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A Phase 3 Study to Evaluate Xilonix as an Anticancer Therapy in Patients With Symptomatic Colorectal Cancer

Primary Purpose

Symptomatic Colorectal Cancer, Advanced Colorectal Cancer, Colorectal Cancer With Cachexia

Status
Completed
Phase
Phase 3
Locations
Poland
Study Type
Interventional
Intervention
Xilonix
Placebo
Sponsored by
Janssen Research & Development, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Symptomatic Colorectal Cancer focused on measuring colorectal cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Subjects with pathologically confirmed colorectal carcinoma that is metastatic or unresectable and which is refractory to standard therapy. To be considered refractory, a subject must have failed both an oxaliplatin (oxaliplatin may have been in the adjuvant setting) and an irinotecan based regimen.
  2. Symptomatic Disease: One symptom from each domain (metabolic and functional) must be present.

    • Evidence of metabolic dysfunction, defined as the presence of one or more of the following:
    • Any degree (up to 20%) of unintentional total body weight loss in the previous 6 months
    • Serum Interleukin 6 levels ≥10 pg/ml
    • Evidence of reduced function or presence of cancer related symptoms as determined by EORTC QLQ-C30.
    • Appetite reduction, with a score of >10
    • Presence of fatigue, with a score of >10
    • Presence of Pain, with a score of >10
    • Decreased Role, Emotional and Social function, with a score of < 90.
  3. Eastern Cooperative Oncology Group (ECOG) performance status 1 or 2.

Exclusion Criteria:

  1. Mechanical obstruction that would prevent adequate oral nutritional intake.
  2. >20% total body weight loss in the previous 6 months.
  3. Serious uncontrolled medical disorder, or active infection, that would impair the ability of the patient to receive protocol therapy.
  4. Uncontrolled or significant cardiovascular disease, including:

    • A myocardial infarction within the past 6 months.
    • Uncontrolled angina within the past 3 months.
    • Congestive heart failure within the past 3 months, if defined as NYHC-II.
    • Diagnosed or suspected congenital long QT syndrome.
    • Any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, Wolff-Parkinson-White (WPW) syndrome, or torsade de pointes).
    • Any history of second or third degree heart block (may be eligible if currently have a pacemaker).
    • Heart rate < 50 beats per minute on pre-entry electrocardiogram.
    • Uncontrolled hypertension (blood pressure >150 mm Hg systolic and >95 mm Hg diastolic).
  5. Dementia or altered mental status that would prohibit the understanding or rendering of informed consent.
  6. Subjects who have not recovered from the adverse effects of prior therapy at the time of enrollment to ≤ grade 1; excluding alopecia and grade 2 neuropathy.
  7. Subjects who have received extensive prior radiation therapy to the bone marrow. Extensive radiation therapy is defined as treatment of more than one axial bony metastasis. However for subjects with rectal cancer pelvic irradiation, in addition to treatment of one axial bony metastasis, is acceptable.
  8. Immunocompromised subjects, including subjects known to be infected with human immunodeficiency virus (HIV).
  9. Known hepatitis B surface antigen and/or hepatitis C antibody or known history of infection.
  10. History of tuberculosis (latent or active) or positive Interferon-gamma release assay (IGRA).
  11. Receipt of a live (attenuated) vaccine within 1 month prior to Randomization
  12. Subjects with history of hypersensitivity to compounds of similar chemical or biologic composition to Xilonix™ or any component of its formulations.
  13. Women who are pregnant or breastfeeding.
  14. WOCBP or men whose sexual partners are WOCBP who are unwilling or unable to use an acceptable method of contraception for at least 1 month prior to randomization, for the duration of the study, and for at least 3 months after the last dose of study medication.
  15. History of progressive multifocal leukoencephalopathy or other demyelinating disease.
  16. Subjects on immunosuppressive therapy, including transplant patients.
  17. Subjects with known brain metastases. Subjects with symptoms of brain metastases during screening should undergo CT imaging prior to randomization.

