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TAS-102 and Oxaliplatin for the Treatment of Refractory Stage IV Colon Cancer

Primary Purpose

Metastatic Colorectal Carcinoma, Recurrent Colon Carcinoma, Refractory Colorectal Carcinoma

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Oxaliplatin
Trifluridine and Tipiracil Hydrochloride
Sponsored by
Rutgers, The State University of New Jersey
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed stage IV colon cancer (American Joint Committee on Cancer [AJCC] 7th edition) that has progressed after standard therapy that included fluorouracil (5-FU), irinotecan, oxaliplatin, bevacizumab (unless contraindicated) and an anti-EGFR antibody, if RAS wild type. Patients who could not tolerate standard agents because of unacceptable, but reversible toxicity necessitating their discontinuation will be allowed to participate
  • Patients who had received adjuvant chemotherapy and had recurrence during or within 6 months of completion of the adjuvant chemotherapy will be allowed to count the adjuvant therapy as one chemotherapy regimen
  • Progression of disease must be documented on the most recent scan
  • Presence of measurable disease
  • RAS mutation and mismatch repair deficiency (MMR) status must be determined (or tissue availability for testing if not already determined)
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  • Life expectancy of at least 3 months
  • Absolute neutrophil count (ANC) >= 1.5 x 10^9/L
  • Hemoglobin >= 9 g/dL
  • Platelets (PLT) >= 75 x 10^9/L
  • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 5 x upper limit of normal (ULN)
  • Adequate contraception if applicable
  • Women who are nursing and discontinue nursing prior to enrollment in the program
  • Ability to take oral medication (i.e., no feeding tube)
  • Patient able and willing to comply with study procedures as per protocol
  • Patient able to understand and willing to sign and date the written voluntary informed consent form (ICF) at screening visit prior to any protocol-specific procedures

Exclusion Criteria:

  • Patients who have previously received TAS-102
  • Grade 2 or higher peripheral neuropathy (functional impairment)
  • Symptomatic central nervous system (CNS) metastases requiring treatment
  • Other active malignancy within the last 3 years (except for non-melanoma skin cancer or a non-invasive/in situ cancer)
  • Pregnancy or breast feeding
  • Current therapy with other investigational agents
  • Active infection with body temperature >= 38 degree Celsius (C) due to infection
  • Major surgery within prior 4 weeks (the surgical incision should be fully healed prior to drug administration)
  • Any anticancer therapy within prior 3 weeks of first dose of study drug
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to TAS-102
  • Current therapy with other investigational agents or participation in another clinical study or any investigational agent received within prior 4 weeks
  • Grade 3 or higher hypersensitivity reaction to oxaliplatin, or grade 1-2 hypersensitivity reaction to oxaliplatin not controlled with pre-medication
  • Has unresolved toxicity of greater than or equal to Common Terminology Criteria for Adverse (CTCAE) grade 2 attributed to any prior therapies (excluding anemia, alopecia, skin pigmentation, and platinum-induced neurotoxicity)

Sites / Locations

  • Trinitas Hospital and Comprehensive Cancer Center
  • RWJBarnabas Health - Monmouth Medical Center Southern Campus
  • Saint Barnabas Medical Center
  • RWJBarnabas Health - Monmouth Medical Center
  • Rutgers Cancer Institute of New Jersey
  • RWJBarnabas Health - Community Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (TAS-102, oxaliplatin)

Arm Description

Patients receive TAS-102 PO BID on days 1-5 and oxaliplatin IV over 2 hours on day 1. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Overall response rate
Response rate is defined as the percentage of subjects with a confirmed complete response (CR) or partial response (PR) by investigator assessment as per Response Evaluation Criteria in Solid Tumors (RECIST) criteria, version 1.1. Response rate will be calculated by dose level. Descriptive statistics will be used to analyze efficacy data using historical data as reference.

