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CMAB009 Combined With FOLFIRI First-line Treatment in Patients With RAS/BRAF Wild-type, Metastatic Colorectal Cancer

Primary Purpose

Metastatic Colorectal Cancer

Status
Active
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
CMAB009
Irinotecan
Folinic acid
5-fluorouracil
Sponsored by
Taizhou Mabtech Pharmaceutical Co.,Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males or females, Aged ≥18 years and ≤75 years
  2. Diagnosis of histologically confirmed adenocarcinoma of the colon or rectum
  3. First occurrence of metastatic disease(not curatively resected)
  4. RAS/BRAF wild-type status in tumor tissue
  5. At least one measurable lesion by computer tomography(CT) or magnetic resonance imaging (MRI)according to RECIST1.1 criteria (not in an irradiated area)
  6. Eastern Cooperative Oncology Group(ECOG)performance status of 0 or 1 at trial entry
  7. Life expectancy of at least 3 months
  8. Medically accepted effective contraception if procreative potential exists(applicable for both male and female subjects until at least 90 days after the last dose of trial treatment)
  9. Recovery from relevant toxicity due to previous treatment before trial entry
  10. Signed the informed consent form voluntarily

Exclusion Criteria:

  1. Radiotherapy or surgery(excluding prior diagnostic biopsy)in the 30 days before trial treatment
  2. Hepatic, marrow, liver and renal function as follows:

    Marrow: white blood cell count <3.0 × 109/L with neutrophils<1.5 × 109/L, platelet count<100×109/L and hemoglobin<90 g/L; Liver function: Total bilirubin >1.5 × upper limit of reference range; Aspartate transaminase (AST) and alanine transaminase (ALT) > 2.5 × upper limit of reference range , or> 5 × upper reference range in subjects with liver metastasis; Renal function: Serum creatinine >1.5 × upper limit of reference range, or creatinine clearance<50 mL/min

  3. Previous chemotherapy for CRC adjuvant treatment if terminated <12 months before diagnosis of recurrence or metastatic disease
  4. Previous treatment with anti-EGFR monoclonal antibody, epidermal growth factor receptor tyrosine kinase inhibitor, or other EGFR targeted inhibitors(such as cetuximab, Nimotuzumab, or panitumumab)
  5. Known hypersensitivity or allergic reactions against any of the components of the trial treatments
  6. History of organ allograft, autologous stem cell transplantation, or allogeneic stem cell transplantation
  7. Other non-permitted concomitant anti-cancer therapies
  8. Known brain metastasis and/or leptomeningeal disease
  9. Previous malignancy other than CRC in the last 5 years except basal cell cancer of the skin or preinvasive cancer of the cervix
  10. Participation in another clinical trial within the past 30 days
  11. Concurrent chronic systemic immune therapy or hormone therapy except physiologic replacement
  12. Any unstable systemic disease, such as active infection, uncontrolled hypertension, unstable angina pectoris, angina in the last 3 months, cardiac failure of New York Heart Association classes ≥II, history of myocardial infarction, serious cardiac arrhythmias that require drug treatment, liver, kidney or metabolic disease in the last 6 months
  13. Acute or sub-acute intestinal occlusion or history of inflammatory bowel disease
  14. severe bone marrow function failure
  15. Any disease, metabolic disorders, or physical/laboratory examination suspected, or patients with high risk of complications
  16. Known and declared history of human immunodeficiency virus(HIV)infection
  17. HBV-DNA >1.0 × 103copy
  18. Pregnancy or breastfeeding
  19. Alcohol or drug abuse
  20. Legal incapacity or limited legal capacity

Sites / Locations

  • Cancer hospital Chinese academy of medical sciences
  • Tianjing medical university cancer institute and hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CMAB009 + FOLFIRI

FOLFIRI

Arm Description

Drug: CMAB009(recombinant chimeric anti-EGFR monoclonal antibody injection), will be administered every 7 days at an initial dose of 400mg/m^2 and 250mg/m^2 for subsequent infusions until progression of disease , withdrawal of consent, or unacceptable toxicity. Drug: Irinotecan bi-weekly irinotecan infusion of 180mg/m^2 on Day 1. Drug: Folinic Acid infusion 400mg/m^2 of folinic acid in on Day 1. Drug: 5-Fluorouracil bolus 5-Fluorouracil bolus of 400mg/m^2 followed by a 46-48 h continuous infusion of 2400mg/m^2. every 2 weeks until progression of disease , withdrawal of consent, or unacceptable toxicity.

