Study of Lenvatinib (MK-7902/E7080) in Combination With Pembrolizumab (MK-3475) Versus Standard of Care in Participants With Metastatic Colorectal Cancer (MK-7902-017/E7080-G000-325/LEAP-017)

Colorectal Neoplasms Clinical Trial

Official title:

A Phase 3 Randomized Study of Lenvatinib in Combination With Pembrolizumab Versus Standard of Care in Participants With Metastatic Colorectal Cancer Who Have Received and Progressed On or After or Became Intolerant to Prior Treatment

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04776148
• Other study ID #: 7902-017
• Secondary ID: MK-7902-017LEAP-
• Status: Active, not recruiting
• Phase: Phase 3
• Start date: March 29, 2021
• Est. completion date: September 27, 2024

Study information

• Verified date: April 2024
• Source: Merck Sharp & Dohme LLC
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to assess the safety and efficacy of lenvatinib (MK-7902/E7080) in combination with pembrolizumab (MK-3475) in participants with metastatic colorectal cancer. The study will also compare lenvatinib plus pembrolizumab with the standard of care treatment of regorafenib and TAS-102 (trifluridine and tipiracil hydrochloride).

The primary study hypothesis is that lenvatinib plus pembrolizumab is superior to standard of care with respect to overall survival.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 480
• Est. completion date: September 27, 2024
• Est. primary completion date: February 20, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Has histologically or cytologically confirmed diagnosis of unresectable and metastatic colorectal adenocarcinoma (Stage IV A, B and C as defined by American Joint Committee on Cancer [AJCC] 8th edition). Note: Tumor must be determined to be NOT microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) by local testing

• Has been previously treated for their disease and has shown disease progression as defined by RECIST 1.1 on or after or could not tolerate standard treatment, which must include ALL of the following agents if approved and locally available in the country where the participant is randomized:

1. fluoropyrimidine, irinotecan and oxaliplatin

2. with or without an anti-vascular endothelial growth factor (VEGF) monoclonal antibody (bevacizumab)

3. with anti- epidermal growth factor receptor (EGFR) monoclonal antibodies (cetuximab or panitumumab) for RAS (KRAS/NRAS) wild-type (WT) participants

4. BRAF inhibitor (in combination with cetuximab +/- binimetinib) for BRAF V600E mutated metastatic colon cancer (mCRC)

• Has measurable disease per RECIST 1.1 assessed by the investigator

• Has provided to a designated central laboratory an archival tumor tissue sample or newly obtained core, incisional, or excisional biopsy of a tumor lesion which has not been previously irradiated

• Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 within 3 days prior to randomization

• Has a life expectancy of at least 3 months, based on the investigator assessment

• Has the ability to swallow capsules or ingest a suspension orally or by a feeding tube

• Has adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP =150/90 millimeter of mercury (mmHg) with no change in antihypertensive medications within 1 week prior to randomization

• Male participants must agree to the following during the treatment period and for at least 90 days after the last dose of regorafenib or TAS-102 and at least 7 days after the last dose of lenvatinib: refrain from donating sperm PLUS either be abstinent from heterosexual intercourse as their preferred and usual lifestyle or use contraception. The male contraception period should continue for at least 7 days after discontinuation of lenvatinib

• A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies: is not a woman of childbearing potential (WOCBP) OR is a WOCBP and using a highly-effective contraceptive method during the treatment period and for at least 30 days after the last dose of lenvatinib, 120 days after the last dose of pembrolizumab, and 180 days after the last dose of regorafenib or TAS-102 (whichever is last) AND agrees not to donate eggs (ova, oocytes)

• A WOCBP must have a negative highly sensitive pregnancy test (urine or serum) within 24 hours before the first dose of study treatment

Exclusion Criteria:

• Has a tumor that is microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) per local testing

• Has presence of gastrointestinal condition, eg, malabsorption, that might affect the absorption of study drug.

• Has present or progressive accumulation of pleural, ascitic, or pericardial fluid requiring drainage or diuretic drugs within 2 weeks prior to enrollment

• Has radiographic evidence of encasement or invasion of a major blood vessel invasion or of intratumoral cavitation. In the chest, major blood vessels include the main pulmonary artery, the left and right pulmonary arteries, the 4 major pulmonary veins, the superior or inferior vena cava, and the aorta

• Has clinically significant hemoptysis or tumor bleeding within 2 weeks prior to the first dose of study drug

• Has clinically significant cardiovascular disease within 12 months from first dose of study intervention, including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability.

