Description:
Drugs used against cancer work in different ways to stop the growth of tumor cells, either by
killing the cells or by stopping them from dividing. Monoclonal antibodies, such as CMAB009,
can block tumor growth in different ways. Giving combination chemotherapy together with
CMAB009 as first treatment after diagnosis of a metastatic colorectal cancer(first-line
treatment)may improve the treatment efficacy. However, it is not yet known whether giving
combination chemotherapy together with CMAB009 is more effective than combination
chemotherapy alone. This open-label trial investigates the effectiveness of CMAB009 in
combination with a standard and effective chemotherapy FOLFIRI(5-Fluorouracil /Folinic acid
plus Irinotecan)for RAS/BRAF wild-type, metastatic colorectal cancer in first-line setting,
compared to the same chemotherapy alone.
Title
- Brief Title: CMAB009 Combined With FOLFIRI First-line Treatment in Patients With RAS/BRAF Wild-type, Metastatic Colorectal Cancer
- Official Title: Open, Randomized, Controlled, Multicenter Phase III Study Comparing CMAB009 Plus FOLFIRI Versus FOLFIRI Alone as First-line Treatment for Epidermal Growth Factor Receptor-expressing, RAS/BRAF Wild-type, Metastatic Colorectal Cancer
Clinical Trial IDs
- ORG STUDY ID:
009mCRCIIIP
- NCT ID:
NCT03206151
Conditions
- Metastatic Colorectal Cancer
Interventions
Drug | Synonyms | Arms |
---|
CMAB009 | Eribitux | CMAB009 + FOLFIRI |
Irinotecan | Camptosar | CMAB009 + FOLFIRI |
Folinic acid | leucovorin | CMAB009 + FOLFIRI |
5-fluorouracil | Fluoroplex | CMAB009 + FOLFIRI |
Purpose
Drugs used against cancer work in different ways to stop the growth of tumor cells, either by
killing the cells or by stopping them from dividing. Monoclonal antibodies, such as CMAB009,
can block tumor growth in different ways. Giving combination chemotherapy together with
CMAB009 as first treatment after diagnosis of a metastatic colorectal cancer(first-line
treatment)may improve the treatment efficacy. However, it is not yet known whether giving
combination chemotherapy together with CMAB009 is more effective than combination
chemotherapy alone. This open-label trial investigates the effectiveness of CMAB009 in
combination with a standard and effective chemotherapy FOLFIRI(5-Fluorouracil /Folinic acid
plus Irinotecan)for RAS/BRAF wild-type, metastatic colorectal cancer in first-line setting,
compared to the same chemotherapy alone.
Detailed Description
Patients will be randomly assign in one of the two groups to either receive the combination
chemotherapy alone or with CMAB009 and will then be treated until progression of the disease
or unacceptable toxicity occurred. Regular efficacy assessments(every 8 weeks)based on
imaging will be performed throughout the study together with regular safety assessments.
After participant discontinuation from the trial, regular updates on further treatments and
survival status will be requested from the investigator.
Trial Arms
Name | Type | Description | Interventions |
---|
CMAB009 + FOLFIRI | Experimental | Drug: CMAB009(recombinant chimeric anti-EGFR monoclonal antibody injection), will be administered every 7 days at an initial dose of 400mg/m^2 and 250mg/m^2 for subsequent infusions until progression of disease , withdrawal of consent, or unacceptable toxicity.
Drug: Irinotecan bi-weekly irinotecan infusion of 180mg/m^2 on Day 1. Drug: Folinic Acid infusion 400mg/m^2 of folinic acid in on Day 1. Drug: 5-Fluorouracil bolus 5-Fluorouracil bolus of 400mg/m^2 followed by a 46-48 h continuous infusion of 2400mg/m^2.
every 2 weeks until progression of disease , withdrawal of consent, or unacceptable toxicity. | - CMAB009
- Irinotecan
- Folinic acid
- 5-fluorouracil
|
FOLFIRI | Active Comparator | FOLFIRI Drug: Irinotecan bi-weekly irinotecan infusion of 180mg/m^2 on Day 1. Drug: Folinic Acid infusion 400mg/m^2 of folinic acid in on Day 1. Drug: 5-Fluorouracil bolus 5-Fluorouracil bolus of 400mg/m^2 followed by a 46-48 h continuous infusion of 2400mg/m^2.
