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Fruquintinib as a Maintenance Therapy Following First-line Treatment for Metastatic Colorectal Cancer

Primary Purpose

Colo-rectal Cancer

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Fruquintinib
Sponsored by
Shanghai Zhongshan Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colo-rectal Cancer focused on measuring fruquintinib, Colo-rectal Cancer, maintenance therapy

Eligibility Criteria

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

Inclusion Criteria:

  • 18-75 years old (including 18 and 75 years);
  • Eastern Cooperative Oncology Group-performance score (ECOG PS) 0 or 1;
  • Estimated survival ≥ 6 months;
  • Histologically and/or cytologically confirmed metastatic left-sided colon cancer with RAS mutation or right-sided colon cancer, having unresectable metastatic or recurrent foci;
  • Having received first-line systemic anti-tumor therapy for mCRC (chemotherapeutic drugs may include fluorouracil, oxaliplatin, irinotecan, such as XELOX, FOLFOX, FOLFIRI, and can combine or not combine with bevacizumab); achieving RECIST1.1-assessed SD (stable disease) or PR (partial response) or CR (complete response) after 18-24 weeks of first-line treatment.
  • UCG suggesting left ventricular ejection fraction ≥50%;
  • Having fully understood and voluntarily signed the informed consent.

Exclusion Criteria:

  • Absolute neutrophil count (ANC) <1.5×109/L, or platelet count <80×109/L, or hemoglobin < 9g/dL; it's not allowed to perform blood transfusion within 2 week before enrollment to meet the inclusion criteria;
  • Serum total bilirubin > 1.5 × upper limit of normal (ULN); > 2.5 × ULN for patients with hepatic metastases;
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) > 2.5 × ULN, or > 5 × ULN for patients with hepatic metastases;
  • Serum creatinine > 1.5 × upper limit of normal (ULN), or creatinine clearance < 50mL / min (calculated using Cockcroft-Gault formula);
  • Partial prothrombin time (APTT) or prothrombin time (PT) > 1.5 times ULN (based on the normal value in the clinical study center);
  • Clinically significant electrolyte abnormalities;
  • Urine protein 2+ or above, or 24-hour urinary protein quantity ≥ 1.0g / 24h;
  • Subjects with dysphagia or known drug absorption disorders;
  • Presence of brain metastasis or leptomeningeal metastasis;
  • The toxicity of previous anticancer treatment has not yet reduced to (NCI CTC AE) level 1, excluding alopecia and oxaliplatin-induced neurotoxicity ≤ 2); patients haven't not fully recovered from previous surgery or less than 4 weeks elapsed since previous anticancer treatment or surgery;
  • Patients have clinically detectable second primary malignant tumors at enrollment, or have other malignant tumors (except for well-treated basal cell carcinoma or cervical carcinoma in situ) in the past 5 years;
  • Patients have clinically uncontrolled active infections such as acute pneumonia, hepatitis B or hepatitis C activity (previous history of hepatitis B infection, whether or not under medication control, HBV DNA ≥ 104 copies or ≥ 2000 IU/ml);
  • Patients have hypertension that cannot be controlled by a single drug. That is, after single drug treatment, systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg;
  • Patients currently have digestive tract diseases such as duodenal ulcer, ulcerative colitis, intestinal obstruction or other conditions that may cause gastrointestinal bleeding or perforation at the discretion of the investigator; or patients have undergone surgery for intestinal perforation and intestinal fistula but was uncured.
  • Patients have a history of arterial thrombosis or deep vein thrombosis within 6 months prior to enrollment, or patients have bleeding tendency or bleeding history within the 2 months before enrollment, regardless of severity;
  • Patients have a stroke or transient ischemic attack within 12 months prior to enrollment;
  • Skin wounds, surgical sites, trauma site, severe mucosal ulcers or fractures haven't completely healed yet.
  • Patients have acute myocardial infarction, severe/unstable angina, coronary artery bypass grafting or NYHA Class II/more severe cardiac insufficiency within 6 months prior to enrollment;
  • Pregnant or lactating women; or women with potentiality of childbearing have a positive pregnancy test result before the first dose;
  • Patients have any clinical or laboratory abnormalities or compliance problems so that the investigator believes that they are not suitable to participate in this clinical study;
  • Patients have serious psychological or mental abnormalities;

Sites / Locations

  • Zhongshan Hospital Affiliated to Fudan UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Fruquintinib

Observation

Arm Description

Patients who achieved stable disease (SD) or partial response (PR) or complete response (CR) following palliative first-line treatment will receive maintenance therapy with fruquintinib.

