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lead-in FOLICOLOR Trial: Following Therapy Response Through Liquid Biopsy in Metastatic Colorectal Cancer Patients

Primary Purpose

Metastatic Colorectal Cancer

Status
Unknown status
Phase
Not Applicable
Locations
Belgium
Study Type
Interventional
Intervention
Liquid biopsy sampling
Sponsored by
University Hospital, Antwerp
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Metastatic Colorectal Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Man or woman ≥ 18 years of age at the time the informed consent is obtained
  • Eastern cooperative oncology group (ECOG) performance status of 0 or 1
  • Histologically or cytologically confirmed adenocarcinoma of the colon or rectum in subjects with unresectable metastatic (M1) disease
  • At least 1 uni-dimensionally measurable lesion of at least 10 mm per RECIST 1.1 guidelines using conventional techniques (CT scan). Lesion must not be chosen from a previously irradiated field, unless there has been documented disease progression in that field after irradiation and prior to inclusion. All sites of disease must be evaluated <28 days prior to the start of first-line therapy
  • Wild-type RAS tumor status (of tumor tissue)
  • Wild-type BRAF tumor status (of tumor tissue)
  • Adequate hematologic, renal, hepatic and coagulation function
  • Starting a first-line treatment with a combination of FOLFOX/FOLFIRI and panitumumab

Exclusion Criteria:

  • History of prior or concurrent central nervous system metastases
  • History of other malignancy, except:

    • Malignancy treated with curative intent and with no known active disease present for ≥ 3 years prior to start therapy and felt to be at low risk for recurrence by the treating physician
    • Adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease
    • Adequately treated cervical carcinoma in situ without evidence of disease
    • Prostatic intraepithelial neoplasia without evidence of prostate cancer
  • Prior chemotherapy or other systemic anticancer therapy for the treatment of metastatic colorectal carcinoma including but not limited to bevacizumab and anti-Epidermal Growth Factor Receptor (EGFR) therapy (e.g. cetuximab, panitumumab, erlotinib, gefitinib, lapatinib)
  • Prior adjuvant chemotherapy (including oxaliplatin therapy) or other adjuvant systemic anticancer therapy including but not limited to bevacizumab and anti-EGFR therapy (e.g. cetuximab, panitumumab, erlotinib, gefitinib, lapatinib) for the treatment of colorectal cancer ≤ 6 months prior to start therapy with the following exceptions:

    • Subjects may have received prior fluoropyrimidine therapy if administered solely for the purpose of radiosensitization for the adjuvant or neoadjuvant treatment of rectal cancer
  • Radiotherapy ≤ 14 days prior to start therapy. Subjects must have recovered from all radiotherapy-related toxicities.
  • Significant cardiovascular risk
  • History of interstitial lung disease (e.g., pneumonitis or pulmonary fibrosis) or evidence of interstitial lung disease on diagnostic CT scan
  • Active inflammatory bowel disease or other bowel disease causing chronic diarrhea (defined as ≥ Common Terminology Criteria (CTC) grade 2, [Common Terminology Criteria for Adverse Events (CTCAE) version 5.0])
  • Peripheral sensory neuropathy (≥ CTC grade 2 [CTCAE version 5.0])

Sites / Locations

  • AZ KlinaRecruiting
  • Antwerp University Hospital (UZA)Recruiting
  • AZ Maria MiddelaresRecruiting
  • AZ GroeningeRecruiting
  • AZ NikolaasRecruiting
  • GZARecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

First-line FOLFOX/FOLFIRI and panitumumab.

Arm Description

Chemotherapeutic agents will be given as an intravenous infusion at a dose and interval consistent with standard institutional practice.

Outcomes

Primary Outcome Measures

Optimize cutoff value
Optimization of the cutoff value for NPY methylation in liquid biopsies (ctDNA) in metastatic colorectal cancer patients receiving first-line FOLFOX/FOLFIRI and panitumumab to discriminate between progressive and non-progressive disease as determined by CT scans based on RECIST criteria 1.1. To this end, a Receiver Operating Characteristic (ROC) curve will be developed with data of this study.

Secondary Outcome Measures

Determine progression free and 9-month survival
To determine the progression free and 9-month survival of RAS and BRAF wild-type metastatic colorectal cancer patients. The progression free survival is defined as time from inclusion to the date of first disease progression per RECIST 1.1 criteria, or death. The 9-month survival will be determined as percentage surviving at 9 months after the start of first-line therapy.

