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Regorafenib in Subjects With Antiangiogenic-naive and Chemotherapy-refractory Advanced Colorectal Cancer

Primary Purpose

Colorectal Neoplasms

Status
Completed
Phase
Phase 2
Locations
Brazil
Study Type
Interventional
Intervention
Regorafenib (Stivarga, BAY73-4506)
Sponsored by
Bayer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Neoplasms focused on measuring Colorectal cancer, Regorafenib

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female subjects ≥18 years of age;
  • Histological or cytological confirmation of adenocarcinoma of the colon or/and rectum;
  • Subjects with metastatic colorectal cancer (CRC) whose disease progressed or who were intolerant to standard chemotherapy based on fluoropyrimidine, oxaliplatin, irinotecan, and an anti-EGFR therapy if RAS wild-type. This progression must be during or within 4 months following the last administration of standard therapies.
  • Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria, Version 1.1.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Adequate bone-marrow, liver, and renal function
  • Women of childbearing potential and men must agree to use adequate contraception when sexually active during the study and for at least 8 weeks after the last study drug administration.

Exclusion Criteria:

  • Prior treatment with an antiangiogenic agent;
  • Congestive heart failure of New York Heart Association (NYHA) class 2 or worse;
  • Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months). Myocardial infarction less than 6 months before start of study drug;
  • Cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted)
  • Uncontrolled hypertension (systolic blood pressure >140 mmHg or diastolic pressure >90 mmHg despite optimal medical management);
  • Ongoing acute or chronic infection (> Grade 2 NCI-CTCAE v 4.03);
  • Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism (except for adequately treated catheter-related venous thrombosis occurring more than one month before the start of study medication) events within 6 months of study enrollment. Subjects being treated with low-weight heparin are allowed to participate as long as dose is limited to prophylactic use.
  • Any history of or currently known brain metastases (head CT/MRI will be performed during screening period if brain metastases are suspected)
  • Previous or concurrent cancer that is distinct in primary site or histology from colorectal cancer within 5 years before study entry, except for curatively treated cervical cancer in situ, in situ ductal breast cancer, non-melanoma skin cancer and superficial bladder tumors;
  • Last chemotherapy dose or any other anti-cancer therapy administered in less than 4 weeks from start of study treatment;
  • Use of therapeutic anticoagulation;
  • Proteinuria > 3.5 g/24 hours measured by urine protein-creatinine ratio from a random urine sample (Grade 3, NCI-CTCAE v 4.03) on urinalysis screening result. If there is medical history of proteinuria, previous urinalysis results should be considered and/or performed so at least 2 results separated by at least 2 weeks are available;
  • History of interstitial lung disease with ongoing signs and symptoms at the time of informed consent;
  • Non-healing wound, non-healing ulcer, or non-healing bone fracture;
  • Subjects with evidence or history of any bleeding diathesis, irrespective of severity;
  • Any hemorrhage or bleeding event ≥ Grade 3 NCI-CTCAE v 4.03 within 4 weeks prior to the start of study medication;
  • Known history of human immunodeficiency virus (HIV) infection;
  • History of active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy;
  • Pregnancy or breastfeeding.

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Regorafenib (BAY73-4506)

Arm Description

Regorafenib 160 mg orally once a day for 3 weeks of every 4 week cycle (i.e., 3 weeks on, 1 week off).

Outcomes

Primary Outcome Measures

Percentage of participants without disease progression or death at the end of 8 weeks

Secondary Outcome Measures

Progression-Free Survival (PFS)
PFS is defined as the date from the first dose of regorafenib until radiologic and/or clear clinical progression or death from any cause, whichever comes first.
Overall Survival (OS)
OS is defined as the date from the first dose of regorafenib until death by any cause.
Overall Response Rate (ORR)
ORR is defined as the proportion of subjects with the best tumor response (confirmed PR or CR) that is achieved during or within 30 days after therapy.
Disease Control Rate (DCR)
DCR is defined as the proportion of subjects who have a best response rating over the whole duration of the study of CR, PR, or SD.
Metabolic response measured by [18F] fluorodeoxyglucose positron emission tomography (FDG PET)
Percentage of participants with grade 1 or higher adverse events, using NCI Common Terminology Criteria for Adverse Events (CTC-AE) Version 4.03

Full Information

First Posted
June 4, 2015
Last Updated
November 6, 2018
Sponsor
Bayer
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1. Study Identification

Unique Protocol Identification Number
NCT02465502
Brief Title
Regorafenib in Subjects With Antiangiogenic-naive and Chemotherapy-refractory Advanced Colorectal Cancer
Official Title
An Uncontrolled, Open-label Phase IIb Trial of Regorafenib in Subjects With Antiangiogenic-naive and Chemotherapy-refractory Advanced Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
July 21, 2015 (Actual)
Primary Completion Date
May 2, 2017 (Actual)
Study Completion Date
December 11, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bayer

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
To determine the efficacy (as measured by progression-free survival [PFS] rate at 8 weeks) of regorafenib in subjects with metastatic colorectal cancer (CRC) whose disease is refractory to standard therapies and who were never exposed to antiangiogenic therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Neoplasms
Keywords
Colorectal cancer, Regorafenib

