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Erlotinib and Combination Chemotherapy in Treating Patients With Metastatic Colorectal Cancer

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
erlotinib hydrochloride
fluorouracil
leucovorin calcium
oxaliplatin
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring recurrent colon cancer, stage IV colon cancer, recurrent rectal cancer, stage IV rectal cancer

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed colon or rectal cancer Metastatic or unresectable disease Unidimensionally measurable disease required for phase II only At least 20 mm by x-ray, CT scan, MRI, or photography The following are not considered measurable: Pleural effusion or ascites Osteoblastic lesions Evidence of disease on bone scan alone Progressive irradiated lesions alone Bone marrow involvement Brain metastases Malignant hepatomegaly by physical exam alone Chemical markers (e.g., carcinoembryonic antigen) Recurrent disease after surgery or radiotherapy is considered measurable as long as the following criteria are met: At least 4 weeks since prior surgery or radiotherapy Measurable disease exists outside the radiation port or clear progression exists within the radiation port Tissue accessible for immunohistochemical evidence of epidermal growth factor receptor expression from a metastatic site (phase II only) No known brain metastases PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 OR Karnofsky 60-100% Life expectancy More than 3 months Hematopoietic WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hepatic Bilirubin normal AST/ALT no greater than 2.5 times upper limit of normal Renal Creatinine normal OR Creatinine clearance at least 60 mL/min Cardiovascular No unstable angina pectoris No symptomatic congestive heart failure No cardiac arrhythmia No uncontrolled hypertension (systolic blood pressure greater than 150 mm Hg) Opthalmic No abnormalities of the cornea (e.g., severe dry eye syndrome or Sjogren's syndrome) No congenital abnormality (e.g., Fuch's dystrophy) No abnormal slit-lamp examination using vital dye (e.g., fluorescein or Bengal-Rose) No abnormal corneal sensitivity test (e.g., Schirmer test or similar tear-production test) Mild dry eye syndrome allowed if patient can use artificial tears and ophthalmologist concurs Gastrointestinal No gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation No active peptic ulcer disease Other Must be able and willing to undergo a mediport insertion Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No other malignancy within the past 5 years except previously excised and inactive basal cell or squamous cell skin cancer No prior allergic reactions attributed to compounds of similar chemical or biological composition to erlotinib or other study drugs (e.g., epidermal growth factor inhibitors like cetuximab) No significant traumatic injury within the past 3 weeks No peripheral neuropathy grade 2 or greater No ongoing or active infection No other uncontrolled concurrent illness that would preclude study entry No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered Phase I: Prior chemotherapy allowed Phase II: No prior chemotherapy for metastatic disease Prior adjuvant therapy allowed if disease progresses during adjuvant therapy No prior oxaliplatin Endocrine therapy Not specified Radiotherapy See Disease Characteristics More than 4 weeks since prior radiotherapy and recovered Surgery See Disease Characteristics More than 3 weeks since prior major surgery and recovered No prior surgical procedures affecting absorption Other No other concurrent investigational agents No other concurrent anticancer agents or therapies (commercial or investigational) No concurrent combination antiretroviral therapy for HIV-positive patients

