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Foxy-5 as Neo-Adjuvant Therapy in Subjects With Wnt-5a Low Colon Cancer (NeoFox)

Primary Purpose

Colon Cancer

Status
Active
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Foxy-5
FOLFOX regimen
Tumour resection (colon cancer surgery)
Sponsored by
WntResearch AB
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colon Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Ability to understand and willingness to provide written informed consent before any trial-related activities.
  2. 18 years of age or older.
  3. Male or female subjects with adenocarcinoma of the colon, judged by CT or MRI as either one of the following stages per TNM classification of colon cancer (8th edition, 2017):

    T1-4, N1-2, M0 or T4, N0, M0 and who are considered to fulfil the local criteria for adjuvant post- operative chemotherapy after scheduled surgery.

  4. Scheduling of surgery according to local practice allows at least 9 pre- surgery administrations of Foxy-5 for the subject. (Please note: surgery should not be postponed for trial purposes.)
  5. Sexually active women of childbearing potential (WOCBP) and males with WOCBP partners who are randomized to the Foxy-5 Arm must use a highly effective method of contraception for the treatment duration and for 28 days after last Foxy-5.
  6. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
  7. Clinical laboratory values at screening:

    1. Absolute neutrophil count ≥1.5 x 109/L
    2. Haemoglobin ≥ 9 g/dL
    3. Platelets ≥ 100 x 109/L
    4. Aspartate Transaminase (AST) and Alanine Transaminase (ALT)

      ≤1.5x Upper Limit of Normal (ULN)

    5. Serum bilirubin ≤1.5 x the ULN
    6. Creatinine clearance >60 mL/min (determined by Cockcroft-Gault Equation).

Exclusion Criteria:

  1. Assessed as not suitable or unable to tolerate adjuvant chemotherapy.
  2. Evidence of distant metastatic (M1) disease at Screening (N1-2 is allowed).
  3. Any surgery (except tumour biopsy) or therapy with immune suppressive agents or bone marrow stimulating factors within the last two weeks prior to randomization.
  4. Any active infection requiring IV antibiotic treatment at the time of screening.
  5. History of hematologic or primary solid tumour malignancy.
  6. Pregnant or breastfeeding women.
  7. Currently participating in another trial and receiving trial therapy or received investigational therapy within 4 weeks of the first dose of Foxy-5.
  8. Any other condition or treatment that, in the opinion of the Investigator, might interfere with the trial or current drug or substance abuse.
  9. Inability to understand the protocol requirements, instructions and trial-related restrictions, the nature, scope, and possible consequences of the trial.
  10. Unlikely to comply with the protocol requirements, instructions and trial-related restrictions; e.g., uncooperative attitude, inability to return for follow-up visits, and improbability of completing the trial.
  11. Legal incapacity or limited legal capacity.
  12. Any condition, which results in an undue risk for the subject during the trial participation according to the Investigator.

Sites / Locations

  • Instituto de Investigación Sanitaria INCLIVA

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Foxy-5

Standard therapy

Arm Description

Arm will receive Foxy-5 as neo-adjuvant therapy prior to surgical removal of tumour and afterwards until initiation of FOLFOX 6 months regimen

Surgical removal of tumour followed by 6 months FOLFOX regimen

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
The incidence of adverse events (AEs) related to Foxy-5 administration of Grade 3 and higher according to the National Cancer Institute - Common Terminology Criteria for Adverse Events (CTCAE, version 5.0) and the Clavien-Dindo classification of surgical complications. cancer.
ctDNA as surrogate marker for disease free period
The level of ctDNA in plasma of subjects with Wnt-5a low colon cancer as a surrogate parameter for disease recurrence in subjects with Wnt-5a low colon cancer treated with Foxy-5 compared to subjects with Wnt-5a low colon cancer who are in the Control Arm.

Secondary Outcome Measures

Overall survival
OS at 2 years after resection of the colon cancer
Disease-Free Survival
DFS at 2 years after resection of the colon cancer
Recurrence-Free Interval
Recurrence-free interval (RFI) defined as the time from randomization to tumour recurrence.
ctDNA in Wnt-5a high patients
The level of ctDNA in plasma of subjects with Wnt-5a high colon cancer.

Full Information

First Posted
December 26, 2018
Last Updated
December 8, 2022
Sponsor
WntResearch AB
Collaborators
SMS-Oncology BV, SAGA diagnostics AB, Unilabs A/S, BioVica AB, Institut Català d'Oncologia
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1. Study Identification

Unique Protocol Identification Number
NCT03883802
Brief Title
Foxy-5 as Neo-Adjuvant Therapy in Subjects With Wnt-5a Low Colon Cancer
Acronym
NeoFox
Official Title
A Randomized, Multicentre, Open-Label Controlled Phase II Trial of Foxy-5 as Neo-Adjuvant Therapy in Subjects With Wnt-5a Low Colon Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 12, 2019 (Actual)
Primary Completion Date
December 14, 2024 (Anticipated)
Study Completion Date
December 14, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
WntResearch AB
Collaborators
SMS-Oncology BV, SAGA diagnostics AB, Unilabs A/S, BioVica AB, Institut Català d'Oncologia