Participants with cardiac failure NYHA Class II, III and IV are not allowed to be assigned to the regorafenib in Arm B

• Has a history of arterial thromboembolism within 12 months of start of study drug

• Has urine protein =1 gram/24 hour

• Has prolongation of QT interval corrected with Fridericia's formula (QTcF interval) to >480 milliseconds

• Has left ventricular ejection fraction (LVEF) below the institutional (or local laboratory) normal range as determined by multigated acquisition (MUGA) or echocardiogram (ECHO)

• Has a known additional malignancy that is progressing or has required active treatment within the past 3 years with certain exceptions

• Has serious nonhealing wound, ulcer or bone fracture

• Has had major surgery within 3 weeks prior to first dose of study treatment

• Has received biologic response modifiers (eg, granulocyte colony-stimulating factor) within 4 weeks before study entry

• Has preexisting =Grade 3 gastrointestinal or nongastrointestinal fistula

• Has received prior treatment with a combination of an anti-PD-1, anti-PD-L1, or anti PD-L2 agent with anti-VEGF monoclonal antibodies or vascular endothelial growth factor receptor (VEGFR) inhibitors

• Has previously received regorafenib or TAS-102

• Has received prior systemic anti-cancer therapy including investigational agents within 28 days prior to randomization

• Has received prior radiotherapy within 2 weeks of start of study treatment

• Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study treatment

• Has known intolerance to lenvatinib, regorafenib, or TAS-102 and/or any of their excipients

• Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 28 days prior to the first dose of study treatment

• Has known central nervous system (CNS) metastases and/or carcinomatous meningitis.

• Has severe hypersensitivity (=Grade 3) to pembrolizumab and/or any of its excipients

• Has an active autoimmune disease that has required systemic treatment in past 2 years

• Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study medication

• Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis

• Has an active infection requiring systemic therapy

• Has a known history of Human Immunodeficiency Virus (HIV) infection

• Has a known history of Hepatitis B or known active Hepatitis C virus infection

• Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator

• Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study

• Has had an allogenic tissue/solid organ transplant

Related Conditions & MeSH terms

• Colorectal Neoplasms

Intervention

Drug:
• pembrolizumab
IV infusion
• lenvatinib
oral capsule
• regorafenib
oral tablet
• TAS-102 (trifluridine and tipiracil)
oral tablet

