A Study of Ramucirumab or Icrucumab in Colorectal Cancer

Phase 2

Completed

• Conditions: Colon Cancer; Rectal Cancer
• Interventions: Biological: Icrucumab; Biological: Ramucirumab; Drug: mFOLFOX-6

• Registration Number: NCT01111604
• Lead Sponsor: Eli Lilly and Company

Brief Summary

The purpose of this study is to determine if participants with metastatic colorectal cancer live longer without their cancer progressing when treated with standard chemotherapy, standard chemotherapy plus ramucirumab, or standard chemotherapy plus icrucumab.

Detailed Description

The purpose of this study is to evaluate the progression-free survival (PFS) in participants with metastatic colorectal cancer when treated with 1 of 3 modified FOLFOX-6 (folinic acid \[FA\] + fluorouracil \[5-FU\] + oxaliplatin \[mFOLFOX-6\])-based regimens, as second-line therapy.

During 2010, there has been an identified shortage of injectable folinic acid (FA) in the United States. Levo-folinic acid (LFA) will be allowed as a substitute for FA in the mFOLFOX-6 chemotherapy regimen in circumstances in which FA is not available, to facilitate continuity of participant care.

Study Timeline

• Study First Submitted: 2010-04-08
• Study First Submitted QC: 2010-04-26
• Study First Posted: 2010-04-27
• Study Start: 2010-08
• Disposition First Submitted: 2010-08-30
• Disposition First Submitted QC: 2010-08-30
• Disposition First Posted: 2010-09-01
• Primary Completion: 2013-12
• Study Completion: 2013-12
• Results First Submitted: 2019-06-13
• Status Verified: 2019-07
• Results First Submitted QC: 2019-07-15
• Last Update Submitted: 2019-07-15
• Results First Posted: 2019-08-06
• Last Update Posted: 2019-08-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 158

Inclusion Criteria

• Disease progression on an irinotecan-based first-line chemotherapy regimen (ie FOLFIRI or CAPIRI [capecitabine + irinotecan], with or without bevacizumab)
• Age ≥ 18 years
• Life expectancy of ≥ 6 months
• Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1 at study entry
• Agrees to adequate contraception during the study period and for 12 weeks after the last dose of study medication
• Provided signed informed consent

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Exclusion Criteria

• Has received prior oxaliplatin-based chemotherapy for locally advanced unresectable or metastatic Colorectal Cancer (CRC) (Prior oxaliplatin-based adjuvant chemotherapy is allowed if the last dose of oxaliplatin was administered > 12 months prior to randomization)
• Has documented and/or symptomatic brain or leptomeningeal metastases
• Has an ongoing or active infection, symptomatic or poorly controlled cardiac arrhythmia, psychiatric illness/social situations, or any other serious uncontrolled medical disorders
• On chronic non-topical corticosteroid treatment. A participant discontinuing such treatment > 3 months prior to randomization is eligible
• Has uncontrolled or poorly controlled hypertension on a standard regimen of antihypertensive therapy
• Has a concurrent active malignancy. A participant with previous history of malignancy is eligible, provided that he/she has been disease free for > 3 years
• If female, is pregnant (confirmed by serum beta human chorionic gonadotropin [βHCG] test) or lactating
• Has received a prior autologous or allogeneic organ or tissue transplantation
• Has undergone major surgery within 28 days prior to randomization
• Has had a serious nonhealing wound, ulcer, or bone fracture within 28 days prior to randomization
• Has an elective or planned major surgery to be performed during the course of the trial
• Has a history of inflammatory bowel disease requiring pharmacological and/or surgical intervention in the 12 months prior to randomization

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
mFOLFOX-6 + Icrucumab	mFOLFOX-6	mFOLFOX-6 + Icrucumab
mFOLFOX-6	mFOLFOX-6	mFOLFOX-6
mFOLFOX-6 + Icrucumab	Icrucumab	mFOLFOX-6 + Icrucumab
mFOLFOX-6 + Ramucirumab	Ramucirumab	mFOLFOX-6 + Ramucirumab
mFOLFOX-6 + Ramucirumab	mFOLFOX-6	mFOLFOX-6 + Ramucirumab

Primary Outcome Measures

Name	Time	Method
Progression-Free Survival (PFS)	Baseline until Disease Progression or Death from Any Cause (Up to 95 Weeks)	PFS is defined as the time from baseline until the date of disease progression as defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1), or death from any cause, whichever was first. Participants who die without a reported prior progression will be considered to have progressed on the day of their death. Participants who did not progress, are lost to follow-up, or have missed two or more scheduled tumor assessments will be censored at the day of their last radiographic tumor assessment, if there are no post-baseline tumor measurements for a randomized and treated participant, the participant will be censored at the date of randomization. If death or progressive disease (PD) occurs after 2 or more missing radiographic visits, censoring will occur at the date of the last radiographic visit prior to the last visit.

