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A Trial of PledOx + FOLFOX6 Compared to Placebo + FOLFOX6 in Patients With Metastatic Colorectal Cancer (PLIANT)

Primary Purpose

Advanced Metastatic (Stage IV) Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
PledOx (2 µmol/kg)
PledOx (5 µmol/kg)
PledOx (10 µmol/kg)
Placebo (0,9% NaCl)
Sponsored by
Egetis Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Metastatic (Stage IV) Colorectal Cancer focused on measuring Metastatic colorectal cancer, stage IV, FOLFOX6, Chemotherapy, PledOx, Mangafodipir, Febrile neutropenia, Oxidative stress, Antioxidant, neutropenia, neuropathy

Eligibility Criteria

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

Inclusion Criteria:

  • Advanced metastatic colorectal (stage IV) cancer verified by biopsy
  • Patients may have received up to three previous treatment lines of chemotherapy, which may include fluoropyrimidine, irinotecan and targeted therapies. The last dose of antitumor drug must be given at least 4 weeks prior to inclusion and all toxicity (except alopecia and fatigue) resolved. Patients may also be chemotherapy-naïve, have received prior adjuvant treatment but no previous treatment with oxaliplatin
  • CT-scan or MRI of thorax, abdomen and pelvis; within ≤4 weeks before start of chemotherapy
  • Evaluable disease and one measurable site of disease according to RECIST 1.1 criteria (at least 10mm for CT-scan or MRI)
  • Neurological examination with no significant pathological findings
  • ≥18 years
  • WHO performance status 0≤2 and Life expectancy ≥ 3 months
  • Adequate haematological function, Hb ≥ 100 g/L, ANC ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L
  • Adequate renal and hepatic functions: creatinine clearance >50 cc/min, total bilirubin ≤ 1.5 times ULN, ASAT and ALAT ≤ 3 times ULN (ASAT and ALAT ≤ 5 times ULN in case of liver metastases)
  • INR ≤1.5 times ULN, unless receiving therapeutic anticoagulation
  • Negative pregnancy test for females of child-producing potential
  • Written informed consent given

Exclusion Criteria:

  • Tumours other than colorectal adenocarcinomas (within the previous 5 years) except for curatively treated non melanoma skin cancer or in situ carcinoma of the cervix
  • Evidence of central nervous system metastases
  • Unresolved bowel obstruction or sub-obstruction, uncontrolled Crohn's disease or ulcerative colitis
  • History of cardiac disease with a New York Heart Association (NYHA) Class II or greater congestive heart failure, myocardial infarction or unstable angina in the past six (6) months prior to Day 1 of treatment and serious arrhythmias requiring medication for treatment
  • Prolonged QTC interval >450 msec
  • Known history of stroke or cerebrovascular accident in the past six (6) months
  • Severe diarrhoea
  • Chronic infection or uncontrolled serious illness causing immunodeficiency
  • Any uncontrolled serious illness or medical condition
  • Received mangafodipir at any time
  • Welders, mine workers or other workers in occupations (current or past) where high manganese exposure is likely
  • Pre-existing neurodegenerative disease (Parkinson's, Alzheimer's, Huntington's etc.) or neuromuscular disorder (Multiple sclerosis, Amyotrophic lateral sclerosis, Polio, hereditary neuromuscular disease)
  • Major psychiatric disorder (major depression, psychosis)
  • Participation in another clinical study with an investigational medicinal product within 1 month prior to inclusion.
  • Blood manganese concentration values >18.3 μg/L at screening

