A Study of Amivantamab and mFOLFOX6 or FOLFIRI Versus Cetuximab and mFOLFOX6 or FOLFIRI as First-line Treatment in Participants With KRAS/NRAS and BRAF Wild-type Unresectable or Metastatic Left-sided Colorectal Cancer

Registration Number
NCT06662786
Lead Sponsor
Janssen Research & Development, LLC
Brief Summary

The purpose of this study is to compare how long the participants are disease-free (progression-free survival) when treated with amivantamab and chemotherapy with 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, oxaliplatin (mFOLFOX6) or 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and irinotecan hydrochloride (FOL...

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1000
Inclusion Criteria
  • Have histologically or cytologically confirmed adenocarcinoma of the left-sided colorectal cancer. Participants must have unresectable or metastatic disease
  • Be diagnosed to have Kirsten rat sarcoma viral oncogene (KRAS), neuroblastoma RAS viral oncogene homolog (NRAS), and v-raf murine sarcoma viral oncogene homolog B (BRAF) wild-type (WT) tumor as determined by local testing
  • Must agree to the submission of fresh tumor tissue
  • Have measurable disease according to RECIST v1.1
  • Have an eastern cooperative oncology group (ECOG) performance status (PS) of 0 or 1
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Exclusion Criteria
  • Has medical history of (noninfectious) interstitial lung disease (ILD) /pneumonitis/pulmonary fibrosis or has current ILD/pneumonitis/pulmonary fibrosis, or where suspected ILD/pneumonitis/pulmonary fibrosis cannot be ruled out by imaging at screening
  • Has known allergies, hypersensitivity, or intolerance to excipients of any of the following: (a) amivantamab or cetuximab, (b) any component of mFOLFOX6 and, (c) any component of FOLFIRI
  • Has a prior or concurrent second malignancy other than the disease under study or one whose natural history or treatment is unlikely to interfere with any study endpoints of safety or the efficacy of the study treatment(s)
  • Participant with known mismatch repair deficiency (dMMR)/ high microsatellite instability (MSI-H) status and human epidermal growth factor receptor 2 (HER2)-positive/amplified tumor
  • Has prior exposure to any agents that target epidermal growth factor receptor (EGFR) or mesenchymal epithelial transition (MET)
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm A: Amivantamab in Combination With ChemotherapyAmivantamabParticipants will receive amivantamab in combination with chemotherapy (mFOLFOX6 \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and oxaliplatin\] or FOLFIRI \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and irinotecan hydrochloride\]) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm A: Amivantamab in Combination With Chemotherapy5-fluorouracilParticipants will receive amivantamab in combination with chemotherapy (mFOLFOX6 \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and oxaliplatin\] or FOLFIRI \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and irinotecan hydrochloride\]) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm A: Amivantamab in Combination With ChemotherapyLeucovorin calcium/LevoleucovorinParticipants will receive amivantamab in combination with chemotherapy (mFOLFOX6 \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and oxaliplatin\] or FOLFIRI \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and irinotecan hydrochloride\]) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm A: Amivantamab in Combination With ChemotherapyOxaliplatinParticipants will receive amivantamab in combination with chemotherapy (mFOLFOX6 \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and oxaliplatin\] or FOLFIRI \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and irinotecan hydrochloride\]) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm A: Amivantamab in Combination With ChemotherapyIrinotecan HydrochlorideParticipants will receive amivantamab in combination with chemotherapy (mFOLFOX6 \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and oxaliplatin\] or FOLFIRI \[chemotherapy consisting of 5-fluorouracil, leucovorin calcium (folinic acid) or levoleucovorin, and irinotecan hydrochloride\]) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm B: Cetuximab in Combination With ChemotherapyCetuximabParticipants will receive cetuximab in combination with chemotherapy (mFOLFOX6 or FOLFIRI) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm B: Cetuximab in Combination With Chemotherapy5-fluorouracilParticipants will receive cetuximab in combination with chemotherapy (mFOLFOX6 or FOLFIRI) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm B: Cetuximab in Combination With ChemotherapyLeucovorin calcium/LevoleucovorinParticipants will receive cetuximab in combination with chemotherapy (mFOLFOX6 or FOLFIRI) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm B: Cetuximab in Combination With ChemotherapyOxaliplatinParticipants will receive cetuximab in combination with chemotherapy (mFOLFOX6 or FOLFIRI) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Arm B: Cetuximab in Combination With ChemotherapyIrinotecan HydrochlorideParticipants will receive cetuximab in combination with chemotherapy (mFOLFOX6 or FOLFIRI) for 28-days treatment cycles and will continue to receive the treatment until radiographic disease progression or other discontinuation criteria are met.
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) as Assessed by Blinded Independent Central Review (BICR)Up to 4 years and 2 months

