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Efficacy of Modified Fruquintinib in Colorectal Cancer Liver Metastases: A Phase II Study

Primary Purpose

Colorectal Cancer Metastatic

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Fruquintinib
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer Metastatic focused on measuring Colorectal cancer, Fruquintinib

Eligibility Criteria

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

Inclusion Criteria: . The pathological diagnosis was colorectal adenocarcinoma liver metastasis; . Age: 18 to 75 years old,allgenders; . Patients who have previously received first-line chemotherapy and have achieved disease control (PR+SD) according to RECIST 1.1; . Patients with liver metastasis of colorectal cancer who have undergone curative local treatment (surgery, ablation, SBRT) and achieved no evidence of disease (NED). Definition of NED: a. After local treatment, no residual signs of primary or metastatic tumors are observed on CT, MRI, PET-CT imaging, or b. No cancer cells are found in biopsies of suspicious lesions; .Completed adjuvant chemotherapy after achieving NED (e.g. 4-8 cycles of CapOX regimen, 6-12 cycles of FOLFOX regimen, or without receiving adjuvant chemotherapy recently) and evaluated as no disease progression. Last chemotherapy within 2 months from enrollment. . The time interval between the last chemotherapy and enrollment does not exceed 2 months; . Performance status (ECOG score) ≤ 2 . Hematology: WBC > 3 × 10^9 / L; PLT > 80 × 10^9 / L; Hb > 90 g/L; . Liver function: ALT and AST ≤ 2.5 × ULN; bilirubin ≤ 1.5 × ULN; .Renal function: Serum creatinine ≤ 1.5 × ULN or creatinine clearance rate (CCr) ≥ 60 ml/min; .Signed informed consent, willingness to undergo treatment according to this protocol, and good compliance with medication. Exclusion Criteria: .Patients with tumor progression before enrollment following the completion of chemotherapy. .Intestinal obstruction or incomplete intestinal obstruction. .Co-existing with other serious illnesses, including severe electrolyte disorders, bleeding tendencies, etc. .Active or uncontrolled severe infections: a) Known human immunodeficiency virus (HIV) infection. b) Known clinically significant liver disease history, including viral hepatitis [known carriers of hepatitis B virus (HBV) must exclude active HBV infection, i.e., HBV DNA positive (>1×104 copies/mL or >2000 IU/mL)]. c) Known hepatitis C virus (HCV) infection with positive HCV RNA (>1×103 copies/mL), or other hepatitis, liver cirrhosis. .Women who are pregnant or breastfeeding and have childbearing potential but are not taking adequate contraceptive measures. .Patients with severe brain disorders or mental illnesses (such as depression, mania, obsessive-compulsive disorder, and schizophrenia) that affect the patient's ability to self-report. .Patients with autoimmune diseases, blood system disorders, and a history of organ transplantation, long-term use of steroids, or immunosuppressive agents. .History of other malignant tumors within the past 5 years, excluding cured cervical carcinoma in situ or basal cell carcinoma of the skin. .History of organ transplantation (including autologous bone marrow transplantation and peripheral stem cell transplantation). .Known or suspected allergies to the investigational drug fruquintinib. .Hypertension that cannot be well controlled with antihypertensive medications (systolic blood pressure ≥150 mmHg or diastolic blood pressure ≥100 mmHg). .Active cardiac disease within 6 months prior to treatment, including myocardial infarction, severe/unstable angina pectoris. Left ventricular ejection fraction <50% on echocardiography, poorly controlled arrhythmias. .Urinalysis indicating urine protein ≥2+ and 24-hour urine protein quantification >1.0g.

Sites / Locations

  • Colorectal Department,SunYat-sen University Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Fruquintinib group

Arm Description

Patients will receive Fruquintinib maintenance treatment for six months, or until tumor recurrence, metastasis, or intolerable drug toxicities occur within six months. After achieving no evidence of disease (NED), a chest, abdomen, and pelvic CT scan with contrast or a chest CT scan with abdominal and pelvic MRI scan will be performed every 6 months within 2 years. Colonoscopy will be performed annually. CEA, CA19-9, and abdominal and pelvic ultrasound will be performed every 3 months. If abnormalities are found, further imaging studies and colonoscopy will be conducted, and if necessary, a PET/CT scan will be performed.