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Regorafenib (BAY73-4506)
Arm Type
Experimental
Arm Description
Regorafenib 160 mg orally once a day for 3 weeks of every 4 week cycle (i.e., 3 weeks on, 1 week off).
Intervention Type
Drug
Intervention Name(s)
Regorafenib (Stivarga, BAY73-4506)
Intervention Description
Regorafenib 160 mg orally once a day for 3 weeks of every 4 week cycle (i.e., 3 weeks on, 1 week off).
Primary Outcome Measure Information:
Title
Percentage of participants without disease progression or death at the end of 8 weeks
Time Frame
At week 8
Secondary Outcome Measure Information:
Title
Progression-Free Survival (PFS)
Description
PFS is defined as the date from the first dose of regorafenib until radiologic and/or clear clinical progression or death from any cause, whichever comes first.
Time Frame
Approximately 2 months
Title
Overall Survival (OS)
Description
OS is defined as the date from the first dose of regorafenib until death by any cause.
Time Frame
Approximately 2 months
Title
Overall Response Rate (ORR)
Description
ORR is defined as the proportion of subjects with the best tumor response (confirmed PR or CR) that is achieved during or within 30 days after therapy.
Time Frame
Approximately 2 months
Title
Disease Control Rate (DCR)
Description
DCR is defined as the proportion of subjects who have a best response rating over the whole duration of the study of CR, PR, or SD.
Time Frame
Approximately 2 months
Title
Metabolic response measured by [18F] fluorodeoxyglucose positron emission tomography (FDG PET)
Time Frame
Approximately 2 months
Title
Percentage of participants with grade 1 or higher adverse events, using NCI Common Terminology Criteria for Adverse Events (CTC-AE) Version 4.03
Time Frame
Approximately 2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects ≥18 years of age; Histological or cytological confirmation of adenocarcinoma of the colon or/and rectum; Subjects with metastatic colorectal cancer (CRC) whose disease progressed or who were intolerant to standard chemotherapy based on fluoropyrimidine, oxaliplatin, irinotecan, and an anti-EGFR therapy if RAS wild-type. This progression must be during or within 4 months following the last administration of standard therapies. Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria, Version 1.1. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Adequate bone-marrow, liver, and renal function Women of childbearing potential and men must agree to use adequate contraception when sexually active during the study and for at least 8 weeks after the last study drug administration. Exclusion Criteria: Prior treatment with an antiangiogenic agent; Congestive heart failure of New York Heart Association (NYHA) class 2 or worse; Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months). Myocardial infarction less than 6 months before start of study drug; Cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted) Uncontrolled hypertension (systolic blood pressure >140 mmHg or diastolic pressure >90 mmHg despite optimal medical management); Ongoing acute or chronic infection (> Grade 2 NCI-CTCAE v 4.03); Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism (except for adequately treated catheter-related venous thrombosis occurring more than one month before the start of study medication) events within 6 months of study enrollment. Subjects being treated with low-weight heparin are allowed to participate as long as dose is limited to prophylactic use. Any history of or currently known brain metastases (head CT/MRI will be performed during screening period if brain metastases are suspected) Previous or concurrent cancer that is distinct in primary site or histology from colorectal cancer within 5 years before study entry, except for curatively treated cervical cancer in situ, in situ ductal breast cancer, non-melanoma skin cancer and superficial bladder tumors; Last chemotherapy dose or any other anti-cancer therapy administered in less than 4 weeks from start of study treatment; Use of therapeutic anticoagulation; Proteinuria > 3.5 g/24 hours measured by urine protein-creatinine ratio from a random urine sample (Grade 3, NCI-CTCAE v 4.03) on urinalysis screening result. If there is medical history of proteinuria, previous urinalysis results should be considered and/or performed so at least 2 results separated by at least 2 weeks are available; History of interstitial lung disease with ongoing signs and symptoms at the time of informed consent; Non-healing wound, non-healing ulcer, or non-healing bone fracture; Subjects with evidence or history of any bleeding diathesis, irrespective of severity; Any hemorrhage or bleeding event ≥ Grade 3 NCI-CTCAE v 4.03 within 4 weeks prior to the start of study medication; Known history of human immunodeficiency virus (HIV) infection; History of active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy; Pregnancy or breastfeeding.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bayer Study Director
Organizational Affiliation
Bayer
Official's Role
Study Director
Facility Information:
City
São Paulo
ZIP/Postal Code
01246000
Country
Brazil

12. IPD Sharing Statement

Citations:
PubMed Identifier
31175167
Citation
Riechelmann RP, Leite LS, Bariani GM, Glasberg J, Rivelli TG, da Fonseca LG, Nebuloni DR, Braghiroli MI, Queiroz MA, Isejima AM, Kappeler C, Kikuchi L, Hoff PM. Regorafenib in Patients with Antiangiogenic-Naive and Chemotherapy-Refractory Advanced Colorectal Cancer: Results from a Phase IIb Trial. Oncologist. 2019 Sep;24(9):1180-1187. doi: 10.1634/theoncologist.2019-0067. Epub 2019 Jun 7.
Results Reference
derived
Links:
URL
https://clinicaltrials.bayer.com/
Description
Click here to find results for studies related to Bayer products.

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Regorafenib in Subjects With Antiangiogenic-naive and Chemotherapy-refractory Advanced Colorectal Cancer

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