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A Study Of PF-05212384 Plus FOLFIRI Versus Bevacizumab Plus FOLFIRI In Metastatic Colorectal Cancer

Phase 1
Terminated
Conditions
Metastatic Colorectal Carcinoma
Interventions
Biological: Bevacizumab
Drug: FOLFIRI regimen
Drug: FOLFIRI
Registration Number
NCT01937715
Lead Sponsor
Pfizer
Brief Summary

This is a multicenter, open label Phase 1b/2 study in patients with metastatic colorectal carcinoma. The Phase 1b will identify the dose of the combination of PF-05212384 plus FOLFIRI. The randomized, two-arm Phase 2 portion will compare the efficacy and safety of PF-05212384 plus FOLFIRI to that of bevacizumab plus FOLFIRI.

The study population will consist of patients with mCRC previously treated with an oxaliplatin-based regimen in the first line setting or who have progressed within 6 months of the end of an adjuvant oxaliplatin-based regimen.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
18
Inclusion Criteria
  • Advanced colorectal carcinoma.
  • Progression on prior oxaliplatin-containing regimen used in 1st line setting for mCRC or progression within 6 months of end of oxaliplatin-containing regimen in the adjuvant setting.
  • Tumor tissue available at time of screening for molecular profiling.
  • Adequate performance status.
  • Adequate glucose control, bone marrow, kidney, liver, and heart function.
Exclusion Criteria
  • Participation in other studies involving investigational drug(s) (Phases 1-4) before the current study begins and/or during study participation.
  • Prior irinotecan treatment.
  • Prior radiation to the pelvis or abdomen in the metastatic or locally advanced setting.
  • History of Gilbert's syndrome.
  • Active brain metastases.
  • Deep vein thrombosis in the preceding 2 months.
  • History of interstitial lung disease.
  • RAS (KRAS/NRAS) wild type mCRC not previously treated with an anti-EGFR containing regimen (unless contraindicated or not considered standard practice per clinical site or country guidelines).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Arm APF-05212384PF-05212384 plus FOLFIRI
Arm AFOLFIRI regimenPF-05212384 plus FOLFIRI
Arm BBevacizumabBevacizumab plus FOLFIRI
Arm BFOLFIRIBevacizumab plus FOLFIRI
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Dose-Limiting Toxicities (DLTs) in First Cycle of TherapyDay 1 up to Day 28

DLTs were classified according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and defined as any of the following events judged to be attributed to the combination of PF-05212384 plus FOLFIRI: hematologic (febrile neutropenia or a sustained temperature \>=38 degrees Celcius for \>1 hour, grade \>=3 neutropenic infection, grade 3 thrombocytopenia with bleeding, grade 4 thrombocytopenia); non-hematologic (grade \>=2 pneumonitis, grade \>=3 toxicities, toxicities which resulted in failure to deliver at least 75% of the planned total dose of PF-05212384 and/or 50% of the planned total dose of FOLFIRI during the first cycle, toxicities which resulted in delay of start of Cycle 2 by \>2 weeks of scheduled day (Day 43 of study), Grade 3 QTc prolongation).

Progression-Free Survival (PFS)Baseline (Day 1) up to disease progression or death whichever occurred first (up to 18 months)

Progression-free survival was the time from randomization the date to date of first documentation of progression or death due to any cause, whichever occurred first. Documentation of progression was by objective disease assessment as defined by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Hematological Test AbnormalitiesDay 1 and Day 15 of each cycle

Number of participants with NCI CTCAE version 4.0 grade 1 to 4 hematological test abnormalities.

Number of Participants With Coagulation Test AbnormalitiesDay 1 and Day 15 of Cycle 1, Day 1 of Cycle 2 and subsequent cycles

Number of participants with NCI CTCAE version 4.0 grade 1 to 4 Coagulation test abnormalities.

Number of Participants With Chemistry Test AbnormalitiesDay 1 and Day 15 of each cycle

Number of participants with NCI CTCAE version 4.0 grade 1 to 4 Chemistry test abnormalities.

Number of Participants With Urinalysis Test AbnormalitiesDay 1 and Day 15 of Cycle 1, Day 1 of Cycle 2 and subsequent cycles

Number of participants with NCI CTCAE version 4.0 grade 1 to 4 Urinalysis test abnormalities.

Number of Participants With Best Overall Response (Phase 1B)Every 8 weeks from Cycle 1 Day 1 until 28 days of last dose

Best overall response is defined as the best response recorded from randomization (or first dose for patients in the Phase 1B) until disease progression, death, start of new anti-cancer treatment or end of study. The categories for best overall response include: complete response (CR) (complete disappearance of all target lesions with the exception of nodal disease and all target nodes must decrease to normal size (short axis \<10 millimeters (mm)); partial response (PR) (at least a 30 percent (%) decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters); stable disease (SD) (not qualify for CR, PR or Progression); progressive disease (PD) (20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy), with a minimum absolute increase of 5 mm); indeterminate (IND) (progression has not been documented).

