Safety and Efficacy Study of Neratinib and Cetuximab to Treat Patients With Quadruple Wild-Type Metastatic Colorectal Cancer
- Registration Number
- NCT01960023
- Lead Sponsor
- NSABP Foundation Inc
- Brief Summary
The FC-7 study is designed as an open label, single arm, Phase I/II dose-escalation study evaluating the combination of neratinib and cetuximab in patients with metastatic colorectal cancer primary tumor that is "quadruple wild-type " (wild-type KRAS, NRAS, BRAF, PIK3CA). The primary aim in the Phase I portion of this study is to determine the safety and tolerability of the two-drug combination. The primary aim of the Phase II part is to determine the overall objective response rate (complete and partial responses) by Response Evaluation Criteria in Solid Tumors (RECIST 1.1).
Patients will receive concurrent therapy with cetuximab (400 mg/m2 IV loading dose followed by 250 mg/m2 IV weekly), and neratinib.
- Detailed Description
The neratinib dose-escalation using a 3+3 design will include 4 dose levels (120 mg, 160 mg, 200 mg, and 240 mg) as a daily oral dose. Up to 12 patients will be treated at the maximum tolerated dose (MTD).
The neratinib dose-escalation for the study will proceed on the basis of dose-limiting toxicity (DLT) during cycle 1. DLT will be defined as the occurrence of 1 or more of the following events during cycle 1: any grade diarrhea that is associated with fever or dehydration requiring IV fluids; grade 3 diarrhea lasting more than 2 days on optimal medical therapy; grade 4 diarrhea of any duration; grade 3 or 4 neutropenia associated with fever; grade 4 neutropenia lasting more than 7 days; grade 4 thrombocytopenia; grade 3 or 4 non-hematological toxicity (excluding grade 3 rash or allergic reaction/hypersensitivity); or any toxicity-related delay of more than 2 weeks to initiate cycle 2. Patients will be enrolled at the next dose level when all evaluable patients at the same dose level have completed the first treatment cycle. Enrolled patients will remain on the assigned dose level treatment until toxicity or disease progression.
The Phase II part of this study will proceed with a two-stage design with a maximum of 46 patients. Between 6 and 12 patients at the Phase I MTD level will be included in the Phase II, stage-one analysis.
Toxicity will be graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events version 4.0.
Submission of tumor and blood samples for FC-7 correlative science studies will be a study requirement for all patients. A core biopsy procedure to procure fresh tumor samples from an accessible site of metastasis will be performed before study dose level assignment (after the patient has signed the consent form and has been screened for eligibility).
Optional biopsy samples of metastatic disease will be procured from consenting patients after Cycle 1 of treatment and at the time of disease progression.
Recruitment & Eligibility
- Status
- WITHDRAWN
- Sex
- All
- Target Recruitment
- Not specified
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Arm 1: Cetuximab and Neratinib Cetuximab Cetuximab 400 mg/m2 IV loading dose followed by weekly cetuximab 250 mg/m2 IV plus neratinib per oral daily until disease progression Arm 1: Cetuximab and Neratinib Neratinib Cetuximab 400 mg/m2 IV loading dose followed by weekly cetuximab 250 mg/m2 IV plus neratinib per oral daily until disease progression
- Primary Outcome Measures
Name Time Method The safety and tolerability of cetuximab and neratinib during the Phase I portion of the study. From start of study therapy weekly through disease progression or end of therapy, approximately 2 years Number of patients experiencing dose limiting toxicities (DLT).
Number of patients with Overall response rate (ORR)(complete response/partial response) and progression free survival (PFS) during the Phase II portion of the study From start of study through 16 weeks. Response as measured by RECIST 1.1 criteria.
- Secondary Outcome Measures
Name Time Method Progression-free survival (PFS). The time to progression and the time to progression based on tumor HER2 status. From start of study through disease progression or end of therapy, approximately 2 years Tumor measurement to determine objective tumor decrease and stable disease From start of study through desease progression or end of therapy, approximately 2 years Measurement of disease status by continuous tumor measurement.
Measure molecular and genetic correlatives for neratinib and cetuximab Baseline (prior to treatment assignment), prior to therapy, after completion of cycle 1, and at disease progression approximately 2 years. The frequency and severity of adverse events to evaluate the overall toxicity in the Phase II portion of the study. From start of study therapy through 30 days after end of therapy, approximately 2 years
Trial Locations
- Locations (12)
Saint Luke's Mountain States Tumor Institute
🇺🇸Boise, Idaho, United States
Saint Joseph Mercy Hospital
🇺🇸Ann Arbor, Michigan, United States
MD Anderson Cancer Center Orlando
🇺🇸Orlando, Florida, United States
Decatur Memorial Hospital
🇺🇸Decatur, Illinois, United States
Allegheny General Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
University of Florida
🇺🇸Gainesville, Florida, United States
Henry Ford Health System
🇺🇸Detroit, Michigan, United States
Levine Cancer Institute
🇺🇸Charlotte, North Carolina, United States
Novant Health Presbyterian Medical Center
🇺🇸Charlotte, North Carolina, United States
Reading Hospital and Medical Center
🇺🇸West Reading, Pennsylvania, United States
University of Pittsburgh
🇺🇸Pittsburgh, Pennsylvania, United States
Thomas Jefferson University Hospital
🇺🇸Philadelphia, Pennsylvania, United States