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Lenalidomide and Cetuximab in Treating Patients With Metastatic Colorectal Cancer

Primary Purpose

Colon Cancer, Rectal Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
lenalidomide
cetuximab
mutation analysis
polymerase chain reaction
polymorphism analysis
Sponsored by
Case Comprehensive Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

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

Inclusion

  • Wild type metastatic colorectal cancer that failed (progressed, refused or not tolerated) on at least two treatment regimens including a fluoropyrimidine, oxaliplatin and irinotecan with or without bevacizumab
  • At least 28 days must have lapsed since completion of prior chemotherapy
  • Subjects must understand and voluntarily sign an informed consent document
  • Subjects must be able to adhere to the study visit schedule and other protocol requirements
  • Histological or cytological diagnosis of colorectal carcinoma
  • Radiographic or clinical evidence of a measurable disease (by RECIST criteria)
  • Subjects must have received prior treatment with at least 2 prior regimens of therapy
  • ECOG performance status of =< 1
  • Anticipated survival >= 3 months
  • Must agree to also take low dose aspirin (or other anticoagulation if unable to take ASA) while receiving study drug and for 30 days after study drug is discontinued
  • Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test within 10-14 days prior to and again within 24 hours of starting lenalidomide and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide; FCBP must also agree to ongoing pregnancy testing
  • Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy

Exclusion

  • Pregnant or lactating females
  • CrCl < 50 mL/min by Cock-Croft and Gault
  • Any serious medical condition or psychiatric illness that places the subject at an unacceptable risk for study participation or would prevent the subject from signing the informed consent
  • Use of any cytotoxic chemotherapy within 28 days of study Day 1
  • Use of therapeutic radiation =< 14 days prior to study Day 1
  • Use of thalidomide, or structurally related compounds or biologic response modifier therapy within 14 days of study Day 1
  • Prior desquamating rash while taking thalidomide, or structurally related compound therapy
  • Prior >= Grade 2 allergic reaction to thalidomide or structurally related compounds
  • Any prior use of Lenalidomide
  • Subjects may have received prior thalidomide
  • Known or suspected brain metastases
  • Concurrent use or anticipated use of any other anti-cancer agents (except for stable dose steroid use for control of metastases symptoms) during participation in this study
  • Absolute Neutrophil Count =< 1500/mm^3 (or 1.5 X10^9/L)
  • Platelet Count =< 100,000/mm^3 (or 100 X 10^9/L)
  • Hemoglobin < 8.0 g/dL
  • Total Bilirubin > 2.0mg/dL
  • Alanine Aminotransferase (ALT/SGPT) >= 3 x upper limit of normal (ULN)
  • Aspartate Aminotransferase (AST/SGOT) >= 3 x upper limit of normal (ULN)
  • Peripheral neuropathy >= Grade 2
  • Active infection
  • Subjects with an infection that is amenable to curative treatment may be eligible for screening once the infection has been treated, cured and not recurred for at least 14 days
  • Uncontrolled hyper- or hypo- calcemia, glycosemia or thyroidism
  • Arterial or venous thrombotic event in the preceding six months
  • Known history of HIV infection
  • Active viral hepatitis who is on active treatment
  • No other malignancies, other than previously treated non-melanoma skin cancer or carcinoma insitu of the cervix or breast

Sites / Locations

  • Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm I

Arm Description

Patients receive oral lenalidomide once daily on days 1-28 and cetuximab IV once weekly over 1-2 hours on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Safety / Tolerability (type, frequency, severity, and relationship of adverse events to study drug)

Secondary Outcome Measures

Time to progression of disease
Tumor response according to RECIST
Lab correlatives (FCGRIIa and FCGRIIIa polymorphisms, K-Ras and B-Raf mutations)
FCGR2a and FCGR3a polymorphisms, K-Ras and B-Raf mutations in patient specimens (paraffin embedded formaldehyde fixed tissues) will be identified.