Sites / Locations

  • XBiotech Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Placebo

Xilonix

Arm Description

Placebo administered intravenously every 2 weeks

Xilonix administered intravenously every 2 weeks

Outcomes

Primary Outcome Measures

Response Rate

Secondary Outcome Measures

Full Information

First Posted
May 12, 2014
Last Updated
February 25, 2021
Sponsor
Janssen Research & Development, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02138422
Brief Title
A Phase 3 Study to Evaluate Xilonix as an Anticancer Therapy in Patients With Symptomatic Colorectal Cancer
Official Title
A Double Blind, Placebo Controlled Pivotal Phase III Study Evaluating Xilonix™ in Symptomatic Colorectal Cancer Patients Refractory to Standard Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
July 31, 2014 (Actual)
Primary Completion Date
November 30, 2015 (Actual)
Study Completion Date
November 30, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Research & Development, LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study will be to assess how effective Xilonix is in the treatment of patients with symptomatic colorectal cancer. By blocking a substance that helps tumours grow and spread, Xilonix therapy may not only slow tumour growth, but also may improve symptoms of muscle loss, fatigue, appetite loss, and pain in patients with colorectal cancer. The effectiveness of the therapy will be measured by assessing the change in these symptoms for patients treated with Xilonix versus those treated with placebo. Reversal of muscle loss will be assessed with a type of X-ray called a DEXA scanner. Improvement in pain, appetite loss, and fatigue will be measured with a questionnaire that is completed by patients enrolled on the trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Symptomatic Colorectal Cancer, Advanced Colorectal Cancer, Colorectal Cancer With Cachexia
Keywords
colorectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
276 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo administered intravenously every 2 weeks
Arm Title
Xilonix
Arm Type
Active Comparator
Arm Description
Xilonix administered intravenously every 2 weeks
Intervention Type
Biological
Intervention Name(s)
Xilonix
Intervention Type
Biological
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Response Rate
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects with pathologically confirmed colorectal carcinoma that is metastatic or unresectable and which is refractory to standard therapy. To be considered refractory, a subject must have failed both an oxaliplatin (oxaliplatin may have been in the adjuvant setting) and an irinotecan based regimen. Symptomatic Disease: One symptom from each domain (metabolic and functional) must be present. Evidence of metabolic dysfunction, defined as the presence of one or more of the following: Any degree (up to 20%) of unintentional total body weight loss in the previous 6 months Serum Interleukin 6 levels ≥10 pg/ml Evidence of reduced function or presence of cancer related symptoms as determined by EORTC QLQ-C30. Appetite reduction, with a score of >10 Presence of fatigue, with a score of >10 Presence of Pain, with a score of >10 Decreased Role, Emotional and Social function, with a score of < 90. Eastern Cooperative Oncology Group (ECOG) performance status 1 or 2. Exclusion Criteria: Mechanical obstruction that would prevent adequate oral nutritional intake. >20% total body weight loss in the previous 6 months. Serious uncontrolled medical disorder, or active infection, that would impair the ability of the patient to receive protocol therapy. Uncontrolled or significant cardiovascular disease, including: A myocardial infarction within the past 6 months. Uncontrolled angina within the past 3 months. Congestive heart failure within the past 3 months, if defined as NYHC-II. Diagnosed or suspected congenital long QT syndrome. Any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, Wolff-Parkinson-White (WPW) syndrome, or torsade de pointes). Any history of second or third degree heart block (may be eligible if currently have a pacemaker). Heart rate < 50 beats per minute on pre-entry electrocardiogram. Uncontrolled hypertension (blood pressure >150 mm Hg systolic and >95 mm Hg diastolic). Dementia or altered mental status that would prohibit the understanding or rendering of informed consent. Subjects who have not recovered from the adverse effects of prior therapy at the time of enrollment to ≤ grade 1; excluding alopecia and grade 2 neuropathy. Subjects who have received extensive prior radiation therapy to the bone marrow. Extensive radiation therapy is defined as treatment of more than one axial bony metastasis. However for subjects with rectal cancer pelvic irradiation, in addition to treatment of one axial bony metastasis, is acceptable. Immunocompromised subjects, including subjects known to be infected with human immunodeficiency virus (HIV). Known hepatitis B surface antigen and/or hepatitis C antibody or known history of infection. History of tuberculosis (latent or active) or positive Interferon-gamma release assay (IGRA). Receipt of a live (attenuated) vaccine within 1 month prior to Randomization Subjects with history of hypersensitivity to compounds of similar chemical or biologic composition to Xilonix™ or any component of its formulations. Women who are pregnant or breastfeeding. WOCBP or men whose sexual partners are WOCBP who are unwilling or unable to use an acceptable method of contraception for at least 1 month prior to randomization, for the duration of the study, and for at least 3 months after the last dose of study medication. History of progressive multifocal leukoencephalopathy or other demyelinating disease. Subjects on immunosuppressive therapy, including transplant patients. Subjects with known brain metastases. Subjects with symptoms of brain metastases during screening should undergo CT imaging prior to randomization.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research & Development, LLC Clinical Trial
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
Facility Name
XBiotech Investigative Site
City
Warsaw
Country
Poland

12. IPD Sharing Statement

Citations:
PubMed Identifier
24746841
Citation
Hong DS, Hui D, Bruera E, Janku F, Naing A, Falchook GS, Piha-Paul S, Wheler JJ, Fu S, Tsimberidou AM, Stecher M, Mohanty P, Simard J, Kurzrock R. MABp1, a first-in-class true human antibody targeting interleukin-1alpha in refractory cancers: an open-label, phase 1 dose-escalation and expansion study. Lancet Oncol. 2014 May;15(6):656-66. doi: 10.1016/S1470-2045(14)70155-X. Epub 2014 Apr 17.
Results Reference
background
PubMed Identifier
28094194
Citation
Hickish T, Andre T, Wyrwicz L, Saunders M, Sarosiek T, Kocsis J, Nemecek R, Rogowski W, Lesniewski-Kmak K, Petruzelka L, Apte RN, Mohanty P, Stecher M, Simard J, de Gramont A. MABp1 as a novel antibody treatment for advanced colorectal cancer: a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncol. 2017 Feb;18(2):192-201. doi: 10.1016/S1470-2045(17)30006-2. Epub 2017 Jan 14.
Results Reference
result

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A Phase 3 Study to Evaluate Xilonix as an Anticancer Therapy in Patients With Symptomatic Colorectal Cancer

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