Clinical Trials /

Phase 2a Study of BAX69 and 5-FU/Leucovorin or Panitumumab Versus Standard of Care in Subjects With Metastatic Colorectal Cancer

NCT02448810

Description:

The purpose of this study is to evaluate the safety and tolerability of BAX69 in combination with 5-fluorouracil (5-FU)/leucovorin (LV) or panitumumab to determine the recommended phase II dose (RP2D) of each combination; and to compare the efficacy between BAX69 in combination with 5-FU/LV for subjects with KRAS or NRAS mutated tumor (mt) or panitumumab, for subjects with KRAS and NRAS wild type tumor (wt) and standard of care (SoC) per investigator choice as third or fourth treatment line in subjects with progressive measurable metastatic colorectal cancer (mCRC).

Related Conditions:
  • Colorectal Carcinoma
Recruiting Status:

Terminated

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Phase 2a Study of BAX69 and 5-FU/Leucovorin or Panitumumab Versus Standard of Care in Subjects With Metastatic Colorectal Cancer
  • Official Title: A Phase 2a Randomized, Open-label Study to Assess the Safety, Tolerability, and Efficacy of BAX69 in Combination With 5-FU/Leucovorin or Panitumumab Versus Standard of Care in Subjects With Metastatic Colorectal Cancer

Clinical Trial IDs

  • ORG STUDY ID: 391401
  • SECONDARY ID: 2015-000896-28
  • NCT ID: NCT02448810

Conditions

  • Metastatic Colorectal Cancer

Interventions

DrugSynonymsArms
BAX69 + infusional 5-FU/LVMacrophage Migration Inhibitory Factor Antibody (Anti-MIF), ImalumabPart 1: Subjects with mutated tumor (mt) (KRAS or NRAS)
BAX69 + panitumumabImalumab, Anti-MIFPart 1: Subjects with wild-type (wt) tumor (KRAS and NRAS wt)
BAX69 + 5-FU/LVImalumab, Anti-MIFPart 2: Subjects with KRAS or NRAS mutated
BAX69 + panitumumabImalumab, Anti-MIFPart 2: Subjects with KRAS and NRAS wt tumor
Standard of CarePart 2: Standard of Care- Subjects with KRAS or NRAS mutated
Standard of CarePart 2: Standard of Care- Subjects with KRAS and NRAS wt tumor

Purpose

The purpose of this study is to evaluate the safety and tolerability of BAX69 in combination with 5-fluorouracil (5-FU)/leucovorin (LV) or panitumumab to determine the recommended phase II dose (RP2D) of each combination; and to compare the efficacy between BAX69 in combination with 5-FU/LV for subjects with KRAS or NRAS mutated tumor (mt) or panitumumab, for subjects with KRAS and NRAS wild type tumor (wt) and standard of care (SoC) per investigator choice as third or fourth treatment line in subjects with progressive measurable metastatic colorectal cancer (mCRC).

Trial Arms

NameTypeDescriptionInterventions
Part 1: Subjects with mutated tumor (mt) (KRAS or NRAS)ExperimentalSubjects stratified according to their mutation status.
  • BAX69 + infusional 5-FU/LV
Part 1: Subjects with wild-type (wt) tumor (KRAS and NRAS wt)ExperimentalSubjects stratified according to their mutation status.
  • BAX69 + panitumumab
Part 2: Subjects with KRAS or NRAS mutatedExperimentalSubjects stratified according to their mutation status.
  • BAX69 + 5-FU/LV
Part 2: Subjects with KRAS and NRAS wt tumorExperimentalSubjects stratified according to their mutation status.
  • BAX69 + panitumumab
Part 2: Standard of Care- Subjects with KRAS or NRAS mutatedActive ComparatorSubjects stratified according to their mutation status.
  • Standard of Care
Part 2: Standard of Care- Subjects with KRAS and NRAS wt tumorActive ComparatorSubjects stratified according to their mutation status.Subjects stratified according to their mutation status.
  • Standard of Care

Eligibility Criteria

        Inclusion Criteria:

          1. Provision of a signed informed consent

          2. Male and female subjects 18 years of age and older at the time of screening

          3. Subjects who progressed after receiving at least 2, but no more than 3, prior SoC
             treatment lines

          4. Anticipated life expectancy >3 months at the time of screening

          5. Weight between 40 kg and 180 kg

          6. Histologically or cytologically confirmed diagnosis of CRC

          7. Metastatic CRC not amenable to surgical resection

          8. Known KRAS and NRAS mutation status (if unknown status for either of these genes, and
             no archival tissues is available, a fresh tumor biopsy will be made)