Outcomes

Primary Outcome Measures

2-year recurrence and metastasis rate
To evaluate the clinical efficacy and safety of fruquintinib as maintenance therapy for advanced CRC patients who achieve NED after adjuvant chemotherapy, with the 2-year recurrence and metastasis rate as the primary indicator.

Secondary Outcome Measures

2-year disease-free survival rate
To evaluate 2-year recurrence-free survival rate, 2-year overall survival rate, recurrence-free survival period in patients accepting fruquintinib maintenance therapy.

Full Information

First Posted
August 9, 2023
Last Updated
August 28, 2023
Sponsor
Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT06018714
Brief Title
Efficacy of Modified Fruquintinib in Colorectal Cancer Liver Metastases: A Phase II Study
Official Title
The Clinical Efficacy of Modified Fruquintinib as Maintenance Treatment for Colorectal Cancer Liver Metastases After NED: Phase II Single-arm Prospective Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 1, 2023 (Actual)
Primary Completion Date
August 1, 2024 (Anticipated)
Study Completion Date
August 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University

4. Oversight

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

5. Study Description

Brief Summary
The overall 5-year survival rate for patients with colorectal liver metastases (CRLM) is still less than 20%. Surgery-based local treatment can achieve no evidence of disease (NED) in CRLM patients, but over 60% of patients experience recurrence even after achieving NED. Even with adjuvant therapy for the 6-month perioperative period after achieving NED, the recurrence rate remains high. Fruquintinib is a selective anti-angiogenic inhibitor that may help reduce tumor recurrence and prolong the time to recurrence and metastasis. The Chinese Society of Clinical Oncology (CSCO) guidelines have recommended fruquintinib as a third-line therapy for colorectal cancer. This study aims to evaluate the effectiveness and safety of fruquintinib as a maintenance therapy for patients with advanced colorectal cancer (CRC) who have achieved no evidence of disease (NED) after completing adjuvant chemotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer Metastatic
Keywords
Colorectal cancer, Fruquintinib

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
This is a prospective, single-arm, phase II study aimed at exploring the clinical efficacy and safety of fruquintinib as maintenance therapy for advanced CRC patients who achieve NED after adjuvant chemotherapy. Patients will receive full supportive care while on this study.
Masking
None (Open Label)
Allocation
N/A
Enrollment
64 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Fruquintinib group
Arm Type
Experimental
Arm Description
Patients will receive Fruquintinib maintenance treatment for six months, or until tumor recurrence, metastasis, or intolerable drug toxicities occur within six months. After achieving no evidence of disease (NED), a chest, abdomen, and pelvic CT scan with contrast or a chest CT scan with abdominal and pelvic MRI scan will be performed every 6 months within 2 years. Colonoscopy will be performed annually. CEA, CA19-9, and abdominal and pelvic ultrasound will be performed every 3 months. If abnormalities are found, further imaging studies and colonoscopy will be conducted, and if necessary, a PET/CT scan will be performed.
Intervention Type
Drug
Intervention Name(s)
Fruquintinib
Intervention Description
Drug: Maintenance treatment regimen: Fruquintinib 5 mg, qd, po, with three weeks of continuous treatment followed by one week of drug discontinuation. Each treatment cycle lasts four weeks. The treatment will be continued for six months, or until tumor recurrence, metastasis, or intolerable drug toxicities occur within six months. Adverse drug reactions that occur during the trial will be graded according to the NCI CTCAE version 5.0 and dose adjustments will be made according to the corresponding rules.
Primary Outcome Measure Information:
Title
2-year recurrence and metastasis rate
Description
To evaluate the clinical efficacy and safety of fruquintinib as maintenance therapy for advanced CRC patients who achieve NED after adjuvant chemotherapy, with the 2-year recurrence and metastasis rate as the primary indicator.
Time Frame
2 years after NED
Secondary Outcome Measure Information:
Title
2-year disease-free survival rate
Description
To evaluate 2-year recurrence-free survival rate, 2-year overall survival rate, recurrence-free survival period in patients accepting fruquintinib maintenance therapy.
Time Frame
2 years after NED
Other Pre-specified Outcome Measures:
Title
completion rate of maintenance therapy
Description
To evaluate safety and completion rate of maintenance therapy
Time Frame
2 years after NED

