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Safety and Efficacy Study of Famitinib in Patients With Advanced Colorectal Adenocarcinoma(FACT)

Phase 3
Completed
Conditions
Colorectal Cancer Recurrent
Colorectal Cancer Metastatic
Interventions
Drug: Placebo
Drug: Famitinib
Registration Number
NCT02390947
Lead Sponsor
Jiangsu HengRui Medicine Co., Ltd.
Brief Summary

Famitinib is a tyrosin-inhibitor agent targeting at c-Kit, VEGFR2, PDGFR, VEGFR3, Flt1 and Flt3, whose anti-tumor and anti-angiogenesis effects have been validated in preclinical tests. In PhaseⅡb study, a significantly improved Progression Free Survival (PFS) was found in patients with advanced colorectal cancer treated with Famitinib compared to placebo. On the other hand, the toxicity of Famitinib was manageable in both PhaseⅠand Ⅱb studies.

The purpose of this study is to determine whether Famitinib can improve Overall Survival (OS) compared with placebo in total 540 patients with advanced colorectal cancer who have failed in previously received at least two lines of standard chemotherapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
543
Inclusion Criteria
  1. Male or female patients aged 18 to 75 (including 18 and 75) at the time of Informed Consent

  2. Pathologically confirmed advanced colorectal adenocarcinoma (all the other histological types are excluded)

  3. Treatment failure in previously received standard therapy (at least two lines), which must include 5-Fu, irinotecan and oxaliplatin

    Definition of "treatment failure":

    A.Disease progression during experimental drug treatment or within 3 months after the last treatment, with definite imaging or clinical evidences;

    B.For patients abandoning chemotherapy because of intolerance of advent events, hematologic toxicity is required to reach ≥Grade IV (platelet decrease ≥ Grade III ), and nonhematologic toxicity is required to reach ≥Grade III , according to NCI CTCAE 4.0. Furthermore, the original treatment should be not tolerated any more when it is repeated to the same patient, judged by investigators.

    Note:

    A.When adjuvant therapy including oxaliplatin was previously used, at least 9 courses of FOLFOX (2 weeks regimens), 6 courses of CapeOX (3 week regimen), or 750mg/m^2 cumulative consumption of oxaliplatin, are required. Adjuvant therapy will be regarded as the first-line treatment when disease progressed during or within 6 months after treatments

    B.Monoclonal antibody drugs (bevacizumab, cetuximab, panitumumab, aflibercept, etc.) are allowed to combine with prior chemotherapy.

  4. At least one measurable targeting lesion according to RECIST 1.1 (The diameter of tumor and lymph node lesion should be ≥ 10 mm and 15mm, respectively, with scanning layer ≤ 5 mm and without local treatment)

  5. Eastern Cooperative Oncology Group (ECOG) performance status:0-1.

  6. Life expectancy ≥ 3 months

  7. Adequate function of major organs, meaning the following criteria should be met within 14 days before randomization:

    A.Routine blood test:

    1. Hemoglobin > 90g/L (not received blood transfusion or drugs to incraese RBC, Hb, WBC and PLT in 14 days before screening )

    2. Neutrophils > 1.5×10^9/L

    3. Platelets > 100×10^9/L

      B. Blood biochemistry:

    4. Total bilirubin < 1.25×the upper limit of normal (ULN)

    5. Serum transaminase ≤ 2×ULN (≤ 5×ULN, If existing liver metastases)

    6. Creatinine clearance rate ≥ 60ml/min (Cockcroft-Gault Formula)

    C.Doppler echocardiography assessment: Left ventricular ejection fraction (LVEF) ≥ 50%

  8. Having recovered from impairments of other therapy before taking research drugs (more than 6 weeks from the last treatment of Nitroso or MMC, more than 4 weeks from the last treatment of other cytotoxic drugs, targeted drugs, radiotherapy or operation, with completely healed wound, more than 2 weeks from the last treatment of Chinese traditional and patent medicine)

