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Safety of AMG 706 Plus Panitumumab Plus Chemotherapy in the Treatment of Subjects With Metastatic Colorectal Cancer

Phase 1
Completed
Conditions
Rectal Cancer
Colon Cancer
Interventions
Drug: FOLFOX-4
Biological: Panitumumab (Part 1a only)
Drug: FOLFIRI
Registration Number
NCT00101894
Lead Sponsor
Amgen
Brief Summary

The purpose of this study is to characterize the safety and tolerability of AMG 706 plus panitumumab when administered with either FOLFIRI or FOLFOX4 chemotherapy regimens. This is a Phase 1b clinical study.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
119
Inclusion Criteria

Not provided

Exclusion Criteria
  1. More than 1 prior chemotherapy regimen for metastatic CRC
  2. Central nervous system (CNS) metastases
  3. History of venous thrombosis
  4. Myocardial infarction, cerebrovascular accident, transient ischemic attack, grade 2 or greater peripheral vascular disease, congestive heart failure, ongoing arrhythmias requiring medication, or unstable angina within 1 year before study enrollment
  5. History of interstitial pneumonitis or pulmonary fibrosis or evidence of interstitial pneumonitis or pulmonary fibrosis on screening chest computed tomograph (CT) scan
  6. Average systolic blood pressure > 150mm Hg or average diastolic blood pressure of > 90mm Hg
  7. Radiotherapy within 28 days of study enrollment or within 14 days of study enrollment for peripheral lesions
  8. Prior AMG 706, oral inhibitors of AMG706, panitumumab, or another anti-EGFr monoclonal antibody (mAb) (e.g., cetuximab [Erbitux®] or EMD 72000)
  9. Systemic chemotherapy within 28 days before study enrollment
  10. Major surgery within 28 days or minor surgery within 7days of study enrollment
  11. History of life threatening ventricular arrhythmia (eg, sustained ventricular tachycardia)
  12. Female and male subjects of childbearing potential not using adequate contraceptive precautions
  13. Participation in therapeutic clinical trials within 30 days before study enrollment
  14. Not recovered from all previous therapies
  15. Clinically significant open would, ulcer or fracture
  16. Any co-morbid medical condition that would increase the risk of toxicity

