Trial of FOLF(HA)Iri Versus FOLFIRI in mCRC

Metastatic Colorectal Cancer Clinical Trial

— FOLF(HA)iri  

Official title:

Randomized Double-blind Phase III Trial of FOLF(HA)Iri vs FOLFIRI for Second or Third Line Therapy in Irinotecan-naïve Patients With Metastatic Colorectal Cancer

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT01290783
• Other study ID #: ACO-002
• Status: Active, not recruiting
• Phase: Phase 3
• First received: January 31, 2011
• Last updated: April 28, 2015
• Start date: December 2011
• Est. completion date: December 2015

Study information

• Verified date: August 2014
• Source: Alchemia Oncology
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

Trial design:

• Phase III, FOLFIRI versus FOLF(HA)iri (the FOLFIRI regimen with "Hyaluronic acid-Irinotecan" or "HA-Irinotecan") regimen.

• Patients with mCRC (metastatic colorectal cancer), 2nd/3rd line irinotecan naïve.

• Randomized 1:1, double-blinded, multi-centre, multi-national (Australia, Bulgaria, Poland, Serbia, Russia, Ukraine and the United Kingdom).

• Dosing regimen:

• Irinotecan (180 mg/m2) or HA-Irinotecan (180 mg/m2), IV, over 90 minutes, day 1 (in patients > 75 years of age, the irinotecan and HA-Irinotecan dose in must be reduced to 150 mg/m2).

• Leucovorin, 400 mg/m2, or levoleucovorin, 200 mg/m2, IV over 90 minutes with irinotecan.

• 5-fluorouracil (5-FU), 400 mg/m2 IV bolus day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) continuous infusion.

• Repeat every 2 weeks for 8 months.

• Patient accrual over approximately 12-14 months.

• Monitoring to 18 months post-randomization.

• 390 patients.

• Progression Free Survival (PFS) primary endpoint.

• Safety analysis on the initial 20 patients.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 390
• Est. completion date: December 2015
• Est. primary completion date: October 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Metastatic colorectal cancer with disease progression after first or second line chemotherapy

• Irinotecan naïve.

• ECOG performance status of 0 or 1.

• Measurable disease, i.e. at least one measurable metastatic lesion (spiral CT or MRI).

• Histological proof of colorectal cancer.

• 18 years of age and older.

• Adequately recovered from and at least 4 weeks after recent surgery or chemotherapy.

• Women of child-bearing potential (WOCBP) and male partners of WOCBP must agree to use adequate contraception.

• Patient consent obtained and signed according to local and/or national ethics.

• CT or MRI scan of chest/abdomen/pelvis within 21 days prior to randomization.

• Hematology done within 14 days prior to randomization.

• Chemistry done within 14 days prior to randomization.

Exclusion Criteria:

• History of other malignancies, except adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumors curatively treated with no evidence of disease for > 5 years.

• Locally advanced or recurrent disease only.

• Unsuitability for irinotecan including known Gilbert's syndrome, active inflammatory bowel disease or chronic diarrhea greater than or equal to grade 2.

• Abdominal or pelvic radiation therapy within the last 12 months.

• Women who are pregnant or breastfeeding.

• Any condition (e.g., psychological, geographical) that would render the protocol treatment dangerous.

• Significant cardiac disease.

• Untreated or symptomatic brain or central nervous system (CNS).

• Presence of pleural effusion or ascites requiring therapeutic thoracocentesis or paracentesis.

• Current partial or complete bowel obstruction.

• Concomitant active infection.

• Enrolled in any other investigational trial, unless treatment in that trial has been discontinued at least 30 days prior to signing the Informed Consent for the ACO-002 study.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Colorectal Neoplasms
• Metastatic Colorectal Cancer

Intervention

Drug:
• Irintoecan
Irinotecan, 180 mg/m2 IV, over 90 minutes, day 1 (in patients > 75 years of age, the irinotecan dose in must be reduced to 150 mg/m2). Leucovorin, 400 mg/m2, or levoleucovorin, 200 mg/m2, IV over 90 minutes with irinotecan. 5-FU, 400 mg/m2 IV bolus day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) continuous infusion. Repeat every two weeks. 8 months of treatment.
• HA-Irinotecan solution for Infusion
HA-Irinotecan (irinotecan 180 mg/m2), IV, over 90 minutes, day 1 (in patients > 75 years of age, the irinotecan dose in must be reduced to 150 mg/m2). Leucovorin, 400 mg/m2, or levoleucovorin, 200 mg/m2, IV over 90 minutes with irinotecan. 5-FU, 400 mg/m2 IV bolus day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) continuous infusion. Repeat every two weeks 8 months of treatment.

Locations

Country	Name	City	State
Australia	Monash Medical Centre	Melbourne	Victoria
Australia	Royal Melbourne Hospital	Melbourne	Victoria
Australia	Western General Hospital	Melbourne	Victoria
Australia	Border Medical Oncology	Wodonga	Victoria
Australia	Southern Medical Day Care Centre	Wollongong	New South Wales

Sponsors (1)

Lead Sponsor	Collaborator
Alchemia Oncology

Country where clinical trial is conducted

Australia, 

References & Publications (1)

Gibbs P, Clingan PR, Ganju V, Strickland AH, Wong SS, Tebbutt NC, Underhill CR, Fox RM, Clavant SP, Leung J, Pho M, Brown TJ. Hyaluronan-Irinotecan improves progression-free survival in 5-fluorouracil refractory patients with metastatic colorectal cancer: a randomized phase II trial. Cancer Chemother Pharmacol. 2011 Jan;67(1):153-63. doi: 10.1007/s00280-010-1303-3. Epub 2010 Mar 24. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Progression Free Survival (PFS)		Approximately 20 months	No
Secondary	Safety	Diarrhea and haematology	After initial 20 patients receive 2 cycles, then 6 monthly thereafter.	Yes