Sites / Locations

  • Moores UCSD Cancer Center
  • Center for Cancer and Blood Disorders
  • Associates in Oncology & Hematology
  • Wellmont Medical Associates Oncology and Hematology
  • The University of Texas, Health Science Center at San Antonio
  • Benaroya Research Institute @ Virginia Mason
  • Complex Oncology Center-Plovdiv EOOD, Department of Medical Oncology and oncology diseases in gastroenterology
  • Complex Oncology Center-Shumen EOOD, Department of Medical Oncology
  • MHAT "Serdika" EOOD, Department of Medical Oncology
  • UMHAT "Tzaritza Joanna-ISUL" EAD, Clinic of Medical Oncology
  • SHATO EAD, Sofia, Clinic of Chemotherapy
  • Aalborg University Hospital, Dept of Oncology, Clinical Research Unit
  • Odense Universitetshospital, Klinisk Forsknings Enhed, Onkologisk Afdelig R
  • LTD Clinic Medina
  • Resaerch Institte of Clinical Medicine
  • JSC "Neo Medi"
  • LTD " High Technology Medical Center University Clinic"
  • S. Khechinashvili University Hospital
  • St. Josef-Hospital -Universitätsklinik Ruhr-Universität Bochum, Leitende Ärztin der Abt. für Hämatologie und Onkologie, Medizinische Klinik I
  • BAG Freiberg-Richter, Jacobasch, Illmer, Wolf; Gemeinschaftspraxis Hämatologie -Onkologie
  • HELIOS Klinikum Wuppertal, Klinik für Hämatologie und Onkologie
  • Centro Hospitalar do Baixo Vouga, E.P.E. (Hospital Infante D. Pedro), Oncologia Médica
  • Hospital de Braga, Oncologia Médica
  • Instituto Português de Oncologia do Porto, Francisco Gentil, E.P.E., Oncologia Médica
  • Institute for Oncology and Radiology of Serbia, Clinic for Medical Oncology
  • Military Medical Academy, Gastroenterology department
  • Clinical Hospital Center Zemun, Insitute for Oncology
  • Clinical Center Kragujevac, Center for Oncology
  • Gävle sjukhus, Oncology unit
  • Sahlgrenska/Östra sjukhuset
  • Universitetssjukhuset i Linköping
  • Karolinska Sjukhuset
  • Akademiska Sjukhuset

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

FOLFOX6 + PledOx 2 µmol/kg

FOLFOX6 + PledOx 5 µmol/kg

FOLFOX6 + PledOx 10 µmol/kg

FOLFOX6 + 0,9% NaCl

Arm Description

PledOx active ingredient= Calmangafodipir; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.

PledOx active ingredient= Calmangafodipir; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.

PledOx active ingredient= Calmangafodipir; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.

Placebo= 0.9% NaCl; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.

Outcomes

Primary Outcome Measures

Number of Patients With Neuropathy Grade 2 or Higher (According to the Oxaliplatin Specific Sanofi Scale (OSSS) Criteria Related Paraesthesia/Dysaesthesia)
Percentage of patients, over cycle 1 to 8, with neuropathy grade 2 or higher (according to the Oxaliplatin Specific Sanofi Scale (OSSS) criteria related paraesthesiae/dysaesthesiae)

Secondary Outcome Measures

Full Information

First Posted
May 25, 2012
Last Updated
July 4, 2018
Sponsor
Egetis Therapeutics
Collaborators
Pharma Consulting Group AB
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1. Study Identification

Unique Protocol Identification Number
NCT01619423
Brief Title
A Trial of PledOx + FOLFOX6 Compared to Placebo + FOLFOX6 in Patients With Metastatic Colorectal Cancer
Acronym
PLIANT
Official Title
A Double Blinded Randomised Three Armed Phase II Trial of PledOx in Two Different Doses in Combination With FOLFOX6 Compared to Placebo + FOLFOX6 in Patients With Advanced Metastatic Colorectal (Stage IV) Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
September 2012 (undefined)
Primary Completion Date
March 2016 (Actual)
Study Completion Date
December 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Egetis Therapeutics
Collaborators
Pharma Consulting Group AB

