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Multicenter Study Of CPX-1 (Irinotecan HCl: Floxuridine) Liposome Injection In Patients With Advanced Colorectal Cancer

Primary Purpose

Colorectal Neoplasms

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
CPX-1 (Irinotecan HCl:Floxuridine) Liposome Injection
Sponsored by
Jazz Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Neoplasms focused on measuring Colorectal cancer, Colorectal carcinoma, Colonic cancer, Rectal cancer

Eligibility Criteria

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

Inclusion Criteria: Ability to understand and voluntarily sign an informed consent form Age > 18 years at the time of signing the informed consent form Histological confirmation of advanced stage, primary or metastatic colorectal carcinoma Prior therapy (Group 1, irinotecan naive): No more than one regimen for metastatic disease No more than two regimens overall; one for neoadjuvant/adjuvant and one for metastatic/advanced disease Prior therapy (Group 2, irinotecan refractory): Disease progression on or within 3 months after prior irinotecan-containing regimen CPX-1 treatment must start within 6 months after documentation of disease progression on irinotecan (other therapies are permitted after irinotecan and before study entry) Must have measurable disease as defined by RECIST Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 Able to adhere to the study visit schedule and other protocol requirements Life expectancy of at least 24 weeks Laboratory values fulfilling the following: Absolute neutrophil count (ANC) >1500 cells/mm3 (1.5 x 109/L) Platelet count > 100,000/mm3 (100 x 109/L) Serum creatinine <1.5 x upper limits of normal (ULN) Serum SGOT/AST and SGPT/ALT <3 x upper limits of normal (ULN) (<5 times ULN if caused by liver metastases) Serum total bilirubin < 1.25 x upper limits of normal (<2 times ULN if caused by liver metastases) All men and women must agree to practice effective contraception during the study period and for three months afterward if not otherwise documented to be infertile. Prior radiation therapy must be completed at least 4 weeks prior to enrollment and the patient recovered from any toxicity related to the radiation therapy. Exclusion Criteria: Prior treatment with irinotecan or an irinotecan-containing regimen (Group 1 only) Intolerant of an irinotecan-containing regimen (Group 2 only) Without documented evidence of irinotecan-refractoriness (Group 2 only) Chemotherapy or investigational anticancer therapeutic drugs in the four weeks prior to study entry. Hypersensitivity to irinotecan, floxuridine or liposomal products. History of Wilson's disease or other copper-related disorder. Clinically significant cardiac disease (New York Heart Association Class III or IV). Severe debilitating pulmonary disease. Active infection requiring continuing intravenous antibiotic treatment; recent infections must have resolved at least 5 days Severe or active enteropathy or recurrent onset of diarrhea, defined as an excess of 2 to 3 stools above the normal daily rate within the past four weeks. Any serious medical condition, laboratory abnormality or psychiatric illness that would prevent the subject from signing the informed consent form. Pregnant or lactating women. Continued use of a drug or other product known to induce or inhibit CYP3A4. ---Patients must discontinue these products for at least 2 week prior to enrollment.

Sites / Locations

  • California Cancer Center
  • Lombardi Comprehensive Cancer Research Institute, Georgetown University Medical Center
  • NW Oncology & Hematology Associates
  • Broward Oncology Associates
  • St. Joseph's/Candler Health System Inc.
  • Presbyterian Hospital
  • Gabrail Cancer Center
  • Cancer Care Oklahoma
  • Cancer Care Oklahoma
  • South Carolina Oncology Association
  • Sarah Cannon Research Institute
  • Cross Cancer Institute
  • Sir Mortimer B. Davis Jewish General Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Irinotecan

Arm Description

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.0
Disease response was assessed using RECIST 1.0. Measurable disease and target lesions were determined prior to study entry. Changes in the largest diameter (unidimensional measurement) of the sum of the target tumor lesions were used in the RECIST criteria. Best response on study was classified as follows. Complete Response (CR), disappearance of all clinical and radiological evidence of tumor. Partial Response (PR) at least a 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum of the longest diameters. Stable Disease (SD), steady state of disease. Neither sufficient shrinkage to qualify for PR or sufficient increase to qualify for PD. Progressive Disease (PD) at least a 20% increase in the sum of the longest diameters of measured lesions taking as references the smallest sum of longest diameters recorded since the treatment started. Appearance of new lesions also constituted progressive disease.
Progression-free Survival (PFS) Per RECIST Version 1.0
Progression-free survival (PFS) was defined as the time from the first dose to the documentation of progressive disease (PD), death, or lost to follow-up at last assessment visit.

