration until development of acneiforme follicular exanthema >= grade 2
Duration until development of acneiforme follicular exanthema >= grade 2 during treatment-phase
Development of paronychia
Development of paronychia during treatment-phase
Development of skin fissure (hand and foot)
Development of skin fissure (hand and foot) during treatment-phase
Rate of secondary resections of metastasis of liver with a curative approach
Rate of secondary resections of metastasis of liver with a curative approach during treatment-phase
Assessment of safety and tolerability
Assessment of safety and tolerability during treatment phase
Development of acneiforme follicular exanthema >= grade2
Development of acneiforme follicular exanthema >= grade2 during treatment phase

Full Information

First Posted
March 11, 2011
Last Updated
December 17, 2013
Sponsor
Dr. Carl Schimanski
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1. Study Identification

Unique Protocol Identification Number
NCT01315990
Brief Title
FOLFIRI in Combination With Cetuximab in the First-line Treatment of Metastatic Colorectal Cancer Including a Regular Dermal Prophylaxis to Prevent Acneiforme Follicular Exanthema
Acronym
DERMATUX
Official Title
Non-randomized Phase-IV-study to Investigate the Efficacy of FOLFIRI in Combination With Cetuximab in the First-line Treatment of Metastatic Colorectal Cancer Including a Regular Dermal Prophylaxis to Prevent Acneiforme Follicular Exanthema
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Unknown status
Study Start Date
January 2011 (undefined)
Primary Completion Date
March 2015 (Anticipated)
Study Completion Date
March 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Dr. Carl Schimanski

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this interventional study is to assess the progression free survival (one year) of patients with treatment of FOLFIRI and cetuximab, combined with an optional dermal prophylaxis. Further Objectives: Development of acneiforme follicular exanthema >= grade 2 Duration until development of acneiforme follicular exanthema >= grade 2 Development of paronychia Development skin fissure (hand and foot) Objective remission according RECIST 1.1 Rate of secondary resections of liver metastasis with a curative approach Assessment of safety and tolerability Overall survival Progression free survival
Detailed Description
Subjects with metastatic colorectal cancer and confirmed KRAS-wildtype status in 1st line therapy will be included in this phase IV-study. Subject will receive a regimen of FOLFIRI in combination with Cetuximab every two weeks during study treatment phase. Treatment continues until disease progression complete response development of status of operability an uncontrollable exanthema grade 3 or 4 or intolerable toxicity is diagnosed. After study discontinuation or end of treatment, respectively, patients will be followed up until the the last patient was treated for 12 months and has completed the 36-months follow up phase. Tumor response will be evaluated (according to RECIST 1.1) every 12 weeks and at the end of study treatment