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The present trial is designed to determine whether pre-treatment with PledOx lowers the frequency and severity of side effects from FOLFOX6 administration in patients with metastatic colorectal cancer. The efficacy of PledOx will be assessed when added to FOLFOX6 chemotherapy as first line treatment of metastatic colorectal cancer. This study was performed in multiple parts/phases. Part 1 was an open dose-escalation study with the doses 2, 5 and 10 micromol/kg of calmangafodipir. No study outcomes were planned for this part. In part 2a, participants randomly received either Placebo, 2 or 10 micromol/kg of calmangafodipir. In part 2b, participants randomly received either Placebo, 2 or 5 micromol/kg of calmangafodipir. The overall intent of the study was to compare the effect of antioxidant agent PledOx against placebo in one of three different doses/combinations (2 micromol/kg, 5/10 micromol/kg, 2/5/10 micromol/kg vs. placebo, in the first 8 cycles of FOLFOX6 treatment
Detailed Description
Globally, nearly 800 000 colorectal cancers are believed to occur annually. Approximately about half of the patients with colorectal cancer develop metastatic disease. These patients are often offered chemotherapy with the FOLFOX6 regimen (FOL = FOLic acid; F = Fluorouracil (5-FU); OX = OXaliplatin) The use of FOLFOX6 is, however, hampered by a high incidence and severity of adverse reactions. In the current trial patients will receive the antioxidant agent PledOx in one of two different doses, or placebo, in the first 8 cycles of FOLFOX6 treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Metastatic (Stage IV) Colorectal Cancer
Keywords
Metastatic colorectal cancer, stage IV, FOLFOX6, Chemotherapy, PledOx, Mangafodipir, Febrile neutropenia, Oxidative stress, Antioxidant, neutropenia, neuropathy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
The study is a three arm study, however, we changed the high dose in the secord part of the study, from 10 micromol/kg (part 2a) to 5 mictomol/kg (part 2b)
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
186 (Actual)