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part 2 AMG 706 (MTD) + FOLFOX-4AMG 706Maximum Tolerated Dose of AMG 706 established in Part 1b + FOLFOX-4
125 mg QD AMG 706 + FOLFOX-4FOLFOX-4125 mg QD AMG 706 + FOLFOX-4
Part 2 AMG 706 (MTD) + FOLFOX-4FOLFOX-4Maximum Tolerated Dose of AMG 706 established in Part 1b + FOLFOX-4
125 mg QD AMG 706 + FOLFOX-4AMG 706125 mg QD AMG 706 + FOLFOX-4
50 mg QD AMG706 + panitumumab + FOLFIRIPanitumumab (Part 1a only)50 mg QD AMG706 + panitumumab + FOLFIRI
50 mg QD AMG706 + panitumumab + FOLFIRIFOLFIRI50 mg QD AMG706 + panitumumab + FOLFIRI
Part 2 AMG 706 (MTD) + FOLFIRIFOLFIRIMaximum Tolerated Dose of AMG 706 established in Part 1b + FOLFIRI
100 mg QD AMG 706 + FOLFIRIAMG 706100 mg AMG 706 + FOLFIRI
100 mg QD AMG 706 + FOLFIRIFOLFIRI100 mg AMG 706 + FOLFIRI
75 mg QD AMG 706 + panitumumab + FOLFOX-4FOLFOX-475 mg QD AMG 706 + panitumumab + FOLFOX-4
75 mg QD AMG 706 + panitumumab + FOLFOX-4AMG 70675 mg QD AMG 706 + panitumumab + FOLFOX-4
75 mg QD AMG 706 + panitumumab + FOLFOX-4Panitumumab (Part 1a only)75 mg QD AMG 706 + panitumumab + FOLFOX-4
75 mg BID AMG 706 + panitumumab + FOLFIRIAMG 70675 mg BID AMG 706 + panitumumab + FOLFIRI
75 mg BID AMG 706 + panitumumab + FOLFIRIPanitumumab (Part 1a only)75 mg BID AMG 706 + panitumumab + FOLFIRI
75 mg BID AMG 706 + panitumumab + FOLFIRIFOLFIRI75 mg BID AMG 706 + panitumumab + FOLFIRI
125 mg QD AMG 706 + panitumumab + FOLFIRIAMG 706125 mg QD AMG 706 + panitumumab + FOLFIRI
125 mg QD AMG 706 + panitumumab + FOLFIRIPanitumumab (Part 1a only)125 mg QD AMG 706 + panitumumab + FOLFIRI
125 mg QD AMG 706 + panitumumab + FOLFIRIFOLFIRI125 mg QD AMG 706 + panitumumab + FOLFIRI
125 mg QD AMG 706 + FOLFIRIAMG 706125 mg QD AMG 706 + FOLFIRI
125 mg QD AMG 706 + FOLFIRIFOLFIRI125 mg QD AMG 706 + FOLFIRI
100 mg QD AMG 706 + panitumumab + FOLFIRIFOLFIRI100 mg QD AMG 706 + panitumumab + FOLFIRI
100 mg QD AMG 706 + panitumumab + FOLFIRIAMG 706100 mg QD AMG 706 + panitumumab + FOLFIRI
100 mg QD AMG 706 + panitumumab + FOLFIRIPanitumumab (Part 1a only)100 mg QD AMG 706 + panitumumab + FOLFIRI
75 mg QD AMG 706 + FOLFOX-4FOLFOX-475 mg QD AMG 706 + FOLFOX-4
75 mg QD AMG 706 + FOLFOX-4AMG 70675 mg QD AMG 706 + FOLFOX-4
100 mg QD AMG 706 + FOLFOX-4FOLFOX-4100 mg QD AMG 706 + FOLFOX-4
100 mg QD AMG 706 + FOLFOX-4AMG 706100 mg QD AMG 706 + FOLFOX-4
50 mg QD AMG 706 + panitumumab + FOLFOX-4FOLFOX-450 mg QD AMG 706 + panitumumab + FOLFOX-4
50 mg QD AMG 706 + panitumumab + FOLFOX-4Panitumumab (Part 1a only)50 mg QD AMG 706 + panitumumab + FOLFOX-4
75 mg QD AMG706 + panitumumab + FOLFIRIAMG 70675 mg QD AMG706 + panitumumab + FOLFIRI
75 mg QD AMG706 + panitumumab + FOLFIRIPanitumumab (Part 1a only)75 mg QD AMG706 + panitumumab + FOLFIRI
75 mg QD AMG706 + panitumumab + FOLFIRIFOLFIRI75 mg QD AMG706 + panitumumab + FOLFIRI
50 mg QD AMG706 + panitumumab + FOLFIRIAMG 70650 mg QD AMG706 + panitumumab + FOLFIRI
Part 2 AMG 706 (MTD) + FOLFIRIAMG 706Maximum Tolerated Dose of AMG 706 established in Part 1b + FOLFIRI
50 mg QD AMG 706 + panitumumab + FOLFOX-4AMG 70650 mg QD AMG 706 + panitumumab + FOLFOX-4
Primary Outcome Measures
NameTimeMethod
Part 1a - The incidence of adverse events and clinical laboratory abnormalities defined as dose-limiting toxicitiesFirst 2 cycles
Part 1b - The incidence of adverse events and clinical laboratory abnormalities defined as dose-limiting toxicitiesFirst 2 cycles
Part 2 - The overall objective tumor response rate (complete and partial response) in subjects treated with AMG 706 (at the dose determined in Part 1b), with either the FOLFIRI or FOLFOX-4 chemotherapy regimenEvery 8 weeks (+/- 7 days)
Secondary Outcome Measures
NameTimeMethod