every 2 weeks until progression of disease , withdrawal of consent, or unacceptable toxicity. | - Irinotecan
- Folinic acid
- 5-fluorouracil
|
Eligibility Criteria
Inclusion Criteria:
1. Males or females, Aged ≥18 years and ≤75 years
2. Diagnosis of histologically confirmed adenocarcinoma of the colon or rectum
3. First occurrence of metastatic disease(not curatively resected)
4. RAS/BRAF wild-type status in tumor tissue
5. At least one measurable lesion by computer tomography(CT) or magnetic resonance
imaging (MRI)according to RECIST1.1 criteria (not in an irradiated area)
6. Eastern Cooperative Oncology Group(ECOG)performance status of 0 or 1 at trial entry
7. Life expectancy of at least 3 months
8. Medically accepted effective contraception if procreative potential exists(applicable
for both male and female subjects until at least 90 days after the last dose of trial
treatment)
9. Recovery from relevant toxicity due to previous treatment before trial entry
10. Signed the informed consent form voluntarily
Exclusion Criteria:
1. Radiotherapy or surgery(excluding prior diagnostic biopsy)in the 30 days before trial
treatment
2. Hepatic, marrow, liver and renal function as follows:
Marrow: white blood cell count <3.0 × 109/L with neutrophils<1.5 × 109/L, platelet
count<100×109/L and hemoglobin<90 g/L; Liver function: Total bilirubin >1.5 × upper
limit of reference range; Aspartate transaminase (AST) and alanine transaminase (ALT)
> 2.5 × upper limit of reference range , or> 5 × upper reference range in subjects
with liver metastasis; Renal function: Serum creatinine >1.5 × upper limit of
reference range, or creatinine clearance<50 mL/min
3. Previous chemotherapy for CRC adjuvant treatment if terminated <12 months before
diagnosis of recurrence or metastatic disease
4. Previous treatment with anti-EGFR monoclonal antibody, epidermal growth factor
receptor tyrosine kinase inhibitor, or other EGFR targeted inhibitors(such as
cetuximab, Nimotuzumab, or panitumumab)
5. Known hypersensitivity or allergic reactions against any of the components of the
trial treatments
6. History of organ allograft, autologous stem cell transplantation, or allogeneic stem
cell transplantation
7. Other non-permitted concomitant anti-cancer therapies
8. Known brain metastasis and/or leptomeningeal disease
9. Previous malignancy other than CRC in the last 5 years except basal cell cancer of the
skin or preinvasive cancer of the cervix
10. Participation in another clinical trial within the past 30 days
11. Concurrent chronic systemic immune therapy or hormone therapy except physiologic
replacement
12. Any unstable systemic disease, such as active infection, uncontrolled hypertension,
unstable angina pectoris, angina in the last 3 months, cardiac failure of New York
Heart Association classes ≥II, history of myocardial infarction, serious cardiac
arrhythmias that require drug treatment, liver, kidney or metabolic disease in the
last 6 months
13. Acute or sub-acute intestinal occlusion or history of inflammatory bowel disease
14. severe bone marrow function failure
15. Any disease, metabolic disorders, or physical/laboratory examination suspected, or
patients with high risk of complications
16. Known and declared history of human immunodeficiency virus(HIV)infection
17. HBV-DNA >1.0 × 103copy
18. Pregnancy or breastfeeding
19. Alcohol or drug abuse
20. Legal incapacity or limited legal capacity
Maximum Eligible Age: | 75 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Progression-free Survival (PFS) |
Time Frame: | Baseline up to 24 months |
Safety Issue: | |
Description: | Defined as the duration from randomization until the date of first documented progression or date of death from any cause when death occurred within 90 days of randomization or the last tumor assessment, whichever was later. Progressive disease assessed by RECIST1.1 |
Secondary Outcome Measures
Measure: | Best Overall Response Rate(ORR) |
Time Frame: | Baseline up to 24 months |
Safety Issue: | |
Description: | Defined as the percentage of subjects having achieved confirmed Complete Response + Partial Response as the best overall response based on RECIST1.1 |
Measure: | Overall Survival Time (OS) |
Time Frame: | Baseline up to 48 months |
Safety Issue: | |
Description: | Defined as the time from randomization to death |
Measure: | Duration of Response |
Time Frame: | Baseline up to 24 months |
Safety Issue: | |
Description: | Defined as the time from first assessment of CR or PR to disease progression or death |
Measure: | Number of Subjects with Curative Surgery of Liver Metastases |
Time Frame: | Baseline up to 12 months |
Safety Issue: | |
Description: | Defined as the number of subjects who underwent liver metastatic surgery with all lesions been resected completely after start of treatment |
Measure: | Quality of Life Assessment |
Time Frame: | Baseline up to 24 months |
Safety Issue: | |
Description: | EORTC-QLQ-C30 |
Measure: | Pharmacokinetic Parameters |
Time Frame: | Baseline up to 50 days |
Safety Issue: | |
Description: | Area under the curve and the Maximum concentration of CMAB009 |
Measure: | Incidence of anti-CMAB009 antibody |
Time Frame: | baseline up to 32 weeks |
Safety Issue: | |
Description: | The incidence rate of ADA (anti-CMAB009 antibody)and Nab(neutralizing antibody) |
Details
Phase: | Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Taizhou Mabtech Pharmaceutical Co.,Ltd |
Last Updated
October 14, 2020