MedPath

A Study to Compare the Efficacy of Arfolitixorin Versus Leucovorin in Combination With 5 Fluorouracil, Oxaliplatin, and Bevacizumab in Patients With Advanced Colorectal Cancer

Phase 3
Completed
Conditions
Colo-rectal Cancer
Interventions
Registration Number
NCT03750786
Lead Sponsor
Isofol Medical AB
Brief Summary

This is a multicenter, randomized, parallel-group, Phase III study in at least 440 patients with advanced colorectal cancer to compare the efficacy of treatment with arfolitixorin versus Leucovorin in combination with 5-fluorouracil, oxaliplatin, and bevacizumab according to modified FOLFOX-6 until PD according to RECIST 1.1 criteria.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
490
Inclusion Criteria
  1. Colorectal adenocarcinoma verified by biopsy.
  2. Availability of biopsy material, from the primary tumor or metastasis, allowing for analysis of tumor gene expression.
  3. Non-resectable metastatic CRC planned for first line therapy with 5-FU, Leucovorin, oxaliplatin, and bevacizumab.
  4. Evaluable disease with at least one measurable lesion of metastatic disease (≥10 mm in longest diameter on axial image on CT-scan or alternatively MRI with <5 mm reconstruction interval) or lymph node (≥ 15 mm in shortest axis when assessed by CT) obtained within 28 days of randomization.
  5. Life expectancy of more than 4 months.
  6. ECOG performance status 0 or 1.
  7. Hemoglobin (Hb) > 80 g/L, Absolute neutrophil count (ANC) > 1.5x10E9/L. Thrombocytes > 100x10E9/L.
  8. Creatinine clearance > 50 mL/min, Total bilirubin < 1.5 x ULN, AST and ALT < 3 x ULN (and < 5 x ULN in case of liver metastases).
  9. Male or female ≥18 years of age.
  10. Female patients of childbearing potential must have a negative urine pregnancy test and use adequate contraceptive measures . Male patients must use adequate contraceptive measures .
  11. Voluntarily signed informed consent before performance of any study related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.
Exclusion Criteria
  1. Malignant tumors other than colorectal adenocarcinomas (current or within the previous five years), with the exception for curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix.
  2. Less than 6 months between randomization and completion of the last anti-cancer treatment (chemotherapy/radiotherapy/immunotherapy, etc.). (NB: Rectal cancer treatment shorter than 8 weeks of chemo/radiation therapy is allowed.)
  3. Confirmation of progressive disease within 6 months after completion of prior adjuvant anti-cancer treatment.
  4. Indication for any metastatic Colo-rectal Cancer (mCRC) surgery or anti-cancer treatment other than study treatment.
  5. Prior treatment with arfolitixorin.
  6. Indication for treatment with a 5-FU analogue, or 5-FU for a condition other than mCRC.
  7. Known Dihydropyrimidine Dehydrogenase Deficiency (DPD) deficiency.
  8. Known or suspected central nervous system (CNS) metastases.
  9. Unresolved bowel obstruction, uncontrolled Crohn's disease, or ulcerative colitis.
  10. History of cardiac disease with a New York Heart Association Class II or greater, congestive heart failure, myocardial infarction, or unstable angina at any time during the 6 months prior to randomization, or serious arrhythmias requiring medication for treatment.
  11. Current CTCAE ≥ grade 3 diarrhea.
  12. Current chronic infection or uncontrolled serious illness causing immunodeficiency.
  13. Known or suspected hypersensitivity or intolerance to arfolitixorin, LV, 5-FU, oxaliplatin, or bevacizumab.
  14. Breastfeeding patients.
  15. Patient who received investigational drugs in other clinical trials within 28 days, or 5 half-lives of the investigational drug, prior to randomization.
  16. Patient with serious medical or psychiatric illness likely to interfere with participation in this clinical study.
  17. Ongoing drug or alcohol abuse, as deemed by the Investigator.
  18. Any condition that, in the opinion of the Investigator, could compromise the patient's safety or adherence to the study protocol.
  19. Involvement, or related to people involved in the planning or conduct of the study (applies to both Isofol Medical AB (publ) staff and staff at the study site)
  20. Surgery (excluding previous diagnostic biopsy) in the 28-day period before randomization

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group AArfolitixorinARFOX (Arfolitixorin and 5-FU and Oxaliplatin) and Bevacizumab
Group BLeucovorinmFOLFOX-6 (Leucovorin and 5-FU and Oxaliplatin) and Bevacizumab
Primary Outcome Measures
NameTimeMethod
Overall Response RateUntil disease progression, an average of ten months

Best ORR, defined as the best response recorded from the start of the study treatment until the end of treatment.

