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Fruquintinib Plus Capecitabine as Maintenance Treatment of RAS / BRAF Wild-type Metastatic Colorectal Cancer

Primary Purpose

Metastatic Colorectal Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
fruquintinib plus capecitabine
Sponsored by
Chinese Academy of Medical Sciences
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:

  • Patients with histologically confirmed metastatic colorectal adenocarcinoma;
  • 18-75 years old;
  • Eastern Cooperation Oncology Group (ECOG) performance score 0-1;
  • At least one evaluable lesion for disease assessment according to RECIST version 1.1;
  • Able to take oral medications;
  • Patient have achieved CR, PR or SD after up to 8 cycles of first-line standard FOLFOX / - FOLFIRI / XELOX / xeliri + cetuximab treatment, and remained unresectable;
  • If radiotherapy has been performed before enrollment, at least one lesion should be located outside the radiation field;
  • Adequate organ functions as assessed by the following laboratory requirements: Leukocytes≥3.0x10^9/L, absolute neutrophil count≥1.5x10^9/L, platelet count≥100x10^9/L, hemoglobin≥9g/dL; serum bilirubin≤1.5x the upper limit of normal(ULN);Alanine aminotransferase(ALT) and aspartate aminotransferase(AST)≤2.5x ULN; serum creatinine≤1.5x ULN.
  • An expected survival of at least 12 weeks;
  • Fertile male or female patients volunteered to use effective contraceptive methods during the study period and within 6 months after the end of treatment;
  • Willing to provide written informed consent to study procedures.

Exclusion Criteria:

  • Patients who have received fruquintinib;
  • Patients who have received TACE within 6 weeks before enrollment;
  • Participated in other unapproved or unlisted drug clinical trials in China within 4 weeks before enrollment, and received corresponding experimental drug treatment;
  • Patients with dysphagia, active peptic ulcer, intestinal obstruction, active gastrointestinal bleeding, peptic perforation, malabsorption syndrome or uncontrolled intestinal inflammatory diseases;
  • International normalized ratio (INR) > 1.5 or partially activated prothrombin time (APTT) > 1.5 × ULN;
  • The researchers judged clinically significant electrolyte abnormalities;
  • At present, the patient has hypertension that cannot be controlled by drugs, which is specified as: systolic blood pressure ≥ 140 mmHg and / or diastolic blood pressure ≥ 90 mmHg;
  • Patients currently have poorly controlled diabetes (fasting glucose level is greater than CTCAE grade 2 after regular treatment);
  • Have received any surgery or invasive treatment or operation within 4 weeks before enrollment (except venous catheterization, puncture and drainage, etc.);
  • Active or uncontrolled severe infection ≥ grade 2 according to National Cancer Institute Common Toxicity (NCI-CTC) criteria;
  • Uncontrolled central nervous system metastasis or previous brain metastasis;
  • Other malignant tumors in the past 5 years, except for skin basal cell or squamous cell carcinoma after radical surgery, or cervical carcinoma in situ;
  • Any kind of concurrent cardiac disease with clinical meanings, such as cardiovascular accident, myocardial infarction, thromboembolism or hemorrhage within 6 months before enrollment, congestive heart failure ≤New York Heart Association (NYHA) class 2; ventricular arrhythmias requiring drug treatment; LVEF < 50%;
  • With positive urine protein and 24-hour urinary protein content>1g;
  • Have a tendency of bleeding or clotting;
  • Known human immunodeficiency virus (HIV) infection; known history of clinically significant liver disease, including viral hepatitis;
  • The target lesions have received brachytherapy (radioactive particle implantation) within 60 days before admission;
  • Unrelieved toxic reactions higher than CTCAE V5.0 grade 1 caused by any previous anti-cancer treatment, excluding hair loss, lymphopenia and neurotoxicity ≤ grade 2 caused by oxaliplatin;
  • With any illness or medical conditions that may jeopardize the patient's compliance or interfere the analyses or judgements of study results;
  • Pregnancy or lactation at the time of study entry;
  • With fertility but refuse to contraception.