Secondary Outcome Measures

Progression free survival
Progression will be assessed by a computed tomography CT scan according to RECIST criteria version 1.1. This criterion will be estimated by the Kaplan-Meier method. Patients who have not progressed or died at the time of analysis will be censored at the time of their latest follow-up with clinically stable disease.
Overall survival
Disease control rate
Duration of response
Response rate will be calculated by dose level. Descriptive statistics will be used to analyze efficacy data using historical data as reference.
Incidence of adverse events
All recorded adverse events will be listed and tabulated by system organ class and dose level. Will utilize the Cancer Therapy Evaluation Program Common Toxicity Criteria (CTC) version 5.0 for toxicity and adverse event reporting.

Full Information

First Posted
March 2, 2020
Last Updated
September 14, 2023
Sponsor
Rutgers, The State University of New Jersey
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT04294264
Brief Title
TAS-102 and Oxaliplatin for the Treatment of Refractory Stage IV Colon Cancer
Official Title
TAS-102 in Combination With Oxaliplatin (TAS-OX) for Refractory Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 12, 2019 (Actual)
Primary Completion Date
March 1, 2024 (Anticipated)
Study Completion Date
March 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Rutgers, The State University of New Jersey
Collaborators
National Cancer Institute (NCI)

4. Oversight

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

5. Study Description

Brief Summary
This phase II trial studies how well TAS-102 and oxaliplatin work in treating patients with stage IV colon cancer. Drugs used in chemotherapy, such as TAS-102 and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.
Detailed Description
PRIMARY OBJECTIVE: I. Overall response rate (ORR). SECONDARY OBJECTIVES: I. Progression free survival (PFS). II. Overall survival (OS). III. Disease control rate (DCR). IV. Duration of response. V. Safety and tolerability. OUTLINE: Patients receive trifluridine and tipiracil hydrochloride (TAS-102) orally (PO) twice daily (BID) on days 1-5 and oxaliplatin intravenously (IV) over 2 hours on day 1. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 28 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Carcinoma, Recurrent Colon Carcinoma, Refractory Colorectal Carcinoma, Stage IV Colon Cancer AJCC v7, Stage IVA Colon Cancer AJCC v7, Stage IVB Colon Cancer AJCC v7

