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Novel Oncology Therapies in Combination With Adjuvant Chemo in High-risk MSS-CRC

Primary Purpose

Microsatellite-stable Colorectal Cancer

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Standard of Care - mFOLFOX6
E1 - mFOLFOX and durvalumab
E2 - mFOLFOX6, durvalumab and oleclumab
E3 - mFOLFOX6, durvalumab and monalizumab
Sponsored by
MedImmune LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Microsatellite-stable Colorectal Cancer focused on measuring Microsatellite stable, Colon Cancer, colorectal cancer, MSS-CRC, adjuvant

Eligibility Criteria

18 Years - 101 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Written informed consent and any locally required authorization obtained from the subject/legal representative prior to performing any protocol-related procedures, including screening evaluations.
  2. Age ≥ 18 years at the time of screening
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  4. Histologically proven Stage II or Stage III CRC

    Subjects must also meet the following criteria:

    1. Eligible for 6 months of mFOLFOX6 adjuvant chemotherapy within 8 weeks after surgery
    2. Must NOT have received prior systemic chemotherapy, immunotherapy, or radiotherapy for treatment of CRC.
    3. Must NOT have defective DNA mismatch repair (MSI) as documented by testing
  5. Margin-negative (R0; defined as >1 mm clearance) surgical resection
  6. Postoperative ctDNA-positive status defined by the presence of ctDNA derived from plasma; determined using a validated assay per protocol
  7. Subjects must have adequate organ function
  8. Body weight > 35 kg
  9. Adequate method of contraception per protocol

Exclusion Criteria:

  1. Any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product or interpretation of subject safety or study results.
  2. Evidence of metastatic disease (including presence of tumor cells in ascites or peritoneal carcinomatosis resected "en bloc").
  3. History of allogeneic organ transplantation.
  4. Active or prior documented autoimmune disorders within the past 5 years as noted in the protocol.
  5. Cardiac and vascular criteria:

    1. History of venous thrombosis within the past 3 months prior to the scheduled first dose of study treatment.
    2. Presence of acute coronary syndrome including myocardial infarction or unstable angina pectoris, other arterial thrombotic event including cerebrovascular accident or transient ischemic attack or stroke within the past 6 months prior to the scheduled first dose of study treatment.
    3. New York Heart Association (NYHA) Class II or greater congestive heart failure, serious cardiac arrhythmia requiring medication, or uncontrolled hypertension.
    4. History of hypertensive crisis/hypertensive encephalopathy within the past 6 months prior to the scheduled first dose of study treatment.
    5. Mean QT interval corrected for heart rate using Fridericia's formula (QTcF) ≥ 470 ms
  6. Uncontrolled intercurrent illness, see the protocol for details.
  7. History of another primary malignancy except for: (a) Malignancy treated with curative intent and with no known active disease ≥ 5 years prior to the scheduled first dose of study treatment and of low potential risk for recurrence
  8. History of active primary immunodeficiency.
  9. Active infection including tuberculosis, hepatitis B, hepatitis C, or human immunodeficiency virus.
  10. Known allergy or hypersensitivity to any of the investigational product or noninvestigational product formulations.
  11. Any condition that, in the opinion of the investigator, would prevent the initiation of 6 months adjuvant therapy within 8 weeks of surgery
  12. Any concurrent chemotherapy, investigational product, biologic, or hormonal therapy for cancer treatment.
  13. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to the scheduled first dose of study treatment, or anticipation of the need for major surgical procedure during the course of the study.
  14. Current or prior use of immunosuppressive medication within 14 days prior to the scheduled first dose of study treatment.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Active Comparator

    Experimental

    Experimental

    Experimental

    Arm Label

    Control Arm (mFOLFOX6)

    Durvalumab

    Oleclumab

    Monalizumab

    Arm Description

    Parts of mFOLFOX6 are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 400 mg/m2 IV bolus on Day 1 then 2,400 mg/m2 over 46 to 48 hours IV infusion Q2W (Day 1-2 of every 14-day cycle).

    Durvalumab 1500 mg IV, Q4W (Day 1 of every other 14-day cycle)

    Oleclumab 3,000 mg IV Q2W x5 then Q4W (Day 1 of every 14-day cycle through cycle 4 then Day 1 of every other 14-day cycle)

    Monalizumab 750 mg IV, Q2W (Day 1 of every 14-day cycle)

    Outcomes

    Primary Outcome Measures

    ctDNA clearance
    ctDNA clearance is defined as the change from ctDNA positive status at baseline to ctDNA negative post baseline (6 months)

    Secondary Outcome Measures

    Incidence of adverse events
    The secondary endpoint of safety as assessed by the number of subjects with adverse events and serious adverse events
    Disease free survival
    From randomization until time of first documented incidence of disease recurrence, secondary cancer, or death due to any cause, whichever occurs first
    Disease free survival at 12 months
    Percentage of subject who are disease free at 12 months post first dose of treatment
    overall survival
    From randomization until death due to any cause
    Serum conenctration levels of novel agents in combination with mFOLFOX6
    Pharmacokinetics of novel agents in combination with FOLFOX
    Number of subjects with detectable anti-drug antibody (ADA) to novel agents in combination with mFOLFOX6
    Immunogenicity of novel agents in combination with mFOLFOX6