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer Metastatic
Keywords
Phase IV Study, Metastatic Colorectal Cancer (mCRC, Cetuximab (Erbitux), first-line treatment, acneiform follicular exanthema, rash, vitamin K1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
165 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
FOLFIRI + Cetuximab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
FOLFIRI + Cetuximab
Intervention Description
Cetuximab (Erbitux® )- Cetuximab is a recombinant IgG1 chimeric monoclonal antibody directed against human epidermal growth factor receptor (EGFR). FOLFIRI regimen Administration Schedule: Cetuximab at a initial dose 400 mg/sqm (first week), then 250 mg/sqm on day 1 and 8 Background Chemotherapy (every two weeks) Irinotecan 180 mg/m² iv , 90 min on day 1 Folic acid (racemic) 400 mg/m², 120 min on day 1 5-FU 400 mg/m² bolus on day 1 5-FU 2400 mg/m² iv over 46 h on day 1 to 2
Primary Outcome Measure Information:
Title
Progression-free survival
Description
Progression-free survival rate at 12 months
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Progression-free survival
Time Frame
up to end of follow-up-phase (36 months)
Title
ORR
Description
Objective response rate over the entire treatment period
Time Frame
approximately 12 months
Title
OS
Description
Overall survival time
Time Frame
The time from regsitration date to the date of death
Title
Duration until development of acneiforme follicular exanthema >= grade 2
Description
Duration until development of acneiforme follicular exanthema >= grade 2 during treatment-phase
Time Frame
approximately 12 months
Title
Development of paronychia
Description
Development of paronychia during treatment-phase
Time Frame
approximately 12 months
Title
Development of skin fissure (hand and foot)
Description
Development of skin fissure (hand and foot) during treatment-phase
Time Frame
approximately 12 months
Title
Rate of secondary resections of metastasis of liver with a curative approach
Description
Rate of secondary resections of metastasis of liver with a curative approach during treatment-phase
Time Frame
approximately 12 months
Title
Assessment of safety and tolerability
Description
Assessment of safety and tolerability during treatment phase
Time Frame
approximately 12 months
Title
Development of acneiforme follicular exanthema >= grade2
Description
Development of acneiforme follicular exanthema >= grade2 during treatment phase
Time Frame
approximately 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically-confirmed metastatic colorectal cancer (primary tumor or metastasis) Confirmation of KRAS wildtype status Confirmation of EGFR-Expression in the tumor Stadium IV Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 Qualified for an application of FOLFIRI + Cetuximab treatment Signed patient informed consent form Of either gender and aged 18 years or more Estimated lifespan more than 3 months Measurable disease according to RECIST 1.1 guidelines. The evaluation has to be max. 4 weeks Effective and adequate contraceptive precautions of man or woman in a childbearing potential age (double barrier method) Leucocytes ≥ 3,0 x 10^9/L with neutrophils ≥ 1,5 x 10^9/L, thrombocytes ≥ 100 x 10^9/L, haemoglobin ≥ 5,6 mmol/L Serum bilirubin ≤ 1,5 x ULN (upper limit of normal) ALAT and ASAT ≤ 2,5 x ULN; if metastasis in liver, than ALAT and ASAT ≤ 5 x ULN Serum creatinin ≤ 1,5 x ULN If applicable a prior operation has to be min. 4 weeks ago, biopsy more than 1 week until initiation of treatment. Wounds of operations had to be completely cured No toxicity of prior treatments Exclusion Criteria: KRAS-gene mutation Confirmation of non-EGFR-Expression Prior treatment with an EGRF-receptor inhibitor Prior chemotherapy of the mCRC, except (neo-)adjuvant therapy, which had to be ended min. 6 months before recruitment Experimental treatment medication within 30 days before recruitment Known hypersensitivity against components of the chemotherapy, cetuximab, doxycycline, Reconval K1 or Dermatop Rosacea Other chronic dermal diseases with development of papula or pustule Known lung fibrosis or interstitial pneumonitis or interstitial lung diseases keratitis, ulcerative keratitis or severe form of dry eye Pregnancy or breast feeding Brain metastasis Clinical relevant coronary heart disease, myocardial infarction within the last 12 months or high risk of uncontrollable arrhythmia Acute or subacute ileus or chronic colon-inflammation or chronic diarrhea Symptomatic peritoneal carcinomatosis Serious, non-healing wounds, ulcera or bone fractures Uncontrollable arterial hypertension Therapeutic anticoagulation (e.g. therapy with marcumar) Known dihydropyrimidine dehydrogenase deficiency Gilbert-Meulengracht-syndrome Other malignant tumours less than five years old. Exceptions include basocellular carcinoma or an in situ cancer of the cervix uteri if they are curative treated as well as an untreated, locally confined, asymptotic "low risk" (indolent) prostata carcinoma (Stage T ≤ T1-2a, PSA < 15 ng/ml, Gleason-Score ≤ 6 ). Known abuse of narcotic drugs or alcohol Any kind of disorder that compromises the ability of the subject to give written informed consent and/or comply with the study procedures Any significant concomitant disease that excludes the participation to the study Missing or limited juristic contractual capability
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carl Christoph Schimanski, PD Dr. med.
Organizational Affiliation
Universitätsmedizin Mainz
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsmedizin Mainz
City
Mainz
ZIP/Postal Code
55131
Country
Germany

12. IPD Sharing Statement

Learn more about this trial

FOLFIRI in Combination With Cetuximab in the First-line Treatment of Metastatic Colorectal Cancer Including a Regular Dermal Prophylaxis to Prevent Acneiforme Follicular Exanthema

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