Number of Participants With All Causality Treatment-Emergent Adverse Events (AEs), Serious Adverse Events (SAEs), and Discontinuations by Relationship and SeriousnessBaseline up to final study evaluation (within 28 days of last dose)

An AE was any untoward medical occurrence without regard to causality in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. An AE was considered treatment emergent if the event occurred for the first time after the start of study treatment and within 28 days after final dose of study treatment and was not seen prior to the start of treatment; or the event was seen prior to the start of treatment but increased in CTCAE version 4.0 grade after the start of study treatment and within 28 days after final dose of study treatment.

Number of Participants With All Causality AEs by System Organ Class (SOC)Baseline up to final study evaluation (within 28 days of last dose)

An AE was any untoward medical occurrence without regard to causality in a participant who received study drug.

Number of Participants With Treatment-Emergent AEs by Worst On-Study GradeBaseline up to final study evaluation (within 28 days of last dose)

An AE was any untoward medical occurrence without regard to causality in a participant who received study drug. AE grades were defined according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 criteria.

Maximum Observed Plasma Concentration (Cmax): PF-05212384, Irinotecan, and FluorouracilPF-05212384: Cycle 1 Day 3. Irinotecan: Cycle 1 Day 1. Fluorouracil: Cycle 1 Day 1.

Maximum Plasma Concentration of PF-05212384, Irinotecan, and Fluorouracil

Time to Reach Maximum Observed Plasma Concentration (Tmax): PF-05212384, Irinotecan, and FluorouracilPF-05212384: Cycle 1 Day 3. Irinotecan: Cycle 1 Day 1. Fluorouracil: Cycle 1 Day 1.

Time to Reach Maximum Observed Plasma Concentration of PF-05212384, Irinotecan, and Fluorouracil

Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast): PF-05212384 and IrinotecanPF-05212384: Cycle 1 Day 3. Irinotecan: Cycle 1 Day 1.

Area Under the Curve From Time Zero to Last Quantifiable Concentration of PF-05212384, and Irinotecan

Area Under the Plasma Concentration-Time Profile From Time 0 Extrapolated to Infinite Time (AUCinf): PF-05212384 and IrinotecanPF-05212384: Cycle 1 Day 3. Irinotecan: Cycle 1 Day 1.

Area Under the Plasma Concentration-Time Profile From Time 0 Extrapolated to Infinite Time of PF-05212384 and Irinotecan

Terminal Elimination Half-Life (t1/2): PF-05212384 and IrinotecanPF-05212384: Cycle 1 Day 3. Irinotecan: Cycle 1 Day 1.

Terminal Elimination Half-Life of PF-05212384 and Irinotecan

Number of Participants Meeting Maximum Post-Baseline QTc Interval ValuesBaseline, Cycle 1 Day 1, and Cycle 2 Day 2

Criteria for corrected QT interval using Fridericia's formula (QTcF) meeting potential clinical concern included: an absolute value \>=450 - \<480 msec, \>=480-\<500 msec, \>500 msec; an absolute change 30 - \<60, \>=60 msec.

Number of Participants With Expression of Gene Sequences or Gene Amplications in Biopsied Tumor TissueBaseline and Cycle 2 Day 17

Biomarker evaluation were to be performed on fresh biopsies, as well as on archival biopsies collected during the study. Samples were to be analyzed for biomarkers indicative of pathway modulation or for genetic markers correlated to drug sensitivity.

Number of Participants With Gene and/or Protein Expression Biomarkers Relating to the PI3K and/or mTOR Pathway Activation in Biopsied Tumor TissueBaseline and Cycle 2 Day 17

Biomarker evaluation were to be performed on fresh biopsies, as well as on archival biopsies collected during the study. Samples were to be analyzed for biomarkers indicative of pathway modulation or for genetic markers correlated to drug sensitivity.

Number of Participants With Best Overall Response (Phase 2)Day 1 up to Day 28

Best overall response is defined as the best response recorded from randomization (or first dose for patients in the Phase 1B) until disease progression, death, start of new anti-cancer treatment or end of study. The categories for best overall response include: complete response (CR) (complete disappearance of all target lesions with the exception of nodal disease and all target nodes must decrease to normal size (short axis \<10 millimeters (mm)); partial response (PR) (at least a 30 percent (%) decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters); stable disease (SD) (not qualify for CR, PR or Progression); progressive disease (PD) (20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy), with a minimum absolute increase of 5 mm); indeterminate (IND) (progression has not been documented).