    Full Information

    First Posted
    October 16, 2019
    Last Updated
    September 17, 2020
    Sponsor
    MedImmune LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04145193
    Brief Title
    Novel Oncology Therapies in Combination With Adjuvant Chemo in High-risk MSS-CRC
    Official Title
    A Phase 2, Open-label, Randomized, Multicenter, Platform Study of Novel Oncology Therapies in Combination With Adjuvant Chemotherapy in High-risk, Microsatellite-stable Colorectal Cancer (COLUMBIA-2)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2020
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Study withdrawn prior to enrollment due to changing standard of care landscape.
    Study Start Date
    October 1, 2020 (Anticipated)
    Primary Completion Date
    March 19, 2024 (Anticipated)
    Study Completion Date
    March 19, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    MedImmune LLC

    4. Oversight

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

    5. Study Description

    Brief Summary
    Columbia 2 is a Phase 2 platform study to evaluate the safety and efficacy of standard of care (FOLFOX) alone and in combination with novel oncology therapies in adjuvant high-risk microsatellite-stable colorectal cancer
    Detailed Description
    Columbia 2 is a Phase 2, open-label, randomized, multicenter, platform study of novel oncology therapies in combination with adjuvant chemotherapy in patients with high-risk microsatellite-stable colorectal cancer.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Microsatellite-stable Colorectal Cancer
    Keywords
    Microsatellite stable, Colon Cancer, colorectal cancer, MSS-CRC, adjuvant

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Sequential Assignment
    Model Description
    The study is designed to evaluate the efficacy and safety of standard-of-care adjuvant mFOLFOX6 chemotherapy alone or in combination with novel oncology therapies. The study will be conducted in subjects who have undergone radical surgical resection for Stage II or III MSS-CRC, are eligible for mFOLFOX6 adjuvant therapy, and are confirmed as ctDNA positive post-surgery.
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Control Arm (mFOLFOX6)
    Arm Type
    Active Comparator
    Arm Description
    Parts of mFOLFOX6 are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 400 mg/m2 IV bolus on Day 1 then 2,400 mg/m2 over 46 to 48 hours IV infusion Q2W (Day 1-2 of every 14-day cycle).
    Arm Title
    Durvalumab
    Arm Type
    Experimental
    Arm Description
    Durvalumab 1500 mg IV, Q4W (Day 1 of every other 14-day cycle)
    Arm Title
    Oleclumab
    Arm Type
    Experimental
    Arm Description
    Oleclumab 3,000 mg IV Q2W x5 then Q4W (Day 1 of every 14-day cycle through cycle 4 then Day 1 of every other 14-day cycle)
    Arm Title
    Monalizumab
    Arm Type
    Experimental
    Arm Description
    Monalizumab 750 mg IV, Q2W (Day 1 of every 14-day cycle)
    Intervention Type
    Drug
    Intervention Name(s)
    Standard of Care - mFOLFOX6
    Other Intervention Name(s)
    FOLFOX (Oxaliplatin, Folinic acid (leucovorin), Fluorouracil (5-FU))
    Intervention Description
    Parts of mFOLFOX6 are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 400 mg/m2 IV bolus on Day 1 then 2,400 mg/m2 over 46 to 48 hours IV infusion Q2W (Day 1-2 of every 14-day cycle).
    Intervention Type
    Drug
    Intervention Name(s)
    E1 - mFOLFOX and durvalumab
    Other Intervention Name(s)
    Durvalumab (MEDI-4736)
    Intervention Description
    Parts of mFOLFOX6 are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 400 mg/m2 IV bolus on Day 1 then 2,400 mg/m2 over 46 to 48 hours IV infusion Q2W (Day 1-2 of every 14-day cycle). Durvalumab 1500 mg IV, Q4W (Day 1 of every other 14-day cycle)
    Intervention Type
    Drug
    Intervention Name(s)
    E2 - mFOLFOX6, durvalumab and oleclumab
    Other Intervention Name(s)
    Durvalumab (MEDI-4736) + Oleclumab (MEDI-9447)
    Intervention Description
    Parts of mFOLFOX6 are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 400 mg/m2 IV bolus on Day 1 then 2,400 mg/m2 over 46 to 48 hours IV infusion Q2W (Day 1-2 of every 14-day cycle). Durvalumab 1500 mg IV, Q4W (Day 1 of every other 14-day cycle) Oleclumab 3,000 mg IV Q2W x5 then Q4W (Day 1 of every 14-day cycle through cycle 4 then Day 1 of every other 14-day cycle)
    Intervention Type
    Drug
    Intervention Name(s)
    E3 - mFOLFOX6, durvalumab and monalizumab
    Other Intervention Name(s)
    Durvalumab (MEDI-4736) + Monalizumab (IPH2201)
    Intervention Description
    Parts of mFOLFOX6 are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 400 mg/m2 IV bolus on Day 1 then 2,400 mg/m2 over 46 to 48 hours IV infusion Q2W (Day 1-2 of every 14-day cycle). Durvalumab 1500 mg IV, Q4W (Day 1 of every other 14-day cycle) Monalizumab 750 mg IV, Q2W (Day 1 of every 14-day cycle)
    Primary Outcome Measure Information:
    Title
    ctDNA clearance
    Description
    ctDNA clearance is defined as the change from ctDNA positive status at baseline to ctDNA negative post baseline (6 months)
    Time Frame
    From the time of first dose to 6 months post treatment
    Secondary Outcome Measure Information:
    Title
    Incidence of adverse events
    Description
    The secondary endpoint of safety as assessed by the number of subjects with adverse events and serious adverse events
    Time Frame
    From time of first dose to 90 days post last dose
    Title
    Disease free survival
    Description
    From randomization until time of first documented incidence of disease recurrence, secondary cancer, or death due to any cause, whichever occurs first
    Time Frame
    From time of first dose till end of study (5 years)
    Title
    Disease free survival at 12 months
    Description
    Percentage of subject who are disease free at 12 months post first dose of treatment
    Time Frame
    From time of first dose till end of study (5 years)
    Title
    overall survival
    Description
    From randomization until death due to any cause
    Time Frame
    From time of first dose till end of study (5 years)
    Title
    Serum conenctration levels of novel agents in combination with mFOLFOX6
    Description
    Pharmacokinetics of novel agents in combination with FOLFOX
    Time Frame
    From Day 1 up to 90 days post last dose
    Title
    Number of subjects with detectable anti-drug antibody (ADA) to novel agents in combination with mFOLFOX6
    Description
    Immunogenicity of novel agents in combination with mFOLFOX6
    Time Frame
    From Day 1 up to 90 days post last dose