Locations

Country	Name	City	State
Argentina	Centro de Educación Médica e Investigaciones Clínicas (CEMIC)-Medical Oncology ( Site 0303)	Buenos Aires
Argentina	Fundación favaloro para la Docencia e Investigación Médica-Oncología ( Site 0301)	Buenos Aires	Caba
Argentina	IDIM - Instituto de Diagnóstico e Investigaciones Metabólicas ( Site 0300)	Buenos Aires
Argentina	Hospital Británico de Buenos Aires-Oncology ( Site 0308)	Ciudad autónoma de Buenos Aires	Buenos Aires
Argentina	Instituto de Oncología de Rosario ( Site 0305)	Rosario	Santa Fe
Australia	Royal Brisbane and Women's Hospital-Medical Oncology Clinical Trials Unit, Cancer Care Services ( Si	Brisbane	Queensland
Australia	Gallipoli Medical Research Foundation-GMRF CTU ( Site 1500)	Greenslopes	Queensland
Australia	Epworth Freemasons ( Site 1506)	Melbourne	Victoria
Australia	Hollywood Private Hospital-Medical Oncology ( Site 1507)	Perth	Western Australia
Australia	Western Health-Sunshine & Footscray Hospitals ( Site 1501)	St Albans	Victoria
Australia	The Queen Elizabeth Hospital-Cancer Clinical Trials ( Site 1503)	Woodville	South Australia
Canada	Cross Cancer Institute-Department of Medical Oncology ( Site 0207)	Edmonton	Alberta
Canada	NSHA-QEII Health Sciences Centre-Dickson Bldg-Dept. of Medical Oncology ( Site 0200)	Halifax	Nova Scotia
Canada	Hamilton Health Sciences-Juravinski Cancer Centre ( Site 0205)	Hamilton	Ontario
Canada	CIUSSS de l'Est-de-l'Île-de-Montréal ( Site 0211)	Montreal	Quebec
Canada	CHU de Quebec - Université Laval - Hotel Dieu de Quebec-Hemato-Dermato-Gyneco-Oncology ( Site 0203)	Québec	Quebec
Canada	North York General Hospital ( Site 0206)	Toronto	Ontario
China	The First People's Hospital of Foshan-Gastrointestinal oncology ( Site 1604)	Foshan	Guangdong
China	SUN YAT-SEN UNIVERSITY CANCER CENTRE ( Site 1600)	Guangzhou	Guangdong
China	Sir Run Run Shaw Hospital-Medical Oncology ( Site 1606)	Hangzhou	Zhejiang
Denmark	Herlev and Gentofte Hospital-Department of Oncology ( Site 0704)	Copenhagen	Hovedstaden
Denmark	Rigshospitalet ( Site 0702)	Copenhagen	Hovedstaden
Denmark	Odense Universitetshospital ( Site 0700)	Odense	Syddanmark
Denmark	Vejle Sygehus-Department of Oncology ( Site 0701)	Vejle	Syddanmark
Germany	Charité Universitaetsmedizin Berlin - Campus Mitte ( Site 0901)	Berlin
Germany	Onkodok GmbH ( Site 0907)	Gütersloh	Nordrhein-Westfalen
Germany	Asklepios Altona-Oncology ( Site 0903)	Hamburg
Germany	klinikum rechts der isar der technischen universität münchen-Klinik und Poliklinik für Innere Mediz	Munich	Bayern
Germany	Klinikum am Steinenberg-Kreiskliniken Reutlingen GmbH ( Site 0908)	Reutlingen	Baden-Wurttemberg
Israel	Rambam Health Care Campus-Oncology ( Site 0800)	Haifa
Israel	Hadassah Medical Center-Oncology ( Site 0802)	Jerusalem
Israel	Shaare Zedek Medical Center-Oncology ( Site 0804)	Jerusalem
Israel	Sheba Medical Center ( Site 0803)	Ramat Gan
Israel	Sourasky Medical Center-Oncology ( Site 0801)	Tel Aviv
Japan	National Hospital Organization Kyushu Cancer Center ( Site 1709)	Fukuoka
Japan	Saitama Prefectural Cancer Center ( Site 1703)	Ina-machi	Saitama
Japan	National Cancer Center Hospital East ( Site 1700)	Kashiwa	Chiba
Japan	Kagawa University Hospital ( Site 1708)	Kita	Kagawa
Japan	Kobe City Medical Center General Hospital ( Site 1707)	Kobe	Hyogo
Japan	Shizuoka Cancer Center ( Site 1706)	Nagaizumi	Shizuoka
Japan	Aichi Cancer Center Hospital ( Site 1701)	Nagoya	Aichi
Japan	Kindai University Hospital- Osakasayama Campus-Medical Oncology ( Site 1704)	Osakasayama	Osaka
Japan	Japanese Foundation for Cancer Research-GI Oncology ( Site 1710)	Tokyo
Japan	National Cancer Center Hospital ( Site 1702)	Tokyo
Japan	Kanagawa cancer center ( Site 1705)	Yokohama	Kanagawa
Korea, Republic of	Asan Medical Center ( Site 1803)	Seoul
Korea, Republic of	Korea University Anam Hospital ( Site 1806)	Seoul
Korea, Republic of	Samsung Medical Center-Division of Hematology/Oncology ( Site 1804)	Seoul
Korea, Republic of	Seoul National University Hospital-Internal Medicine ( Site 1800)	Seoul