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 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment (TAS-102, oxaliplatin)
Arm Type
Experimental
Arm Description
Patients receive TAS-102 PO BID on days 1-5 and oxaliplatin IV over 2 hours on day 1. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Other Intervention Name(s)
1-OHP, Ai Heng, Aiheng, Dacotin, Dacplat, Diaminocyclohexane Oxalatoplatinum, Eloxatin, Eloxatine, JM-83, Oxalatoplatin, Oxalatoplatinum, RP 54780, RP-54780, SR-96669
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Trifluridine and Tipiracil Hydrochloride
Other Intervention Name(s)
Lonsurf, TAS 102, TAS-102, Tipiracil Hydrochloride Mixture with Trifluridine, Trifluridine/Tipiracil, Trifluridine/Tipiracil Hydrochloride Combination Agent TAS-102
Intervention Description
Given PO
Primary Outcome Measure Information:
Title
Overall response rate
Description
Response rate is defined as the percentage of subjects with a confirmed complete response (CR) or partial response (PR) by investigator assessment as per Response Evaluation Criteria in Solid Tumors (RECIST) criteria, version 1.1. Response rate will be calculated by dose level. Descriptive statistics will be used to analyze efficacy data using historical data as reference.
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
Progression free survival
Description
Progression will be assessed by a computed tomography CT scan according to RECIST criteria version 1.1. This criterion will be estimated by the Kaplan-Meier method. Patients who have not progressed or died at the time of analysis will be censored at the time of their latest follow-up with clinically stable disease.
Time Frame
From the date of start of treatment to the date of first documented progression or any cause of death during the study, assessed up to 2 years
Title
Overall survival
Time Frame
Up to 2 years
Title
Disease control rate
Time Frame
Up to 2 years
Title
Duration of response
Description
Response rate will be calculated by dose level. Descriptive statistics will be used to analyze efficacy data using historical data as reference.
Time Frame
Up to 2 years
Title
Incidence of adverse events
Description
All recorded adverse events will be listed and tabulated by system organ class and dose level. Will utilize the Cancer Therapy Evaluation Program Common Toxicity Criteria (CTC) version 5.0 for toxicity and adverse event reporting.
Time Frame
Up to 28 days post treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed stage IV colon cancer (American Joint Committee on Cancer [AJCC] 7th edition) that has progressed after standard therapy that included fluorouracil (5-FU), irinotecan, oxaliplatin, bevacizumab (unless contraindicated) and an anti-EGFR antibody, if RAS wild type. Patients who could not tolerate standard agents because of unacceptable, but reversible toxicity necessitating their discontinuation will be allowed to participate Patients who had received adjuvant chemotherapy and had recurrence during or within 6 months of completion of the adjuvant chemotherapy will be allowed to count the adjuvant therapy as one chemotherapy regimen Progression of disease must be documented on the most recent scan Presence of measurable disease RAS mutation and mismatch repair deficiency (MMR) status must be determined (or tissue availability for testing if not already determined) Eastern Cooperative Oncology Group (ECOG) performance status 0-1 Life expectancy of at least 3 months Absolute neutrophil count (ANC) >= 1.5 x 10^9/L Hemoglobin >= 9 g/dL Platelets (PLT) >= 75 x 10^9/L Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 5 x upper limit of normal (ULN) Adequate contraception if applicable Women who are nursing and discontinue nursing prior to enrollment in the program Ability to take oral medication (i.e., no feeding tube) Patient able and willing to comply with study procedures as per protocol Patient able to understand and willing to sign and date the written voluntary informed consent form (ICF) at screening visit prior to any protocol-specific procedures Exclusion Criteria: Patients who have previously received TAS-102 Grade 2 or higher peripheral neuropathy (functional impairment) Symptomatic central nervous system (CNS) metastases requiring treatment Other active malignancy within the last 3 years (except for non-melanoma skin cancer or a non-invasive/in situ cancer) Pregnancy or breast feeding Current therapy with other investigational agents Active infection with body temperature >= 38 degree Celsius (C) due to infection Major surgery within prior 4 weeks (the surgical incision should be fully healed prior to drug administration) Any anticancer therapy within prior 3 weeks of first dose of study drug History of allergic reactions attributed to compounds of similar chemical or biologic composition to TAS-102 Current therapy with other investigational agents or participation in another clinical study or any investigational agent received within prior 4 weeks Grade 3 or higher hypersensitivity reaction to oxaliplatin, or grade 1-2 hypersensitivity reaction to oxaliplatin not controlled with pre-medication Has unresolved toxicity of greater than or equal to Common Terminology Criteria for Adverse (CTCAE) grade 2 attributed to any prior therapies (excluding anemia, alopecia, skin pigmentation, and platinum-induced neurotoxicity)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Howard S Hochster
Organizational Affiliation
Rutgers Cancer Institute of New Jersey
Official's Role
Principal Investigator
Facility Information:
Facility Name
Trinitas Hospital and Comprehensive Cancer Center
City
Elizabeth
State/Province
New Jersey
ZIP/Postal Code
07202
Country
United States
Facility Name
RWJBarnabas Health - Monmouth Medical Center Southern Campus
City
Lakewood
State/Province
New Jersey
ZIP/Postal Code
08701
Country
United States
Facility Name
Saint Barnabas Medical Center
City
Livingston
State/Province
New Jersey
ZIP/Postal Code
07039
Country
United States
Facility Name
RWJBarnabas Health - Monmouth Medical Center
City
Long Branch
State/Province
New Jersey
ZIP/Postal Code
07740
Country
United States
Facility Name
Rutgers Cancer Institute of New Jersey
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08903
Country
United States
Facility Name
RWJBarnabas Health - Community Medical Center
City
Toms River
State/Province
New Jersey
ZIP/Postal Code
08755
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

TAS-102 and Oxaliplatin for the Treatment of Refractory Stage IV Colon Cancer

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