MEK and MET Inhibition in Colorectal Cancer
- Conditions
- Topic: CancerSubtopic: Colorectal CancerDisease: ColonCancer
- Registration Number
- ISRCTN18043777
- Lead Sponsor
- niversity of Oxford
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 148
Participant inclusion criteria as of 21/11/2018:
All patients
1. Age at least 16 years
2. ECOG performance status 0-1
3. Adequate respiratory and cardiac function on clinical assessment
4. Left ventricular ejection fraction (LVEF) = 50% as determined by a multigated acquisition (MUGA) scan or echocardiogram
5. Able to give informed consent prior to any screening procedures being performed and be capable of complying with the protocol and its requirements
6. Haematological and biochemical indices within the ranges shown below:
6.1. Haemoglobin (Hb) =9g/dl (transfusion to achieve this allowed),
6.2. Neutrophils= 1,500/µl,
6.3. Platelet count = 100,000/µl,
6.4. AST or ALT =2.5 x ULN, patient with liver metastases <5 x ULN, alkaline phosphatase =5 x ULN,
6.5. Serum Bilirubin =1.5 x ULN,
6.6. Creatinine Clearance =50ml/min
7. Able to swallow oral medication
8. Life expectancy of at least 3 months
Dose escalation phase:
1. Patients with any advanced solid tumours
2. Patients for whom the combination of PF-02341066 with Binimetinib is a reasonable option.
Dose expansion phase:
Patients will be eligible for pre-screening for MErCuRIC provided that:
1. They have given informed consent to screening.
2. They are willing to undergo a biopsy for assessment of tumour RAS mutation status and c-MET assessment.
3. The Investigator anticipates that they are likely to satisfy the eligibility criteria for the trial. Formal screening should not be performed until the tumour pre-screening result is known.
Eligibility for the trial, in patients passing pre-screening, requires:
1. Histologically confirmed colon adenocarcinoma that is either a) RASMT (KRAS codon 12, 13, 61, 117, 146; NRAS codon 12, 13, 61, 117, 146 mutations) or b) RASWT/c-MET mutated or amplified CRC or c) RASWT/c-MET over-expressed with progressive disease on or within 6 months of completion of adjuvant therapy or after chemotherapy and/or targeted therapies for metastatic disease.
2. Prior treatment with an EGFR targeted monoclonal antibody for patients with RASWT/c-MET mutated or amplified CRC or RASWT/c-MET over-expressed.
3. No evidence for a mutation in BRAF at codon600
4. Metastases accessible for biopsy on at least 2-3 occasions
5. At least one other measurable lesion (according to RECIST v1.1).
6. Unsuitable for potential curative resection.
Participant inclusion criteria as of 19/09/2017:
All patients
1. Age at least 16 years
2. ECOG performance status 0-1
3. Adequate respiratory and cardiac function on clinical assessment
4. Left ventricular ejection fraction (LVEF) = 50% as determined by a multigated acquisition (MUGA) scan or echocardiogram
5. Able to give informed consent prior to any screening procedures being performed and be capable of complying with the protocol and its requirements
6. Haematological and biochemical indices within the ranges shown below:
Exclusion criteria as of 21/11/2018:
1. Unstable ischemic heart disease, cardiac dysrhythmias, coronary/peripheral artery bypass graft or cerebrovascular accident within 6 months prior to starting treatment.
2. Uncontrolled arterial hypertension despite medical treatment.
3. Ongoing congestive heart failure or cardiac dysrhythmias of NCI CTCAE Grade >2 or uncontrolled atrial fibrillation.
4. History of extensive disseminated/bilateral or known presence of Grade 3 or 4 interstitial fibrosis or interstitial lung disease, including a history of pneumonitis, hypersensitivity pneumonitis, interstitial pneumonia, interstitial lung disease (ILD), obliterative bronchiolitis, and pulmonary fibrosis. A history of prior radiation pneumonitis is allowed.
5. Any active central nervous system (CNS) lesion (i.e., those with radiographically unstable, symptomatic lesions) and/or leptomeningeal metastases. However, patients treated with stereotactic radiotherapy or surgery are eligible if the patient remained without evidence of CNS disease progression = 3 months. Patients must be off corticosteroid therapy for = 3 weeks.
6. Patients who have neuromuscular disorders that are associated with elevated CK (e.g. inflammatory myopathies, muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy);
7. Patients who are planning on embarking on a new strenuous exercise regimen after first dose of study treatment. NB: Muscular activities, such as strenuous exercise, that can result in significant increases in plasma CK levels should be avoided while on Binimetinib treatment.
8. Spinal cord compression unless treated with the patient attaining good pain control and stable or recovered neurologic function.
9. Carcinomatous meningitis or leptomeningeal disease.
10. History of hypoalbuminaemia, or patients with peritoneal disease or pleural disease, where there is a requirement for ascitic or pleural taps.
11. History of retinal vein occlusion, intraocular pressure > 21 mmHg or patient considered at risk of retinal vein thrombosis.
12. History of retinal degenerative disease.
13. History of Gilbert’s syndrome.
14. Active infections (including chronic hepatitis type B or C and HIV infection if status known), severe immunologic defect, compromised bone marrow function
15. Other severe acute or chronic medical conditions
16. Patients who have undergone major surgery = 3 weeks prior to starting study drug or who have not recovered from side effects of such procedure
17. Use of drugs or foods that are known potent CYP3A4 inhibitors or inhibitors or are CYP3A4 substrates with narrow therapeutic indices
18. Radiotherapy (except for palliative reasons), endocrine therapy, immunotherapy or chemotherapy during the previous four weeks (six weeks for nitrosoureas, Mitomycin-C)
19. Resting ECG with QTc >480msec at 2 or more time points within a 24h period.
20. Requirement for medication known to prolong QT interval.
21. History of other malignancy less than 3 years before the diagnosis of current cancer
22. Women with the ability to become pregnant (or already pregnant or lactating). However, those fe
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method <br> As of 07/09/2016:<br> Dose Expansion phase; Time point(s): Clinical & radiological response to PD-0325901 or Binimetinib with PF-02341066 using RECIST v1.1<br><br> Initial:<br> Dose Expansion phase; Timepoint(s): Clinical & radiological response to PD-0325901 with PF-02341066 using RECIST v1.1<br>
- Secondary Outcome Measures
Name Time Method <br> As of 07/09/2016:Dose Escalation Phase; Time point(s): Maximal tolerated dose of PD-0325901 or Binimetinib with PF-02341066 according to toxicities in cycle 1.<br><br> Initial:<br> Dose Escalation Phase; Timepoint(s): Maximal tolerated dose of PD-0325901 with PF-02341066 according to toxicities in cycle 1.<br>