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Linifanib in Treating Patients With Advanced, Refractory Colorectal Cancer

Primary Purpose

Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IVA Colon Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
linifanib
Sponsored by
Vanderbilt-Ingram Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Colon Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed colorectal cancer refractory to at least 1 but no more than 3 systemic chemotherapy regimens
  • Patients must have received one standard chemotherapy regimen in the metastatic setting
  • Established Ras-mutant tumor status (archived specimens are okay and this test can have been performed at local laboratories)
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
  • The subject must have adequate bone marrow and organ function, defined as follows:
  • Hemoglobin ≥ 9g/dL
  • Platelets >100,000,
  • Absolute neutrophil count (ANC) > 1000/uL,
  • Serum creatinine < 1.5 x upper limit of normal,
  • Total bilirubin < 1.5 x the upper limit of normal,
  • AST and ALT ≤ 2.0 x upper limit of normal (or ≤ 5 x ULN in the presence of liver metastases)
  • Measurable disease, defined as at least 1 unidimensionally measurable lesion on a computed tomography (CT) scan or magnetic resonance imaging (MRI) as defined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
  • Female subjects of childbearing potential must have a negative urine or serum pregnancy test within 7 days of study treatment; surgically sterile and/or postmenopausal women must be amenorrheic for at least 12 months to be considered of non-child-bearing potential
  • Female subjects of child-bearing potential and male subjects must agree to use adequate contraception prior to study entry, for the duration of study participation and up to two months after the last dose of ABT 869; adequate contraception methods should be used consistently and correctly and include the following:
  • Total abstinence from sexual intercourse (minimum one complete menstrual cycle)
  • A vasectomized partner
  • Hormonal contraceptives (oral, parenteral or transdermal) for at least 3 months prior to study drug administration
  • Double-barrier method (condoms, contraceptive sponge, diaphragm or vaginal ring with spermicidal jellies or cream)
  • The subject must be willing and able to comply with the protocol for the duration of the study, including undergoing treatment and scheduled visits and examinations
  • The subject must have given written informed consent prior to the initiation of any screening or study-specific procedures
  • Ability to understand and the willingness to sign a written informed consent; a signed informed consent must be obtained prior to any study-specific procedures
  • Patients must be at least 14 days status post last day of prior chemotherapy (at least 28 days since last dose of bevacizumab) and have recovered to grade =< 1 from all chemotherapy-associated side effects
  • Patients must have the ability to swallow pills

Exclusion Criteria:

  • Untreated central nervous system (CNS) metastases; patients may have CNS metastases from any timeframe as long as they are treated and not progressing; brain imaging is not required if there is no clinical suspicion of brain metastases
  • Pregnant or lactating females are excluded
  • Uncontrolled hypertension defined as systolic blood pressure (BP) > 140 and/or diastolic BP > 90 initially evaluated on day of study eligibility determination (when laboratory parameters are assessed), but must be maintained on day of study initiation; (If a patient is found to have a value outside the range above, repeat BP may be assessed and if at subsequent readings x 2 (taken in clinic at least 15 minutes apart) criteria are met, the patient can then be eligible; initiation or modification of antihypertensives is allowed to achieve adequate BP for eligibility; finally, in the case that subsequent determinations are required, the BP assessment that counts towards eligibility is the reading on the day of study initiation); (note: a clinic BP reading without the patient having been at rest for 15 minutes or with the wrong cuff size can be repeated the same day for eligibility criteria to be determined
  • Active bleeding or history of bleeding from cancer related events
  • History of cerebral vascular accident (CVA) or transient ischemic attack (TIA) or recent myocardial infarction (MI) (< 6 months)
  • Active ulcerative colitis, Crohn's disease or Celiac disease that could interfere with the absorption of the drug
  • Current use of therapeutic anticoagulation; low dose anticoagulation for catheter prophylaxis is permitted; Lovenox is permitted for prophylaxis; (Note: patients who develop thrombosis and are placed on anticoagulation while on this trial may continue on study at the discretion of the investigator)
  • The subject has had major surgery within 28 days of Study Day 1
  • The subject has had radiation therapy within 14 days of Study Day 1
  • The subject had prior bevacizumab within 28 days of study day 1
  • No prior treatment with vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitors; prior treatment with other investigational agents is allowed
  • The subject has a medical condition, which in the opinion of the study investigator, places them at unacceptably high risk for toxicities
  • Other active malignancy for which the patient has been treated within the past one year
  • Subjects with known human immunodeficiency virus (HIV) infection are excluded
  • Subject has documented left ventricular ejection fraction (LVEF) < 50%
  • Subject has Proteinuria > grade 1 at baseline measured by urine dipstick (2+ or greater) and confirmed by 24 hour (hr) urine collection (> = 1g/24hrs)

Sites / Locations

  • Vanderbilt Cool Springs
  • Vanderbilt-Ingram Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (enzyme inhibitor)

Arm Description

Patients receive linifanib PO QD. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Overall Response Rate (Complete Response + Partial Response) With a Target of at Least 15%
Per Response Evaluation in Solid Tumors (RECIST) criteria v. 1.1: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) > 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions. Defined as the CR + PR recorded from the start of the treatment until disease progression/recurrence, the exact two-sided 95% confidence intervals will be reported.

