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Everolimus and OSI-906 for Patients With Refractory Metastatic Colorectal Cancer

Primary Purpose

Metastatic Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
OSI-906
Everolimus
Sponsored by
SCRI Development Innovations, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer focused on measuring refractory metastatic colorectal cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Metastatic cancer of the colon or rectum that has progressed on or for which the patient is intolerant to or not a candidate for: fluoropyrimidines, oxaliplatin, irinotecan, bevacizumab, and cetuximab or panitumumab.
  • Testing for Kras mutation performed;Patients with mutated or wild type Kras are eligible.
  • ECOG PS of 0-1
  • Life expectancy of ≥ 3 months
  • Adequate hematological function with ANC 1500, Platelets of 100,000, and hemoglobin of 9.0
  • AST, ALT and Alk. Phos. ≤2.5 x ULN or ≤5 x ULN if known hepatic metastases and a total bilirubin ≤1.5 ULN
  • Serum creatinine of ≤1.5 x ULN
  • Fasting blood glucose <150 mg/dL
  • Measurable disease according to RECIST 1.1
  • Able to swallow whole pills
  • INR ≤1.5 - Anticoagulation is allowed with LMW heparin
  • Fasting serum cholesterol ≤300 mg/dL OR ≤7.75 mmol/L AND fasting triglycerides ≤2.5 x ULN;If these thresholds are exceeded, the patient can be included after initiation of lipid lowering medication

Exclusion Criteria:

  • Patients who have received any cancer therapies <4 weeks or 5 half lives (whichever is shorter) of initiating study therapy
  • Treatment with any investigational drug ≤ 4 weeks, or 5 half-lives of the drug, whichever is shorter
  • Patients who require coumadin for anticoagulation
  • Patients who have had major surgery or significant traumatic injury ≤4 weeks of the of study treatment
  • Minor surgery (with the exception of port placement) must be completed ≤ 7days prior to study therapy
  • Previous treatment with an IGFR inhibitor or MTOR Inhibitor
  • Chronic, systemic treatment with corticosteroids or another immunosuppressive agent
  • Patients with QTc interval >450ms
  • Patients who require drugs that can prolong QTc.
  • Patients with congenital long QT syndrome, history of ventricular tachycardia, or ventricular fibrillation, or Torsades de Pointes with bradycardia.
  • Immunization with attenuated live vaccines within 1 week of beginning study therapy or during study period;Close contact to anyone that has received live virus vaccine should be avoided
  • Meningeal or brain metastasis
  • Other malignancies < 3 years, with the exception of adequately treated basal or squamous cell carcinomas of the skin, or carcinoma in situ of the cervix
  • Patients with known HIV
  • Patients with positive testing for hepatitis B or C
  • Patients with risk factors for hepatitis must be tested for hepatitis viral loadHepatitis risk factors include the following:

Lived in Asia, Africa, Central and South America, Eastern Europe, Spain, Portugal, and Greece Any blood transfusions before 1990 Any IV drug use Any dialysis Household contact with a Hep B infected patient Mother had Hep B High-risk sexual activity Body piercing/tattoos

  • History suggestive of hepatitis B
  • Any severe or uncontrolled conditions that could affect their study participation such as:Severely impaired lung function;DCLO ≤ 50% of normal predicted value;O² Sat <88% at rest on room air
  • Congestive Heart Failure of NYHA Class III or IV
  • Unstable angina, symptomatic CHF, MI ≤ 6 months, serious uncontrolled cardiac arrhythmia or any other clinically significant heart disease
  • CVA, TIA, angioplasty, or cardiac stenting <12 months
  • Ventricular arrhythmia requiring medication
  • Known history of diabetes and/or patients who require ongoing use of insulin or oral anti-hyperglycemic therapy
  • Known liver disease
  • Impairment of GI function or gastrointestinal disease that in may significantly alter the absorption of study drugs
  • Concurrent treatment with drugs that are strong CYP3A4 inducers or moderate/strong CYP3A4 inhibitors
  • Concurrent treatment with drugs that are strong CYP1A2 inhibitors or inducers Women who are pregnant or breastfeeding.
  • Concurrent severe, intercurrent illness including, but not limited to, ongoing or active infection, or psychiatric illness/social situations that would limit compliance with study requirements

Sites / Locations

  • Florida Cancer Specialists
  • Tennessee Oncology

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Dose Level 1

Dose Level 2

Dose Level 2a

Arm Description

combination of OSI-906 and everolimus OSI-906: 50 mg Twice a Day, cycle-28 days Everolimus: 5mg Daily, cycle-28 days

combination of OSI-906 and everolimus OSI-906: 100 mg Twice a Day, cycle-28 days Everolimus: 10mg Daily, cycle-28 days

combination of OSI-906 and everolimus OSI-906: 100 mg Twice a Day, cycle-28 days Everolimus: 5mg Daily, cycle-28 days