Secondary Outcome Measures

Duration of Response (DoR) Per RECIST Version 1.0
The duration of overall response was measured from the time that measurement criteria were met for CR or PR (whichever status was recorded first) until the first date that recurrent or progressive disease was objectively documented (taking as reference for progressive disease the smallest measurements recorded since the treatment started). The duration of overall complete response was measured from the time measurement criteria were first met for complete response until the first date that recurrent disease was objectively documented.

Full Information

First Posted
August 7, 2006
Last Updated
July 1, 2021
Sponsor
Jazz Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00361842
Brief Title
Multicenter Study Of CPX-1 (Irinotecan HCl: Floxuridine) Liposome Injection In Patients With Advanced Colorectal Cancer
Official Title
Multicenter, Open-Label, Phase 2 Study Of CPX-1 (Irinotecan HCl: Floxuridine) Liposome Injection In Patients With Advanced Colorectal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
July 2006 (undefined)
Primary Completion Date
December 2008 (Actual)
Study Completion Date
December 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jazz Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether CPX-1 is effective in patients with advanced colorectal cancer who have already received chemotherapy that included the drug oxaliplatin or irinotecan. All patients will receive CPX-1 at a dose of 210 units/m2 over 90 minutes every two weeks.
Detailed Description
CPX-1 Liposome Injection is a liposomal formulation of a fixed combination of the antineoplastic drugs irinotecan HCl and floxuridine. The two drugs are present inside the liposome in a fixed 1:1 molar ratio. CPX-1 was developed as a means of delivering and preserving a fixed 1:1 molar ratio of the two drugs. This ratio was found in vitro and in vivo models of cancer to have synergistic anti-cancer activity and preservation and delivery of this ratio is important because other ratios of these two drugs have been found to be antagonistic or only additive. Both floxuridine and irinotecan HCl are active chemotherapeutic agents, each approved for clinical use in the United States and Canada for colorectal cancer. Current practice routinely administers 5- fluorouracil with irinotecan in combination regimens in first or second line treatment without the means of preserving the synergistic ratio.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Neoplasms
Keywords
Colorectal cancer, Colorectal carcinoma, Colonic cancer, Rectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
65 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Irinotecan
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
CPX-1 (Irinotecan HCl:Floxuridine) Liposome Injection
Intervention Description
CPX-1 Liposome Injection is a liposomal formulation of a fixed combination of the antineoplastic drugs irinotecan HCl and floxuridine.
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.0
Description
Disease response was assessed using RECIST 1.0. Measurable disease and target lesions were determined prior to study entry. Changes in the largest diameter (unidimensional measurement) of the sum of the target tumor lesions were used in the RECIST criteria. Best response on study was classified as follows. Complete Response (CR), disappearance of all clinical and radiological evidence of tumor. Partial Response (PR) at least a 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum of the longest diameters. Stable Disease (SD), steady state of disease. Neither sufficient shrinkage to qualify for PR or sufficient increase to qualify for PD. Progressive Disease (PD) at least a 20% increase in the sum of the longest diameters of measured lesions taking as references the smallest sum of longest diameters recorded since the treatment started. Appearance of new lesions also constituted progressive disease.
Time Frame
From date of first dose until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 48 months
Title
Progression-free Survival (PFS) Per RECIST Version 1.0
Description
Progression-free survival (PFS) was defined as the time from the first dose to the documentation of progressive disease (PD), death, or lost to follow-up at last assessment visit.
Time Frame
Every 8 weeks
Secondary Outcome Measure Information:
Title
Duration of Response (DoR) Per RECIST Version 1.0
Description
The duration of overall response was measured from the time that measurement criteria were met for CR or PR (whichever status was recorded first) until the first date that recurrent or progressive disease was objectively documented (taking as reference for progressive disease the smallest measurements recorded since the treatment started). The duration of overall complete response was measured from the time measurement criteria were first met for complete response until the first date that recurrent disease was objectively documented.
Time Frame
