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Cetuximab Rechallenge in Irinotecan-pretreated mCRC, KRAS, NRAS and BRAF Wild-type Treated in 1st Line With Anti-EGFR Therapy (CRICKET). (CRICKET)

Primary Purpose

Metastatic Colorectal Cancer

Status
Unknown status
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
cetuximab
irinotecan
Sponsored by
Gruppo Oncologico del Nord-Ovest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer focused on measuring cetuximab rechallenge

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically proven diagnosis of colorectal adenocarcinoma;
  • RAS and BRAF wild-type status;
  • First-line irinotecan-based (FOLFIRI or FOLFOXIRI) cetuximab-containing therapy producing at least a partial response;
  • First-line progression-free survival in response to cetuximab-containing therapy ≥6 months;
  • Documentation of progression to first-line cetuximab within 4 weeks after last cetuximab administration;
  • Time between the end of first-line therapy and the start of third-line treatment with cetuximab plus irinotecan ≥4 months;
  • Second-line oxaliplatin-based (FOLFOXIRI, FOLFOX or XELOX) bevacizumab-containing therapy;
  • Documentation of progression to second-line treatment;
  • Measurable disease according to RECIST criteria v1.1;
  • Have tumor tissue (of primary tumor and metastases or at least one of the two) available for biomarker analysis;
  • Male or female patients > 18 years of age;
  • ECOG Performance Status ≤ 2;
  • Life expectancy of at least 3 months;
  • Adequate bone marrow, liver and renal function assessed within 14 days before starting study treatment;
  • Women of childbearing potential must have a negative blood pregnancy test at the baseline visit. For this trial, women of childbearing potential are defined as all women after puberty, unless they are postmenopausal for at least 12 months, are surgically sterile or are sexually inactive;
  • Subjects and their partners must be willing to avoid pregnancy during the trial and until 6 months after the last trial treatment. Male subjects with female partners of childbearing potential and female subjects of childbearing potential must, therefore, be willing to use adequate contraception as approved by the investigator, such as a two-barrier method or one-barrier method with spermicidal or intrauterine device. This requirement begins 2 weeks before receiving the first trial treatment and ends 6 months after receiving the last treatment;
  • Signed informed consent obtained before any study specific procedure.

Exclusion Criteria:

  • Active uncontrolled infections or active disseminated intravascular coagulation;
  • Past or current history of malignancies other than colorectal carcinoma, except for curatively treated basal and squamous cell carcinoma of the skin cancer or in situ carcinoma of the cervix;
  • Fertile women (< 12 months after last menstruation) and men of childbearing potential not willing to use effective means of contraception
  • Women who are pregnant or are breastfeeding;
  • Previous grade 3/4 infusion related reaction to cetuximab.

Sites / Locations

  • AUSL DI FROSINONE - FROSINONE (FR) ONCOLOGIA MEDICA U.O. Oncologia Medica
  • Irccs Istituto Oncologico Veneto (Iov) - Padova (Pd) Oncologia Medica
  • Azienda Ospedaliero Universitaria Di Parma - U.O.Oncologia Medica
  • A.O. Universitaria Pisana - Pisa (Pi) Oncologia Medica
  • AUSL 5 DI PISA - PISA (PI) ONCOLOGIA MEDICA oncologia medica Osp Lotti Pontedera
  • Ospedale Fatebenefratelli
  • Azienda Policlinico Umberto I - Oncologia Medica
  • Campus Biomedico
  • A.O. Universitaria S.Maria Della Misericordia Di Udine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

cetuximab and irinotecan

Arm Description

Outcomes

Primary Outcome Measures

percentage of patients achieving a decrease equal or more than 30% in the sum of the longest diameters of target lesions
ORR is defined as the percentage of patients, relative to the total of enrolled subjects, achieving a complete (CR) or partial (PR) response, according to RECIST 1.1 criteria. The determination of clinical response will be based on investigator-reported measurements. Responses will be evaluated with a chest and abdominal computed tomography (CT) scan every 8 weeks. Patients who do not have an on-study assessment will be included in the analysis as non-responders.

Secondary Outcome Measures

Full Information

First Posted
October 15, 2014
Last Updated
February 14, 2018
Sponsor
Gruppo Oncologico del Nord-Ovest
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1. Study Identification

Unique Protocol Identification Number
NCT02296203
Brief Title
Cetuximab Rechallenge in Irinotecan-pretreated mCRC, KRAS, NRAS and BRAF Wild-type Treated in 1st Line With Anti-EGFR Therapy (CRICKET).
Acronym
CRICKET
Official Title
A PHASE II SINGLE-ARM STUDY OF CETUXIMAB PLUS IRINOTECAN AS RECHALLENGE 3RD-LINE TREATMENT OF KRAS, NRAS AND BRAF WILD-TYPE IRINOTECAN-PRETREATED METASTATIC COLORECTAL CANCER PATIENTS PROGRESSING AFTER AN INITIAL RESPONSE TO A 1ST-LINE CETUXIMAB-CONTAINING THERAPY AND A STANDARD 2ND-LINE
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Unknown status
Study Start Date
October 2014 (undefined)
Primary Completion Date
June 19, 2017 (Actual)
Study Completion Date
June 15, 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gruppo Oncologico del Nord-Ovest

