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Cetuximab With or Without Brivanib in Treating Patients With K-Ras Wild Type Tumours and Metastatic Colorectal Cancer

Phase 3
Completed
Conditions
Colorectal Cancer
Interventions
Biological: cetuximab
Registration Number
NCT00640471
Lead Sponsor
NCIC Clinical Trials Group
Brief Summary

RATIONALE: Brivanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. It is not yet known whether giving brivanib together with cetuximab is more effective than cetuximab alone in treating patients with metastatic colorectal cancer.

PURPOSE: This randomized phase III trial is studying cetuximab to see how well it works compared with cetuximab given together with brivanib in treating patients with metastatic colorectal cancer.

Detailed Description

OBJECTIVES:

Primary

* To compare the overall survival of patients with previously treated K-Ras wild type metastatic colorectal carcinoma treated with brivanib alaninate in combination with cetuximab versus placebo in combination with cetuximab.

Secondary

* To compare the progression-free survival of these patients.

* To compare the objective response rate and duration of response in these patients.

* To compare the quality of life of these patients.

* To compare the health utilities of these patients.

* To conduct a comparative economic evaluation of these patients.

* To evaluate the safety profile of this regimen in these patients.

* To explore an association between FGF-2, BRAF mutations, amphiregulin (AREG) and epiregulin (EREG) as determined from paraffin embedded tumor specimens and the potential for clinical benefit from the addition of brivanib alaninate or placebo to cetuximab in terms of overall survival, progression-free survival and objective response rate compared to cetuximab alone.

* To explore associations with mRNA and/or protein expression and/or variations in genes associated with epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), angiogenesis, and other related pathways and the potential for clinical benefit from the addition of brivanib alaninate to cetuximab in terms of overall survival, progression-free survival, and objective response rate compared to cetuximab alone.

* To explore an association with changes of Collagen IV in the blood and the potential for clinical benefit from the addition of brivanib alaninate to cetuximab in terms of overall survival, progression-free survival and objective response rate compared to cetuximab alone.

* To establish a comprehensive tumor bank linked to a clinical database for the further study of molecular markers in colorectal cancer.

OUTLINE: This is a multicenter study. Patients are stratified according to participating center and ECOG performance status (0-1 vs 2). Patients are randomized to 1 of 2 arms.

* Arm I: Patients receive oral brivanib alaninate once daily and cetuximab IV over 60-120 minutes once weekly.

* Arm II: Patients receive oral placebo once daily and cetuximab IV over 60-120 minutes once weekly.

In both arms, treatment continues in the absence of disease progression or unacceptable toxicity.

Tumor tissue and blood samples are collected for correlative studies. Samples are analyzed for biomarker levels (Collagen IV, FGF-2, and epiregulin, amphiregulin, and BRAF mutation status) and correlation with response.

After completion of study treatment, patients are followed at 4 weeks and then every 8 weeks thereafter.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
750
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebocetuximab-
Brivanibcetuximab-
Brivanibbrivanib alaninate-
Primary Outcome Measures
NameTimeMethod
Overall survival3 years
Secondary Outcome Measures
NameTimeMethod
Economic evaluation3 years
Molecular markers3 years
Progression-free survival3 years
Quality of life (using EORTC QLQ-C30 and Skindex-16 Dermatology Survey)3 years
Safety profile3 years
Health utilities (using HUI3 Health Utilities Index)3 years
Objective response rate3 years
Duration of response3 years

Trial Locations

Locations (37)

BCCA - Cancer Centre for the Southern Interior

🇨🇦

Kelowna, British Columbia, Canada

Atlantic Health Sciences Corporation

🇨🇦

Saint John, New Brunswick, Canada

Dr. H. Bliss Murphy Cancer Centre

🇨🇦

St. John's, Newfoundland and Labrador, Canada

CHUM - Hopital Notre-Dame

🇨🇦

Montreal, Quebec, Canada

Cancer Centre of Southeastern Ontario at Kingston

🇨🇦

Kingston, Ontario, Canada

Hopital du Sacre-Coeur de Montreal

🇨🇦

Montreal, Quebec, Canada

Tom Baker Cancer Centre

🇨🇦

Calgary, Alberta, Canada

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

BCCA - Abbotsford Centre

🇨🇦

Abbotsford, British Columbia, Canada

The Moncton Hospital

🇨🇦

Moncton, New Brunswick, Canada

BCCA - Vancouver Cancer Centre

🇨🇦

Vancouver, British Columbia, Canada

BCCA - Fraser Valley Cancer Centre

🇨🇦

Surrey, British Columbia, Canada

The Vitalite Health Network - Dr. Leon Richard

🇨🇦

Moncton, New Brunswick, Canada

The Royal Victoria Hospital

🇨🇦

Barrie, Ontario, Canada

Juravinski Cancer Centre at Hamilton Health Sciences

🇨🇦

Hamilton, Ontario, Canada

Grand River Regional Cancer Centre

🇨🇦

Kitchener, Ontario, Canada

London Regional Cancer Program

🇨🇦

London, Ontario, Canada

Stronach Regional Health Centre at Southlake

🇨🇦

Newmarket, Ontario, Canada

Niagara Health System

🇨🇦

St. Catharines, Ontario, Canada

Algoma District Cancer Program

🇨🇦

Sault Ste. Marie, Ontario, Canada

Ottawa Health Research Institute - General Division

🇨🇦

Ottawa, Ontario, Canada

Toronto East General Hospital

🇨🇦

Toronto, Ontario, Canada

Odette Cancer Centre

🇨🇦

Toronto, Ontario, Canada

St. Michael's Hospital

🇨🇦

Toronto, Ontario, Canada

Thunder Bay Regional Health Science Centre

🇨🇦

Thunder Bay, Ontario, Canada

Univ. Health Network-Princess Margaret Hospital

🇨🇦

Toronto, Ontario, Canada

PEI Cancer Treatment Centre,Queen Elizabeth Hospital

🇨🇦

Charlottetown, Prince Edward Island, Canada

L'Hotel-Dieu de Levis

🇨🇦

Levis, Quebec, Canada

Hopital Charles LeMoyne

🇨🇦

Greenfield Park, Quebec, Canada

McGill University - Dept. Oncology

🇨🇦

Montreal, Quebec, Canada

CHUQ-Pavillon Hotel-Dieu de Quebec

🇨🇦

Quebec City, Quebec, Canada

Centre hospitalier universitaire de Sherbrooke

🇨🇦

Sherbrooke, Quebec, Canada

CHA-Hopital Du St-Sacrement

🇨🇦

Quebec City, Quebec, Canada

Allan Blair Cancer Centre

🇨🇦

Regina, Saskatchewan, Canada

Saskatoon Cancer Centre

🇨🇦

Saskatoon, Saskatchewan, Canada

CancerCare Manitoba

🇨🇦

Winnipeg, Manitoba, Canada

Lakeridge Health Oshawa

🇨🇦

Oshawa, Ontario, Canada

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