Every 8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability to understand and voluntarily sign an informed consent form Age > 18 years at the time of signing the informed consent form Histological confirmation of advanced stage, primary or metastatic colorectal carcinoma Prior therapy (Group 1, irinotecan naive): No more than one regimen for metastatic disease No more than two regimens overall; one for neoadjuvant/adjuvant and one for metastatic/advanced disease Prior therapy (Group 2, irinotecan refractory): Disease progression on or within 3 months after prior irinotecan-containing regimen CPX-1 treatment must start within 6 months after documentation of disease progression on irinotecan (other therapies are permitted after irinotecan and before study entry) Must have measurable disease as defined by RECIST Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 Able to adhere to the study visit schedule and other protocol requirements Life expectancy of at least 24 weeks Laboratory values fulfilling the following: Absolute neutrophil count (ANC) >1500 cells/mm3 (1.5 x 109/L) Platelet count > 100,000/mm3 (100 x 109/L) Serum creatinine <1.5 x upper limits of normal (ULN) Serum SGOT/AST and SGPT/ALT <3 x upper limits of normal (ULN) (<5 times ULN if caused by liver metastases) Serum total bilirubin < 1.25 x upper limits of normal (<2 times ULN if caused by liver metastases) All men and women must agree to practice effective contraception during the study period and for three months afterward if not otherwise documented to be infertile. Prior radiation therapy must be completed at least 4 weeks prior to enrollment and the patient recovered from any toxicity related to the radiation therapy. Exclusion Criteria: Prior treatment with irinotecan or an irinotecan-containing regimen (Group 1 only) Intolerant of an irinotecan-containing regimen (Group 2 only) Without documented evidence of irinotecan-refractoriness (Group 2 only) Chemotherapy or investigational anticancer therapeutic drugs in the four weeks prior to study entry. Hypersensitivity to irinotecan, floxuridine or liposomal products. History of Wilson's disease or other copper-related disorder. Clinically significant cardiac disease (New York Heart Association Class III or IV). Severe debilitating pulmonary disease. Active infection requiring continuing intravenous antibiotic treatment; recent infections must have resolved at least 5 days Severe or active enteropathy or recurrent onset of diarrhea, defined as an excess of 2 to 3 stools above the normal daily rate within the past four weeks. Any serious medical condition, laboratory abnormality or psychiatric illness that would prevent the subject from signing the informed consent form. Pregnant or lactating women. Continued use of a drug or other product known to induce or inhibit CYP3A4. ---Patients must discontinue these products for at least 2 week prior to enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerald Batist, MD
Organizational Affiliation
Sir Mortimer B. Davis - Jewish General Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
John Marshall, MD
Organizational Affiliation
Lombardi Comprehensive Cancer Center, Georgetown University Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Arthur Louie, MD
Organizational Affiliation
Jazz Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
California Cancer Center
City
Greenbrae
State/Province
California
ZIP/Postal Code
94904
Country
United States
Facility Name
Lombardi Comprehensive Cancer Research Institute, Georgetown University Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20057
Country
United States
Facility Name
NW Oncology & Hematology Associates
City
Coral Springs
State/Province
Florida
ZIP/Postal Code
33065
Country
United States
Facility Name
Broward Oncology Associates
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States
Facility Name
St. Joseph's/Candler Health System Inc.
City
Savannah
State/Province
Georgia
ZIP/Postal Code
31405
Country
United States
Facility Name
Presbyterian Hospital
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Gabrail Cancer Center
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
Facility Name
Cancer Care Oklahoma
City
Oklahoma City
State/Province
Oklahoma
Country
United States
Facility Name
Cancer Care Oklahoma
City
Tulsa
State/Province
Oklahoma
Country
United States
Facility Name
South Carolina Oncology Association
City
Columbia
State/Province
South Carolina
ZIP/Postal Code
29210
Country
United States
Facility Name
Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Cross Cancer Institute
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G1Z2
Country
Canada
Facility Name
Sir Mortimer B. Davis Jewish General Hospital
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3T1E2
Country
Canada

12. IPD Sharing Statement

Links:
URL
http://www.nccn.org/
Description
Web site of national Comprehensive Cancer Network

Learn more about this trial

Multicenter Study Of CPX-1 (Irinotecan HCl: Floxuridine) Liposome Injection In Patients With Advanced Colorectal Cancer

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