Secondary Outcome Measures

Name	Time	Method
Minimum Concentration (Cmin) at Day 4	Day 4 (cycles 1 and 5)	Cmin is the minimum peak concentration measured in blood plasma after drug infusion.
Minimum Concentration (Cmin) at Day 8	Day 8 (cycles 1 and 5)	Minimum concentration (Cmin) is the minimum peak concentration measured in blood plasma after drug infusion.
Pharmacokinetics (PK): Maximum Concentration (Cmax) at Cycle 5	Cycle 5, 1 Hour Post End of Infusion	Maximum concentration (1 hour post end of infusion, Cmax) is the concentration measured in serum.
Pharmacokinetics (PK): Trough Serum Concentrations (Ctrough) at Cycle 5	Cycle 5, Prior to Infusion	Trough (prior to infusion, Ctrough) concentrations measured in serum.
Maximum Concentration (Cmax) at Day 8	Day 8 (cycles 1 and 5)	Maximum concentration (Cmax) is the maximum peak concentration measured in blood plasma after drug infusion.
Percentage of Participants Achieving Complete Response (CR) or Partial Response (PR) (Objective Response Rate [ORR])	Baseline until Disease Progression (Up to 95 Weeks)	The ORR is the percentage of participants with Complete Response (CR, the disappearance of target lesions and any pathological lymph nodes \[target or non-target\] taking as reference the baseline sum of diameters in response to treatment) or Partial Response (PR, at least a 30% decrease in the sum of diameter of target lesions, taking as reference the baseline sum diameters in response to treatment) according to RECIST v1.1 from the start of the treatment until disease progression.
Duration of Response (DoR)	Criteria First Met for CR or PR until Disease Progression or Death from Any Cause (Up to 95 Weeks)	DoR was measured from the time measurement criteria are first met for Complete Response or Partial Response or until the first date that the criteria for disease progression or death from any cause. whichever is first recorded. As defined according to RECIST v1.1, CR is the disappearance of all non-nodal target lesions, and PR is the short axes of any target lymph nodes reduced to \< 10 mm and at least a 30% decrease in the sum of the diameters of target lesions including the short axes of any target lymph nodes.)
Overall Survival (OS)	Baseline Until Death from Any Cause (Up to 163 Weeks)	Overall survival is defined as the time from baseline to the date of death from any cause. If the participant is alive at the end of the follow-up period or is lost to follow-up, OS will be censored on the last date the participant is known to be alive.
Maximum Concentration (Cmax) at Day 15	Day 15 (Cycles 1 and 5)	Cmax is the maximum peak concentration measured in blood plasma after drug infusion.
Minimum Concentration (Cmin) at Day 1	Day 1 (cycles 1, 5, 9, and 13)	Cmin is the minimum peak concentration measured in blood plasma after drug infusion.
Number of Participants With Serum Ramucirumab Antibody Assessment	31 Weeks	A sample will be considered positive for anti-Ramucirumab antibodies if it exhibits a post-baseline antibody level exceeding the normal anti-Ramucirumab antibody level seen in healthy untreated individuals.
Minimum Concentration (Cmin) at Day 15	Day 15 (cycles 1 and 5)	Minimum concentration (Cmin) is the minimum peak concentration measured in blood plasma after drug infusion.
Serum Anti-Icrucumab Antibody Assessment	31 Weeks	A sample will be considered positive for anti-icrucumab antibodies if it exhibits a post-baseline antibody level exceeding the normal anti-icrucumab antibody level seen in healthy untreated individuals.
Number of Participants With Adverse Events	Baseline up to 165 weeks	A summary of serious AEs (SAEs) and all other non-serious AEs regardless of causality, is located in the Reported Adverse Events module.

Trial Locations

Locations (1)

ImClone Investigational Site; 🇨🇦 Montreal, Quebec, Canada