Korea, Republic of	Severance Hospital, Yonsei University Health System-Medical oncology ( Site 1801)	Seoul
Korea, Republic of	The Catholic Univ. of Korea Seoul St. Mary's Hospital ( Site 1802)	Seoul
Russian Federation	SVERDLOVSK REGIONAL ONCOLOGY DISPENSARY ( Site 1108)	Ekaterinburg	Sverdlovskaya Oblast
Russian Federation	Fed State Budgetary Inst N.N. Blokhin Med Center of Oncology MHRF ( Site 1107)	Moscow	Moskva
Russian Federation	First Moscow State Medical University I.M. Sechenov-Interhospital Institution ""Health Management (	Moscow	Moskva
Russian Federation	The National Medico-Surgical Center N.I. Pirogov ( Site 1102)	Moscow	Moskva
Russian Federation	Saint-Petersburg City Clinical Oncology Dispensary-Department of chemotherapy ( Site 1100)	Saint Petersburg	Leningradskaya Oblast
Russian Federation	SHBI Leningrad Regional Clinical Oncology Dispensary-Clinical Trials Department ( Site 1111)	Sankt-Peterburg
Russian Federation	GBUZ Republican Clinical Oncological Dispensary-Antitumor drug therapy department ( Site 1109)	Ufa	Baskortostan, Respublika
Spain	Hospital Universitari Vall d'Hebron-Oncology ( Site 1204)	Barcelona
Spain	HOSPITAL GENERAL UNIVERSITARIO GREGORIO MARAÑON ( Site 1205)	Madrid
Spain	Hospital Universitario Central de Asturias-Digestive ( Site 1200)	Oviedo	Asturias
Spain	Hospital Universitario Marqués de Valdecilla ( Site 1201)	Santander	Cantabria
Spain	Hospital Universitario Virgen de Valme-Departamento de Oncologia ( Site 1207)	Sevilla
Taiwan	China Medical University Hospital-Surgical Department ( Site 1903)	Taichung
Taiwan	NATIONAL CHENG-KUNG UNI. HOSP. ( Site 1904)	Tainan
Taiwan	National Taiwan University Hospital ( Site 1900)	Taipei
Taiwan	Taipei Veterans General Hospital-Oncology ( Site 1901)	Taipei
Taiwan	Chang Gung Medical Foundation.Linkou Branch ( Site 1902)	Taoyuan
Turkey	Hacettepe Universitesi-oncology hospital ( Site 1302)	Ankara
Turkey	Memorial Ankara Hastanesi-Medical Oncology ( Site 1304)	Ankara
Turkey	Trakya University-Oncology ( Site 1303)	Edirne
Turkey	Acibadem Maslak Hastanesi ( Site 1307)	Istanbul
Turkey	Istanbul Universitesi Cerrahpasa-Medical Oncology ( Site 1300)	Istanbul
Turkey	TC Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin Sehir Hastanesi-oncology ( Site 1301)	Istanbul
Turkey	Ege University Medicine of Faculty-Medical Oncology ( Site 1305)	Izmir
Turkey	Inönü Üniversitesi Turgut Özal Tip Merkezi ( Site 1306)	Malatya
United Kingdom	Addenbrooke's Hospital ( Site 1407)	Cambridge	Cambridgeshire
United Kingdom	Western General Hospital ( Site 1401)	Edinburgh	Midlothian
United Kingdom	Guy's & St Thomas' NHS Foundation Trust ( Site 1404)	London	London, City Of
United Kingdom	ROYAL MARSDEN HOSPITAL (CHELSEA) ( Site 1403)	London	London, City Of
United Kingdom	Royal Marsden Hospital (Sutton) ( Site 1409)	London	Surrey
United Kingdom	UCLH-Cancer Clinical Trials Unit ( Site 1400)	London	Essex
United Kingdom	The Christie-Medical Oncology ( Site 1411)	Manchester
United States	MedStar Good Samaritan Hospital-Oncology Research ( Site 0038)	Baltimore	Maryland
United States	MFSMC-HJWCI-Oncology Research ( Site 0012)	Baltimore	Maryland
United States	St. Vincent Frontier Cancer Center ( Site 0005)	Billings	Montana
United States	University of Chicago Medical Center-Medicine - Section of Hematology/Oncology - Gastrointestinal P	Chicago	Illinois
United States	Henry Ford Hospital ( Site 0024)	Detroit	Michigan
United States	Inova Schar Cancer Institute ( Site 0022)	Fairfax	Virginia
United States	Northwest Georgia Oncology Centers, a Service of Wellstar Cobb Hospital ( Site 0021)	Marietta	Georgia
United States	Pacific Cancer Care ( Site 0031)	Monterey	California
United States	Thomas Jefferson University - Clinical Trials Office ( Site 0027)	Philadelphia	Pennsylvania
United States	Providence Portland Medical Center ( Site 0019)	Portland	Oregon
United States	Blue Ridge Cancer Care ( Site 0036)	Roanoke	Virginia
United States	Northwest Medical Specialties, PLLC ( Site 0033)	Tacoma	Washington