Patients who achieved SD or PR or CR following palliative first-line treatment will receive treatment-free observation.

Outcomes

Primary Outcome Measures

PFS
progression-free survival (PFS) is defined as time from randomization to disease progression.

Secondary Outcome Measures

OS
Overall survival (OS) is defined as time from randomization to death.
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Adverse events (AE) will be graded and documented according to NCI-CTC AE v4.0 from the beginning of treatment to 1 months after the last date of treatment. Documentary will include severity, lasting period and occurrence time. Main AEs include hypertension, albuminuria, skin reaction of hands and feet, hemorrhage, dysphonia, transaminase rise, abdominal pain / abdominal discomfort, blood bilirubin rise, thyroid dysfunction, infection, diarrhea, fatigue / fatigue, appetite decline, oral mucositis, weight loss, fecal occult blood and platelet count decline

Full Information

First Posted
January 1, 2020
Last Updated
November 1, 2021
Sponsor
Shanghai Zhongshan Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04296019
Brief Title
Fruquintinib as a Maintenance Therapy Following First-line Treatment for Metastatic Colorectal Cancer
Official Title
A Randomized, Open-label, Multicenter, Phase II Clinical Study Evaluating the Efficacy and Safety of Fruquintinib as a Maintenance Therapy Following First-line Treatment for Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Recruiting
Study Start Date
February 1, 2021 (Actual)
Primary Completion Date
July 1, 2023 (Anticipated)
Study Completion Date
January 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai Zhongshan Hospital

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
Yes

5. Study Description

Brief Summary
This study was a randomized, controled, multicenter, phase II clinical study evaluating the efficacy and safety of fruquintinib as a maintenance therapy following first-line treatment for metastatic colorectal cancer. This study will include the patients with confirmed unresectable metastatic left-sided colon cancer with RAS mutation or right-sided colon cancer who achieved stable disease (SD) or partial response (PR) or complete response (CR) via palliative first-line treatment. It's expected to include 110 patients and they will be randomly stratified at 2:1 into fruquintinib group and observation group based on whether bevacizumab is used and the primary tumor site, using the Interactive Network Response System (IWRS). The random No. corresponds to the respective patient. The enrollment time is expected to be 18 months, followed up for 24 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colo-rectal Cancer
Keywords
fruquintinib, Colo-rectal Cancer, maintenance therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
110 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Fruquintinib
Arm Type
Experimental
Arm Description
Patients who achieved stable disease (SD) or partial response (PR) or complete response (CR) following palliative first-line treatment will receive maintenance therapy with fruquintinib.
Arm Title
Observation
Arm Type
No Intervention
Arm Description
Patients who achieved SD or PR or CR following palliative first-line treatment will receive treatment-free observation.
Intervention Type
Drug
Intervention Name(s)
Fruquintinib
Intervention Description
Maintenance therapy with fruquintinib ( 5 mg qd for 3 consecutive weeks, followed by discontinuation for 1 week).
Primary Outcome Measure Information:
Title
PFS
Description
progression-free survival (PFS) is defined as time from randomization to disease progression.
Time Frame
24 months after the last subject participating in
Secondary Outcome Measure Information:
Title
OS
Description
Overall survival (OS) is defined as time from randomization to death.
Time Frame
36 months after the last subject participating in
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
Adverse events (AE) will be graded and documented according to NCI-CTC AE v4.0 from the beginning of treatment to 1 months after the last date of treatment. Documentary will include severity, lasting period and occurrence time. Main AEs include hypertension, albuminuria, skin reaction of hands and feet, hemorrhage, dysphonia, transaminase rise, abdominal pain / abdominal discomfort, blood bilirubin rise, thyroid dysfunction, infection, diarrhea, fatigue / fatigue, appetite decline, oral mucositis, weight loss, fecal occult blood and platelet count decline
Time Frame
1 month after the last administration of fruquintinib

