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Panitumimab in combination with radiotherapy in patients with locally advanced RAS wildtype rectal cancer (clinical stages II and III)

Conditions
ocally advanced RAS wildtype rectal cancer (clinical stage II and III)
MedDRA version: 14.1Level: PTClassification code 10038050Term: Rectal cancer stage IIISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
MedDRA version: 14.1Level: PTClassification code 10038049Term: Rectal cancer stage IISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2009-016782-28-DE
Lead Sponsor
GMIHO Gesellschaft für Medizinische Innovation - Hämatologie und Onkologie mbH
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
Not specified
Inclusion Criteria

• Locally advanced rectal cancer (stage II or III; EUS and MRI mandatory)
• RAS wildtype mandatory (to be determined at accredited local
laboratory or pathology of Mannheim Univ.)
•RAS wild-type tested in
? KRAS exon 2 (codons 12/13)
? KRAS exon 3 (codons 59/61)
? KRAS exon 4 (codons 117/146)
? NRAS exon 2 (codons 12/13)
? NRAS exon 3 (codons 59/61)
? NRAS exon 4 (codons 117/146)

• PTEN expression result available (IHC - to be determined by pathology of
Mannheim Univ.)
• adequate hematologic, hepatic, renal and metabolic parameters
E.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 58
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 58

Exclusion Criteria

• Distant metastases (excluded by CT scan)
• cT4 tumor (excluded by MRI and EUS)
• Risk of tumor involvement of the circumferential resection margin, according to the
MRI assessment
• Sphincter sparing as the major reason for choosing the neoadjuvant treatment
approach
• Prior antineoplastic therapy for rectal cancer

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: The primary objective of the study is to estimate the efficacy of panitumumab concurrent to radiotherapy in<br>patients with wild-type RAS. The rate of pathological complete remissions will be compared to expectations<br>derived from historical data.;Secondary Objective: - Safety of the combination (Toxicity assessment according to NCI CTCAE V.3)<br>- Surgical morbidity and complications<br>- Pathological staging, tumor downstaging; assessed by pTNM findings in<br>relation to initial cTNM staging; regression grading according to Dworak<br>- Clinical response (rates of CR/PR/SD/PD after neoadjuvant treatment)<br>- Biomarker studies (KRAS, NRAS, BRAF, PI3K-Akt, PTEN, EGFR);Primary end point(s): pCR rate, defined by the number of patients with a pCR finding divided by the number of patients recruited and<br>having received at least one application of antitumor therapy;Timepoint(s) of evaluation of this end point: At surgical resection of the rectal tumor
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s): 1. Safety of the combination (Toxicity assessment according to NCI CTCAE V.4)<br>2. Surgical morbidity and complications<br>3. Pathological staging, tumor downstaging; assessed by pTNM findings in relation to initial cTNM staging; regression grading according to Dworak<br>4. Clinical response (rates of CR/PR/SD/PD after neoadjuvant treatment)<br>5. Biomarker studies (KRAS, BRAF, PI3K-Akt, PTEN, EGFR);Timepoint(s) of evaluation of this end point: 1. During radio-immunotherapy<br>2. At surgery and 4 weeks after surgery<br>3. At surgical resection of the rectal tumor<br>4. At surgical resection of the rectal tumor<br>5. At inclusion in the study and at surgical resection of the rectal tumor
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