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CY-503 for the Treatment of Chemotherapy-refractory Metastatic Colorectal Cancer (CY503C2)

Primary Purpose

Metastatic Colorectal Cancer

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
CY-503
Placebo
Sponsored by
Cytavis Biopharma GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer focused on measuring Metastatic, Colorectal, Cancer, refractory, Phase II, randomised, double-blind, controlled, multicenter, CY-503, Cytavis

Eligibility Criteria

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

Inclusion Criteria

  • Age ≥ 18 years
  • Patients are eligible with diagnosis of measurable metastatic colorectal carcinoma and radiologic documentation of disease progression during or with 3 months after termination of standard chemotherapy (fluoropyrimidine-based therapy with oxaliplatin and irinotecan). Patients who had to interrupt the 1st or 1nd line therapy due to intolerance or who were refractory or intolerant to the standard treatment regimens are eligible, too. Bevacizumab can, but does not need to be administered at discretion of treating physician. Patients with K-RAS wild-type can be treated with cetuximab or panitumumab before they enter the study.
  • No chemotherapy within 4 weeks before treatment start
  • No residual significant toxicity (greater than NCI grade 1), in case of peripheral neuropathy: no symptoms of peripheral neuropathy of NCI CTC grade 4 within 4 weeks before treatment start.
  • No previous treatment with experimental therapies after standard therapies is allowed.
  • Patients must use effective contraception if of reproductive potential. Females must not be pregnant or lactating
  • Eastern Cooperative Oncology Group (ECOG) Performance status of 0 - 2
  • WBC ≥ 3,000/mm3, absolute neutrophil count (ANC) ≥ 1,500/mm3, platelet count ≥100,000/mm3
  • Bilirubin ≤ 2.0 mg/dL (40 μmol/L) (unless due to Gilbert's syndrome in which case the bilirubin should be ≤3.5 mg/dL (59.86 μmol/L)), aspartate transaminase (AST)/alanine transaminase (ALT) ≤ 5 × upper limit of normal (ULN); hepatic alkaline phosphatase ≤ 3.0 × ULN (in case of liver metastases higher levels do not hinder inclusion of patients)
  • Serum creatinine ≤ 2.0 mg/dL (180 μmol/L)or creatinine clearance >= 50 ml/min. , proteinuria < 2.0 g/24 hr urine collection in patients with a positive urine dipstick for protein
  • Written informed consent according to ICH-GCP and national laws and regulations prior to receipt of any trial medication or beginning trial procedures

Exclusion Criteria:

  • Evidence of any other malignant disease (with the exception of tumors operatively cured at least 5 years prior to the trial)
  • Known brain metastases
  • Uncontrolled pleural effusions
  • Interstitial pneumonitis or pulmonary fibrosis
  • Severe/ unstable systemic disease or infection and circumstances not permitting trial participation (e.g., alcoholism or substance abuse)
  • Unstable cardiac disease in the last 6 months
  • Use of conventional mistletoe preparations, any immunostimulating substances and/or monoclonal antibodies within four weeks prior to and during the trial - ongoing therapy with steroids is permitted if the dose is not higher than 20 mg of prednisone-equivalent at the time of inclusion and during this clinical trial
  • Any evidence or history (elicited by the investigator) of symptomatic cerebrovascular events (i.e., stroke or transient ischemic attack) within 6 months prior to randomization
  • Any history or evidence of pulmonary embolism or thrombophlebitis (including deep vein thrombosis) requiring anticoagulant therapy (e.g., marcumar or heparin)
  • History of hypersensitivity to mistletoe
  • History of primary immunodeficiency
  • Known human immunodeficiency virus (HIV) or known active viral hepatic infections
  • Prior treatment with CY-503
  • A general medical or psychological condition or behaviour, including substance dependence or abuse that, in the opinion of the investigator, might not permit the patient to complete the trial or sign the informed consent

