An open-label single arm interventional phase 2 study to investigate outcome of individualized treatment based on pharmacogenomic profiling and ex vivo drug sensitivity testing of patient-derived organoids in patients with metastatic colorectal cancer
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 发起方
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- Pre-screening: Number of patients from whom organoids and a full combined pharmacogenomic profiling were established and eligible for considering an MTBnominated treatment provided in the Main Study
研究概览
简要总结
Pre-screening: Based on a tumor biopsy, establish a full combined pharmacogenomic profile which can be used to obtain an MTB-nominated treatment provided in the Main Study
Main Study: To evaluate the anti-tumor activity, measured as objective response rate (ORR) of MTB-nominated therapies with drugs not approved or implemented in SOC clinical practice for treatment of mCRC ORR will be assessed for the total population treated ORR in each study drug cohort
入排标准
- 年龄范围
- 18 years 至 65+ years(65+ Years, 18-64 Years)
- 接受健康志愿者
- 是
入选标准
- •Pre-screeining: Has a histologically-proven locally advanced or metastatic adenocarcinoma from colon or rectum
- •Main study: Has measurable or evaluable disease (per RECIST v1.1)
- •main Study: ECOG performance status 0 or 1
- •Main study: For orally administered drugs, the participant must be able to swallow and tolerate oral medication and must have no known malabsorption syndrome.
- •Main study: Because of the risks of drug treatment to a developing fetus, women of child-bearing potential and men must agree to use adequate contraception in accordance with the respective SmPC
- •Main study: Has acceptable organ function as defined below. However, as noted below (exclusion criteriom 16), drug-specific inclusion/exclusion criteria specified in the Appendix 16/respective SmPC for each agent will take precedence for this and all inclusion criteria:
- •Pre-screening: Has received or is receiving systemic treatment for mCRC
- •Pre-screening: Has non-resectable metastases and eligible to undergo a radiological-guided core biopsy from at least one metastasis
- •Pre-screening: ECOG performance status 0 or 1
- •Pre-screening: Has measurable or evaluable disease (per RECIST v1.1)
- •Pre-screening: Is capable of giving signed informed consent, as described in Appendix 1, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol
- •Main studiy: Has a histologically-proven locally advanced or metastatic adenocarcinoma from colon or rectum (mCRC)
- •Main studiy: Has received at least two lines of SOC chemotherapy for mCRC
- •Main study: Has full combined pharmacogenomic profile (genomic and transcriptomic profile of the patients tumor and ex vivo drug sensitivity testing of PDOs from the patient’s own tumors cells) from which the MTB suggests a treatment with one of the defined targeted anti-cancer therapies provided this study
排除标准
- •Pree-screening: Has other clinically significant medical conditions which, in the opinion of the treating physician, makes it undesirable for the patient to participate in the study or which could jeopardize compliance with study requirements.
- •Main study: Has had a stroke (including TIA) or an acute myocardial infarction within 6 months before the first dose of study treatment.
- •Main study: Has had acute gastrointestinal bleeding within 1 month of start of treatment
- •Main study: Has other clinically significant medical conditions which, in the opinion of the treating physician, makes it undesirable for the patient to participate in the study or which could jeopardize compliance with study requirements.
- •Main study: Meets any of the assigned drug contraindications or other drug-specific exclusion criteria as described in the respective SmPC and in Appendix 16
- •Main study: Has ongoing toxicity > CTCAE grade 2, other than peripheral neuropathy and alopecia, related to anti-tumor treatment that was completed within 4 weeks prior to registration. Patients with ongoing peripheral neuropathy of ≥ CTCAE grade 3 will be excluded.
- •Main Study: Has received previous treatment with the selected study drug for the same malignancy
- •Main study: Has a tumor with a genomic variant known to confer resistance to an anti-cancer agent available in this study, the patient will not be eligible to receive that agent but will be eligible to receive other drugs available in this study if all inclusion and exclusion criteria are met for that drug.
- •Main study: Is receiving any other anti-cancer therapies (cytotoxic, biologic, radiation, or hormonal other than for replacement). Participants may be on warfarin, low molecular weight heparin or direct factor Xa inhibitors, unless such therapies are prohibited by drugspecific exclusion criteria (please consult the corresponding SmPC and Appendix 16 for prohibited medication and contraindication/precautions).
- •Main study: Is pregnant or breastfeeding or refusing any type of required contraception methods.
- •Main study: Has known CNS metastases.
- •Main study: Has preexisting cardiac conditions, including uncontrolled or symptomatic angina, uncontrolled atrial or ventricular arrhythmias, or symptomatic congestive heart failure.
- •Main study: Has left ventricular ejection fraction (LVEF) known to be < 40%.
结局指标
主要结局
Pre-screening: Number of patients from whom organoids and a full combined pharmacogenomic profiling were established and eligible for considering an MTBnominated treatment provided in the Main Study
Pre-screening: Number of patients from whom organoids and a full combined pharmacogenomic profiling were established and eligible for considering an MTBnominated treatment provided in the Main Study
Main study: Objective response rate (ORR) is a confirmed complete response (CR) or partial response (PR). ORR in the total population. ORR in each study drug cohort
Main study: Objective response rate (ORR) is a confirmed complete response (CR) or partial response (PR). ORR in the total population. ORR in each study drug cohort
次要结局
- Pre-screening: Number of patients from whom organoids and a full combined pharmacogenomic profile was established and eligible to have suggested: An MTB-nominated treatment provided in the Main Study. An MTB-nominated treatment considered as SOC. An MTB-nominated treatment not considered as SOC and not provided in the Main Study. No MTB-nominated treatment
- Pre-screening: Registered outcome of all systemic SOC oncological treatment; objective response (OR), PFS and DOR. OS from start of firstline SOC chemotherapy and OS from start of each line of SOC treatment
- Main study: PFS, defined as the time from the first dose of the MTB-nominated treatment to the first documented disease progression or death due to any cause, whichever occurs first. DOR, defined as the time from the first documented evidence of CR or PR until progressive disease (PD) or death due to any cause, whichever occurs first, in participants demonstrating CR or PR
- Main study: OS, defined as the time from the first dose of MTB-nominated treatment to the date of death from any cause. Classify and register adverse vents.
- Main study: Assess ORR, DOR, PFS of MTB-nominated treatment and from the previous line of SOC treatment regimen in each patient. Assess the number of patients who have a PFS of the MTB-nominated treatment which is >1.3 x PFS of the previous line of therapy.
- Main study: Assess ORR, DOR, PFS and of MTB-nominated treatment and form anticancer therapy in the next/later lines of SOC treatment in each patient
- Main study: Patient-reported outcome measures
研究者
Tormod Kyrre Guren
Scientific
Oslo University Hospital HF