8. Arms, Groups, and Interventions

Arm Title
FOLFOX6 + PledOx 2 µmol/kg
Arm Type
Active Comparator
Arm Description
PledOx active ingredient= Calmangafodipir; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.
Arm Title
FOLFOX6 + PledOx 5 µmol/kg
Arm Type
Active Comparator
Arm Description
PledOx active ingredient= Calmangafodipir; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.
Arm Title
FOLFOX6 + PledOx 10 µmol/kg
Arm Type
Active Comparator
Arm Description
PledOx active ingredient= Calmangafodipir; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.
Arm Title
FOLFOX6 + 0,9% NaCl
Arm Type
Placebo Comparator
Arm Description
Placebo= 0.9% NaCl; FOLFOX6=Combination of FOLinic Acid, 5-Fluorouracil (5-FU), and Oxaliplatin.
Intervention Type
Drug
Intervention Name(s)
PledOx (2 µmol/kg)
Other Intervention Name(s)
Calmangafodipir
Intervention Description
PledOx is administered intravenously for up to 5 minutes, about 10 min prior to start of FOLFOX6 chemotherapy which will be administered day 1 and 2 every second week for up to 8 cycles.
Intervention Type
Drug
Intervention Name(s)
PledOx (5 µmol/kg)
Other Intervention Name(s)
Calmangafodipir
Intervention Description
PledOx is administered intravenously for up to 5 minutes, about 10 min prior to start of FOLFOX6 chemotherapy which will be administered day 1 and 2 every second week for up to 8 cycles
Intervention Type
Drug
Intervention Name(s)
PledOx (10 µmol/kg)
Other Intervention Name(s)
Calmangafodipir
Intervention Description
PledOx is administered intravenously for up to 5 minutes, about 10 min prior to start of FOLFOX6 chemotherapy which will be administered day 1 and 2 every second week for up to 8 cycles
Intervention Type
Drug
Intervention Name(s)
Placebo (0,9% NaCl)
Other Intervention Name(s)
Sodium chloride
Intervention Description
Placebo (0,9% NaCl) is administered intravenously for up to 5 minutes, about 10 min prior to start of FOLFOX6 chemotherapy which will be administered day 1 and 2 every second week for up to 8 cycles.
Primary Outcome Measure Information:
Title
Number of Patients With Neuropathy Grade 2 or Higher (According to the Oxaliplatin Specific Sanofi Scale (OSSS) Criteria Related Paraesthesia/Dysaesthesia)
Description
Percentage of patients, over cycle 1 to 8, with neuropathy grade 2 or higher (according to the Oxaliplatin Specific Sanofi Scale (OSSS) criteria related paraesthesiae/dysaesthesiae)
Time Frame
Every second week during cycle 1-8, for up to 16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Advanced metastatic colorectal (stage IV) cancer verified by biopsy Patients may have received up to three previous treatment lines of chemotherapy, which may include fluoropyrimidine, irinotecan and targeted therapies. The last dose of antitumor drug must be given at least 4 weeks prior to inclusion and all toxicity (except alopecia and fatigue) resolved. Patients may also be chemotherapy-naïve, have received prior adjuvant treatment but no previous treatment with oxaliplatin CT-scan or MRI of thorax, abdomen and pelvis; within ≤4 weeks before start of chemotherapy Evaluable disease and one measurable site of disease according to RECIST 1.1 criteria (at least 10mm for CT-scan or MRI) Neurological examination with no significant pathological findings ≥18 years WHO performance status 0≤2 and Life expectancy ≥ 3 months Adequate haematological function, Hb ≥ 100 g/L, ANC ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L Adequate renal and hepatic functions: creatinine clearance >50 cc/min, total bilirubin ≤ 1.5 times ULN, ASAT and ALAT ≤ 3 times ULN (ASAT and ALAT ≤ 5 times ULN in case of liver metastases) INR ≤1.5 times ULN, unless receiving therapeutic anticoagulation Negative pregnancy test for females of child-producing potential Written informed consent given Exclusion Criteria: Tumours other than colorectal adenocarcinomas (within the previous 5 years) except for curatively treated non melanoma skin cancer or in situ carcinoma of the cervix Evidence of central nervous system metastases Unresolved bowel obstruction or sub-obstruction, uncontrolled Crohn's disease or ulcerative colitis History of cardiac disease with a New York Heart Association (NYHA) Class II or greater congestive heart failure, myocardial infarction or unstable angina in the past six (6) months prior to Day 1 of treatment and serious arrhythmias requiring medication for treatment Prolonged QTC interval >450 msec Known history of stroke or cerebrovascular accident in the past six (6) months Severe diarrhoea Chronic infection or uncontrolled serious illness causing immunodeficiency Any uncontrolled serious illness or medical condition Received mangafodipir at any time Welders, mine workers or other workers in occupations (current or past) where high manganese exposure is likely Pre-existing neurodegenerative disease (Parkinson's, Alzheimer's, Huntington's etc.) or neuromuscular disorder (Multiple sclerosis, Amyotrophic lateral sclerosis, Polio, hereditary neuromuscular disease) Major psychiatric disorder (major depression, psychosis) Participation in another clinical study with an investigational medicinal product within 1 month prior to inclusion. Blood manganese concentration values >18.3 μg/L at screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marie Bengtson