PFS is defined as the time from randomization until the date of objective disease progression or death (due to any cause), whichever comes first, as assessed by BICR using response evaluation criteria in solid tumors (RECIST) version (v) 1.1. Participants who have not progressed or have not died at the time of analysis will be censored at their last evaluabl...

Secondary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS) as Assessed by InvestigatorUp to 7 Years 3 Months

PFS is defined as the time from randomization until the date of objective disease progression or death (due to any cause), whichever comes first, as assessed by the investigator.

Objective Response Rate (ORR) as Assessed by InvestigatorUp to 7 Years 3 Months

ORR is defined as the percentage of randomized participants achieving complete CR or PR, as assessed by the investigator.

Overall Survival (OS)Up to 7 Years 3 Months

OS is defined as the time from the date of randomization to the date of participant's death due to any cause. Any participant not known to have died at the time of analysis will be censored based on the last recorded date on which the participant was known to be alive.

Objective Response Rate (ORR) as Assessed by BICRUp to 7 Years 3 Months

ORR is defined as the percentage of randomized participants achieving complete response (CR) or partial response (PR), as determined by BICR using RECIST v1.1 criteria.

Duration of Response (DOR) as Assessed by BICRUp to 7 Years 3 Months

DOR is defined as time from the date of first documented response (CR or PR) until the date of documented progression or death, whichever comes first, for participants who have PR or CR, as assessed by BICR using RECIST v1.1 criteria.

Duration of Response (DOR) as Assessed InvestigatorUp to 7 Years 3 Months

DOR is defined as time from the date of first documented response (CR or PR) until the date of documented progression or death, whichever comes first, for participants who have PR or CR, as assessed by the investigator.

Progression-free Survival After Subsequent Therapy (PFS2)Up to 7 Years 3 Months

PFS2 is defined as the time from randomization until the date of second objective disease progression, after initiation of subsequent anticancer therapy, based on investigator assessment (after that used for PFS) or death, whichever comes first.

Disease Control Rate (DCR) as Assessed by BICRUp to 7 Years 3 Months

DCR is defined as the percentage of randomized participants achieving CR, PR, or stable disease (with minimum duration of 7 weeks) as assessed by BICR using RECIST v1.1 criteria.

Disease Control Rate (DCR) as Assessed by InvestigatorUp to 7 Years 3 Months

DCR is defined as the percentage of randomized participants achieving CR, PR, or stable disease (with minimum duration of 7 weeks) as assessed by the investigator.

Time to Treatment FailureUp to 7 Years 3 Months

Time to treatment failure is defined as time from randomization to discontinuation of therapy for any reason including death, progression, toxicity, or initiation of new anticancer therapy.

Curative Resection (R0) RateUp to 7 Years 3 Months

Curative resection (R0) rate is defined as the percentage of participants (or participants with limited disease at baseline) who underwent curative surgery.

Number of Participants with Adverse Events (AEs) by SeverityUp to 7 Years 3 Months

An AE can be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non-investigational) product, whether or not related to that medicinal (investigational or non-investigational) product. AE severity will be graded according to the national cancer institu...

Number of Participants with Abnormalities in Laboratory ValuesUp to 7 Years 3 Months

Participants with abnormalities in laboratory values (such as serum chemistry, hematology) will be reported.

Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) ScoreFrom Baseline up to 7 Years 3 Months

The EORTC QLQ-C30, is a self-administered, 30-item questionnaire measuring the health-related quality of life (HRQoL) of participants with cancer. EORTC QLQ-C30 includes 5 functional scales, 3 symptom scales, a global health status / quality of life scale, and 6 single items. Responses to items 1-28 are rated on a 4-point Likert response scale ranging from 1...

Time to Worsening in Symptoms and Functioning as Measured by EORTC QLQ-C30Up to 7 Years 3 Months

The EORTC QLQ-C30, is a self-administered, 30-item questionnaire measuring the HRQoL of participants with cancer. EORTC QLQ-C30 includes 5 functional scales, 3 symptom scales, a global health status / quality of life scale, and 6 single items. Responses to items 1-28 are rated on a 4-point Likert response scale ranging from 1 "Not at all" to 4 "Very much." T...

Change from Baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Colorectal Cancer Module 29 (EORTC-QLQ-C30) ScoreFrom Baseline up to 7 Years 3 Months

The EORTC QLQ-CR29, is a self-administered, 29-item questionnaire measuring the HRQoL of participants with colorectal cancer. The QLQ CR29 includes items that evaluate symptoms (gastrointestinal, urinary, pain, and others) and functional areas (sexual, body image, weight, and anxiety) that are associated with colorectal cancer and its treatments. Responses a...

Time to Worsening in Symptoms and Functioning as Measured by EORTC QLQ-CR29Up to 7 Years 3 Months

The EORTC QLQ-CR29, is a self-administered, 29-item questionnaire measuring the HRQoL of participants with colorectal cancer. The QLQ CR29 includes items that evaluate symptoms (gastrointestinal, urinary, pain, and others) and functional areas (sexual, body image, weight, and anxiety) that are associated with colorectal cancer and its treatments. Responses a...

Overall Side Effect Burden as Measured by European Organisation for Research and Treatment of Cancer (EORTC) Item 168 Scale ScoreUp to 7 Years 3 Months

The EORTC item 168 is a single item used to measure the overall impact of treatment side effects. Responses are rated on a 4-point Likert response scale ranging from 1 "not at all" to 4 "very much." Higher scores indicate severe side effects.

Trial Locations

Locations (23)

Hospital Pulau Pinang

🇲🇾

Georgetown, Malaysia

Hospital Umum Sarawak

🇲🇾

Kuching, Malaysia

Hospital Raja Permaisuri Bainun

🇲🇾

Ipoh, Malaysia

Hospital Kuala Lumpur

🇲🇾

Kuala Lumpur, Malaysia

University Malaya Medical Centre

🇲🇾

Kuala Lumpur, Malaysia

Cancer and Blood Specialty Clinic

🇺🇸

Los Alamitos, California, United States

Providence Medical Foundation

🇺🇸

Santa Rosa, California, United States

MedStar Franklin Square Medical Center

🇺🇸

Baltimore, Maryland, United States

Nebraska Cancer Specialists Midwest Cancer Center

🇺🇸

Omaha, Nebraska, United States

Comprehensive Cancer Centers of Nevada

🇺🇸

Las Vegas, Nevada, United States

Baylor Scott and White Health

🇺🇸

Temple, Texas, United States

Az Groeninge

🇧🇪

Kortrijk, Belgium

National Cancer Center Hospital

🇯🇵

Chuo Ku, Japan

National Hospital Organization Osaka National Hospital

🇯🇵

Osaka-Shi, Japan

Osaka University Hospital

🇯🇵

Suita, Japan

The Cancer Institute Hospital of JFCR

🇯🇵

Tokyo, Japan

Hospital Canselor Tuanku Muhriz UKM

🇲🇾

Cheras, Malaysia

National Cancer Institute

🇲🇾

Putrajaya, Malaysia

Chang Kung Memorial Hospital

🇨🇳

Kaohsiung City, Taiwan

Kaohsiung Medical University Chung Ho Memorial Hospital

🇨🇳

Kaohsiung, Taiwan

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiwan

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Linkou Chang Gung Memorial Hospital

🇨🇳

Taoyuan, Taiwan

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