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Clinical Study of Apatinib Combined With Second - Line Chemotherapy for Metastatic Colorectal Cancer

Primary Purpose

Colorectal Neoplasms

Status
Unknown status
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Apatinib
standard second-line chemotherapy
Sponsored by
Liqiang Zhong
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Neoplasms

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female aged 18 to 70 years old;
  2. Histologically or cytologically proven patients with metastatic colorectal cancer have undergone a first-line standard regimen recommended by the NCCN guidelines for progression;
  3. According to the RECIST 1.1 criteria, the patient has at least one target lesion that can measure the diameter;
  4. ECOG PS ≤ 2;
  5. Expected survival time of more than 12 weeks.
  6. The level of organ function must meet the following requirements:

    Bone marrow: neutrophil count (ANC) ≥ 1.5 × 10^9/L, platelet ≥ 75 × 10^9/L, hemoglobin ≥ 90g/L.

    Liver: serum bilirubin ≤ 2 times the upper limit of normal, aminotransferase AST and ALT ≤ 2.5 times the normal upper limit.

    Kidney: Serum creatinine ≤1.5 times upper limit of normal.

  7. Patient compliance is good;
  8. Understand and voluntarily sign a written informed consent.

Exclusion Criteria:

  1. Other previous or concurrent malignancy, except cured skin basal cell carcinoma and cervical carcinoma in situ;
  2. Already known to be allergic to apatinib or any excipient;
  3. Use unapproved drugs or other test medications within 4 weeks prior to enrollment;
  4. There are many factors that affect oral medications (such as inability to swallow, chronic diarrhea and intestinal obstruction);
  5. Patients with a history of CNS metastases or CNS metastases;
  6. A history of bleeding, with any serious grading within 4 weeks prior to screening reaching a bleeding event of 3 degrees Celsius or greater in CTCAE4.0;
  7. Serious infection;
  8. Serious cardiovascular disease: uncontrolled hypertension, unstable angina, grade 3-4 heart failure (NYHA standard), congestive heart failure;
  9. urinary routine urinary protein ≥ ++ and confirmed 24-hour urinary protein quantitation> 1.0 g;
  10. Within 30 days after major surgery;
  11. Thrombotic disease. Anemia or venous thrombosis occurred in the previous year, such as cerebrovascular accident (including transient ischemic attack), deep vein thrombosis, pulmonary embolism, etc.;
  12. Those with history of psychotropic substance abuse who can not be abstinent or have mental disorders;
  13. Have clinical symptoms, need clinical intervention pleural effusion or ascites;
  14. At the investigator's discretion, there is a serious concomitant condition that compromises the patient's safety or affects the patient in completing the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Apatinib group

    Control group

    Arm Description

    Apatinib combined with second-line chemotherapy (5-Fu combined with irinotecan or oxaliplatin standard regimen ) Apatinib tablets: 500 mg po qd . Continuous medication, the cycle is consistent with the chemotherapy cycle. Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example)

    Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example)

    Outcomes

    Primary Outcome Measures

    Progression-free survival (PFS)
    the time from randomize to progression or death; RECIST guidelines were used to define all responses after patients had received every 4 weeks of therapy

    Secondary Outcome Measures

    Overall survival (OS)
    Defined as the time from randomize to death
    Objective Response Rate (ORR)
    ORR=complete response (CR) + partial response (PR)
    Disease control rate(DCR)
    Defined as the rate of complete response , partial response and stable disease according to RECIST guidelines
    Quality of life(QoL)
    As measured by the European Organization for Research and Treatment of Cancer questionnaire (EORTC QLQ C30)

    Full Information

    First Posted
    January 22, 2018
    Last Updated
    January 22, 2018
    Sponsor
    Liqiang Zhong
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03412994
    Brief Title
    Clinical Study of Apatinib Combined With Second - Line Chemotherapy for Metastatic Colorectal Cancer
    Official Title
    A Randomized, Parallel-controlled, Exploratory Clinical Trial of Second-line Chemotherapy With Second-line Chemotherapy Versus Second-line Chemotherapy With Apatinib in the Treatment of Metastatic Colorectal Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2018
    Overall Recruitment Status
    Unknown status
    Study Start Date
    February 28, 2018 (Anticipated)
    Primary Completion Date
    February 28, 2020 (Anticipated)
    Study Completion Date
    February 28, 2021 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor-Investigator
    Name of the Sponsor
    Liqiang Zhong