Secondary Outcome Measures

Progression-free Survival
Estimated probable duration of life without disease progression, from on-study date to earlier of progression date or date of death from any cause, using the Kaplan-Meier method with censoring. Disease progression is defined under RECIST v1.1 as >=20% increase in sum of longest diameters of target lesions, unequivocal progression of non-target lesions, or appearance of new lesions.
Overall Survival
Estimated probable duration of life from on-study date to date of death from any cause, using the Kaplan-Meier method with censoring.
Number of Patients With Each Worst-Grade Toxicity
Count of patients according to the worst-grade toxicity experienced by each, where worst-grade toxicity is per NCI common toxicity criteria: grade 1= mild; grade 2 = moderate; grade 3 = severe; grade 4 = life-threatening; grade 5 = death Assessed: days 1 &15 of cycle 1; day 1 of each subsequent 28-day cycle; at 30-day follow-up for two years

Full Information

First Posted
June 1, 2011
Last Updated
August 24, 2014
Sponsor
Vanderbilt-Ingram Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT01365910
Brief Title
Linifanib in Treating Patients With Advanced, Refractory Colorectal Cancer
Official Title
An Investigator Initiated, Phase II Study of Linifanib in Patients With Advanced, Refractory Colorectal Cancer Expressing Mutated kRas
Study Type
Interventional