Part 1a - The PK of irinotecan (and its active metabolite SN38) when administered as a part of the FOLFIRI regimen with panitumumab and AMG 706Cycle 1 and 2 (Days 1, 2, 3)
Part 1a - The PK of oxaliplatin when administered as a part of the FOLFOX-4 regimen with panitumumab and AMG 706Cycle 1 and 2 (Day 1)
Part 1a - The objective tumor response rate (complete and partial response) throughout the studyEvery 6 to 8 weeks
Part 1b - The incidence of adverse events and clinical laboratory abnormalities not defined as dose-limiting toxicitiesEvery visit
Part 1b - The PK of AMG 706 when administered with either the FOLFIRI or FOLFOX-4 chemotherapy regimenCycle 2 (Day 1-2), Cycle 3 (Day 1)
Part 1b - The PK of 5-FU when administered as a part of the FOLFIRI or FOLFOX-4 regimen with AMG 706Cycle 1 and 2 (Day 3)
Part 2 - Duration of response: (Calculated for only those subjects who respond)Time from first objective tumor response (subsequently confirmed at least 4 weeks later) to objective disease progression or death.
Part 2 - Time-to-progressionTime from first dose of investigational product to objective disease progression or death due to disease progression.
Part 1b - The PK of irinotecan (and its active metabolite SN38) when administered as a part of the FOLFIRI regimen with AMG 706Cycle 1 and 2 (Days 1, 2, 3)
Part 1b- The PK of oxaliplatin when administered as a part of the FOLFOX-4 regimen with AMG 706Cycle 1 and 2 (Day 1)
Part 1b - The objective tumor response rate (complete and partial response) throughout the studyEvery 8 weeks (+/- 7 days)
Part 2 - Overall survivalTime from first dose of investigational product to death. Subjects who have not died while on study or are lost to follow-up will be censored at their last contact date. (Time on study plus 36 months of long term follow-up)
Part 2 - The incidence of adverse events and clinical laboratory abnormalitiesEvery visit
Part 2 - The PK of AMG 706 when administered with either the FOLFIRI or FOLFOX-4 chemotherapy regimen (at a subset of the study centers with the capabilities to draw, ship and process PK samples)Cycles 2, 4, 7, and every 3 subsequent cycles (Day 1)
Exploratory - Potential biomarker development based on assessment of blood cells, tumor cells, and urine and the proposed mechanism of action of study drugs, and responseDay 1 of cycles 1 and 2, and within 7 days of a radiographic assessment
Exploratory - The effects of genetic variation in drug metabolism genes, cancer genes, and drug target genes on subject response to investigational products (separate informed consent)Day 1 of cycles 1 and 2, and within 7 days of a radiographic assessment
Part 2 - Progression-free survival timeTime from first dose of investigational product to objective disease progression or death, subjects who have not progressed or died while on study will be censored at their last evaluable assessment date.
Part 2 - Incidence of subjects undergoing resection of metastases for curative intentAs needed
Part 1a - The incidence of adverse events and clinical laboratory abnormalities not defined as dose-limiting toxicitiesEvery visit
Part 1a - The PK of AMG 706 when administered with panitumumab and either the FOLFIRI or FOLFOX-4 chemotherapy regimenCycle 2 (Day 1-2), Cycle 3 (Day 1)
Part 1a - The serum concentration of panitumumab when administered with AMG 706 and either the FOLFIRI or FOLFOX-4 chemotherapy regimenCycle 1 (Day 1), Cycle 2 (Day 1), Cycle 4 (Day 1)
Part 1a - The incidence of HAPA response following panitumumab administrationCycle 1 (Day 1), Cycle 4 (Day 1), End of Study
Part 1a - The PK of 5-FU when administered as a part of the FOLFIRI or FOLFOX-4 regimen with panitumumab and AMG 706Cycle 1 and 2 (Day 3)
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