Sites / Locations

  • Bezirkskrankenhaus Hall
  • Medizinische Universität Innsbruck
  • Bezirkskrankenhaus Kufstein
  • St. Vinzenz Krankenhaus Zams
  • Klinikum Altenburger Land GmbH
  • Gesundheitszentrum St. Marien GmbH am Klinikum St. Marien
  • Studienzentrum f. Hämatologie, Onkologie u. Diabetologie
  • Klinikum Bayreuth
  • Klinikum Dortmund GmbH
  • Universitätsklinik Dresden
  • Westdeutsches Tumorzentrum - Universitätsklinikum Essen
  • Klinikum Esslingen
  • Klinikum der Johann Wolfgang-Universität Frankfurt
  • MVZ Onkologische Schwerpunktpraxis
  • Martin-Luther Universität Halle
  • Onkologische Schwerpunktpraxis
  • Universitätsklinkum Heidelberg - Nationales Centrum f. Tumorerkrankungen
  • Marienhospital Herne
  • Onkologische Schwerpunktpraxis
  • Onkologische Schwerpunktpraxis
  • Praxis für Hämatologie und internistische Onkologie
  • Praxis Onkologie
  • Klinikum der Stadt Ludwigshafen
  • Klinikum Lüdenscheid
  • Klinikum Magdeburg gGmbH
  • Johanness-Gutenberg Universität Mainz
  • Praxis für Hämatologie und internistische Onkologie
  • Gemeinschaftspraxis f. Hämatologie u. Onkologie
  • Studienzentrum Onkologie Ravensburg
  • Prosper-Hospital
  • Onkologische Schwerpunktpraxis, Hämatologie und Onkologie
  • Universitätsklinikum Ulm
  • Klinikum Nordoberpfalz AG

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

CY-503

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Tumor assessment by using CT scans and/or MRIs

Secondary Outcome Measures

Assessment of Adverse Events
Assessment of quality of life using a standardized questionaire
Assessment of survival by "physical exam"

Full Information

First Posted
June 25, 2009
Last Updated
July 9, 2013
Sponsor
Cytavis Biopharma GmbH
Collaborators
ClinAssess GmbH, Medical University Innsbruck, Charite University, Berlin, Germany
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1. Study Identification

Unique Protocol Identification Number
NCT00932724
Brief Title
CY-503 for the Treatment of Chemotherapy-refractory Metastatic Colorectal Cancer
Acronym
CY503C2
Official Title
Phase II Double-blind Placebo-controlled Trial of CY503 in Patients With Chemotherapy-refractory Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2011
Overall Recruitment Status
Terminated
Why Stopped
The sponsor declared the early termination of the study due to poor recruitment of patients.
Study Start Date
July 2009 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Cytavis Biopharma GmbH
Collaborators
ClinAssess GmbH, Medical University Innsbruck, Charite University, Berlin, Germany

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This trial is designed as a phase II evaluation of the effect of CY-503 or placebo on progression free survival (PFS) defined as the time from start of treatment until the objective observation of progressive disease (PD) or death from any course in patients with chemotherapy-refractory metastatic colorectal cancer.
Detailed Description
Colorectal cancer has a worldwide annual incidence of approximately 1 million new cases diagnosed yearly and it is the second leading cause of cancer-related death in Western nations. There are a couple of approved standard therapies for the treatment of MCRC with cytotoxic agents irinotecan, oxaliplatin, and the fluoropyrimidines , as well as bevacizumab, the antibody against vascular endothelial growth factor A, and cetuximab, the antibody against the epidermal growth factor receptor. But there are only a few studies achieving a median survival time of more than 20 months in MCRC patients with standard regimens. After a 1st line therapy a high proportion (50% to 80%) of patients receives a 2nd line therapy with drugs not used in 1st line therapy and a part of them gets a 3rd line treatment. Results from a 2nd line therapy are best response rates ranging from 4 % - 23 %, a median PFS rate of 5.1 months, a median TTP of 4.1 - 4.6 months and median overall survival 6.9 - 12 months. However, for patients who experience disease progression after standard therapy (definition see inclusion criteria) there is no further standard therapeutic option. These patients developed a resistance to these therapies and finally die of their disease. They generally get best supportive care (BSC). Thus, there is a need for new active treatment options in this setting. In this phase II double-blind placebo-controlled trial the efficacy and safety of CY-503, 350 ng s.c. injected in patients with chemotherapy refractory MCRC are tested. Approved treatments given to MCRC patients are usually discontinued after a treatment over some weeks at the first detection of objective PD. It will be tested if CY-503 is able to achieve progression-free-survival (PFS) in comparison to placebo. Patients will initially be included to receive either CY-503 or placebo until documentation of objective PD. Standard therapy must be finished and has shown objective PD. Also patients with contraindications to standard therapy can be included. CY-503 shows the potential to improve treatment of MCRC. This study aims at evaluating the activity and therapeutic effects of the substance. Anticipated capabilities are substitution of cytostatic drugs or improvement of their efficacy and tolerability . Furthermore, the expected improvement of PFS rates after failure of standard chemotherapies has to be investigated. In a phase I trial CY-503 showed SD in patients who had exhausted standard therapy options for metastatic disease with subsequent disease progression with a median TTP of 17.4 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer
Keywords
Metastatic, Colorectal, Cancer, refractory, Phase II, randomised, double-blind, controlled, multicenter, CY-503, Cytavis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
77 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CY-503
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
CY-503
Intervention Description
Ampoules with 1 ml 350 ng CY-503 solution for s.c. injection twice weekly. One cycle is defined as 4 consecutive weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Ampoules with 1 ml placebo solution for s.c. injection twice weekly. One cycle is defined as 4 consecutive weeks
Primary Outcome Measure Information:
Title
Tumor assessment by using CT scans and/or MRIs
Time Frame
every 8 weeks (each 2 cycles)
Secondary Outcome Measure Information:
Title
Assessment of Adverse Events
Time Frame
every 4 weeks (every cycle)
Title
Assessment of quality of life using a standardized questionaire
Time Frame
every 4 weeks (every cycle)
Title
Assessment of survival by "physical exam"
Time Frame
every 4 weeks (every cycle) / every 3 months during follow-up