Outcomes

Primary Outcome Measures

To Determine the Maximum Tolerated Dose (MTD) of the Combination of OSI-906 and Everolimus for the Treatment of Patients With Refractory Metastatic Colorectal Cancer.
The MTD of the drug combination will be determined as the highest dose at which ≤1 of 6 subjects experiences a Grade 3 or Grade 4 DLT according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.0

Secondary Outcome Measures

Progression-Free Survival (PFS)
Progression-free survival (PFS) is defined as the time between Day 1 Cycle 1 and date of first documented recurrence or death. Patients who do not exhibit progression while on trial will be censored at their last known assessment. Progression is defined per RECIST criteria as either 1) at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest (nadir) sum since the treatment started, or the appearance of one or more new lesions. Requires not only 20% increase, but absolute increase of a minimum of 5 mm over sum. OR 2) Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.
Overall Survival (OS)
Overall survival (OS) is defined as the time between Day 1 Cycle 1 to the date of death from any cause. Those remaining alive will be censored at their last known assessment or follow-up.
Response Rate
Response rate (RR) will be estimated as the proportion of patients exhibiting complete response or partial response out of all evaluable cases. Complete Response is defined per RECIST as disappearance of all target/non-target lesions and normalization of tumor markers. Partial Response is defined per RECIST as At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Full Information

