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Pemetrexed and Erlotinib for Metastatic Colorectal Cancer

Primary Purpose

Metastatic Colorectal Cancer

Status
Completed
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Pemetrexed
Erlotinib
Sponsored by
Yonsei University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female, aged ≥ 19 years
  2. Histologic or cytologic confirmed diagnosis of colorectal carcinoma with metastatic (STAGE IV) disease.
  3. Confirmed KRAS(codon 12 or 13) status
  4. Prior chemotherapy for metastatic disease is required; prior regimens must include fluoropyrimidine, oxaliplatin and irinotecan
  5. Eastern Cooperative Oncology Group performance status ≤ 2
  6. Patients who can swallow oral medication.
  7. Life expectancy of greater than 3 months
  8. Patients must have normal organ and marrow function as defined below:

    • absolute neutrophil count ≥ 1,500/mm3
    • hemoglobin ≥ 9 g/dl
    • platelets ≥ 100,000/mm3
    • serum total bilirubin ≤ 1.5 X institutional upper limit of normal
    • aspartate aminotransferase(SGOT)/alanine aminotransferase(SGPT) ≤ 3.0 X institutional upper limit of normal (≤ 5 times the upper institutional limits of normal if hepatic metastases are present)
    • serum creatinine ≤ 1.5 times the institutional upper limits of normal or Creatinine Clearance ≥ 50ml/min
  9. The effects of Pemetrexed and Erlotinib on the developing human fetus at the recommended therapeutic dose are unknown. For this reason and because therapeutic agents used in this trial are known to be teratogenic, female participants of child bearing potential and male participants whose partner is of child bearing potential must be willing to ensure that they or their partner use effective contraception (hormonal or barrier method of birth control; abstinence) during the study and for 6 months thereafter. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  10. Participant is willing and able to give informed consent for participation in the study. Voluntary signed and dated written informed consent form in accordance with regulatory and institutional guidelines obtained before the performance of any protocol-related procedures not part of normal patient care.

Exclusion Criteria:

  1. Previous treatment with Pemetrexed and Erlotinib
  2. History of allergic reactions attributed to compounds of similar chemical or biologic composition to Pemetrexed or Erlotinib or other agents used in the study
  3. Patients who can not allow the administration of Folic acid or Vitamin B12.
  4. Past or current history of neoplasm other than colorectal carcinoma with a disease-free interval of less than 5 years, except for non-melanoma skin cancer or curatively treated carcinoma in situ of the cervix.
  5. Systemic chemotherapy within three weeks after the administration of the last before the test treatment
  6. Major surgical operation or major trauma within 4 weeks.
  7. Patients who have had wide-ranged radiotherapy within 4 weeks or limited radiotherapy within 2 2 weeks.
  8. Persistent toxicity (> CTCAE grade 1) related to previous treatment except for the hair loss.
  9. Patients with active brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
  10. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  11. Breast-feeding or pregnant female

Sites / Locations

  • Yonsei University Health System, Severance Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pemetrexed and Erlotinib

Arm Description

Pemetrexed 500 mg/m2 IV over 10 minutes on day 1 every 21 days and Erlotinib 150 mg PO once daily on days 1-21 every 21 days

Outcomes

Primary Outcome Measures

Overall response rate
Progression-free survival

Secondary Outcome Measures

Overall survival
Disease control rate
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Full Information

First Posted
March 9, 2016
Last Updated
January 10, 2020
Sponsor
Yonsei University
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1. Study Identification