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: . The pathological diagnosis was colorectal adenocarcinoma liver metastasis; . Age: 18 to 75 years old,allgenders; . Patients who have previously received first-line chemotherapy and have achieved disease control (PR+SD) according to RECIST 1.1; . Patients with liver metastasis of colorectal cancer who have undergone curative local treatment (surgery, ablation, SBRT) and achieved no evidence of disease (NED). Definition of NED: a. After local treatment, no residual signs of primary or metastatic tumors are observed on CT, MRI, PET-CT imaging, or b. No cancer cells are found in biopsies of suspicious lesions; .Completed adjuvant chemotherapy after achieving NED (e.g. 4-8 cycles of CapOX regimen, 6-12 cycles of FOLFOX regimen, or without receiving adjuvant chemotherapy recently) and evaluated as no disease progression. Last chemotherapy within 2 months from enrollment. . The time interval between the last chemotherapy and enrollment does not exceed 2 months; . Performance status (ECOG score) ≤ 2 . Hematology: WBC > 3 × 10^9 / L; PLT > 80 × 10^9 / L; Hb > 90 g/L; . Liver function: ALT and AST ≤ 2.5 × ULN; bilirubin ≤ 1.5 × ULN; .Renal function: Serum creatinine ≤ 1.5 × ULN or creatinine clearance rate (CCr) ≥ 60 ml/min; .Signed informed consent, willingness to undergo treatment according to this protocol, and good compliance with medication. Exclusion Criteria: .Patients with tumor progression before enrollment following the completion of chemotherapy. .Intestinal obstruction or incomplete intestinal obstruction. .Co-existing with other serious illnesses, including severe electrolyte disorders, bleeding tendencies, etc. .Active or uncontrolled severe infections: a) Known human immunodeficiency virus (HIV) infection. b) Known clinically significant liver disease history, including viral hepatitis [known carriers of hepatitis B virus (HBV) must exclude active HBV infection, i.e., HBV DNA positive (>1×104 copies/mL or >2000 IU/mL)]. c) Known hepatitis C virus (HCV) infection with positive HCV RNA (>1×103 copies/mL), or other hepatitis, liver cirrhosis. .Women who are pregnant or breastfeeding and have childbearing potential but are not taking adequate contraceptive measures. .Patients with severe brain disorders or mental illnesses (such as depression, mania, obsessive-compulsive disorder, and schizophrenia) that affect the patient's ability to self-report. .Patients with autoimmune diseases, blood system disorders, and a history of organ transplantation, long-term use of steroids, or immunosuppressive agents. .History of other malignant tumors within the past 5 years, excluding cured cervical carcinoma in situ or basal cell carcinoma of the skin. .History of organ transplantation (including autologous bone marrow transplantation and peripheral stem cell transplantation). .Known or suspected allergies to the investigational drug fruquintinib. .Hypertension that cannot be well controlled with antihypertensive medications (systolic blood pressure ≥150 mmHg or diastolic blood pressure ≥100 mmHg). .Active cardiac disease within 6 months prior to treatment, including myocardial infarction, severe/unstable angina pectoris. Left ventricular ejection fraction <50% on echocardiography, poorly controlled arrhythmias. .Urinalysis indicating urine protein ≥2+ and 24-hour urine protein quantification >1.0g.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Junzhong Lin, Doctor
Phone
020-87343533
Email
linjzh@sysucc.org.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Zhizhong Pan, Prof
Phone
020-87343533
Email
panzhzh@sysucc.org.cn
Facility Information:
Facility Name
Colorectal Department,SunYat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510062
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Junzhong lin, PhD
Phone
+86-13802446666
Email
linjzh@sysucc.org.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Efficacy of Modified Fruquintinib in Colorectal Cancer Liver Metastases: A Phase II Study

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