First Posted
June 29, 2010
Last Updated
April 5, 2022
Sponsor
SCRI Development Innovations, LLC
Collaborators
Novartis Pharmaceuticals, OSI Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01154335
Brief Title
Everolimus and OSI-906 for Patients With Refractory Metastatic Colorectal Cancer
Official Title
A Phase I Study of Everolimus (mTOR Inhibitor) and OSI-906 (Dual IGFR and IR Tyrosine Kinase Inhibitor) for the Treatment of Patients With Refractory Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
July 2010 (undefined)
Primary Completion Date
May 2013 (Actual)
Study Completion Date
May 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SCRI Development Innovations, LLC
Collaborators
Novartis Pharmaceuticals, OSI Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the maximum tolerated dose (MTD) of the combination of OSI-906 and everolimus for the treatment of patients with refractory metastatic colorectal cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer
Keywords
refractory metastatic colorectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose Level 1
Arm Type
Experimental
Arm Description
combination of OSI-906 and everolimus OSI-906: 50 mg Twice a Day, cycle-28 days Everolimus: 5mg Daily, cycle-28 days
Arm Title
Dose Level 2
Arm Type
Experimental
Arm Description
combination of OSI-906 and everolimus OSI-906: 100 mg Twice a Day, cycle-28 days Everolimus: 10mg Daily, cycle-28 days
Arm Title
Dose Level 2a
Arm Type
Experimental
Arm Description
combination of OSI-906 and everolimus OSI-906: 100 mg Twice a Day, cycle-28 days Everolimus: 5mg Daily, cycle-28 days
Intervention Type
Drug
Intervention Name(s)
OSI-906
Intervention Description
Dose Level 1: 50 mg Twice a Day, cycle-28 days Dose Level 2: 100 mg Twice a Day, cycle-28 days Dose Level 2a: 100 mg Twice a Day, cycle-28 days
Intervention Type
Drug
Intervention Name(s)
Everolimus
Intervention Description
Dose Level 1: 5mg Daily, cycle-28 days Dose Level 2: 10mg Daily, cycle-28 days Dose Level 2a: 5mg Daily, cycle-28 days
Primary Outcome Measure Information:
Title
To Determine the Maximum Tolerated Dose (MTD) of the Combination of OSI-906 and Everolimus for the Treatment of Patients With Refractory Metastatic Colorectal Cancer.
Description
The MTD of the drug combination will be determined as the highest dose at which ≤1 of 6 subjects experiences a Grade 3 or Grade 4 DLT according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.0
Time Frame
18 Months
Secondary Outcome Measure Information:
Title
Progression-Free Survival (PFS)
Description
Progression-free survival (PFS) is defined as the time between Day 1 Cycle 1 and date of first documented recurrence or death. Patients who do not exhibit progression while on trial will be censored at their last known assessment. Progression is defined per RECIST criteria as either 1) at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest (nadir) sum since the treatment started, or the appearance of one or more new lesions. Requires not only 20% increase, but absolute increase of a minimum of 5 mm over sum. OR 2) Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.
Time Frame
18 Months
Title
Overall Survival (OS)
Description
Overall survival (OS) is defined as the time between Day 1 Cycle 1 to the date of death from any cause. Those remaining alive will be censored at their last known assessment or follow-up.
Time Frame
18 months
Title
Response Rate
Description
Response rate (RR) will be estimated as the proportion of patients exhibiting complete response or partial response out of all evaluable cases. Complete Response is defined per RECIST as disappearance of all target/non-target lesions and normalization of tumor markers. Partial Response is defined per RECIST as At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.
Time Frame
18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Metastatic cancer of the colon or rectum that has progressed on or for which the patient is intolerant to or not a candidate for: fluoropyrimidines, oxaliplatin, irinotecan, bevacizumab, and cetuximab or panitumumab. Testing for Kras mutation performed;Patients with mutated or wild type Kras are eligible. ECOG PS of 0-1 Life expectancy of ≥ 3 months Adequate hematological function with ANC 1500, Platelets of 100,000, and hemoglobin of 9.0 AST, ALT and Alk. Phos. ≤2.5 x ULN or ≤5 x ULN if known hepatic metastases and a total bilirubin ≤1.5 ULN Serum creatinine of ≤1.5 x ULN Fasting blood glucose <150 mg/dL Measurable disease according to RECIST 1.1 Able to swallow whole pills INR ≤1.5 - Anticoagulation is allowed with LMW heparin Fasting serum cholesterol ≤300 mg/dL OR ≤7.75 mmol/L AND fasting triglycerides ≤2.5 x ULN;If these thresholds are exceeded, the patient can be included after initiation of lipid lowering medication Exclusion Criteria: Patients who have received any cancer therapies <4 weeks or 5 half lives (whichever is shorter) of initiating study therapy Treatment with any investigational drug ≤ 4 weeks, or 5 half-lives of the drug, whichever is shorter Patients who require coumadin for anticoagulation Patients who have had major surgery or significant traumatic injury ≤4 weeks of the of study treatment Minor surgery (with the exception of port placement) must be completed ≤ 7days prior to study therapy Previous treatment with an IGFR inhibitor or MTOR Inhibitor Chronic, systemic treatment with corticosteroids or another immunosuppressive agent Patients with QTc interval >450ms Patients who require drugs that can prolong QTc. Patients with congenital long QT syndrome, history of ventricular tachycardia, or ventricular fibrillation, or Torsades de Pointes with bradycardia. Immunization with attenuated live vaccines within 1 week of beginning study therapy or during study period;Close contact to anyone that has received live virus vaccine should be avoided Meningeal or brain metastasis Other malignancies < 3 years, with the exception of adequately treated basal or squamous cell carcinomas of the skin, or carcinoma in situ of the cervix Patients with known HIV Patients with positive testing for hepatitis B or C Patients with risk factors for hepatitis must be tested for hepatitis viral loadHepatitis risk factors include the following: Lived in Asia, Africa, Central and South America, Eastern Europe, Spain, Portugal, and Greece Any blood transfusions before 1990 Any IV drug use Any dialysis Household contact with a Hep B infected patient Mother had Hep B High-risk sexual activity Body piercing/tattoos History suggestive of hepatitis B Any severe or uncontrolled conditions that could affect their study participation such as:Severely impaired lung function;DCLO ≤ 50% of normal predicted value;O² Sat <88% at rest on room air Congestive Heart Failure of NYHA Class III or IV Unstable angina, symptomatic CHF, MI ≤ 6 months, serious uncontrolled cardiac arrhythmia or any other clinically significant heart disease CVA, TIA, angioplasty, or cardiac stenting <12 months Ventricular arrhythmia requiring medication Known history of diabetes and/or patients who require ongoing use of insulin or oral anti-hyperglycemic therapy Known liver disease Impairment of GI function or gastrointestinal disease that in may significantly alter the absorption of study drugs Concurrent treatment with drugs that are strong CYP3A4 inducers or moderate/strong CYP3A4 inhibitors Concurrent treatment with drugs that are strong CYP1A2 inhibitors or inducers Women who are pregnant or breastfeeding. Concurrent severe, intercurrent illness including, but not limited to, ongoing or active infection, or psychiatric illness/social situations that would limit compliance with study requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Johanna Bendell, MD
Organizational Affiliation
SCRI Development Innovations, LLC
Official's Role
Study Chair
Facility Information:
Facility Name
Florida Cancer Specialists
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33916
Country
United States
Facility Name
Tennessee Oncology
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25335932
Citation
Bendell JC, Jones SF, Hart L, Spigel DR, Lane CM, Earwood C, Infante JR, Barton J, Burris HA. A phase Ib study of linsitinib (OSI-906), a dual inhibitor of IGF-1R and IR tyrosine kinase, in combination with everolimus as treatment for patients with refractory metastatic colorectal cancer. Invest New Drugs. 2015 Feb;33(1):187-93. doi: 10.1007/s10637-014-0177-3. Epub 2014 Oct 22.
Results Reference
derived

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Everolimus and OSI-906 for Patients With Refractory Metastatic Colorectal Cancer

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