          9. At least 1 measurable lesion as defined by RECIST v1.1

         10. ECOG PS of 0-2

         11. Adequate hematological function, defined as:

               1. Platelet count ≥ 100,000/μL

               2. Prothrombin time and activated partial thromboplastin time (aPTT) < 1.5 times the
                  upper limit of normal (ULN)

               3. Absolute neutrophil count (ANC) ≥ 1,000/μL

               4. Hemoglobin ≥ 9 g/dL, without the need for transfusion in the 2 weeks prior to
                  screening

         12. Adequate renal function, defined as serum creatinine ≤ 2.0 times ULN and creatinine
             clearance > 50 mL/min

         13. Adequate liver function, defined as:

               1. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

                  ≤ 2.5 times ULN for subjects without liver metastases, or ≤ 5 times ULN in the
                  presence of liver metastases

               2. Bilirubin ≤ 2.0 times ULN, unless subject has known Gilbert's syndrome

         14. Adequate venous access

         15. For female subjects of childbearing potential, the subject presents with a negative
             serum pregnancy test at screening and agrees to employ 2 forms of adequate birth
             control measures, including at least 1 barrier method (eg, diaphragm with spermicidal
             jelly or foam, or [for male partner] condom) throughout the course of the study and
             for at least 90 days after the last administration of BAX69. Other acceptable
             contraceptive measures include birth control pills/patches or intrauterine devices

         16. For male subjects, the subject must agree to use adequate contraceptive measures
             including at least 1 barrier method (eg, condom with spermicidal jelly or foam and
             [for the female partner] diaphragm with spermicidal jelly or foam, birth control
             pills/patches, or intrauterine device) and abstain from sperm donation throughout the
             course of the study and for at least 90 days after the last administration of BAX69

         17. Subject is willing and able to comply with the requirements of the protocol.

        Exclusion Criteria:

          1. Known central nervous system metastases

          2. Prior malignancy(s) within the past 3 years, with the exception of curatively treated
             basal or squamous cell carcinoma of the skin, locally advanced prostate cancer, ductal
             carcinoma in situ of breast, in situ cervical carcinoma and superficial bladder cancer

          3. Prior treatment with panitumumab for subjects with KRAS and NRAS wt tumor

          4. Residual AE from previous treatment > Grade 1

          5. Prior intolerance to fluoropyrimidine for subjects with KRAS or NRAS mut tumor

          6. Myocardial infarction within 6 months prior to C1D1, and/or prior diagnoses of
             congestive heart failure (New York Heart Association Class III or IV), unstable
             angina, unstable cardiac arrhythmia requiring medication; and/or the subject is at
             risk for polymorphic ventricular tachycardia (eg, hypokalemia, family history or long
             QT syndrome)

          7. Uncontrolled hypertension defined as systolic blood pressure ≥ 160 mmHg and/or
             diastolic blood pressure ≥ 100 mmHg confirmed upon repeated measures

          8. LVEF < 40% as determined by echocardiogram performed at screening or within 90 days
             prior to C1D1

          9. QT/QTc interval > 450 msec, as determined by screening ECG performed no earlier than 1
             week before C1D1

         10. Prior anti-tumor therapy (chemotherapy, radiotherapy, antibody therapy, molecular
             targeted therapy, retinoid therapy or hormonal therapy) within 4 weeks prior to C1D1.

         11. Major surgery within 4 weeks prior to C1D1

         12. Active joint inflammation or history of inflammatory arthritis or other immune
             disorder involving joints

         13. Active infection involving IV antibiotics within 2 weeks prior to C1D1

         14. Known history of, or active hepatitis B virus (HBV), hepatitis C virus (HCV) or active
             tuberculosis

         15. Known history of human immunodeficiency virus (HIV) type 1/2 or other immunodeficiency
             disease

         16. Subject has received a live vaccine within 4 weeks prior to C1D1

         17. Known hypersensitivity to any component of recombinant protein production by CHO cells

         18. Exposure to an investigational product or investigational device in another clinical
             study within 4 weeks prior to C1D1, or is scheduled to participate in another clinical
             study involving an investigational product or device during the course of this study

