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Tolerability and Safety of Vemurafenib, Cetuximab Combined With Camrelizumab for BRAF V600E-mutated /MSS Metastatic Colorectal Cancer

Primary Purpose

BRAF V600E-mutated /MSS Metastatic Colorectal Cancer, Vemurafenib (BRAFi) Plus Cetuximab (EGFRi) Combined With PD-1 Monoclonal Antibody

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Vemurafenib Oral Tablet [Zelboraf]
Cetuximab Injection [Erbitux]
Camrelizumab
Sponsored by
West China Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for BRAF V600E-mutated /MSS Metastatic Colorectal Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female ≥ 18 years of age
  2. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
  3. Participants must have histologically or cytologically confirmed diagnosis of adenocarcinoma of the colon or rectum, with clinical confirmation of unresectable and/or metastatic disease that is measurable according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1) criteria
  4. Presence of BRAF V600E in tumor tissue determined by local assay at any time prior to screening and confirmed by central laboratory. And confirmation of MSS or pMMR status from immunohistochemistry or PCR or NGS;
  5. Prior treatment with at least one systemic treatment (chemotherapy or target therapy) for mCRC, and prior treatment did not include cetuximab
  6. Adequate organ and marrow function:

    • ①Hemoglobin (Hb) ≥ 90 g/L;Platelets (PLT) ≥ 75 x 10^9/L;Neutrophil ≥1.5 x 10^9/L
    • ②Total bilirubin ≤ 1.5 x upper limit of normal (ULN);Aspartate aminotransferase (AST) ≤3 x ULN ;Alanine aminotransferase (ALT) ≤3 x ULN
    • ③Serum creatinine ≤ 1.5 x ULN, or calculated creatinine clearance (determined as per Cockcroft-Gault) ≥ 50 mL/min at screening
    • ④INR, APTT, and PT≤ 1.5 x ULN
    • ⑤Serum albumin≥ 28 g/L
    • ⑥ECG showed no evident abnormality
  7. Written informed consent

Exclusion Criteria:

  1. Known hypersensitivity or contraindication to any component of cetuximab or PD-1 monoclonal antibody or macromolecular protein reagent.
  2. A history of other malignancies with a disease-free survival of less than 5 years, with the following exceptions: adequately treated basal or squamous cell skin cancer, carcinoma in-situ of the cervix, and gastrointestinal tumors treated curatively with endoscopic mucosectomy;
  3. Any active autoimmune disease or a history of autoimmune disease
  4. Use of immunosuppressive medications or glucocorticoid therapy ≤2 weeks prior to entry
  5. Uncontrolled active infection requiring antibiotics
  6. Known history of HIV infection or active hepatitis
  7. Severe complications, including any of the following:

    • ①Massive gastrointestinal bleeding, perforation, or gastrointestinal obstruction
    • ②Symptomatic heart disease
    • ③Uncontrolled diabetes and hypertension
    • ④Uncontrolled diarrhea
  8. Women who are pregnant or lactating and people who do not agree to avoid pregnancy
  9. Patients with serious psychiatric that may interfere treatment.
  10. Other conditions which are inappropriate to participate in the study confirmed by investigators.

Sites / Locations

  • Sichuan University West China HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Vemurafenib, Cetuximab Combined With Camrelizumab (VCC)

Arm Description

Cetuximab and Camrelizumab in the fixed dose Vemurafenib have two dose groups: 960mg qd or 960mg bid

Outcomes

Primary Outcome Measures

Evaluate tolerability and safety and identify the recommended Phase 2 dose(RP2D)

Secondary Outcome Measures

Object Response Rate (ORR)
Rate of patients with partial or complete response according to modified RECIST criteria.
Disease Control Rate (DCR)
the proportion of patients who had a best response rating of complete response, partial response, or stable disease according to modified RECIST
Progression Free Survival (PFS)
Progression free survival (Medium, Kaplan-Meier-estimation, ITT- population)
Overall Survival (OS)
Overall survival (Kaplan-Meier-estimation, ITT- population)
Preliminary efficacy
Evaluation of preliminary efficacyaccording to RECIST 1.1

Full Information

First Posted
August 5, 2021
Last Updated
May 12, 2022
Sponsor
West China Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05019534
Brief Title
Tolerability and Safety of Vemurafenib, Cetuximab Combined With Camrelizumab for BRAF V600E-mutated /MSS Metastatic Colorectal Cancer
Official Title
A Phase I Study on Tolerance and Safety of Vemurafenib Film-coated Tablets, Cetuximab Solution for Infusion and Camrelizumab Protocol(VCC) in the After Line Therapy of BRAF V600E Mutation/MSS Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 15, 2021 (Actual)
Primary Completion Date
August 1, 2022 (Anticipated)
Study Completion Date
December 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
West China Hospital