Sites / Locations

  • National Center/Cancer Hospital, China Academy of Medical Science and Peking Union Medical CollegeRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental

Arm Description

fruquintinib plus capecitabine

Outcomes

Primary Outcome Measures

recommended phase 2 dose (RP2D)
RP2D is determined according to DLT and MTD in the phase 1 study
progression-free survival (PFS)
PFS is defined as the time from the start of maintenance treatment to the earliest evidence of disease progression (per RECIST v1.1), or death from any cause

Secondary Outcome Measures

disease control rate (DCR)
DCR is defined as the proportion of patients achieving complete response, partial response or having stable disease
objective response rate (ORR)
ORR is defined as the proportion of patients achieving complete response or partial response
overall survival (OS)
OS is defined as the time from randomized to death from any cause or to last contact
Adverse events (AEs)
Adverse events assessments are computed and categorized according to the Common Toxicity Criteria of the National Cancer Institute, version 5.0

Full Information

First Posted
August 17, 2021
Last Updated
August 17, 2022
Sponsor
Chinese Academy of Medical Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT05016869
Brief Title
Fruquintinib Plus Capecitabine as Maintenance Treatment of RAS / BRAF Wild-type Metastatic Colorectal Cancer
Official Title
A Phase Ⅰb/Ⅱ Study of Fruquintinib Combined With Capecitabine in the First-line Maintenance Treatment of RAS/BRAF Wild-type Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 12, 2022 (Actual)
Primary Completion Date
February 2023 (Anticipated)
Study Completion Date
August 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Chinese Academy of Medical Sciences

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
This phase I/II study was designed to evaluate the efficacy and safety of fruquintinib combination with capecitabine in maintenance treatment after first-line chemotherapy combined with cetuximab.
Detailed Description
At present, most studies use chemotherapy combined with cetuximab or cetuximab alone as the maintenance treatment scheme after the first-line regimen containing cetuximab. However, the skin reaction caused by cetuximab and frequent infusion treatment will bring inconvenience to patients. MACBETH study compared the maintenance of bevacizumab with cetuximab, although there was no significant difference in PFS between them, the Bev group seemed to convey a longer median OS. Fruquintinib is a highly selective anti angiogenesis TKI. This study aims to explore the efficacy and safety of fruquintinib combined with capecitabine in maintenance treatment after first-line chemotherapy combined with cetuximab. Both fruquintinib and capecitabine are orally given, so this regimen may provide a maintenance treatment option that is more manageable for patients in clinical practice.

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 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental
Arm Type
Experimental
Arm Description
fruquintinib plus capecitabine
Intervention Type
Drug
Intervention Name(s)
fruquintinib plus capecitabine
Intervention Description
Ⅰb: capecitabine: 1000 mg/m²,PO BID, d1-14,Q3W; fruquintinib 3mg/4mg/5mg, d1-14, PO QD, Q3W. ⅠⅠ: fruquintinib RP2D, d1-14, PO QD, Q3W, capecitabine: 1000 mg/m²,PO BID, d1-14,Q3W
Primary Outcome Measure Information:
Title
recommended phase 2 dose (RP2D)
Description
RP2D is determined according to DLT and MTD in the phase 1 study
Time Frame
up to 1 year
Title
progression-free survival (PFS)
Description
PFS is defined as the time from the start of maintenance treatment to the earliest evidence of disease progression (per RECIST v1.1), or death from any cause
Time Frame
up to 3 years
Secondary Outcome Measure Information:
Title
disease control rate (DCR)
Description
DCR is defined as the proportion of patients achieving complete response, partial response or having stable disease
Time Frame
up to 3 years
Title
objective response rate (ORR)
Description
ORR is defined as the proportion of patients achieving complete response or partial response
Time Frame
up to 3 years
Title
overall survival (OS)
Description
OS is defined as the time from randomized to death from any cause or to last contact
Time Frame
up to 3 years
Title
Adverse events (AEs)
Description
Adverse events assessments are computed and categorized according to the Common Toxicity Criteria of the National Cancer Institute, version 5.0
Time Frame
up to 3 years