Organizational Affiliation
Egetis Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Moores UCSD Cancer Center
City
La Jolla
State/Province
California
ZIP/Postal Code
92093-0698
Country
United States
Facility Name
Center for Cancer and Blood Disorders
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20817
Country
United States
Facility Name
Associates in Oncology & Hematology
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37421
Country
United States
Facility Name
Wellmont Medical Associates Oncology and Hematology
City
Kingsport
State/Province
Tennessee
ZIP/Postal Code
37660
Country
United States
Facility Name
The University of Texas, Health Science Center at San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Benaroya Research Institute @ Virginia Mason
City
Seattle
State/Province
Washington
ZIP/Postal Code
98101
Country
United States
Facility Name
Complex Oncology Center-Plovdiv EOOD, Department of Medical Oncology and oncology diseases in gastroenterology
City
Plovdiv
ZIP/Postal Code
4004
Country
Bulgaria
Facility Name
Complex Oncology Center-Shumen EOOD, Department of Medical Oncology
City
Shumen
ZIP/Postal Code
9700
Country
Bulgaria
Facility Name
MHAT "Serdika" EOOD, Department of Medical Oncology
City
Sofia
ZIP/Postal Code
1303
Country
Bulgaria
Facility Name
UMHAT "Tzaritza Joanna-ISUL" EAD, Clinic of Medical Oncology
City
Sofia
ZIP/Postal Code
1527
Country
Bulgaria
Facility Name
SHATO EAD, Sofia, Clinic of Chemotherapy
City
Sofia
ZIP/Postal Code
1756
Country
Bulgaria
Facility Name
Aalborg University Hospital, Dept of Oncology, Clinical Research Unit
City
Aalborg
ZIP/Postal Code
9000
Country
Denmark
Facility Name
Odense Universitetshospital, Klinisk Forsknings Enhed, Onkologisk Afdelig R
City
Odense
ZIP/Postal Code
5000
Country
Denmark
Facility Name
LTD Clinic Medina
City
Batumi
ZIP/Postal Code
6000
Country
Georgia
Facility Name
Resaerch Institte of Clinical Medicine
City
Tbilisi
ZIP/Postal Code
0112
Country
Georgia
Facility Name
JSC "Neo Medi"
City
Tbilisi
ZIP/Postal Code
0131
Country
Georgia
Facility Name
LTD " High Technology Medical Center University Clinic"
City
Tbilisi
ZIP/Postal Code
0144
Country
Georgia
Facility Name
S. Khechinashvili University Hospital
City
Tbilisi
ZIP/Postal Code
179
Country
Georgia
Facility Name
St. Josef-Hospital -Universitätsklinik Ruhr-Universität Bochum, Leitende Ärztin der Abt. für Hämatologie und Onkologie, Medizinische Klinik I
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
BAG Freiberg-Richter, Jacobasch, Illmer, Wolf; Gemeinschaftspraxis Hämatologie -Onkologie
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
HELIOS Klinikum Wuppertal, Klinik für Hämatologie und Onkologie
City
Wuppertal
ZIP/Postal Code
42283
Country
Germany
Facility Name
Centro Hospitalar do Baixo Vouga, E.P.E. (Hospital Infante D. Pedro), Oncologia Médica
City
Aveiro
ZIP/Postal Code
3814-501
Country
Portugal
Facility Name
Hospital de Braga, Oncologia Médica
City
Braga
ZIP/Postal Code
4710-243
Country
Portugal
Facility Name
Instituto Português de Oncologia do Porto, Francisco Gentil, E.P.E., Oncologia Médica
City
Porto
ZIP/Postal Code
4200-072
Country
Portugal
Facility Name
Institute for Oncology and Radiology of Serbia, Clinic for Medical Oncology
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Military Medical Academy, Gastroenterology department
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Clinical Hospital Center Zemun, Insitute for Oncology
City
Belgrade
ZIP/Postal Code
11080
Country
Serbia
Facility Name
Clinical Center Kragujevac, Center for Oncology
City
Kragujevac
ZIP/Postal Code
34000
Country
Serbia
Facility Name
Gävle sjukhus, Oncology unit
City
Gävle
ZIP/Postal Code
80187
Country
Sweden
Facility Name
Sahlgrenska/Östra sjukhuset
City
Göteborg
ZIP/Postal Code
41685
Country
Sweden
Facility Name
Universitetssjukhuset i Linköping
City
Linköping
ZIP/Postal Code
SE-581 85
Country
Sweden
Facility Name
Karolinska Sjukhuset
City
Stockholm
Country
Sweden
Facility Name
Akademiska Sjukhuset
City
Uppsala
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
29140155
Citation
Glimelius B, Manojlovic N, Pfeiffer P, Mosidze B, Kurteva G, Karlberg M, Mahalingam D, Buhl Jensen P, Kowalski J, Bengtson M, Nittve M, Nasstrom J. Persistent prevention of oxaliplatin-induced peripheral neuropathy using calmangafodipir (PledOx(R)): a placebo-controlled randomised phase II study (PLIANT). Acta Oncol. 2018 Mar;57(3):393-402. doi: 10.1080/0284186X.2017.1398836. Epub 2017 Nov 15.
Results Reference
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A Trial of PledOx + FOLFOX6 Compared to Placebo + FOLFOX6 in Patients With Metastatic Colorectal Cancer

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