FOLFIRI Drug: Irinotecan bi-weekly irinotecan infusion of 180mg/m^2 on Day 1. Drug: Folinic Acid infusion 400mg/m^2 of folinic acid in on Day 1. Drug: 5-Fluorouracil bolus 5-Fluorouracil bolus of 400mg/m^2 followed by a 46-48 h continuous infusion of 2400mg/m^2. every 2 weeks until progression of disease , withdrawal of consent, or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Progression-free Survival (PFS)
Defined as the duration from randomization until the date of first documented progression or date of death from any cause when death occurred within 90 days of randomization or the last tumor assessment, whichever was later. Progressive disease assessed by RECIST1.1

Secondary Outcome Measures

Best Overall Response Rate(ORR)
Defined as the percentage of subjects having achieved confirmed Complete Response + Partial Response as the best overall response based on RECIST1.1
Overall Survival Time (OS)
Defined as the time from randomization to death
Duration of Response
Defined as the time from first assessment of CR or PR to disease progression or death
Number of Subjects with Curative Surgery of Liver Metastases
Defined as the number of subjects who underwent liver metastatic surgery with all lesions been resected completely after start of treatment
Quality of Life Assessment
EORTC-QLQ-C30
Pharmacokinetic Parameters
Area under the curve and the Maximum concentration of CMAB009
Incidence of anti-CMAB009 antibody
The incidence rate of ADA (anti-CMAB009 antibody)and Nab(neutralizing antibody)

Full Information

First Posted
June 28, 2017
Last Updated
October 18, 2022
Sponsor
Taizhou Mabtech Pharmaceutical Co.,Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT03206151
Brief Title
CMAB009 Combined With FOLFIRI First-line Treatment in Patients With RAS/BRAF Wild-type, Metastatic Colorectal Cancer
Official Title
Open, Randomized, Controlled, Multicenter Phase III Study Comparing CMAB009 Plus FOLFIRI Versus FOLFIRI Alone as First-line Treatment for Epidermal Growth Factor Receptor-expressing, RAS/BRAF Wild-type, Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 12, 2017 (Actual)
Primary Completion Date
May 6, 2022 (Actual)
Study Completion Date
June 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Taizhou Mabtech Pharmaceutical Co.,Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Drugs used against cancer work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as CMAB009, can block tumor growth in different ways. Giving combination chemotherapy together with CMAB009 as first treatment after diagnosis of a metastatic colorectal cancer(first-line treatment)may improve the treatment efficacy. However, it is not yet known whether giving combination chemotherapy together with CMAB009 is more effective than combination chemotherapy alone. This open-label trial investigates the effectiveness of CMAB009 in combination with a standard and effective chemotherapy FOLFIRI(5-Fluorouracil /Folinic acid plus Irinotecan)for RAS/BRAF wild-type, metastatic colorectal cancer in first-line setting, compared to the same chemotherapy alone.
Detailed Description
Patients will be randomly assign in one of the two groups to either receive the combination chemotherapy alone or with CMAB009 and will then be treated until progression of the disease or unacceptable toxicity occurred. Regular efficacy assessments(every 8 weeks)based on imaging will be performed throughout the study together with regular safety assessments. After participant discontinuation from the trial, regular updates on further treatments and survival status will be requested from the investigator.