2. Study Status

Record Verification Date
August 2014
Overall Recruitment Status
Terminated
Why Stopped
Interim analysis determined the study did not meet criteria to proceed
Study Start Date
June 2011 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
June 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Vanderbilt-Ingram Cancer Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase II trial studies how well Linifanib works in treating patients with advanced, refractory colorectal cancer expressing k-Ras mutations. Linifanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Detailed Description
PRIMARY OBJECTIVES: I. To achieve an overall response rate of 15% or more. SECONDARY OBJECTIVES: I. Determine progression free survival. II. Determine overall survival. III. Evaluate toxicity profile of ABT 869 (linifanib) in this patient population. OUTLINE: Patients receive Linifanib orally (PO) once daily (QD). 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, every 3 months for 2 years, and then every 6 months for 3 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IVA Colon Cancer, Stage IVA Rectal Cancer, Stage IVB Colon Cancer, Stage IVB Rectal Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (enzyme inhibitor)
Arm Type
Experimental
Arm Description
Patients receive linifanib PO QD. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
linifanib
Other Intervention Name(s)
ABT-869, multitargeted receptor tyrosine kinase inhibitor ABT-869
Intervention Description
Given PO
Primary Outcome Measure Information:
Title
Overall Response Rate (Complete Response + Partial Response) With a Target of at Least 15%
Description
Per Response Evaluation in Solid Tumors (RECIST) criteria v. 1.1: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) > 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions. Defined as the CR + PR recorded from the start of the treatment until disease progression/recurrence, the exact two-sided 95% confidence intervals will be reported.
Time Frame
Baseline and every 8 weeks, up to 2 years
Secondary Outcome Measure Information:
Title
Progression-free Survival
Description
Estimated probable duration of life without disease progression, from on-study date to earlier of progression date or date of death from any cause, using the Kaplan-Meier method with censoring. Disease progression is defined under RECIST v1.1 as >=20% increase in sum of longest diameters of target lesions, unequivocal progression of non-target lesions, or appearance of new lesions.
Time Frame
Every 3 months, up to 2 years
Title
Overall Survival
Description
Estimated probable duration of life from on-study date to date of death from any cause, using the Kaplan-Meier method with censoring.
Time Frame
Every 3 months, up to 2 years
Title
Number of Patients With Each Worst-Grade Toxicity
Description
Count of patients according to the worst-grade toxicity experienced by each, where worst-grade toxicity is per NCI common toxicity criteria: grade 1= mild; grade 2 = moderate; grade 3 = severe; grade 4 = life-threatening; grade 5 = death Assessed: days 1 &15 of cycle 1; day 1 of each subsequent 28-day cycle; at 30-day follow-up for two years
Time Frame
date on-study up to 2 years following final dose of study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed colorectal cancer refractory to at least 1 but no more than 3 systemic chemotherapy regimens Patients must have received one standard chemotherapy regimen in the metastatic setting Established Ras-mutant tumor status (archived specimens are okay and this test can have been performed at local laboratories) Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 The subject must have adequate bone marrow and organ function, defined as follows: Hemoglobin ≥ 9g/dL Platelets >100,000, Absolute neutrophil count (ANC) > 1000/uL, Serum creatinine < 1.5 x upper limit of normal, Total bilirubin < 1.5 x the upper limit of normal, AST and ALT ≤ 2.0 x upper limit of normal (or ≤ 5 x ULN in the presence of liver metastases) Measurable disease, defined as at least 1 unidimensionally measurable lesion on a computed tomography (CT) scan or magnetic resonance imaging (MRI) as defined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 Female subjects of childbearing potential must have a negative urine or serum pregnancy test within 7 days of study treatment; surgically sterile and/or postmenopausal women must be amenorrheic for at least 12 months to be considered of non-child-bearing potential Female subjects of child-bearing potential and male subjects must agree to use adequate contraception prior to study entry, for the duration of study participation and up to two months after the last dose of ABT 869; adequate contraception methods should be used consistently and correctly and include the following: Total abstinence from sexual intercourse (minimum one complete menstrual cycle) A vasectomized partner Hormonal contraceptives (oral, parenteral or transdermal) for at least 3 months prior to study drug administration Double-barrier method (condoms, contraceptive sponge, diaphragm or vaginal ring with spermicidal jellies or cream) The subject must be willing and able to comply with the protocol for the duration of the study, including undergoing treatment and scheduled visits and examinations The subject must have given written informed consent prior to the initiation of any screening or study-specific procedures Ability to understand and the willingness to sign a written informed consent; a signed informed consent must be obtained prior to any study-specific procedures Patients must be at least 14 days status post last day of prior chemotherapy (at least 28 days since last dose of bevacizumab) and have recovered to grade =< 1 from all chemotherapy-associated side effects Patients must have the ability to swallow pills Exclusion Criteria: Untreated central nervous system (CNS) metastases; patients may have CNS metastases from any timeframe as long as they are treated and not progressing; brain imaging is not required if there is no clinical suspicion of brain metastases Pregnant or lactating females are excluded Uncontrolled hypertension defined as systolic blood pressure (BP) > 140 and/or diastolic BP > 90 initially evaluated on day of study eligibility determination (when laboratory parameters are assessed), but must be maintained on day of study initiation; (If a patient is found to have a value outside the range above, repeat BP may be assessed and if at subsequent readings x 2 (taken in clinic at least 15 minutes apart) criteria are met, the patient can then be eligible; initiation or modification of antihypertensives is allowed to achieve adequate BP for eligibility; finally, in the case that subsequent determinations are required, the BP assessment that counts towards eligibility is the reading on the day of study initiation); (note: a clinic BP reading without the patient having been at rest for 15 minutes or with the wrong cuff size can be repeated the same day for eligibility criteria to be determined Active bleeding or history of bleeding from cancer related events History of cerebral vascular accident (CVA) or transient ischemic attack (TIA) or recent myocardial infarction (MI) (< 6 months) Active ulcerative colitis, Crohn's disease or Celiac disease that could interfere with the absorption of the drug Current use of therapeutic anticoagulation; low dose anticoagulation for catheter prophylaxis is permitted; Lovenox is permitted for prophylaxis; (Note: patients who develop thrombosis and are placed on anticoagulation while on this trial may continue on study at the discretion of the investigator) The subject has had major surgery within 28 days of Study Day 1 The subject has had radiation therapy within 14 days of Study Day 1 The subject had prior bevacizumab within 28 days of study day 1 No prior treatment with vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitors; prior treatment with other investigational agents is allowed The subject has a medical condition, which in the opinion of the study investigator, places them at unacceptably high risk for toxicities Other active malignancy for which the patient has been treated within the past one year Subjects with known human immunodeficiency virus (HIV) infection are excluded Subject has documented left ventricular ejection fraction (LVEF) < 50% Subject has Proteinuria > grade 1 at baseline measured by urine dipstick (2+ or greater) and confirmed by 24 hour (hr) urine collection (> = 1g/24hrs)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jordan Berlin, MD
Organizational Affiliation
Vanderbilt-Ingram Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Vanderbilt Cool Springs
City
Franklin
State/Province
Tennessee
ZIP/Postal Code
37067
Country
United States
Facility Name
Vanderbilt-Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232-6838
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.vicc.org/ct/
Description
Vanderbilt-Ingram Cancer Center, Find a Clnical Trial

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Linifanib in Treating Patients With Advanced, Refractory Colorectal Cancer

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