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: 18-75 years old (including 18 and 75 years); Eastern Cooperative Oncology Group-performance score (ECOG PS) 0 or 1; Estimated survival ≥ 6 months; Histologically and/or cytologically confirmed metastatic left-sided colon cancer with RAS mutation or right-sided colon cancer, having unresectable metastatic or recurrent foci; Having received first-line systemic anti-tumor therapy for mCRC (chemotherapeutic drugs may include fluorouracil, oxaliplatin, irinotecan, such as XELOX, FOLFOX, FOLFIRI, and can combine or not combine with bevacizumab); achieving RECIST1.1-assessed SD (stable disease) or PR (partial response) or CR (complete response) after 18-24 weeks of first-line treatment. UCG suggesting left ventricular ejection fraction ≥50%; Having fully understood and voluntarily signed the informed consent. Exclusion Criteria: Absolute neutrophil count (ANC) <1.5×109/L, or platelet count <80×109/L, or hemoglobin < 9g/dL; it's not allowed to perform blood transfusion within 2 week before enrollment to meet the inclusion criteria; Serum total bilirubin > 1.5 × upper limit of normal (ULN); > 2.5 × ULN for patients with hepatic metastases; Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) > 2.5 × ULN, or > 5 × ULN for patients with hepatic metastases; Serum creatinine > 1.5 × upper limit of normal (ULN), or creatinine clearance < 50mL / min (calculated using Cockcroft-Gault formula); Partial prothrombin time (APTT) or prothrombin time (PT) > 1.5 times ULN (based on the normal value in the clinical study center); Clinically significant electrolyte abnormalities; Urine protein 2+ or above, or 24-hour urinary protein quantity ≥ 1.0g / 24h; Subjects with dysphagia or known drug absorption disorders; Presence of brain metastasis or leptomeningeal metastasis; The toxicity of previous anticancer treatment has not yet reduced to (NCI CTC AE) level 1, excluding alopecia and oxaliplatin-induced neurotoxicity ≤ 2); patients haven't not fully recovered from previous surgery or less than 4 weeks elapsed since previous anticancer treatment or surgery; Patients have clinically detectable second primary malignant tumors at enrollment, or have other malignant tumors (except for well-treated basal cell carcinoma or cervical carcinoma in situ) in the past 5 years; Patients have clinically uncontrolled active infections such as acute pneumonia, hepatitis B or hepatitis C activity (previous history of hepatitis B infection, whether or not under medication control, HBV DNA ≥ 104 copies or ≥ 2000 IU/ml); Patients have hypertension that cannot be controlled by a single drug. That is, after single drug treatment, systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg; Patients currently have digestive tract diseases such as duodenal ulcer, ulcerative colitis, intestinal obstruction or other conditions that may cause gastrointestinal bleeding or perforation at the discretion of the investigator; or patients have undergone surgery for intestinal perforation and intestinal fistula but was uncured. Patients have a history of arterial thrombosis or deep vein thrombosis within 6 months prior to enrollment, or patients have bleeding tendency or bleeding history within the 2 months before enrollment, regardless of severity; Patients have a stroke or transient ischemic attack within 12 months prior to enrollment; Skin wounds, surgical sites, trauma site, severe mucosal ulcers or fractures haven't completely healed yet. Patients have acute myocardial infarction, severe/unstable angina, coronary artery bypass grafting or NYHA Class II/more severe cardiac insufficiency within 6 months prior to enrollment; Pregnant or lactating women; or women with potentiality of childbearing have a positive pregnancy test result before the first dose; Patients have any clinical or laboratory abnormalities or compliance problems so that the investigator believes that they are not suitable to participate in this clinical study; Patients have serious psychological or mental abnormalities;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tianshu Liu
Phone
021-13681973996
Email
liu.tianshu@zs-hospital.sh.cn
First Name & Middle Initial & Last Name or Official Title & Degree
yiyi yu
Phone
021-13816730912
Email
yu.yiyi@zs-hospital.sh.cn
Facility Information:
Facility Name
Zhongshan Hospital Affiliated to Fudan University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tianshu Liu, Doctor
Email
liu.tianshu@zs-hospital.sh.cn
First Name & Middle Initial & Last Name & Degree
Yiyi Yu, master

12. IPD Sharing Statement

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Fruquintinib as a Maintenance Therapy Following First-line Treatment for Metastatic Colorectal Cancer

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