Irinotecan and Cetuximab for Colorectal Cancer as Second Line Therapy

Colon Cancer Clinical Trial

Official title:

A Phase 2 Study of Irinotecan and Cetuximab on an Every 2 Week Schedule, as Second Line Therapy in Patients With Advanced Colorectal Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00336856
• Other study ID #: 06-006
• Status: Completed
• Phase: Phase 2
• First received: June 12, 2006
• Last updated: December 2, 2015
• Start date: June 2006
• Est. completion date: June 2011

Study information

• Verified date: December 2015
• Source: University of Pittsburgh
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

Research Hypothesis: Subjects in the study population who are treated with cetuximab in combination with irinotecan will have higher response rates than subjects treated with irinotecan alone.

Description:

Primary Objective:

·The primary aim of this study is to assess the response rate of patients with previously treated CRC Number of Subjects: 31

Study Population:

Subjects with metastatic, CRC who have failed a first-line chemotherapeutic regimen containing oxaliplatin and a fluoropyrimidine, and who have not previously received irinotecan or cetuximab for treatment of CRC.

Test Product, Dose and Mode of Administration, Duration of Treatment:

Cetuximab administered at an initial dose of 500 mg/m2 intravenously (IV) over 120 minutes, followed by 500 mg/m2 every 2 weeks IV over 60 minutes.

Reference Therapy, Dose and Mode of Administration, Duration of Treatment: Irinotecan administered at a dose of 150a or 180 mg/m2 IV over 60 minutes every two weeks.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 35
• Est. completion date: June 2011
• Est. primary completion date: June 2011
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients must consent to be in the study

• Patients must have advanced, surgically unresectable CRC, who have failed a first line metastatic regimen, within 12 months of starting protocol therapy.

• Patients must have measurable disease

• There must be histologic confirmation of adenocarcinoma of the colon or rectum.

• Patients must have an ECOG performance status of 0, 1, or 2

• Estimated life expectancy of at least 12 weeks.

• One prior therapy for metastatic disease is permitted.

• Recurrence within 12 months of adjuvant therapy with FOLFOX or a similar regimen (i.e FLOX, CapOX) is considered one regimen and allowed for study

• There must be evidence of adequate organ function

• Patients with a history of prior non-colorectal malignancies are eligible if they have been disease-free for ³ 5 years prior to study entry and are deemed by the physician to be at low risk for recurrence.

• Age > 18 yrs.

Exclusion Criteria:

• Any prior therapy with irinotecan or cetuximab or an EGFR targeting agent.

• Any systemic therapy administered for metastatic or locally recurrent colorectal cancer within 28 days of study treatment.

• Patients who are considered candidates for surgical resection of metastatic and/or locally advanced disease.

• Any histology other than adenocarcinoma of the colon or rectum.

• Serious concomitant medical conditions that, in the opinion of the investigator, would compromise the safety of the patient or compromise the patient's ability to complete the study.

• Evidence of central nervous system metastases

• Pulmonary fibrosis or interstitial pneumonitis

• General Medical Concerns

• History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that might affect the interpretation of the results of the study or render the subject at high risk from treatment complications.

• Serious, uncontrolled, concurrent infection.

• Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 0, or anticipation of need for major surgical procedure during the course of the study; fine needle aspirations or core biopsies within 7 days prior to Day 0. Line placement (i.e Infus-a-port or PICC) is not considered major surgery.

• Evidence of bleeding diathesis or coagulopathy

• Prior severe infusion reaction to a monoclonal antibody.

• Significant history of uncontrolled cardiac disease; i.e., uncontrolled hypertension, unstable angina, recent myocardial infarction (within prior 6 months), uncontrolled congestive heart failure, and cardiomyopathy with decreased ejection fraction.

• Patients with Gilbert's Syndrome

• Prior to study enrollment, women of childbearing potential (WOCBP) must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy. In addition, men enrolled on this study should understand the risks to any sexual partner of childbearing potential and should practice an effective method of birth control.

• All WOCBP MUST have a negative pregnancy test within 7 days prior to first receiving investigational product. If the pregnancy test is positive, the patient must not receive investigational product and must not be enrolled in the study.

• In addition, all WOCBP should be instructed to contact the Investigator immediately if they suspect they might be pregnant (e.g., missed or late menstrual period) at any time during study participation.

• The Investigator must immediately notify BMS in the event of a confirmed pregnancy in a patient participating in the study.

Study Design

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Colon Cancer
• Colorectal Neoplasms
• Rectum Cancer

Intervention

Drug:
• Cetuximab
The treatment will include cetuximab 500 mg/m² IV for 120 minutes followed by irinotecan 180 mg/m² or 60 minutes. The starting dose of irinotecan for patients who are 70 years old or greater, or who have had radiation therapy to the abdomen or pelvis, or whose level of functioning is poor (performance status of 2) will have a starting dose of 150 mg/m2 for irinotecan. All subsequent treatments will include cetuximab 500 mg/m² IV over 60 minutes and irinotecan 150 mg/m² or 180 mg/m2 intravenously over 60 minutes every 2 weeks.
• Irinotecan
The treatment will include cetuximab 500 mg/m² IV for 120 minutes followed by irinotecan 180 mg/m² or 60 minutes. The starting dose of irinotecan for patients who are 70 years old or greater, or who have had radiation therapy to the abdomen or pelvis, or whose level of functioning is poor (performance status of 2) will have a starting dose of 150 mg/m2 for irinotecan. All subsequent treatments will include cetuximab 500 mg/m² IV over 60 minutes and irinotecan 150 mg/m² or 180 mg/m2 intravenously over 60 minutes every 2 weeks.

Locations

Country	Name	City	State
United States	UPMC Cancer Centers	Pittsburgh	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
University of Pittsburgh	Bristol-Myers Squibb

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	To assess the response rate of patients with previously treated CRC		every 6 - 8 weeks	No
Secondary	To measure time to progression		every 6 - 8 weeks	No
Secondary	To measure the duration of response for responding patients.		every 6 - 8 weeks	No
Secondary	To characterize the quantitative and qualitative toxicities in this patient population.		monthly	Yes
Secondary	To study the effect of cetuximab on serial serum EGF levels, over expression of EGFR pathways and downstream markers on tumor tissue (STAT, mutant EGFR and MAPK)		2 years	No
Secondary	To characterize the pharmacokinetics of cetuximab given on a every 2 week schedule		monthly	No