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    101 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria Written informed consent and any locally required authorization obtained from the subject/legal representative prior to performing any protocol-related procedures, including screening evaluations. Age ≥ 18 years at the time of screening Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Histologically proven Stage II or Stage III CRC Subjects must also meet the following criteria: Eligible for 6 months of mFOLFOX6 adjuvant chemotherapy within 8 weeks after surgery Must NOT have received prior systemic chemotherapy, immunotherapy, or radiotherapy for treatment of CRC. Must NOT have defective DNA mismatch repair (MSI) as documented by testing Margin-negative (R0; defined as >1 mm clearance) surgical resection Postoperative ctDNA-positive status defined by the presence of ctDNA derived from plasma; determined using a validated assay per protocol Subjects must have adequate organ function Body weight > 35 kg Adequate method of contraception per protocol Exclusion Criteria: Any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product or interpretation of subject safety or study results. Evidence of metastatic disease (including presence of tumor cells in ascites or peritoneal carcinomatosis resected "en bloc"). History of allogeneic organ transplantation. Active or prior documented autoimmune disorders within the past 5 years as noted in the protocol. Cardiac and vascular criteria: History of venous thrombosis within the past 3 months prior to the scheduled first dose of study treatment. Presence of acute coronary syndrome including myocardial infarction or unstable angina pectoris, other arterial thrombotic event including cerebrovascular accident or transient ischemic attack or stroke within the past 6 months prior to the scheduled first dose of study treatment. New York Heart Association (NYHA) Class II or greater congestive heart failure, serious cardiac arrhythmia requiring medication, or uncontrolled hypertension. History of hypertensive crisis/hypertensive encephalopathy within the past 6 months prior to the scheduled first dose of study treatment. Mean QT interval corrected for heart rate using Fridericia's formula (QTcF) ≥ 470 ms Uncontrolled intercurrent illness, see the protocol for details. History of another primary malignancy except for: (a) Malignancy treated with curative intent and with no known active disease ≥ 5 years prior to the scheduled first dose of study treatment and of low potential risk for recurrence History of active primary immunodeficiency. Active infection including tuberculosis, hepatitis B, hepatitis C, or human immunodeficiency virus. Known allergy or hypersensitivity to any of the investigational product or noninvestigational product formulations. Any condition that, in the opinion of the investigator, would prevent the initiation of 6 months adjuvant therapy within 8 weeks of surgery Any concurrent chemotherapy, investigational product, biologic, or hormonal therapy for cancer treatment. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to the scheduled first dose of study treatment, or anticipation of the need for major surgical procedure during the course of the study. Current or prior use of immunosuppressive medication within 14 days prior to the scheduled first dose of study treatment.

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
    IPD Sharing Time Frame
    AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
    IPD Sharing Access Criteria
    When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
    IPD Sharing URL
    https://astrazenecagroup-dt.pharmacm.com/DT/Home

    Learn more about this trial

    Novel Oncology Therapies in Combination With Adjuvant Chemo in High-risk MSS-CRC

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