4. Oversight

5. Study Description

Brief Summary
This is a multicentric, phase II single-arm study in which KRAS, NRAS and BRAF wild-type, irinotecan-resistant metastatic colorectal cancer patients progressing after an initial response to a first-line cetuximab-containing therapy, receive a rechallenge third-line treatment with cetuximab plus irinotecan.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
cetuximab and irinotecan
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
cetuximab
Intervention Type
Drug
Intervention Name(s)
irinotecan
Primary Outcome Measure Information:
Title
percentage of patients achieving a decrease equal or more than 30% in the sum of the longest diameters of target lesions
Description
ORR is defined as the percentage of patients, relative to the total of enrolled subjects, achieving a complete (CR) or partial (PR) response, according to RECIST 1.1 criteria. The determination of clinical response will be based on investigator-reported measurements. Responses will be evaluated with a chest and abdominal computed tomography (CT) scan every 8 weeks. Patients who do not have an on-study assessment will be included in the analysis as non-responders.
Time Frame
evaluation every 8 weeks until 48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically proven diagnosis of colorectal adenocarcinoma; RAS and BRAF wild-type status; First-line irinotecan-based (FOLFIRI or FOLFOXIRI) cetuximab-containing therapy producing at least a partial response; First-line progression-free survival in response to cetuximab-containing therapy ≥6 months; Documentation of progression to first-line cetuximab within 4 weeks after last cetuximab administration; Time between the end of first-line therapy and the start of third-line treatment with cetuximab plus irinotecan ≥4 months; Second-line oxaliplatin-based (FOLFOXIRI, FOLFOX or XELOX) bevacizumab-containing therapy; Documentation of progression to second-line treatment; Measurable disease according to RECIST criteria v1.1; Have tumor tissue (of primary tumor and metastases or at least one of the two) available for biomarker analysis; Male or female patients > 18 years of age; ECOG Performance Status ≤ 2; Life expectancy of at least 3 months; Adequate bone marrow, liver and renal function assessed within 14 days before starting study treatment; Women of childbearing potential must have a negative blood pregnancy test at the baseline visit. For this trial, women of childbearing potential are defined as all women after puberty, unless they are postmenopausal for at least 12 months, are surgically sterile or are sexually inactive; Subjects and their partners must be willing to avoid pregnancy during the trial and until 6 months after the last trial treatment. Male subjects with female partners of childbearing potential and female subjects of childbearing potential must, therefore, be willing to use adequate contraception as approved by the investigator, such as a two-barrier method or one-barrier method with spermicidal or intrauterine device. This requirement begins 2 weeks before receiving the first trial treatment and ends 6 months after receiving the last treatment; Signed informed consent obtained before any study specific procedure. Exclusion Criteria: Active uncontrolled infections or active disseminated intravascular coagulation; Past or current history of malignancies other than colorectal carcinoma, except for curatively treated basal and squamous cell carcinoma of the skin cancer or in situ carcinoma of the cervix; Fertile women (< 12 months after last menstruation) and men of childbearing potential not willing to use effective means of contraception Women who are pregnant or are breastfeeding; Previous grade 3/4 infusion related reaction to cetuximab.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alfredo Falcone, MD, PhD
Organizational Affiliation
U.O. Oncologia Medica 2 Universitaria, Università di Pisa - AOUP, Polo Oncologico, Area Vasta Nord-Ovest, Istituto Toscano Tumori
Official's Role
Principal Investigator
Facility Information:
Facility Name
AUSL DI FROSINONE - FROSINONE (FR) ONCOLOGIA MEDICA U.O. Oncologia Medica
City
Frosinone
ZIP/Postal Code
03100
Country
Italy
Facility Name
Irccs Istituto Oncologico Veneto (Iov) - Padova (Pd) Oncologia Medica
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria Di Parma - U.O.Oncologia Medica
City
Parma
Country
Italy
Facility Name
A.O. Universitaria Pisana - Pisa (Pi) Oncologia Medica
City
Pisa
ZIP/Postal Code
56126
Country
Italy
Facility Name
AUSL 5 DI PISA - PISA (PI) ONCOLOGIA MEDICA oncologia medica Osp Lotti Pontedera
City
Pontedera
ZIP/Postal Code
56100
Country
Italy
Facility Name
Ospedale Fatebenefratelli
City
Roma
ZIP/Postal Code
00186
Country
Italy
Facility Name
Azienda Policlinico Umberto I - Oncologia Medica
City
Roma
Country
Italy
Facility Name
Campus Biomedico
City
Roma
Country
Italy
Facility Name
A.O. Universitaria S.Maria Della Misericordia Di Udine
City
Udine
ZIP/Postal Code
33100
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
30476968
Citation
Cremolini C, Rossini D, Dell'Aquila E, Lonardi S, Conca E, Del Re M, Busico A, Pietrantonio F, Danesi R, Aprile G, Tamburini E, Barone C, Masi G, Pantano F, Pucci F, Corsi DC, Pella N, Bergamo F, Rofi E, Barbara C, Falcone A, Santini D. Rechallenge for Patients With RAS and BRAF Wild-Type Metastatic Colorectal Cancer With Acquired Resistance to First-line Cetuximab and Irinotecan: A Phase 2 Single-Arm Clinical Trial. JAMA Oncol. 2019 Mar 1;5(3):343-350. doi: 10.1001/jamaoncol.2018.5080.
Results Reference
derived

Learn more about this trial

Cetuximab Rechallenge in Irinotecan-pretreated mCRC, KRAS, NRAS and BRAF Wild-type Treated in 1st Line With Anti-EGFR Therapy (CRICKET).

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