Unique Protocol Identification Number
NCT02723578
Brief Title
Pemetrexed and Erlotinib for Metastatic Colorectal Cancer
Official Title
A Phase 2 Study of Pemetrexed and Erlotinib for Metastatic Colorectal Cancer Refractory to Standard Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
December 1, 2015 (Actual)
Primary Completion Date
August 2018 (Actual)
Study Completion Date
December 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Yonsei University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Pemetrexed is a multitargeted antifolate, which primarily inhibits thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase in the folate-dependent metabolic process. Nowadays, pemetrexed is used to treat malignant pleural mesothelioma and non-squamous non-small cell lung cancer. Preclinical and clinical studies showed that pemetrexed had cytotoxic activity in many kinds of cancers including colorectal cancer. Erlotinib is a tyrosine-kinase inhibitor of EGFR, which was approved for the treatment of non-small cell lung cancer. Erlotinib also showed activity to colorectal cancer cells. Recently, Zhang et al. demonstrated synergistic cytotoxicity of pemetrexed and gefitinib in preclinical study. In this multicenter, non randomized, open label phase II study, investigators aimed to evaluate the efficacy and safety of Pemetrexed and Erlotinib combination.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Pemetrexed and Erlotinib
Arm Type
Experimental
Arm Description
Pemetrexed 500 mg/m2 IV over 10 minutes on day 1 every 21 days and Erlotinib 150 mg PO once daily on days 1-21 every 21 days
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Intervention Description
Pemetrexed 500 mg/m2 IV over 10 minutes on day 1 every 21 days
Intervention Type
Drug
Intervention Name(s)
Erlotinib
Intervention Description
Erlotinib 150 mg PO once daily on days 1-21 every 21 days
Primary Outcome Measure Information:
Title
Overall response rate
Time Frame
up to 2 years
Title
Progression-free survival
Time Frame
up to 2 years
Secondary Outcome Measure Information:
Title
Overall survival
Time Frame
up to 2 years
Title
Disease control rate
Time Frame
up to 2 years
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, aged ≥ 19 years Histologic or cytologic confirmed diagnosis of colorectal carcinoma with metastatic (STAGE IV) disease. Confirmed KRAS(codon 12 or 13) status Prior chemotherapy for metastatic disease is required; prior regimens must include fluoropyrimidine, oxaliplatin and irinotecan Eastern Cooperative Oncology Group performance status ≤ 2 Patients who can swallow oral medication. Life expectancy of greater than 3 months Patients must have normal organ and marrow function as defined below: absolute neutrophil count ≥ 1,500/mm3 hemoglobin ≥ 9 g/dl platelets ≥ 100,000/mm3 serum total bilirubin ≤ 1.5 X institutional upper limit of normal aspartate aminotransferase(SGOT)/alanine aminotransferase(SGPT) ≤ 3.0 X institutional upper limit of normal (≤ 5 times the upper institutional limits of normal if hepatic metastases are present) serum creatinine ≤ 1.5 times the institutional upper limits of normal or Creatinine Clearance ≥ 50ml/min The effects of Pemetrexed and Erlotinib on the developing human fetus at the recommended therapeutic dose are unknown. For this reason and because therapeutic agents used in this trial are known to be teratogenic, female participants of child bearing potential and male participants whose partner is of child bearing potential must be willing to ensure that they or their partner use effective contraception (hormonal or barrier method of birth control; abstinence) during the study and for 6 months thereafter. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Participant is willing and able to give informed consent for participation in the study. Voluntary signed and dated written informed consent form in accordance with regulatory and institutional guidelines obtained before the performance of any protocol-related procedures not part of normal patient care. Exclusion Criteria: Previous treatment with Pemetrexed and Erlotinib History of allergic reactions attributed to compounds of similar chemical or biologic composition to Pemetrexed or Erlotinib or other agents used in the study Patients who can not allow the administration of Folic acid or Vitamin B12. Past or current history of neoplasm other than colorectal carcinoma with a disease-free interval of less than 5 years, except for non-melanoma skin cancer or curatively treated carcinoma in situ of the cervix. Systemic chemotherapy within three weeks after the administration of the last before the test treatment Major surgical operation or major trauma within 4 weeks. Patients who have had wide-ranged radiotherapy within 4 weeks or limited radiotherapy within 2 2 weeks. Persistent toxicity (> CTCAE grade 1) related to previous treatment except for the hair loss. Patients with active brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Breast-feeding or pregnant female
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joong Bae Ahn
Organizational Affiliation
Yonsei Cancer Center, Yonsei University Health System
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yonsei University Health System, Severance Hospital
City
Seoul
ZIP/Postal Code
03722
Country
Korea, Republic of

12. IPD Sharing Statement

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Pemetrexed and Erlotinib for Metastatic Colorectal Cancer

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