Full Information

First Posted
December 30, 2020
Last Updated
January 29, 2021
Sponsor
University Hospital, Antwerp
Collaborators
Amgen
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1. Study Identification

Unique Protocol Identification Number
NCT04735900
Brief Title
lead-in FOLICOLOR Trial: Following Therapy Response Through Liquid Biopsy in Metastatic Colorectal Cancer Patients
Official Title
Detection of Progressive Disease in Metastatic Colorectal Cancer Patients by NPY Methylation in Liquid Biopsies
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Unknown status
Study Start Date
September 14, 2020 (Actual)
Primary Completion Date
March 2022 (Anticipated)
Study Completion Date
March 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Antwerp
Collaborators
Amgen

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Detection of progressive disease by neuropeptide Y (NPY) methylation in liquid biopsies in patients with RAS and BRAF wild-type, unresectable, metastatic colorectal cancer receiving first-line treatment FOLFOX/FOLFIRI and panitumumab.
Detailed Description
Prospective, multicentric interventional study to optimize the cutoff value of NPY methylation in liquid biopsies in metastatic colorectal cancer patients treated with first-line FOLFOX/FOLFIRI and panitumumab. Inclusion is possible after histologically or cytologically proven colorectal adenocarcinoma with metastatic lesions according to RECIST 1.1 at the start of first-line treatment using FOLFOX/FOLFIRI and panitumumab. Patient must have a proven RAS and BRAF wild-type tumor. Patients will be followed by study protocol up to and including the first CT scan following the last liquid biopsies taken, or when a follow-up period of 11 months is reached, until death, until metastasectomy, until lost to follow-up or until (consent) withdrawal.