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Age ≥ 18 years Patients are eligible with diagnosis of measurable metastatic colorectal carcinoma and radiologic documentation of disease progression during or with 3 months after termination of standard chemotherapy (fluoropyrimidine-based therapy with oxaliplatin and irinotecan). Patients who had to interrupt the 1st or 1nd line therapy due to intolerance or who were refractory or intolerant to the standard treatment regimens are eligible, too. Bevacizumab can, but does not need to be administered at discretion of treating physician. Patients with K-RAS wild-type can be treated with cetuximab or panitumumab before they enter the study. No chemotherapy within 4 weeks before treatment start No residual significant toxicity (greater than NCI grade 1), in case of peripheral neuropathy: no symptoms of peripheral neuropathy of NCI CTC grade 4 within 4 weeks before treatment start. No previous treatment with experimental therapies after standard therapies is allowed. Patients must use effective contraception if of reproductive potential. Females must not be pregnant or lactating Eastern Cooperative Oncology Group (ECOG) Performance status of 0 - 2 WBC ≥ 3,000/mm3, absolute neutrophil count (ANC) ≥ 1,500/mm3, platelet count ≥100,000/mm3 Bilirubin ≤ 2.0 mg/dL (40 μmol/L) (unless due to Gilbert's syndrome in which case the bilirubin should be ≤3.5 mg/dL (59.86 μmol/L)), aspartate transaminase (AST)/alanine transaminase (ALT) ≤ 5 × upper limit of normal (ULN); hepatic alkaline phosphatase ≤ 3.0 × ULN (in case of liver metastases higher levels do not hinder inclusion of patients) Serum creatinine ≤ 2.0 mg/dL (180 μmol/L)or creatinine clearance >= 50 ml/min. , proteinuria < 2.0 g/24 hr urine collection in patients with a positive urine dipstick for protein Written informed consent according to ICH-GCP and national laws and regulations prior to receipt of any trial medication or beginning trial procedures Exclusion Criteria: Evidence of any other malignant disease (with the exception of tumors operatively cured at least 5 years prior to the trial) Known brain metastases Uncontrolled pleural effusions Interstitial pneumonitis or pulmonary fibrosis Severe/ unstable systemic disease or infection and circumstances not permitting trial participation (e.g., alcoholism or substance abuse) Unstable cardiac disease in the last 6 months Use of conventional mistletoe preparations, any immunostimulating substances and/or monoclonal antibodies within four weeks prior to and during the trial - ongoing therapy with steroids is permitted if the dose is not higher than 20 mg of prednisone-equivalent at the time of inclusion and during this clinical trial Any evidence or history (elicited by the investigator) of symptomatic cerebrovascular events (i.e., stroke or transient ischemic attack) within 6 months prior to randomization Any history or evidence of pulmonary embolism or thrombophlebitis (including deep vein thrombosis) requiring anticoagulant therapy (e.g., marcumar or heparin) History of hypersensitivity to mistletoe History of primary immunodeficiency Known human immunodeficiency virus (HIV) or known active viral hepatic infections Prior treatment with CY-503 A general medical or psychological condition or behaviour, including substance dependence or abuse that, in the opinion of the investigator, might not permit the patient to complete the trial or sign the informed consent
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heinz Zwierzina, MD
Organizational Affiliation
University Hospital Innsbruck, Austria
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Lothar Bergmann, MD