4. Oversight

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

5. Study Description

Brief Summary
BRAF mutation exists in about 10-12% of colorectal cancer, among which BRAF V600E mutation is the most common type, which is an important biomarker for predicting the prognosis and precise treatment efficacy of metastatic colorectal cancer (mCRC). The prognosis of metastatic colorectal cancer with BRAF V600E mutation is very poor, with OS of about 6-9 months. Previous studies have shown that single anti-BRAF inhibitor are ineffective, while multi-target inhibitions of Ras-Raf -MEK pathway is a possible effective strategy for BRAF V600E-mutant mCRC. Currently, the proven effective regimens include the VIC regimen (Vemurafenib + cetuximab + Irinotecan) and BEACON regimen (Encorafenib+ cetuximab +/- Binimetinib) from the SWOGS1406 study. Furthermore, BRAF inhibitor +MEK inhibitor combined with PD-1 monoclonal antibody has been shown to be an effective strategy in BRAF V600E-mutant malignant melanoma, which promote the study of the regimens for the treatment of BRAF V600E-mutant mCRC. Increasing basic and clinical studies have shown that cetuximab has ADCC effect, induces immunogenic cell death, promotes immune cell infiltration and other immunomodulatory effects, and has a synergistic effect with PD-1 monoclonal antibody in colorectal cancer. Based on those theories, we conducted the phase I study to explore the safety and preliminary efficacy of the regimen of Vemurafenib (BRAFi) plus cetuximab (EGFRi) combined with PD-1 monoclonal antibody in BRAF V600E-mutant /MSS type mCRC.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
BRAF V600E-mutated /MSS Metastatic Colorectal Cancer, Vemurafenib (BRAFi) Plus Cetuximab (EGFRi) Combined With PD-1 Monoclonal Antibody

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Vemurafenib, Cetuximab Combined With Camrelizumab (VCC)
Arm Type
Experimental
Arm Description
Cetuximab and Camrelizumab in the fixed dose Vemurafenib have two dose groups: 960mg qd or 960mg bid
Intervention Type
Drug
Intervention Name(s)
Vemurafenib Oral Tablet [Zelboraf]
Other Intervention Name(s)
Zelboraf
Intervention Description
Vemurafenib 960mg qd or 960mg bid (2 cohorts)
Intervention Type
Drug
Intervention Name(s)
Cetuximab Injection [Erbitux]
Other Intervention Name(s)
Erbitux
Intervention Description
Cetuximab 500mg/m2 Q2W
Intervention Type
Drug
Intervention Name(s)
Camrelizumab
Intervention Description
Camrelizumab 200mg Q2W
Primary Outcome Measure Information:
Title
Evaluate tolerability and safety and identify the recommended Phase 2 dose(RP2D)
Time Frame
Subjects will be treated and observed for dose-limiting toxicity(DLT) through the end of the first cycle (Days 1-28)
Secondary Outcome Measure Information:
Title
Object Response Rate (ORR)
Description
Rate of patients with partial or complete response according to modified RECIST criteria.
Time Frame
up to 24 weeks
Title
Disease Control Rate (DCR)
Description
the proportion of patients who had a best response rating of complete response, partial response, or stable disease according to modified RECIST
Time Frame
up to 24 weeks
Title
Progression Free Survival (PFS)
Description
Progression free survival (Medium, Kaplan-Meier-estimation, ITT- population)
Time Frame
up to 1 year
Title
Overall Survival (OS)
Description
Overall survival (Kaplan-Meier-estimation, ITT- population)
Time Frame
up to 3 year
Title
Preliminary efficacy
Description
Evaluation of preliminary efficacyaccording to RECIST 1.1
Time Frame
up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female ≥ 18 years of age Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 Participants must have histologically or cytologically confirmed diagnosis of adenocarcinoma of the colon or rectum, with clinical confirmation of unresectable and/or metastatic disease that is measurable according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1) criteria Presence of BRAF V600E in tumor tissue determined by local assay at any time prior to screening and confirmed by central laboratory. And confirmation of MSS or pMMR status from immunohistochemistry or PCR or NGS; Prior treatment with at least one systemic treatment (chemotherapy or target therapy) for mCRC, and prior treatment did not include cetuximab Adequate organ and marrow function: ①Hemoglobin (Hb) ≥ 90 g/L;Platelets (PLT) ≥ 75 x 10^9/L;Neutrophil ≥1.5 x 10^9/L ②Total bilirubin ≤ 1.5 x upper limit of normal (ULN);Aspartate aminotransferase (AST) ≤3 x ULN ;Alanine aminotransferase (ALT) ≤3 x ULN ③Serum creatinine ≤ 1.5 x ULN, or calculated creatinine clearance (determined as per Cockcroft-Gault) ≥ 50 mL/min at screening ④INR, APTT, and PT≤ 1.5 x ULN ⑤Serum albumin≥ 28 g/L ⑥ECG showed no evident abnormality Written informed consent Exclusion Criteria: Known hypersensitivity or contraindication to any component of cetuximab or PD-1 monoclonal antibody or macromolecular protein reagent. A history of other malignancies with a disease-free survival of less than 5 years, with the following exceptions: adequately treated basal or squamous cell skin cancer, carcinoma in-situ of the cervix, and gastrointestinal tumors treated curatively with endoscopic mucosectomy; Any active autoimmune disease or a history of autoimmune disease Use of immunosuppressive medications or glucocorticoid therapy ≤2 weeks prior to entry Uncontrolled active infection requiring antibiotics Known history of HIV infection or active hepatitis Severe complications, including any of the following: ①Massive gastrointestinal bleeding, perforation, or gastrointestinal obstruction ②Symptomatic heart disease ③Uncontrolled diabetes and hypertension ④Uncontrolled diarrhea Women who are pregnant or lactating and people who do not agree to avoid pregnancy Patients with serious psychiatric that may interfere treatment. Other conditions which are inappropriate to participate in the study confirmed by investigators.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Meng Qiu
Phone
+862885423203
Email
qiumeng33@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Weibing Leng, Ph.D
Phone
+8618980601776
Email
s103470@stu.scu.edu.cn
Facility Information:
Facility Name
Sichuan University West China Hospital
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610044
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Weibing Leng, Ph.D
Phone
+8618980601776
Email
s103470@stu.scu.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

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Tolerability and Safety of Vemurafenib, Cetuximab Combined With Camrelizumab for BRAF V600E-mutated /MSS Metastatic Colorectal Cancer

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