Secondary Outcome Measures
NameTimeMethod
Progression Free SurvivalUntil disease progression, an average of ten months

PFS, defined as the time from randomization to first occurrence of tumor progression based on CT-scans/MRIs.

Duration of ResponseUntil disease progression, an average of ten months

The duration of response is measured from the time measurement criteria are first met for CR/PR until the first date that recurrent or progressive disease is objectively documented.

Trial Locations

Locations (94)

840-01 - HOAG Memorial Hospital

🇺🇸

Newport Beach, California, United States

124-11 - CISSS de Chaudière-Appalaches

🇨🇦

Lévis, Quebec, Canada

250-05 - Clinique Sainte Anne

🇫🇷

Strasbourg, France

300-01 - Aretaieo Hospital

🇬🇷

Athens, Greece

300-03 - Metropolitan General Hospital

🇬🇷

Athens, Greece

392-01 - National Cancer Center Hospital East

🇯🇵

Chiba, Japan

392-05 - University of Tsukuba Hospital

🇯🇵

Ibaraki, Japan

392-08 - St.Marianna University School of Medicine Hospital

🇯🇵

Kanagawa, Japan

300-05 - Metropolitan General SA

🇬🇷

Athen, Greece

300-06 - University General Hospital of Larissa

🇬🇷

Larissa, Greece

392-10 - Aichi Cancer Center

🇯🇵

Aichi, Japan

840-32 - University of Miami

🇺🇸

Miami, Florida, United States

840-02 - The University of Texas Health Science Center

🇺🇸

San Antonio, Texas, United States

840-13 - UCH-MHS d/b/a Memorial Health System

🇺🇸

Colorado Springs, Colorado, United States

840-22 - University of Oklahoma Stephenson Cancer Center

🇺🇸

Oklahoma City, Oklahoma, United States

840-34 - Banner MD Anderson Cancer Center

🇺🇸

Greeley, Colorado, United States

840-04 - St. Vincent Frontier Cancer Center

🇺🇸

Billings, Montana, United States

036-03 - Westmead Hospital

🇦🇺

Sydney, New South Wales, Australia

036-09 - Southern Medical Day Care Center

🇦🇺

Wollongong, New South Wales, Australia

124-03 - William Osler Health System - Brampton Civi Hospital

🇨🇦

Brampton, Ontario, Canada

040-05 - Wilhelminenspital

🇦🇹

Wien, Austria

124-07 - Sunnybrook Research Institute

🇨🇦

Toronto, Ontario, Canada

276-01 - Klinikum der Universität München - Campus Grosshadern

🇩🇪

München, Germany

392-07 - Gifu University Hospital

🇯🇵

Gifu City, Japan

276-04 - MVZ Mitte - Onkologische Schwerpunktpraxis

🇩🇪

Leipzig, Germany

276-09 - Klinikum Nürnberg Nord

🇩🇪

Nürnberg, Germany

276-05 - Kliniken Nordoberpfalz AG

🇩🇪

Weiden, Germany

300-04 - 251 Airforce Hospital

🇬🇷

Athens, Greece

392-09 - National Hospital Organization Shikoku Cancer Center

🇯🇵

Ehime, Japan

392-12 - Saitama Medical University International Medical Center

🇯🇵

Hidaka City, Japan

300-02 - University General Hospital Attikon

🇬🇷

Athens, Greece

392-14 - Kansai Medical University Hospital

🇯🇵

Osaka, Japan

392-15 - Kagawa University Hospital

🇯🇵

Kagawa, Japan

392-04 - Saitama Cancer Center

🇯🇵

Saitama, Japan

392-02 - Shizuoka Cancer Center

🇯🇵

Shizuoka, Japan

392-06 - National Cancer Center Hospital

🇯🇵

Tokyo, Japan

724-03 - Instituto Oncologico Baselga - Hospital Quiron

🇪🇸

Barcelona, Spain

752-01 - Akademiska Sjukhuset

🇸🇪

Uppsala, Sweden

724-07 - Hospital del la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

724-01 - Vall d'Hebron Institute of Oncology

🇪🇸

Barcelona, Spain

724-04 - Hospital Unviersitario 12 de Octubre

🇪🇸

Madrid, Spain

724-09 - Hospital Universitario HM Sanchinarro

🇪🇸

Madrid, Spain

724-02 - Hospital Regional Universitario Carlos Haya

🇪🇸

Málaga, Spain

752-02 - Södersjukhuset

🇸🇪

Stockholm, Sweden

724-05 - Hospital Universitario Virgen del Rocío

🇪🇸

Sevilla, Spain

724-06 - Hospital Universitario Reina Sofia

🇪🇸

Córdoba, Spain

840-29 - Ashland-Bellefonte Cancer Center

🇺🇸

Ashland, Kentucky, United States

840-15 - University of Southern California

🇺🇸

Los Angeles, California, United States

840-06 - Cancer Center of Kansas

🇺🇸

Wichita, Kansas, United States

840-30 - Joliet Oncology-Hematology Associates

🇺🇸

Joliet, Illinois, United States

840-19 - University of Louisville Research Foundation Inc. (ULRF)