Organizational Affiliation
University Hospital, Frankfurt, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bezirkskrankenhaus Hall
City
Hall in Tirol
ZIP/Postal Code
6060
Country
Austria
Facility Name
Medizinische Universität Innsbruck
City
Innsbruck
ZIP/Postal Code
6020
Country
Austria
Facility Name
Bezirkskrankenhaus Kufstein
City
Kufstein
ZIP/Postal Code
6330
Country
Austria
Facility Name
St. Vinzenz Krankenhaus Zams
City
Zams
ZIP/Postal Code
6511
Country
Austria
Facility Name
Klinikum Altenburger Land GmbH
City
Altenburg
ZIP/Postal Code
04600
Country
Germany
Facility Name
Gesundheitszentrum St. Marien GmbH am Klinikum St. Marien
City
Amberg
ZIP/Postal Code
922224
Country
Germany
Facility Name
Studienzentrum f. Hämatologie, Onkologie u. Diabetologie
City
Aschaffenburg
ZIP/Postal Code
63739
Country
Germany
Facility Name
Klinikum Bayreuth
City
Bayreuth
ZIP/Postal Code
95445
Country
Germany
Facility Name
Klinikum Dortmund GmbH
City
Dortmund
ZIP/Postal Code
44137
Country
Germany
Facility Name
Universitätsklinik Dresden
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Westdeutsches Tumorzentrum - Universitätsklinikum Essen
City
Essen
ZIP/Postal Code
45147
Country
Germany
Facility Name
Klinikum Esslingen
City
Esslingen
ZIP/Postal Code
7370
Country
Germany
Facility Name
Klinikum der Johann Wolfgang-Universität Frankfurt
City
Frankfurt a.M.
ZIP/Postal Code
60590
Country
Germany
Facility Name
MVZ Onkologische Schwerpunktpraxis
City
Frankfurt
ZIP/Postal Code
60596
Country
Germany
Facility Name
Martin-Luther Universität Halle
City
Halle/Saale
ZIP/Postal Code
06120
Country
Germany
Facility Name
Onkologische Schwerpunktpraxis
City
Hamburg
ZIP/Postal Code
20249
Country
Germany
Facility Name
Universitätsklinkum Heidelberg - Nationales Centrum f. Tumorerkrankungen
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Marienhospital Herne
City
Herne
ZIP/Postal Code
44625
Country
Germany
Facility Name
Onkologische Schwerpunktpraxis
City
Hildesheim
ZIP/Postal Code
31135
Country
Germany
Facility Name
Onkologische Schwerpunktpraxis
City
Hof
ZIP/Postal Code
95028
Country
Germany
Facility Name
Praxis für Hämatologie und internistische Onkologie
City
Kronach
ZIP/Postal Code
96317
Country
Germany
Facility Name
Praxis Onkologie
City
Köln
ZIP/Postal Code
51103
Country
Germany
Facility Name
Klinikum der Stadt Ludwigshafen
City
Ludwigshafen
ZIP/Postal Code
67063
Country
Germany
Facility Name
Klinikum Lüdenscheid
City
Luedenscheid
ZIP/Postal Code
58515
Country
Germany
Facility Name
Klinikum Magdeburg gGmbH
City
Magdeburg
ZIP/Postal Code
39130
Country
Germany
Facility Name
Johanness-Gutenberg Universität Mainz
City
Mainz
ZIP/Postal Code
55101
Country
Germany
Facility Name
Praxis für Hämatologie und internistische Onkologie
City
München
ZIP/Postal Code
80638
Country
Germany
Facility Name
Gemeinschaftspraxis f. Hämatologie u. Onkologie
City
Münster
ZIP/Postal Code
48149
Country
Germany
Facility Name
Studienzentrum Onkologie Ravensburg
City
Ravensburg
ZIP/Postal Code
88212
Country
Germany
Facility Name
Prosper-Hospital
City
Recklinghausen
ZIP/Postal Code
45657
Country
Germany
Facility Name
Onkologische Schwerpunktpraxis, Hämatologie und Onkologie
City
Trier
ZIP/Postal Code
54292
Country
Germany
Facility Name
Universitätsklinikum Ulm
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Klinikum Nordoberpfalz AG
City
Weiden Oberpfalz
ZIP/Postal Code
92637
Country
Germany

12. IPD Sharing Statement

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CY-503 for the Treatment of Chemotherapy-refractory Metastatic Colorectal Cancer

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