Durvalumab and Tremelimumab and Best Supportive Care vs Best Supportive Care in Patients With Advanced Colorectal Cancer
Colorectal Cancer
About this trial
This is an interventional treatment trial for Colorectal Cancer
Eligibility Criteria
Inclusion Criteria:
- Must have histologically or pathologically confirmed advanced (metastatic or locally advanced) colorectal cancer that is unresectable.
- Received a prior thymidylate synthase inhibitor (e.g. 5-fluorouracil (5-FU), capecitabine, raltitrexed, UFT) for metastatic disease or as adjuvant therapy. A thymidylate synthase inhibitor may have been given in combination with oxaliplatin or irinotecan.
- Received and failed an irinotecan -containing regimen (i.e. single-agent or in combination) for treatment of metastatic disease, OR relapsed within 6 months of completion of an irinotecan-containing adjuvant therapy, OR have documented unsuitability for an irinotecan-containing regimen.
- Received and failed an oxaliplatin-containing regimen (i.e. single-agent or in combination) for treatment of metastatic disease, OR relapsed within 6 months of completion of an oxaliplatin-containing adjuvant therapy OR have documented unsuitability for an oxaliplatin-containing regimen.
- For patients with colorectal cancer that is RAS-wild type:
Received and failed a cetuximab or panitumumab-containing regimen (i.e. single-agent or in combination) for treatment of metastatic disease OR have documented unsuitability for a cetuximab or panitumumab-containing regimen
- Patient prior treatment with VEGF targeting therapy, such as bevacizumab, aflibercept, ramucirumab, or regorafenib, is permitted but not mandatory. Reasons not used are to be documented.
- Patient prior treatment with TAS-102 (an agent composed of a combination of trifluorothymidine (FTD) and tipiracil hydrochloride (TPI)), is permitted but not mandatory.
- The only remaining standard available therapy as recommended by the Investigator, in consultation with the patient, is best supportive care.
- Must have presence of measurable or evaluable disease as defined by Response Evaluation Criteria in Solid Tumours (RECIST 1.1).
- Imaging investigations including CT/MRI of chest/abdomen/pelvis or other scans as necessary to document all sites of disease done within 28 days prior to randomization.
- Must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Life expectancy of ≥ 12 weeks at the time of study entry.
- Must be ≥ 18 years of age.
- Women/men of childbearing potential must have agreed to use a highly effective contraceptive method.
- Patient must consent to provision of, and investigator(s) must confirm adequacy of tissue, and confirm access to and agree to submit within 4 weeks of randomization to the CCTG Central Tumour Bank, a representative formalin fixed paraffin block of tumour tissue in order that the specific correlative marker assays may be conducted.
- Patient must consent to provision of samples of blood in order that the specific correlative marker assays
- Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life questionnaires in either English or French.
Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients randomized on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
- In accordance with CCTG policy, protocol treatment is to begin within 2 working days of patient randomization.
- The patient is not receiving therapy in a concurrent clinical study and the patient agrees not to participate in other clinical studies during their participation in this trial while on study treatment.
Sites / Locations
- Tom Baker Cancer Centre
- BCCA - Vancouver Cancer Centre
- The Moncton Hospital
- Dr. H. Bliss Murphy Cancer Centre
- QEII Health Sciences Centre
- Royal Victoria Regional Health Centre
- Juravinski Cancer Centre at Hamilton Health Sciences
- Cancer Centre of Southeastern Ontario at Kingston
- London Regional Cancer Program
- Ottawa Hospital Research Institute
- Algoma District Cancer Program
- Odette Cancer Centre
- University Health Network
- Windsor Regional Cancer Centre
- Hopital Charles LeMoyne
- Hopital de la Cite-de-la-Sante
- L'Hotel-Dieu de Levis
- CHUM - Hopital Notre-Dame
- The Jewish General Hospital
- Centre Integre Universitaire De Sante Et De Services
- CHUQ-Pavillon Hotel-Dieu de Quebec
- Centre hospitalier universitaire de Sherbrooke
- Centre hospitalier regional de Trois-Rivieres
- Allan Blair Cancer Centre
- Saskatoon Cancer Centre
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Best Supportive Care
Durvalumab plus Tremelimumab and Best Supportive Care
Best supportive care available
Tremelimumab 75mg IV 60 minutes Day 1, cycles 1-4 Durvalumab 1500mg IV 60 minutes Day 1 every 28 days. Plus best supportive care