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Phase II study investigating the safety, tolerability and effect on disease reccurence of Foxy-5 as neo-adjuvant therapy in resected colon cancer patients treated with FOLFOX chemotherapy regimen. It is a two-arm study and patients will be randomised to receive either standard therapy (surgery + FOLFOX 6 months regimen) or standard therapy + neo-adjuvant administration of Foxy-5 prior to- and following surgery (maximum of 39 administrations) until initiation of FOLFOX therapy.
Detailed Description
Foxy-5 is a synthetic hexapeptide with a formylated N-terminus, derived from the protein sequence of the Wnt-5a protein. Low/no expression levels of Wnt-5 protein in primary tumour cells have been correlated to high risk of recurrent metastatic disease and shortened survival in several different types of cancer patients, including colon cancer. Current standard therapy involves surgical removal of the tumour followed by 6 months treatment with chemotherapy (FOLFOX). Foxy-5 is expected to decrease migration of cancer cells, in subjects with low/absent levels of Wnt-5a protein in their primary tumour and hence result in lower recurrence and a better overall survival. The trial intends to establish the safety and tolerability of Foxy-5 and to evaluate early signs of anti-metastatic activity in subjects with resectable colon cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colon Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
two-arm study, 1 to 1 randomization: treatment group and standard therapy
Masking
None (Open Label)
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Foxy-5
Arm Type
Experimental
Arm Description
Arm will receive Foxy-5 as neo-adjuvant therapy prior to surgical removal of tumour and afterwards until initiation of FOLFOX 6 months regimen
Arm Title
Standard therapy
Arm Type
Active Comparator
Arm Description
Surgical removal of tumour followed by 6 months FOLFOX regimen
Intervention Type
Drug
Intervention Name(s)
Foxy-5
Intervention Description
Lyophilized powder for solution for intravenous infusion
Intervention Type
Drug
Intervention Name(s)
FOLFOX regimen
Intervention Description
6 months treatment regimen
Intervention Type
Procedure
Intervention Name(s)
Tumour resection (colon cancer surgery)
Intervention Description
Surgical removal of patients colon cancer
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Description
The incidence of adverse events (AEs) related to Foxy-5 administration of Grade 3 and higher according to the National Cancer Institute - Common Terminology Criteria for Adverse Events (CTCAE, version 5.0) and the Clavien-Dindo classification of surgical complications. cancer.
Time Frame
From date of randomization until 28 days after the last dose of Foxy-5, assessed up to 120 days
Title
ctDNA as surrogate marker for disease free period
Description
The level of ctDNA in plasma of subjects with Wnt-5a low colon cancer as a surrogate parameter for disease recurrence in subjects with Wnt-5a low colon cancer treated with Foxy-5 compared to subjects with Wnt-5a low colon cancer who are in the Control Arm.
Time Frame
2 years after resection of colon cancer
Secondary Outcome Measure Information:
Title
Overall survival
Description
OS at 2 years after resection of the colon cancer
Time Frame
2 years after resection of tumour
Title
Disease-Free Survival
Description
DFS at 2 years after resection of the colon cancer
Time Frame
2 years after resection of tumour
Title
Recurrence-Free Interval
Description
Recurrence-free interval (RFI) defined as the time from randomization to tumour recurrence.
Time Frame
study start to 2 years after resection of tumour
Title
ctDNA in Wnt-5a high patients
Description
The level of ctDNA in plasma of subjects with Wnt-5a high colon cancer.
Time Frame
2 years after resection of tumour
Other Pre-specified Outcome Measures:
Title
Thymidine Kinase activity
Description
The level of thymidine kinase activity in serum in relationship to Wnt- 5a expression in the tumour.
Time Frame
1 year after resection of tumour

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability to understand and willingness to provide written informed consent before any trial-related activities. 18 years of age or older. Male or female subjects with adenocarcinoma of the colon, judged by CT or MRI as either one of the following stages per TNM classification of colon cancer (8th edition, 2017): T1-4, N1-2, M0 or T4, N0, M0 and who are considered to fulfil the local criteria for adjuvant post- operative chemotherapy after scheduled surgery. Scheduling of surgery according to local practice allows at least 9 pre- surgery administrations of Foxy-5 for the subject. (Please note: surgery should not be postponed for trial purposes.) Sexually active women of childbearing potential (WOCBP) and males with WOCBP partners who are randomized to the Foxy-5 Arm must use a highly effective method of contraception for the treatment duration and for 28 days after last Foxy-5. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. Clinical laboratory values at screening: Absolute neutrophil count ≥1.5 x 109/L Haemoglobin ≥ 9 g/dL Platelets ≥ 100 x 109/L Aspartate Transaminase (AST) and Alanine Transaminase (ALT) ≤1.5x Upper Limit of Normal (ULN) Serum bilirubin ≤1.5 x the ULN Creatinine clearance >60 mL/min (determined by Cockcroft-Gault Equation). Exclusion Criteria: Assessed as not suitable or unable to tolerate adjuvant chemotherapy. Evidence of distant metastatic (M1) disease at Screening (N1-2 is allowed). Any surgery (except tumour biopsy) or therapy with immune suppressive agents or bone marrow stimulating factors within the last two weeks prior to randomization. Any active infection requiring IV antibiotic treatment at the time of screening. History of hematologic or primary solid tumour malignancy. Pregnant or breastfeeding women. Currently participating in another trial and receiving trial therapy or received investigational therapy within 4 weeks of the first dose of Foxy-5. Any other condition or treatment that, in the opinion of the Investigator, might interfere with the trial or current drug or substance abuse. Inability to understand the protocol requirements, instructions and trial-related restrictions, the nature, scope, and possible consequences of the trial. Unlikely to comply with the protocol requirements, instructions and trial-related restrictions; e.g., uncooperative attitude, inability to return for follow-up visits, and improbability of completing the trial. Legal incapacity or limited legal capacity. Any condition, which results in an undue risk for the subject during the trial participation according to the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ramon Salazar, MD
Organizational Affiliation
Institut Català d'Oncologia
Official's Role
Principal Investigator
Facility Information:
Facility Name
Instituto de Investigación Sanitaria INCLIVA
City
Valencia
ZIP/Postal Code
46010
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

Foxy-5 as Neo-Adjuvant Therapy in Subjects With Wnt-5a Low Colon Cancer

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