🇺🇸

Louisville, Kentucky, United States

840-12 - Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

840-10 - Oregon Health and Science University-Knight Cancer Institute

🇺🇸

Portland, Oregon, United States

840-27 - Charleston Hematology Oncology Associates

🇺🇸

Charleston, South Carolina, United States

036-10 - Border Medical Oncology Research Unit

🇦🇺

Albury, New South Wales, Australia

036-02 - Chris O'Brien Lifehouse

🇦🇺

Sydney, New South Wales, Australia

036-01 - Western Health - Sunshine Hospital

🇦🇺

Melbourne, Victoria, Australia

036-07 - Northern Health - Epping Hospital

🇦🇺

Melbourne, Victoria, Australia

040-06 - Ordensklinikum Linz GmbH - Barmherzige Schwestern

🇦🇹

Linz, Austria

036-05 - Monash Health

🇦🇺

Melbourne, Victoria, Australia

040-02 - Klinikum Klagenfurt am Wörthersee

🇦🇹

Klagenfurt, Austria

040-03 - Uniklinikum Salzburg

🇦🇹

Salzburg, Austria

040-04 - Landesklinikum Wiener Neustadt

🇦🇹

Wiener Neustadt, Austria

040-01 - Allgemeines Krankenhaus der Stadt Wien

🇦🇹

Wien, Austria

124-10 - Thunder Bay Regional Health Research Institute

🇨🇦

Thunder Bay, Ontario, Canada

124-06 - Jewish General Hospital

🇨🇦

Montréal, Canada

124-05 - Ottawa Hospital Research Institute

🇨🇦

Ottawa, Canada

250-04 - Polyclinique Francheville

🇫🇷

Périgueux, France

250-07 - Hôpital Henri Mondor

🇫🇷

Créteil, France

250-06 - Centre Georges Francois Leclerc

🇫🇷

Dijon, France

250-09 - Hopital Privé Jean Mermoz

🇫🇷

Lyon, France

250-02 - Hôpital Saint-Antoine

🇫🇷

Paris, France

250-08 - Hôpital Européen

🇫🇷

Marseille, France

250-01 - Institute Hospitalier Franco-Britannique

🇫🇷

Levallois-Perret, France

250-03 - Hôpital Paris Saint Joseph

🇫🇷

Paris, France

276-03 - Krankenhaus Nordwest GmbH

🇩🇪

Frankfurt am Main, Germany

276-12 - Charité - Universitätsmedizin Berlin

🇩🇪

Berlin, Germany

276-02 - Universitätsklinikum Carl Gustav Carus

🇩🇪

Dresden, Germany

276-11 - Klinikum Kassel GmbH

🇩🇪

Kassel, Germany

276-08 - Carl von Basedow Klinikum Saalekrei GmbH

🇩🇪

Merseburg, Germany

276-13 - Universitäres Krebszentrum Leipzig (UCCL)

🇩🇪

Leipzig, Germany

276-07 - Philipps-Universität Marburg

🇩🇪

Marburg, Germany

840-24 - Banner Gateway Medical Center

🇺🇸

Gilbert, Arizona, United States

840-08 - Pinellas Hematology Oncology

🇺🇸

Saint Petersburg, Florida, United States

124-01 - Montreal University Health Center

🇨🇦

Montreal, Quebec, Canada

124-02 - Hôpital de la Cité-de-la-Santé

🇨🇦

Laval, Canada

124-08 - Hôpital Maisonneuve Rosemont

🇨🇦

Montréal, Canada

840-14 - University of Michigan Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

036-04 - Peninsula Health - Frankston Hospital

🇦🇺

Frankston, Victoria, Australia

124-04 - CISSS de l'Outaouais - Hôpital de Gatineau

🇨🇦

Gatineau, Quebec, Canada

276-10 - Universitärers Cancer Center Hamburg (UCCH)

🇩🇪

Hamburg, Germany

392-11 - National Hospital Organization Osaka National Hospital

🇯🇵

Osaka, Japan

392-13 - Osaka General Medical Center

🇯🇵

Osaka, Japan

392-03 - Hokkaido University Hospital

🇯🇵

Sapporo Hokkaido, Japan

© Copyright 2025. All Rights Reserved by MedPath