Metastatic Colorectal Cancer Clinical Trial
Official title:
A Open Label, Non Randomized, Phase Two Trial in Metastatic Colorectal Cancer (mCRC) With the Combination of m FOLFIRI Plus Aflibercept as First Line Treatment: MINOAS Trial
Investigators propose to study the combination of m FOLFIRI plus Aflibercept in a Phase II trial of patients with metastatic colorectal cancer. The promising results of aflibercept derived from preclinical studies and from clinical trials conducted in patients with refractory of recurrent to oxaliplatin-based 1st line treatment in patients with mCRC open the field to explore such therapeutic approaches in the 1st line setting in combination with the FOLFIRI regimen.
Colorectal cancer accounts for 8% of all malignant tumors in adults and is considered as a
major cause of cancer morbidity and mortality worldwide. Although curative surgical resection
is possible in 70-80% of patients at diagnosis, almost half of them will develop local or/and
metastatic recurrence and will die of the disease with the liver been the most common site of
metastatic spread from CRC.
Combinations of infusional administrated 5-fluorouracil/Leucovorin with irinotecan or
oxaliplatin are accepted as the mainstay of first-line treatment and have increase the median
overall survival of patients with advanced CRC from 12 months to about 21-22 months. In
addition, resection for colorectal metastases (mainly in the liver), has become the standard
of care, for patients with limited metastatic disease confounded to the liver and currently
remains the only potentially curative therapy Aflibercept, also known as vascular endothelial
growth factor (VEGF) Trap, is an angiogenesis inhibitor with a unique mechanism of action.
Aflibercept is a recombinant fusion protein that consists of portions of human VEGFR1 and
VEGFR2 extracellular domains fused to the Fc portion of human immunoglobulin G1. This fusion
protein binds all forms of Vascular Endothelial Growth Factor-A, as well as VEGF-B and
placental growth factor, additional angiogenic growth factors that appear to play a role in
tumor angiogenesis and inflammation. Aflibercept has been shown to bind VEGF-A, VEGF-B, and
placental growth factor (PlGF) with higher affinity than their native receptors. In vitro and
in vivo studies have shown that aflibercept can inhibit new vessel growth and tumor
vascularization in tumor models.
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