Sponsors (2)

Lead Sponsor	Collaborator
Merck Sharp & Dohme LLC	Eisai Inc.

Countries where clinical trial is conducted

United States,  Argentina,  Australia,  Canada,  China,  Denmark,  Germany,  Israel,  Japan,  Korea, Republic of,  Russian Federation,  Spain,  Taiwan,  Turkey,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall Survival (OS)	OS was defined as the time from randomization to the date of death from any cause.	Up to approximately 22 months
Secondary	Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR)	PFS was defined as the time from date of randomization to the date of the first documentation of progressive disease (PD) or death from any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, PD was defined as =20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of =5 mm. Note: The appearance of one or more new lesions was also considered PD. PFS as assessed by BICR per modified RECIST 1.1 is presented.	Up to approximately 22 months
Secondary	Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by BICR	ORR is defined as the percentage of participants in the analysis population who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ. ORR per modified RECIST 1.1 assessed by BICR is presented.	Up to approximately 22 months
Secondary	Duration of Response (DOR) Per RECIST 1.1 as Assessed by BICR	For participants who demonstrated CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions), DOR is defined as the time from the first documented evidence of CR or PR until PD or death from any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, or death from any cause, PD is defined as =20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of =5 mm. Note: The appearance of one or more new lesions is also considered PD. DOR as assessed by BICR per modified RECIST 1.1 is presented.	Up to approximately 22 months
Secondary	Number of Participants Who Experience an Adverse Event (AE)	An adverse event is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.	Up to approximately 22 months
Secondary	Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE)	An adverse event is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The number of participants who discontinued any study treatment due to an adverse event is presented.	Up to approximately 22 months
Secondary	Change From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score	The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant responses to the questions regarding Global Health Status (GHS; "How would you rate your overall health during the past week?") and Quality of Life (QoL; "How would you rate your overall quality of life during the past week?") are scored on a 7-point scale (1= Very poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The change from baseline in GHS (EORTC QLQ-C30 Item 29) and QoL (EORTC QLQ-C30 Item 30) combined score will be presented. A higher score indicates a better outcome.	Baseline and 8 weeks
Secondary	Change From Baseline in EORTC QLQ-C30 Physical Functioning (Items 1-5) Score	The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant responses to 5 questions about their physical functioning (Items 1-5) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. Higher scores meant a better level of function.	Baseline and 8 weeks
Secondary	Change From Baseline in EORTC QLQ-C30 Appetite Loss (Item 13) Score	The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire, including a single-item scale score for appetite loss (QLQ-C30 Item 13). For this item, individual responses to the question "Have you lacked appetite?" are given on a 4-point scale (1=Not at all; 4=Very much). Scores are transformed to a range from 0-100, with a lower score indicating a better outcome. The change from baseline in the EORTC QLQ-C30 appetite loss (Item 13) scale score is presented.	Baseline and 8 weeks
Secondary	Change From Baseline in EORTC Quality of Life Questionnaire-Colorectal Cancer-Specific 29 Items (QLQ-CR29) Bloating (Item 37) Score	The EORTC QLQ-CR29 is a health-related quality-of life (QoL) questionnaire specific for colorectal cancer, including a single-item scale score for bloating (QLQ-CR29 Item 37). For this item, individual responses to the question "Did you have a bloated feeling in your abdomen?" are given on a 4-point scale (1=Not at all; 4=Very much). Scores are transformed to a range from 0-100, with a lower score indicating a better outcome. The change from baseline in the EORTC QLQ-CR29 bloating (Item 37) scale score is presented.	Baseline and 8 weeks
Secondary	Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score	TTD is defined as the time from baseline to the first onset of a =10-point deterioration (decrease) from baseline in Global Health Status (GHS; EORTC QLQ-C30 Item 29) & Quality of Life (QoL; EORTC QLQ-C30 Item 30) combined score. Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a =10-point negative change (decrease) from baseline in GHS and QoL combined score, is presented. A longer TTD indicates a better outcome.	Up to approximately 21 months
Secondary	TTD in EORTC QLQ-C30 Physical Functioning (Items 1-5) Score	TTD is defined as the time from baseline to the first onset of a =10-point deterioration (decrease) from baseline in physical functioning score (QLQ-C30 Items 1-5). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a =10-point negative change (decrease) from baseline in physical functioning score, is presented. A longer TTD indicates a better outcome.	Up to approximately 21 months
Secondary	TTD in EORTC QLQ-C30 Appetite Loss (Item 13) Score	TTD is defined as the time from baseline to the first onset of a =10-point deterioration (increase) from baseline in appetite loss (QLQ-C30 Item 13) score. Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a =10-point change (increase) from baseline in appetite loss score, is presented. A longer TTD indicates a better outcome.	Up to approximately 21 months
Secondary	TTD in EORTC Quality of Life Questionnaire-Colorectal Cancer-Specific 29 Items (QLQ-CR29) Bloating (Item 37) Score	TTD is defined as the time from baseline to the first onset of a =10-point deterioration (increase) from baseline in bloating (QLQ-CR29 Item 37) score. Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a =10-point change (increase) from baseline in appetite loss score, is presented. A longer TTD indicates a better outcome.	Up to approximately 21 months

External Links

•   Merck Clinical Trials Information