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 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
520 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CMAB009 + FOLFIRI
Arm Type
Experimental
Arm Description
Drug: CMAB009(recombinant chimeric anti-EGFR monoclonal antibody injection), will be administered every 7 days at an initial dose of 400mg/m^2 and 250mg/m^2 for subsequent infusions until progression of disease , withdrawal of consent, or unacceptable toxicity. Drug: Irinotecan bi-weekly irinotecan infusion of 180mg/m^2 on Day 1. Drug: Folinic Acid infusion 400mg/m^2 of folinic acid in on Day 1. Drug: 5-Fluorouracil bolus 5-Fluorouracil bolus of 400mg/m^2 followed by a 46-48 h continuous infusion of 2400mg/m^2. every 2 weeks until progression of disease , withdrawal of consent, or unacceptable toxicity.
Arm Title
FOLFIRI
Arm Type
Active Comparator
Arm Description
FOLFIRI Drug: Irinotecan bi-weekly irinotecan infusion of 180mg/m^2 on Day 1. Drug: Folinic Acid infusion 400mg/m^2 of folinic acid in on Day 1. Drug: 5-Fluorouracil bolus 5-Fluorouracil bolus of 400mg/m^2 followed by a 46-48 h continuous infusion of 2400mg/m^2. every 2 weeks until progression of disease , withdrawal of consent, or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
CMAB009
Other Intervention Name(s)
Eribitux
Intervention Description
for injection only
Intervention Type
Drug
Intervention Name(s)
Irinotecan
Other Intervention Name(s)
Camptosar
Intervention Description
for injection only
Intervention Type
Drug
Intervention Name(s)
Folinic acid
Other Intervention Name(s)
leucovorin
Intervention Description
for injection only
Intervention Type
Drug
Intervention Name(s)
5-fluorouracil
Other Intervention Name(s)
Fluoroplex
Intervention Description
for injection only
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
Defined as the duration from randomization until the date of first documented progression or date of death from any cause when death occurred within 90 days of randomization or the last tumor assessment, whichever was later. Progressive disease assessed by RECIST1.1
Time Frame
Baseline up to 24 months
Secondary Outcome Measure Information:
Title
Best Overall Response Rate(ORR)
Description
Defined as the percentage of subjects having achieved confirmed Complete Response + Partial Response as the best overall response based on RECIST1.1
Time Frame
Baseline up to 24 months
Title
Overall Survival Time (OS)
Description
Defined as the time from randomization to death
Time Frame
Baseline up to 48 months
Title
Duration of Response
Description
Defined as the time from first assessment of CR or PR to disease progression or death
Time Frame
Baseline up to 24 months
Title
Number of Subjects with Curative Surgery of Liver Metastases
Description
Defined as the number of subjects who underwent liver metastatic surgery with all lesions been resected completely after start of treatment
Time Frame
Baseline up to 12 months
Title
Quality of Life Assessment
Description
EORTC-QLQ-C30
Time Frame
Baseline up to 24 months
Title
Pharmacokinetic Parameters
Description
Area under the curve and the Maximum concentration of CMAB009
Time Frame
Baseline up to 50 days
Title
Incidence of anti-CMAB009 antibody
Description
The incidence rate of ADA (anti-CMAB009 antibody)and Nab(neutralizing antibody)
Time Frame
baseline up to 32 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or females, Aged ≥18 years and ≤75 years Diagnosis of histologically confirmed adenocarcinoma of the colon or rectum First occurrence of metastatic disease(not curatively resected) RAS/BRAF wild-type status in tumor tissue At least one measurable lesion by computer tomography(CT) or magnetic resonance imaging (MRI)according to RECIST1.1 criteria (not in an irradiated area) Eastern Cooperative Oncology Group(ECOG)performance status of 0 or 1 at trial entry Life expectancy of at least 3 months Medically accepted effective contraception if procreative potential exists(applicable for both male and female subjects until at least 90 days after the last dose of trial treatment) Recovery from relevant toxicity due to previous treatment before trial entry Signed the informed consent form voluntarily Exclusion Criteria: Radiotherapy or surgery(excluding prior diagnostic biopsy)in the 30 days before trial treatment Hepatic, marrow, liver and renal function as follows: Marrow: white blood cell count <3.0 × 109/L with neutrophils<1.5 × 109/L, platelet count<100×109/L and hemoglobin<90 g/L; Liver function: Total bilirubin >1.5 × upper limit of reference range; Aspartate transaminase (AST) and alanine transaminase (ALT) > 2.5 × upper limit of reference range , or> 5 × upper reference range in subjects with liver metastasis; Renal function: Serum creatinine >1.5 × upper limit of reference range, or creatinine clearance<50 mL/min Previous chemotherapy for CRC adjuvant treatment if terminated <12 months before diagnosis of recurrence or metastatic disease Previous treatment with anti-EGFR monoclonal antibody, epidermal growth factor receptor tyrosine kinase inhibitor, or other EGFR targeted inhibitors(such as cetuximab, Nimotuzumab, or panitumumab) Known hypersensitivity or allergic reactions against any of the components of the trial treatments History of organ allograft, autologous stem cell transplantation, or allogeneic stem cell transplantation Other non-permitted concomitant anti-cancer therapies Known brain metastasis and/or leptomeningeal disease Previous malignancy other than CRC in the last 5 years except basal cell cancer of the skin or preinvasive cancer of the cervix Participation in another clinical trial within the past 30 days Concurrent chronic systemic immune therapy or hormone therapy except physiologic replacement Any unstable systemic disease, such as active infection, uncontrolled hypertension, unstable angina pectoris, angina in the last 3 months, cardiac failure of New York Heart Association classes ≥II, history of myocardial infarction, serious cardiac arrhythmias that require drug treatment, liver, kidney or metabolic disease in the last 6 months Acute or sub-acute intestinal occlusion or history of inflammatory bowel disease severe bone marrow function failure Any disease, metabolic disorders, or physical/laboratory examination suspected, or patients with high risk of complications Known and declared history of human immunodeficiency virus(HIV)infection HBV-DNA >1.0 × 103copy Pregnancy or breastfeeding Alcohol or drug abuse Legal incapacity or limited legal capacity
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yuankai Shi Professor, Ph.D
Organizational Affiliation
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Yi Ba Professor, Ph.D
Organizational Affiliation
Tianjin Medical University Cancer Institute & Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer hospital Chinese academy of medical sciences
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100021
Country
China
Facility Name
Tianjing medical university cancer institute and hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300000
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

CMAB009 Combined With FOLFIRI First-line Treatment in Patients With RAS/BRAF Wild-type, Metastatic Colorectal Cancer

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