    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
    (1) Evaluate the efficacy of apatinib in combination with standard second-line chemotherapy for advanced colorectal cancer. Whether it can prolong Progression Free Survival (PFS), overall survival (OS) in patients with advanced colorectal cancer and reduce symptoms and improve quality of life compared with standard second-line chemotherapy; (2) Observe the safety of apatinib for the treatment of advanced colorectal cancer.
    Detailed Description
    Standard second line chemotherapy includes chemotherapy based on irinotecan or chemotherapy based on oxaliplatin. Apatinib is a small-molecule tyrosine kinase inhibitor (TKI) that highly selectively binds to and strongly inhibits vascular endothelial growth factor receptor 2 (VEGFR-2), with a decrease in VEGF-mediated endothelial cell migration, proliferation, and tumor microvascular density. A phase II trail of Apatinib has been demonstrated that Apatinib is safe to treat the metastatic colorectal cancer and the disease control rate can reach 50%.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Colorectal Neoplasms

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    60 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Apatinib group
    Arm Type
    Experimental
    Arm Description
    Apatinib combined with second-line chemotherapy (5-Fu combined with irinotecan or oxaliplatin standard regimen ) Apatinib tablets: 500 mg po qd . Continuous medication, the cycle is consistent with the chemotherapy cycle. Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example)
    Arm Title
    Control group
    Arm Type
    Placebo Comparator
    Arm Description
    Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example)
    Intervention Type
    Drug
    Intervention Name(s)
    Apatinib
    Other Intervention Name(s)
    YN968D1
    Intervention Description
    Apatinib in combination with standard second-line chemotherapy for advanced colorectal cancer
    Intervention Type
    Drug
    Intervention Name(s)
    standard second-line chemotherapy
    Other Intervention Name(s)
    FOLFOX、FOLFIRI、CapeOX
    Intervention Description
    The second line standard chemotherapy regimen recommended by the NCCN
    Primary Outcome Measure Information:
    Title
    Progression-free survival (PFS)
    Description
    the time from randomize to progression or death; RECIST guidelines were used to define all responses after patients had received every 4 weeks of therapy
    Time Frame
    Approximately 2 year
    Secondary Outcome Measure Information:
    Title
    Overall survival (OS)
    Description
    Defined as the time from randomize to death
    Time Frame
    Approximately 3 years
    Title
    Objective Response Rate (ORR)
    Description
    ORR=complete response (CR) + partial response (PR)
    Time Frame
    Approximately 2 years
    Title
    Disease control rate(DCR)
    Description
    Defined as the rate of complete response , partial response and stable disease according to RECIST guidelines
    Time Frame
    Approximately 2 years
    Title
    Quality of life(QoL)
    Description
    As measured by the European Organization for Research and Treatment of Cancer questionnaire (EORTC QLQ C30)
    Time Frame
    Approximately 2 year

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female aged 18 to 70 years old; Histologically or cytologically proven patients with metastatic colorectal cancer have undergone a first-line standard regimen recommended by the NCCN guidelines for progression; According to the RECIST 1.1 criteria, the patient has at least one target lesion that can measure the diameter; ECOG PS ≤ 2; Expected survival time of more than 12 weeks. The level of organ function must meet the following requirements: Bone marrow: neutrophil count (ANC) ≥ 1.5 × 10^9/L, platelet ≥ 75 × 10^9/L, hemoglobin ≥ 90g/L. Liver: serum bilirubin ≤ 2 times the upper limit of normal, aminotransferase AST and ALT ≤ 2.5 times the normal upper limit. Kidney: Serum creatinine ≤1.5 times upper limit of normal. Patient compliance is good; Understand and voluntarily sign a written informed consent. Exclusion Criteria: Other previous or concurrent malignancy, except cured skin basal cell carcinoma and cervical carcinoma in situ; Already known to be allergic to apatinib or any excipient; Use unapproved drugs or other test medications within 4 weeks prior to enrollment; There are many factors that affect oral medications (such as inability to swallow, chronic diarrhea and intestinal obstruction); Patients with a history of CNS metastases or CNS metastases; A history of bleeding, with any serious grading within 4 weeks prior to screening reaching a bleeding event of 3 degrees Celsius or greater in CTCAE4.0; Serious infection; Serious cardiovascular disease: uncontrolled hypertension, unstable angina, grade 3-4 heart failure (NYHA standard), congestive heart failure; urinary routine urinary protein ≥ ++ and confirmed 24-hour urinary protein quantitation> 1.0 g; Within 30 days after major surgery; Thrombotic disease. Anemia or venous thrombosis occurred in the previous year, such as cerebrovascular accident (including transient ischemic attack), deep vein thrombosis, pulmonary embolism, etc.; Those with history of psychotropic substance abuse who can not be abstinent or have mental disorders; Have clinical symptoms, need clinical intervention pleural effusion or ascites; At the investigator's discretion, there is a serious concomitant condition that compromises the patient's safety or affects the patient in completing the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Liqiang Zhong
    Phone
    15283572951
    Email
    zhongliqiang@163.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Liqiang Zhong
    Organizational Affiliation
    Yibin Second People's Hospital
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

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    Clinical Study of Apatinib Combined With Second - Line Chemotherapy for Metastatic Colorectal Cancer

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