         19. Subject is nursing or intends to begin nursing during the course of the study

         20. Any disorder or disease, or clinically significant abnormality on laboratory or other
             clinical test(s) (eg, blood tests, ECG), that in medical judgment of the investigator
             may impede the subject's participation in the study, pose increased risk to the
             subject, and/or confound the results of the study

         21. Subject is a family member or employee of the investigator
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Part 2: Progression-Free Survival (PFS)
Time Frame:From start of the study up to safety follow-up visit occurred (30 [-/+7]) days after the last dose of study treatment or until disease progression
Safety Issue:
Description:PFS was defined as time between treatment initiation and tumor progression (per Response Evaluation Criteria in Solid Tumors [RECIST] v1.1 criteria) or death from any cause, with censoring of participants who were lost to follow-up or withdrew consent.

Secondary Outcome Measures

Measure:Number of Participants With Occurrence of Binding and/or Neutralizing Anti-imalumab Antibodies
Time Frame:From start of study drug administration up to end of treatment (EOT) (approximately 21 Months)
Safety Issue:
Description:Number of participants with occurrence of binding and/or neutralizing anti-imalumab antibodies were reported.
Measure:Number of Participants With Incidence of Infusion Reactions After Imalumab Administration
Time Frame:From start of study drug administration up to EOT (approximately 21 Months)
Safety Issue:
Description:Infusion reaction was defined as any relevant sign or symptom occurring during or after imalumab infusion and considered by the investigator as an infusion reaction.
Measure:Number of Participants With Serious Adverse Events (SAEs) and Treatment-emergent Adverse Events (TEAEs)
Time Frame:From start of study drug administration up to EOT (approximately 21 Months)
Safety Issue:
Description:An adverse event (AE) was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. SAE was any AE that results in any of the following outcomes: death, a life-threatening event, inpatient hospitalization or prolongation of an existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, a congenital anomaly/birth defect, other medically important events based upon appropriate medical judgement. TEAEs was defined as any event not present prior to the initiation of the treatments or any event already present that worsens in either intensity or frequency following exposure to the treatments.
Measure:Number of Participants With Response Evaluation According to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
Time Frame:Day 28 of Cycle 2 followed by every 2 Cycles of 28 day Cycles: Day 56, Day 112, Day 168 and Day 224
Safety Issue:
Description:Number of participants with response evaluation according to RECIST v1.1 was evaluated according to complete response (CR): disappearance of all target and non-target lesions and no new lesions; partial response (PR): >= 30 percent (%) decrease in the sum of diameters of target lesions (compared to baseline) and no new lesions; stable disease (SD): neither sufficient shrinkage to qualify as a response nor sufficient growth to qualify as progression; progressive disease (PD): >= 20% increase in the sum of diameters of target lesions and an absolute increase in sum of diameters of >=5 millimeter (mm) (compared to the previous minimum sum) or progression of a new lesion.
Measure:Overall Survival
Time Frame:From start of study drug administration up to EOT (approximately 21 Months)
Safety Issue:
Description:Overall survival was defined as the time from randomization until death due to any cause. Here, number of participants analyzed was based on the number of participants who underwent death.
Measure:Change From Baseline for Quality of Life (QoL) Measure - European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)
Time Frame:Baseline, 21 Months (EOT) up to follow-up
Safety Issue:
Description:EORTC QLQ-C30 was a validated instrument used to measure QoL and assess symptoms and side effects of treatment and the impact on everyday life.The QLQ-C30 was composed of: A) 5 multi-item functioning scales(physical, role, social, emotional and cognitive), that were answered on a 4-point scale (1=Not at all,2=A Little,3=Quite a Bit,4=Very Much). Each score range from 0 to 100 with a higher score representing a higher level of functioning and a better QoL. B) A global health status/QoL scale that was answered on a 7-point scale (1=Very Poor to 7=Excellent). Each score range from 0 to 100 with a higher score representing a better QoL. C) 9 symptom scales(fatigue, nausea/vomiting,pain,financial impact/difficulties,appetite loss,diarrhea, constipation,sleep disturbance/insomnia and dyspnea), that were answered on a 4-point scale (1=Not at all,2=A Little,3=Quite a Bit,4=Very Much). Each score range from 0 to 100 with a higher score representing a greater degree of symptoms and a worse QoL.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Terminated
Lead Sponsor:Baxalta now part of Shire

Last Updated

May 25, 2021