Sites / Locations

  • Memorial Sloan-Kettering Cancer Center

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 12, 2002
Last Updated
June 21, 2013
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00049101
Brief Title
Erlotinib and Combination Chemotherapy in Treating Patients With Metastatic Colorectal Cancer
Official Title
A Phase I/II Study Of OSI-774 In Combination With Oxaliplatin, And 5-Fluourouracil In Patients With Metastatic Colorectal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2004
Overall Recruitment Status
Completed
Study Start Date
August 2002 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
August 2004 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. Combining erlotinib with combination chemotherapy may kill more tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of combining erlotinib with oxaliplatin, leucovorin, and fluorouracil in treating patients who have metastatic colorectal cancer.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of erlotinib when administered with oxaliplatin, leucovorin calcium, and fluorouracil in patients with metastatic colorectal cancer. Determine the pharmacokinetics of this regimen in these patients. Determine any antitumor activity of this regimen in these patients. Determine the time to progression in patients treated with this regimen. Determine the objective response rate and response duration in patients treated with this regimen. Determine the safety and tolerability of this regimen in these patients. OUTLINE: This is a dose-escalation study of erlotinib. Phase I: During the first week of the first course only, patients receive oral erlotinib daily alone. Patients then begin the regular schedule comprising oral erlotinib daily, oxaliplatin IV over 2 hours on day 1, and leucovorin calcium IV over 2 hours and fluorouracil IV over 22 hours on days 1 and 2. Treatment repeats every 2 weeks for at least 6 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of erlotinib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Phase II: Patients receive erlotinib at the MTD plus oxaliplatin, leucovorin calcium, and fluorouracil as in phase I. Erlotinib may be administered alone if toxicity is caused by oxaliplatin, leucovorin calcium, and fluorouracil. Patients are followed for at least 6 months or until disease progression. PROJECTED ACCRUAL: A total of 4-18 patients will be accrued for phase I of this study within 1-4 months. A total of 50 patients will be accrued for phase II of this study within 10 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
recurrent colon cancer, stage IV colon cancer, recurrent rectal cancer, stage IV rectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Masking
None (Open Label)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
erlotinib hydrochloride
Intervention Type
Drug
Intervention Name(s)
fluorouracil
Intervention Type
Drug
Intervention Name(s)
leucovorin calcium
Intervention Type
Drug
Intervention Name(s)
oxaliplatin

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed colon or rectal cancer Metastatic or unresectable disease Unidimensionally measurable disease required for phase II only At least 20 mm by x-ray, CT scan, MRI, or photography The following are not considered measurable: Pleural effusion or ascites Osteoblastic lesions Evidence of disease on bone scan alone Progressive irradiated lesions alone Bone marrow involvement Brain metastases Malignant hepatomegaly by physical exam alone Chemical markers (e.g., carcinoembryonic antigen) Recurrent disease after surgery or radiotherapy is considered measurable as long as the following criteria are met: At least 4 weeks since prior surgery or radiotherapy Measurable disease exists outside the radiation port or clear progression exists within the radiation port Tissue accessible for immunohistochemical evidence of epidermal growth factor receptor expression from a metastatic site (phase II only) No known brain metastases PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 OR Karnofsky 60-100% Life expectancy More than 3 months Hematopoietic WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hepatic Bilirubin normal AST/ALT no greater than 2.5 times upper limit of normal Renal Creatinine normal OR Creatinine clearance at least 60 mL/min Cardiovascular No unstable angina pectoris No symptomatic congestive heart failure No cardiac arrhythmia No uncontrolled hypertension (systolic blood pressure greater than 150 mm Hg) Opthalmic No abnormalities of the cornea (e.g., severe dry eye syndrome or Sjogren's syndrome) No congenital abnormality (e.g., Fuch's dystrophy) No abnormal slit-lamp examination using vital dye (e.g., fluorescein or Bengal-Rose) No abnormal corneal sensitivity test (e.g., Schirmer test or similar tear-production test) Mild dry eye syndrome allowed if patient can use artificial tears and ophthalmologist concurs Gastrointestinal No gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation No active peptic ulcer disease Other Must be able and willing to undergo a mediport insertion Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No other malignancy within the past 5 years except previously excised and inactive basal cell or squamous cell skin cancer No prior allergic reactions attributed to compounds of similar chemical or biological composition to erlotinib or other study drugs (e.g., epidermal growth factor inhibitors like cetuximab) No significant traumatic injury within the past 3 weeks No peripheral neuropathy grade 2 or greater No ongoing or active infection No other uncontrolled concurrent illness that would preclude study entry No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered Phase I: Prior chemotherapy allowed Phase II: No prior chemotherapy for metastatic disease Prior adjuvant therapy allowed if disease progresses during adjuvant therapy No prior oxaliplatin Endocrine therapy Not specified Radiotherapy See Disease Characteristics More than 4 weeks since prior radiotherapy and recovered Surgery See Disease Characteristics More than 3 weeks since prior major surgery and recovered No prior surgical procedures affecting absorption Other No other concurrent investigational agents No other concurrent anticancer agents or therapies (commercial or investigational) No concurrent combination antiretroviral therapy for HIV-positive patients
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Leonard B. Saltz, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Study Chair
Facility Information:
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

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Erlotinib and Combination Chemotherapy in Treating Patients With Metastatic Colorectal Cancer

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