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
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
First-line FOLFOX/FOLFIRI and panitumumab.
Arm Type
Experimental
Arm Description
Chemotherapeutic agents will be given as an intravenous infusion at a dose and interval consistent with standard institutional practice.
Intervention Type
Procedure
Intervention Name(s)
Liquid biopsy sampling
Intervention Description
Biweekly liquid biopsy sampling to measure circulating tumor DNA (ctDNA) level up to and including 9 months after start first-line therapy.
Primary Outcome Measure Information:
Title
Optimize cutoff value
Description
Optimization of the cutoff value for NPY methylation in liquid biopsies (ctDNA) in metastatic colorectal cancer patients receiving first-line FOLFOX/FOLFIRI and panitumumab to discriminate between progressive and non-progressive disease as determined by CT scans based on RECIST criteria 1.1. To this end, a Receiver Operating Characteristic (ROC) curve will be developed with data of this study.
Time Frame
Start cycle 1 of first-line FOLFOX/FOLFIRI and panitumumab therapy until the day on which the first CT scan is performed following the liquid biopsies taken 9 months after the start of first-line therapy, or when 11 months of follow-up is reached.
Secondary Outcome Measure Information:
Title
Determine progression free and 9-month survival
Description
To determine the progression free and 9-month survival of RAS and BRAF wild-type metastatic colorectal cancer patients. The progression free survival is defined as time from inclusion to the date of first disease progression per RECIST 1.1 criteria, or death. The 9-month survival will be determined as percentage surviving at 9 months after the start of first-line therapy.
Time Frame
Start cycle 1 of first-line FOLFOX/FOLFIRI and panitumumab therapy until the day on which the first CT scan is performed following the liquid biopsies taken 9 months after the start of first-line therapy, or when 11 months of follow-up is reached.
Other Pre-specified Outcome Measures:
Title
Exploratory objective 1
Description
To compare the use of NPY methylated ctDNA and carcinoembryonic antigen (CEA) to predict progressive disease.
Time Frame
Start cycle 1 of first-line FOLFOX/FOLFIRI and panitumumab therapy until the day on which the first CT scan is performed following the liquid biopsies taken 9 months after the start of first-line therapy, or when 11 months of follow-up is reached.
Title
Exploratory objective 2
Description
Further exploration of ctDNA in liquid biopsies and searching for novel biomarkers.
Time Frame
Start cycle 1 of first-line FOLFOX/FOLFIRI and panitumumab therapy until the day on which the first CT scan is performed following the liquid biopsies taken 9 months after the start of first-line therapy, or when 11 months of follow-up is reached.
Title
Exploratory objective 3
Description
To assess the quality of life and the patient experience in the patient population with regard to the use of liquid biopsies for follow-up through questionnaires. This will include, but will not be limited to the following: burden of extra blood samples (extra blood samples during routine blood test), burden of CT scan with intravenous contrast, confidence in liquid biopsy guided therapy (ctDNA analysis) compared to CT scan guided therapy and preference between extra blood sample and CT scan (taking into account: burden, pain, time in the hospital, extra travel time to the hospital, confidence in technique…).
Time Frame
Start cycle 1 of first-line FOLFOX/FOLFIRI and panitumumab therapy until the day on which the first CT scan is performed following the liquid biopsies taken 9 months after the start of first-line therapy, or when 11 months of follow-up is reached.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Man or woman ≥ 18 years of age at the time the informed consent is obtained Eastern cooperative oncology group (ECOG) performance status of 0 or 1 Histologically or cytologically confirmed adenocarcinoma of the colon or rectum in subjects with unresectable metastatic (M1) disease At least 1 uni-dimensionally measurable lesion of at least 10 mm per RECIST 1.1 guidelines using conventional techniques (CT scan). Lesion must not be chosen from a previously irradiated field, unless there has been documented disease progression in that field after irradiation and prior to inclusion. All sites of disease must be evaluated <28 days prior to the start of first-line therapy Wild-type RAS tumor status (of tumor tissue) Wild-type BRAF tumor status (of tumor tissue) Adequate hematologic, renal, hepatic and coagulation function Starting a first-line treatment with a combination of FOLFOX/FOLFIRI and panitumumab Exclusion Criteria: History of prior or concurrent central nervous system metastases History of other malignancy, except: Malignancy treated with curative intent and with no known active disease present for ≥ 3 years prior to start therapy and felt to be at low risk for recurrence by the treating physician Adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease Adequately treated cervical carcinoma in situ without evidence of disease Prostatic intraepithelial neoplasia without evidence of prostate cancer Prior chemotherapy or other systemic anticancer therapy for the treatment of metastatic colorectal carcinoma including but not limited to bevacizumab and anti-Epidermal Growth Factor Receptor (EGFR) therapy (e.g. cetuximab, panitumumab, erlotinib, gefitinib, lapatinib) Prior adjuvant chemotherapy (including oxaliplatin therapy) or other adjuvant systemic anticancer therapy including but not limited to bevacizumab and anti-EGFR therapy (e.g. cetuximab, panitumumab, erlotinib, gefitinib, lapatinib) for the treatment of colorectal cancer ≤ 6 months prior to start therapy with the following exceptions: Subjects may have received prior fluoropyrimidine therapy if administered solely for the purpose of radiosensitization for the adjuvant or neoadjuvant treatment of rectal cancer Radiotherapy ≤ 14 days prior to start therapy. Subjects must have recovered from all radiotherapy-related toxicities. Significant cardiovascular risk History of interstitial lung disease (e.g., pneumonitis or pulmonary fibrosis) or evidence of interstitial lung disease on diagnostic CT scan Active inflammatory bowel disease or other bowel disease causing chronic diarrhea (defined as ≥ Common Terminology Criteria (CTC) grade 2, [Common Terminology Criteria for Adverse Events (CTCAE) version 5.0]) Peripheral sensory neuropathy (≥ CTC grade 2 [CTCAE version 5.0])
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Silke Raats
Phone
+32 3 821 42 15
Email
folicolor@uza.be
First Name & Middle Initial & Last Name or Official Title & Degree
Katleen Janssens, MD
Phone
+32 3 275 97 80
Email
katleen.janssens@student.uantwerpen.be
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marc Peeters, MD, PhD
Organizational Affiliation
Antwerp University Hospital (UZA)
Official's Role
Principal Investigator
Facility Information:
Facility Name
AZ Klina
City
Brasschaat
ZIP/Postal Code
2930
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laura Tanasale
Email
laura.tanasale@klina.be
First Name & Middle Initial & Last Name & Degree
Sofie Herman
Email
sofie.herman@klina.be
First Name & Middle Initial & Last Name & Degree
Wim Demey, MD
Facility Name
Antwerp University Hospital (UZA)
City
Edegem
ZIP/Postal Code
2650
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Silke Raats
Phone
+32 3 821 42 15
Email
folicolor@uza.be
First Name & Middle Initial & Last Name & Degree
Katleen Janssens, MD
Phone
+32 3 275 97 80
Email
katleen.janssens@student.uantwerpen.be
First Name & Middle Initial & Last Name & Degree
Marc Peeters, MD
Facility Name
AZ Maria Middelares
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laura Van Damme
Email
laura.vandamme@azmmsj.be
First Name & Middle Initial & Last Name & Degree
Nina Van Heddegem
Email
nina.vanheddegem@azmmsj.be
First Name & Middle Initial & Last Name & Degree
Els Monsaert, MD
Facility Name
AZ Groeninge
City
Kortrijk
ZIP/Postal Code
8500
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Emma Callewaert
Email
emma.callewaert@azgroeninge.be
First Name & Middle Initial & Last Name & Degree
Fien Verplancke
Email
fien.verplancke@azgroeninge.be
First Name & Middle Initial & Last Name & Degree
Philippe Vergauwe, MD
Facility Name
AZ Nikolaas
City
Sint-Niklaas
ZIP/Postal Code
9100
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Roos Haeck
Email
roos.haeck@aznikolaas.be
First Name & Middle Initial & Last Name & Degree
Helga Vunic
Email
helga.vunic@aznikolaas.be
First Name & Middle Initial & Last Name & Degree
Koen Gorleer, MD
Facility Name
GZA
City
Wilrijk
ZIP/Postal Code
2610
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Isabelle Maurissen, MD
Email
isabelle.maurissen@gza.be
First Name & Middle Initial & Last Name & Degree
Isabelle Maurissen, MD

12. IPD Sharing Statement

Learn more about this trial

lead-in FOLICOLOR Trial: Following Therapy Response Through Liquid Biopsy in Metastatic Colorectal Cancer Patients

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