Duration of Response (Phase 2)Day 1 to Day 28

Duration of response is the time from first documentation of CR or PR to date of first documentation of objective progression or death.

Overall Survival (Phase 2)Day 1 up to Day 28

Overall survival is the time from randomization date to date of death due to any cause.

Number of Participants With Evidence of Pathway Signaling Related Genes and/or Proteins in Biopsied Tumor Tissue (Phase 2)Baseline and Cycle 2 Day 17

Biomarker evaluation were to be performed on these fresh biopsies, as well as on archival biopsies collected during the study. Samples were to be analyzed for biomarkers indicative of pathway modulation or for genetic markers correlated to drug sensitivity.

Change From Baseline in Functional Assessment of Cancer Therapy-Colorectal (FACT-C) (Phase 2)Day 1 of each cycle

The FACT-C was to assess health-related quality of life and colorectal cancer (CRC)-related symptoms. It includes a total of 36 items, which are summarized into 6 subscales: physical well-being (7 items), functional well-being (7 items), social/family well-being (7 items), emotional well-being (6 items), CRC subscale (9 items) which addresses a subset of CRC concerns such as diarrhea.

Trial Locations

Locations (37)

Drug Management Only: UCLA West Medical Pharmacy, Attn Steven L. Wong, Pharm .D.

🇺🇸

Los Angeles, California, United States

Comprehensive Cancer Centers of Nevada

🇺🇸

Henderson, Nevada, United States

Spartanburg Regional Medical Center

🇺🇸

Spartanburg, South Carolina, United States

Metrohealth Medical Center

🇺🇸

Cleveland, Ohio, United States

Comprehensive Cancer Centers of NV

🇺🇸

Las Vegas, Nevada, United States

Ronald Reagan UCLA Medical Center

🇺🇸

Los Angeles, California, United States

Medical Oncology Associates, PS

🇺🇸

Spokane, Washington, United States

COmprehensive Cancer Centers of Nevada

🇺🇸

Las Vegas, Nevada, United States

Comprehensive Cancer Centers for Nevada

🇺🇸

Las Vegas, Nevada, United States

Comprehensive Cancer Centers of Nevada Research Department

🇺🇸

Henderson, Nevada, United States

Medical Group of the Carolinas - Hematology Spartanburg

🇺🇸

Spartanburg, South Carolina, United States

St. Jude Hospital Yorba Linda DBA St. Joseph Heritage Healthcare

🇺🇸

Fullerton, California, United States

UCLA Hematology Oncology

🇺🇸

Santa Monica, California, United States

UCLA Hematology Oncology Administrative Address

🇺🇸

Los Angeles, California, United States

UCLA West Medical Pharmacy, Att: Steven L. Wong, Pharm D.

🇺🇸

Los Angeles, California, United States

TRIO-US Central Administration, Regulatory Management Only

🇺🇸

Los Angeles, California, United States

TRIO_US

🇺🇸

Los Angeles, California, United States

Westwood Bowyer Clinic, Peter Morton Medical Building

🇺🇸

Los Angeles, California, United States

TRIO-US Central Administration

🇺🇸

Los Angeles, California, United States

Central Coast Medical Oncology Corporation

🇺🇸

Santa Maria, California, United States

West Valley Hematology/Oncology Med Group

🇺🇸

Northridge, California, United States

UCLA/Pasadena Healthcare

🇺🇸

Pasadena, California, United States

UCLA Santa Monica Medical Center & Orthopaedic Hospital

🇺🇸

Santa Monica, California, United States

Kadlec Medical Center

🇺🇸

Richland, Washington, United States

Kadlec Clinic Hematology and Oncology

🇺🇸

Kennewick, Washington, United States

Outpatient Imaging Center

🇺🇸

Richland, Washington, United States

Investigational Drug Services

🇺🇸

Seattle, Washington, United States

Princess Margaret Cancer Centre

🇨🇦

Toronto, Ontario, Canada

Virginia Mason Medical Center

🇺🇸

Seattle, Washington, United States

Spokane Valley Cancer Center

🇺🇸

Spokane Valley, Washington, United States

The Ottawa Hospital Cancer Centre

🇨🇦

Ottawa, Ontario, Canada

Hospital General Universitario Gregorio Marañón

🇪🇸

Madrid, Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Drug Management Only: UCLA West Medical Pharmacy

🇺🇸

Los Angeles, California, United States

Ronald Regan UCLA Medical Center, Drug Information Center

🇺🇸

Los Angeles, California, United States

UCLA/Santa Clarita Valley Cancer Center

🇺🇸

Valencia, California, United States

UCLA Cancer Center

🇺🇸

Westlake Village, California, United States

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