  9. Signed and dated informed consent

  10. Good compliance of patients and agreement of their family members to cooperate on the follow-up of survival.

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Exclusion Criteria
  1. Second malignancies, except for cured skin basal cell carcinoma and carcinoma in-situ of uterine cervix, before or during screening
  2. Previously received therapy of tyrosine kinase inhibitor agent targeting at VEGFR, e.g. famitinib, sorafenib, sunitinib, regorafenib
  3. Having joined in other clinical trials within 4 weeks
  4. Factors influencing the usage of oral administration (e.g. unable to swallow, chronic diarrhea and intestinal obstruction, etc.)
  5. Having haemorrhage history, ≥ Grade Ⅲ (NCI CTCAE 4.0 ) haemorrhage occurred within 4 weeks before screening
  6. Known central nervous system (CNS) metastasis or having CNS metastasis history before screening. CT or MRI scan should be received 28 days before randomization when CNS metastases is clinically suspected
  7. Uncontrolled hypertension with single medical therapy (systolic blood pressure > 140 mmHg, diastolic blood pressure > 90 mmHg), History of unstable angina pectoris or newly diagnosed unstable angina pectoris within 3 months before screening, myocardial infarction events within 6 months before screening, Arrhythmias (QTcF: ≥450ms in male, ≥ 470ms in female) needed long-term treatment of drugs, ≥ class II cardiac insufficiency by New York Heart Association (NYHA) classification
  8. urinary protein ≥ ++ or 24-hour urinary protein ≥ 1.0 g
  9. Chronic untreated wounds or fractures
  10. Tumor invasion around major vessels shown by imaging, high risk of major vascular invasion leading to massive hemorrhage judged by investigators
  11. Abnormal international normalized ratio (INR) of patients with coagulation dysfunction and hemorrhagic tendency at 14 days before randomization. Application of anticoagulants or vitamin K antagonists such as warfarin, heparin or its analogues. However, low doses of warfarin (1mg orally, once daily) or aspirin (between 80mg to 100mg daily) can be used for prevention on the premise of INR ≤ 1.5
  12. Artery/venous thromboembolic events occurred within 1 year before screening, such as cerebral vascular accident (including transient ischemic attack), deep vein thrombosis (except for recovered venous thrombosis judged by investigators, which was caused by venous catheter in previous chemotherapy) and pulmonary embolism, etc.
  13. All female patients who are not surgically sterilized or postmenopausal refusing to take a reliable method of birth control during the study and within 6 months after the last dose of test article. All female patients in breastfeeding period or in child-bearing period with a positive urine or serum pregnancy test result before randomization. All male subjects who are not surgically sterilized refusing to take a reliable method of birth control during the study and within 6 months after the last dose of test article.
  14. Preexisted thyroid dysfunction, thyroid function cannot be controlled within normal range even using medical therapy
  15. History of psychiatric drug abuse and addiction, dysphrenia
  16. Symptomatic pleural effusion, hydropericardium or ascites needed clinical intervention or being stable less than 4 weeks.
  17. History of Immunodeficiency, acquired or congenital immunodeficiency, history of organ transplantation
  18. Known active HBV or HCV infection companion with hepatic dysfunction
  19. Concomitant disease judged by investigators that may bring serious harm to the safety of patients or the completion of this study
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control armsPlaceboPlacebo 25 mg p.o. qd and the medication continued until disease progression or intolerable toxicity or patients withdrawal of consent
Famitinib armsFamitinibFamitinib 25 mg p.o. qd and the medication continued until disease progression or intolerable toxicity or patients withdrawal of consent
Primary Outcome Measures
NameTimeMethod
Overall Survival(OS)3 years
Secondary Outcome Measures
NameTimeMethod
Progression Free Survival(PFS)1.5 years
Disease Control Rate(DCR)1.5 years
The incidence of Adverse Events3 years
Objective response rate(ORR)6 months
The severity of Adverse Events3 years
Quality of Life as measured by EORTC QLQ-C30(3.0)1.5 years