Full Information

First Posted
May 18, 2010
Last Updated
March 16, 2012
Sponsor
Case Comprehensive Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT01126450
Brief Title
Lenalidomide and Cetuximab in Treating Patients With Metastatic Colorectal Cancer
Official Title
A Phase I, Open-Label Study To Determine The Maximum Tolerated Dose (Mtd) Of The Combination Of Lenalidomide And Cetuximab, And To Evaluate The Efficacy Of This Combination In Subjects With Wild Type K-Ras Metastatic Colorectal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Terminated
Why Stopped
low accrual,loss of funding and results from EU study showing drug ineffective.
Study Start Date
October 2009 (undefined)
Primary Completion Date
November 2010 (Actual)
Study Completion Date
December 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Case Comprehensive Cancer Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Lenalidomide may stop the growth of tumor cells by blocking blood flow to the tumor. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving lenalidomide together with cetuximab may kill more tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of lenalidomide when given together with cetuximab in treating patients with metastatic colorectal cancer.
Detailed Description
PRIMARY OBJECTIVES: I. To determine the maximum tolerated dose (MTD). SECONDARY OBJECTIVES: I. To further explore the safety and efficacy profile. OUTLINE: This is a dose-escalation study of lenalidomide. Patients receive oral lenalidomide once daily on days 1-28 and cetuximab IV once weekly over 1-2 hours on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colon Cancer, Rectal Cancer
Keywords
recurrent colon cancer, recurrent rectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
3 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive oral lenalidomide once daily on days 1-28 and cetuximab IV once weekly over 1-2 hours on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
lenalidomide
Other Intervention Name(s)
CC-5013, IMiD-1, Revlimid
Intervention Description
Given orally
Intervention Type
Biological
Intervention Name(s)
cetuximab
Other Intervention Name(s)
Anti-EGFR Monoclonal Antibody, C225, C225 monoclonal antibody, IMC-C225, MOAB C225, monoclonal antibody C225
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
mutation analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
polymerase chain reaction
Other Intervention Name(s)
PCR
Intervention Description
Correlative studies
Intervention Type
Genetic
Intervention Name(s)
polymorphism analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Safety / Tolerability (type, frequency, severity, and relationship of adverse events to study drug)
Time Frame
Courses repeat every 28 days in the absence of unacceptable toxicity.
Secondary Outcome Measure Information:
Title
Time to progression of disease
Time Frame
Courses repeat every 28 days in the absence of disease progression .
Title
Tumor response according to RECIST
Time Frame
at the end of Cycle 2 and every 56 days thereafter until tumor progression
Title
Lab correlatives (FCGRIIa and FCGRIIIa polymorphisms, K-Ras and B-Raf mutations)
Description
FCGR2a and FCGR3a polymorphisms, K-Ras and B-Raf mutations in patient specimens (paraffin embedded formaldehyde fixed tissues) will be identified.
Time Frame
Tissue collection less than or equal to 28 days prior to day 1 of therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Wild type metastatic colorectal cancer that failed (progressed, refused or not tolerated) on at least two treatment regimens including a fluoropyrimidine, oxaliplatin and irinotecan with or without bevacizumab At least 28 days must have lapsed since completion of prior chemotherapy Subjects must understand and voluntarily sign an informed consent document Subjects must be able to adhere to the study visit schedule and other protocol requirements Histological or cytological diagnosis of colorectal carcinoma Radiographic or clinical evidence of a measurable disease (by RECIST criteria) Subjects must have received prior treatment with at least 2 prior regimens of therapy ECOG performance status of =< 1 Anticipated survival >= 3 months Must agree to also take low dose aspirin (or other anticoagulation if unable to take ASA) while receiving study drug and for 30 days after study drug is discontinued Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test within 10-14 days prior to and again within 24 hours of starting lenalidomide and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide; FCBP must also agree to ongoing pregnancy testing Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy Exclusion Pregnant or lactating females CrCl < 50 mL/min by Cock-Croft and Gault Any serious medical condition or psychiatric illness that places the subject at an unacceptable risk for study participation or would prevent the subject from signing the informed consent Use of any cytotoxic chemotherapy within 28 days of study Day 1 Use of therapeutic radiation =< 14 days prior to study Day 1 Use of thalidomide, or structurally related compounds or biologic response modifier therapy within 14 days of study Day 1 Prior desquamating rash while taking thalidomide, or structurally related compound therapy Prior >= Grade 2 allergic reaction to thalidomide or structurally related compounds Any prior use of Lenalidomide Subjects may have received prior thalidomide Known or suspected brain metastases Concurrent use or anticipated use of any other anti-cancer agents (except for stable dose steroid use for control of metastases symptoms) during participation in this study Absolute Neutrophil Count =< 1500/mm^3 (or 1.5 X10^9/L) Platelet Count =< 100,000/mm^3 (or 100 X 10^9/L) Hemoglobin < 8.0 g/dL Total Bilirubin > 2.0mg/dL Alanine Aminotransferase (ALT/SGPT) >= 3 x upper limit of normal (ULN) Aspartate Aminotransferase (AST/SGOT) >= 3 x upper limit of normal (ULN) Peripheral neuropathy >= Grade 2 Active infection Subjects with an infection that is amenable to curative treatment may be eligible for screening once the infection has been treated, cured and not recurred for at least 14 days Uncontrolled hyper- or hypo- calcemia, glycosemia or thyroidism Arterial or venous thrombotic event in the preceding six months Known history of HIV infection Active viral hepatitis who is on active treatment No other malignancies, other than previously treated non-melanoma skin cancer or carcinoma insitu of the cervix or breast
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Kim
Organizational Affiliation
Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States

12. IPD Sharing Statement

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Lenalidomide and Cetuximab in Treating Patients With Metastatic Colorectal Cancer

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