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: Patients with histologically confirmed metastatic colorectal adenocarcinoma; 18-75 years old; Eastern Cooperation Oncology Group (ECOG) performance score 0-1; At least one evaluable lesion for disease assessment according to RECIST version 1.1; Able to take oral medications; Patient have achieved CR, PR or SD after up to 8 cycles of first-line standard FOLFOX / - FOLFIRI / XELOX / xeliri + cetuximab treatment, and remained unresectable; If radiotherapy has been performed before enrollment, at least one lesion should be located outside the radiation field; Adequate organ functions as assessed by the following laboratory requirements: Leukocytes≥3.0x10^9/L, absolute neutrophil count≥1.5x10^9/L, platelet count≥100x10^9/L, hemoglobin≥9g/dL; serum bilirubin≤1.5x the upper limit of normal(ULN);Alanine aminotransferase(ALT) and aspartate aminotransferase(AST)≤2.5x ULN; serum creatinine≤1.5x ULN. An expected survival of at least 12 weeks; Fertile male or female patients volunteered to use effective contraceptive methods during the study period and within 6 months after the end of treatment; Willing to provide written informed consent to study procedures. Exclusion Criteria: Patients who have received fruquintinib; Patients who have received TACE within 6 weeks before enrollment; Participated in other unapproved or unlisted drug clinical trials in China within 4 weeks before enrollment, and received corresponding experimental drug treatment; Patients with dysphagia, active peptic ulcer, intestinal obstruction, active gastrointestinal bleeding, peptic perforation, malabsorption syndrome or uncontrolled intestinal inflammatory diseases; International normalized ratio (INR) > 1.5 or partially activated prothrombin time (APTT) > 1.5 × ULN; The researchers judged clinically significant electrolyte abnormalities; At present, the patient has hypertension that cannot be controlled by drugs, which is specified as: systolic blood pressure ≥ 140 mmHg and / or diastolic blood pressure ≥ 90 mmHg; Patients currently have poorly controlled diabetes (fasting glucose level is greater than CTCAE grade 2 after regular treatment); Have received any surgery or invasive treatment or operation within 4 weeks before enrollment (except venous catheterization, puncture and drainage, etc.); Active or uncontrolled severe infection ≥ grade 2 according to National Cancer Institute Common Toxicity (NCI-CTC) criteria; Uncontrolled central nervous system metastasis or previous brain metastasis; Other malignant tumors in the past 5 years, except for skin basal cell or squamous cell carcinoma after radical surgery, or cervical carcinoma in situ; Any kind of concurrent cardiac disease with clinical meanings, such as cardiovascular accident, myocardial infarction, thromboembolism or hemorrhage within 6 months before enrollment, congestive heart failure ≤New York Heart Association (NYHA) class 2; ventricular arrhythmias requiring drug treatment; LVEF < 50%; With positive urine protein and 24-hour urinary protein content>1g; Have a tendency of bleeding or clotting; Known human immunodeficiency virus (HIV) infection; known history of clinically significant liver disease, including viral hepatitis; The target lesions have received brachytherapy (radioactive particle implantation) within 60 days before admission; Unrelieved toxic reactions higher than CTCAE V5.0 grade 1 caused by any previous anti-cancer treatment, excluding hair loss, lymphopenia and neurotoxicity ≤ grade 2 caused by oxaliplatin; With any illness or medical conditions that may jeopardize the patient's compliance or interfere the analyses or judgements of study results; Pregnancy or lactation at the time of study entry; With fertility but refuse to contraception.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lin Yang, M.D.
Phone
13681015148
Email
lyang69@sina.com
Facility Information:
Facility Name
National Center/Cancer Hospital, China Academy of Medical Science and Peking Union Medical College
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lin Yang, M.D
Phone
13681015148
Ext
13681015148
Email
lyang69@sina.com
First Name & Middle Initial & Last Name & Degree
Lin Yang, M.D

12. IPD Sharing Statement

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Fruquintinib Plus Capecitabine as Maintenance Treatment of RAS / BRAF Wild-type Metastatic Colorectal Cancer

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