Trial Locations

Locations (44)

The Second Affiliated Hospital of Anhui Medical University

🇨🇳

Hefei, Anhui, China

The Third Xiangya Hospital of Cental South University

🇨🇳

Changsha, Hunan, China

Cancer Hospital of Guangxi Zhuang Autonomous Region

🇨🇳

Nanning, Guangxi, China

Union Hospital of Tongji Medical College, Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

Cancer Hospital of Hunan Province

🇨🇳

Changsha, Hunan, China

The First People's Hospital of Changzhou

🇨🇳

Changzhou, Jiangsu, China

Cancer Hospital of Jiangsu Province

🇨🇳

Nanjing, Jiangsu, China

The Affiliated Hospital of Xuzhou Medical Collage

🇨🇳

Xuzhou, Jiangsu, China

The Second Affiliated Hospital of Nanchang University

🇨🇳

Nanchang, Jiangxi, China

People's Hospital of Tianjin City

🇨🇳

Tianjin, Tianjin, China

Cancer Hospital of Yunnan Province

🇨🇳

Kunming, Yunnan, China

The First Affiliated Hospital of Anhui Medical University

🇨🇳

Hefei, Anhui, China

Chinese Academy of Medical Sciences Cancer Hospital

🇨🇳

Beijing, Beijing, China

Beijing Cancer Hospital, Peking University

🇨🇳

Beijing, Beijing, China

Beijing Friendship Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

Beijing Chao-yang Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

PLA Hospital 301

🇨🇳

Beijing, Beijing, China

Fujian Medical University Union Hospital

🇨🇳

Fuzhou, Fujian, China

The Third Affiliated Hospital of The Third Military Medical University

🇨🇳

Chongqing, Chongqing, China

Cancer center, Sun Yet-sen University

🇨🇳

Guangzhou, Guangdong, China

The First Affiliated Hospital of Guangzhou Medical University of Chinese Medicine

🇨🇳

Guangzhou, Guangdong, China

Harbin Medical University Cancer Hospital

🇨🇳

Harbin, Heilongjiang, China

The first affiliated hospital of Xinxiang medical university

🇨🇳

Xinxiang, Henan, China

Hospital of Guangxi Zhuang Autonomous Region

🇨🇳

Nanning, Guangxi, China

Hainan General Hospital

🇨🇳

Hainan, Hainan, China

Cancer Hospital of Henan Province

🇨🇳

Zhengzhou, Henan, China

The First affiliated Hospital of Zhengzhou University

🇨🇳

Zhengzhou, Henan, China

Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

The Second Affiliated Hospital of Nanjing Medical University

🇨🇳

Nanjing, Jiangsu, China

Wuhan General Hospital of Guangzhou Military

🇨🇳

Wuhan, Hubei, China

Cancer Hospital of Jilin province

🇨🇳

Changchun, Jilin, China

Cancer Hospital of Shanxi Province

🇨🇳

Xian, Shanxi, China

Cancer Hospital of Jiangxi Province

🇨🇳

Nanchang, Jiangxi, China

Chinese Medical University First Hospital

🇨🇳

Shenyang, Liaoning, China

The First Affiliated Hospital of Jilin University

🇨🇳

Changchun, Jilin, China

Cancer Hospital of Liaoning Province

🇨🇳

Shenyang, Liaoning, China

Fudan University Cancer Hospital

🇨🇳

Shanghai, Shanghai, China

Zhongshan Hospital of Fudan University

🇨🇳

Shanghai, Shanghai, China

Ruijin Hospital, Shanghai jiaotong University, School of Medicine

🇨🇳

Shanghai, Shanghai, China

Shanghai General Hospital

🇨🇳

Shanghai, Shanghai, China

Tangdu Hospital of The Fouth Military Medical University

🇨🇳

Xian, Shanxi, China

Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

Cancer Hospital of Tianjin City

🇨🇳

Tianjin, Tianjin, China

The Second Affiliated Hospital of Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

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