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A Study Evaluating S 95005 Plus Bevacizumab and Capecitabine Plus Bevacizumab in Patients With Previously Untreated Colorectal Cancer Who Are Non-eligible for Intensive Therapy

Phase 2
Completed
Conditions
Metastatic Colorectal Cancer
Interventions
Drug: Trifluridine/tipiracil + bevacizumab
Drug: Capecitabine + bevacizumab
Registration Number
NCT02743221
Lead Sponsor
Institut de Recherches Internationales Servier
Brief Summary

The main purpose of this study is to evaluate the progression-free survival (PFS) in patients receiving S 95005 + bevacizumab (experimental arm) or capecitabine + bevacizumab (control arm) as first-line treatment for unresectable metastatic colorectal cancer in patients non-eligible for intensive therapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
154
Inclusion Criteria
  • Written informed consent obtained.
  • Has ECOG (Eastern Cooperative Oncology Group) performance status of 0, 1 or 2 at the time of the randomisation.
  • Has definitive histologically or cytologically confirmed adenocarcinoma of the colon or rectum.
  • RAS status must have been determined (mutant or wild).
  • Has at least one measurable metastatic lesion.
  • No previous systemic anticancer therapy for unresectable metastatic colorectal cancer.
  • Previous adjuvant (or neoadjuvant for patients with rectal cancer) chemotherapy is allowed only if if it has been completed more than 6 months before start of study treatment.
  • Patient is not a candidate for combination chemotherapy with irinotecan or oxaliplatin, or for curative resection of metastatic lesions.
  • Is able to take medication orally (i.e., no feeding tube).
  • Has adequate organ function.
  • Coagulation parameters in normal limit (or in therapeutic limit for patients treated with anticoagulant drugs).
  • Women of childbearing potential must have been tested negative in a serum pregnancy test. Female participants of childbearing potential and male participants with partners of childbearing potential must agree to use a highly effective method of birth control. Women and female partners using hormonal contraceptive must also use a barrier method.
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Exclusion Criteria
  • Is a pregnant or lactating female.
  • Has certain serious illness or serious medical condition(s) as described in the protocol.
  • Has had certain other recent treatment e.g. major surgery, field radiation, received investigational agent, within the specified time frames prior to randomisation.
  • Has previously received Trifluridine/tipiracil or history of allergic reactions attributed to compounds of similar composition to Trifluridine/tipiracil or any of its excipients.
  • Has rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
  • Has contra-indication to bevacizumab or capecitabine.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Trifluridine/tipiracil + bevacizumabTrifluridine/tipiracil + bevacizumabTrifluridine/tipiracil (S95005): film-coated tablets containing 15mg of trifluridine and 7.065mg of tipiracil hydrochloride, or 20mg of trifluridine and 9.42mg of tipiracil hydrochloride. Bevacizumab: concentrate for solution for IV infusion containing 25mg/ml of bevacizumab. Trifluridine/tipiracil was administered at 35 mg/m2/dose orally within 1 hour after completion of morning and evening meals, for 5 days on/2 days off, over 2 weeks, followed by a 14-day rest period, with bevacizumab administered intravenously at the dose of 5 mg/kg every 2 weeks at Day 1 and Day 15.This treatment cycle was repeated every 4 weeks.
Capecitabine + bevacizumabCapecitabine + bevacizumabCapecitabine was administered at 1250 mg/m² orally BID (bis in die)on Days 1-14 of each cycle, with bevacizumab (7.5 mg/kg, IV) administered on Day 1 of each cycle. This treatment cycle was repeated every 3 weeks
Primary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS)Baseline and every 8 weeks (maximum follow-up duration: 17.9 months)

The progression free survival (PFS), defined as the time from the date of randomisation until the date of the investigator-assessed radiological disease progression or death due to any cause according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Progressive disease (PD) was defined at least a 20% increase in the sum of diameters of target lesions (taking as reference the smallest sum on study) and an absolute increase of at least 5 mm in the sum of lesions or the appearance of new lesions.

Secondary Outcome Measures
NameTimeMethod
Overall Response Rate (ORR)Baseline and every 8 weeks (maximum follow-up duration: 17.9 months)

As per RECIST v1.1, Complete Response (CR) was disappearance of all target lesions; Partial Response (PR) was at least 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. The ORR was the proportion of patients who presented CR or PR with confirmation at subsequent time point or at least 4 weeks later.

Duration of Response (DR)Baseline and every 8 weeks (maximum follow-up duration: 16.6 months)

The DR was calculated among patients with CR or PR as the time (months) from the first documentation of response to the first documentation of objective tumor progression or death due to any cause, whichever occurred first.

Disease Control Rate (DCR)Baseline and every 8 weeks (maximum follow-up duration: 17.9 months)

DCR was the proportion of patients with confirmed CR, PR or stable disease (SD) as best overall response. SD defined as neither sufficient decrease to qualify for PR nor sufficient increase to qualify for PD.

Overall Survival (OS)Baseline up to death or study cut-off (maximum follow-up duration: 19.9 months)

The OS was defined as the time from the date of randomisation to the date of death. If death was not confirmed, or patient was alive at study cut-off date, survival time was censored at the date of last follow-up or at the study cut-off date, whichever was earlier.

Trial Locations

Locations (57)

VieCurie Medisch Centrum, Interne Geneeskunde, Tegelseweg 210

🇳🇱

Venlo, Netherlands

Centralny Szpital Kliniczny MSW Klinika Onkologii i Hematologii

🇵🇱

Warszawa, Poland

Szpitale Pomorskie Sp. z o.o. Oddzial Onkologii i Radioterapii

🇵🇱

Gdynia, Poland

SP ZOZ Szpital Uniwersytecki w Krakowie Oddzial Kliniczny Onkologii

🇵🇱

Krakow, Poland

Rigshospitalet - Dpt of Oncology

🇩🇰

Copenhagen, Denmark

Chris O'Brien Lifehouse Oncology

🇦🇺

Camperdown, Australia

Grand Hôpital de Charleroi Oncologie-Hématologie

🇧🇪

Charleroi, Belgium

The Queen Elizabeth Hospital Haematology and Oncology Unit

🇦🇺

Woodville, Australia

UZ Leuven Campus Gasthuisberg Digestieve Oncologie

🇧🇪

Leuven, Belgium

CHC Saint-Joseph Oncologie-Hématoimmunopathologie

🇧🇪

Liège, Belgium

Hospital do Câncer de Barretos - Fundação Pio XII

🇧🇷

Barretos, Brazil

Centro de Pesquisa Hospital de Caridade de Ijuí

🇧🇷

Ijui, Brazil

Hospital de Base, Centro Intergrado de Pesquisa

🇧🇷

Sao Jose do Rio Preto, Brazil

Instituto do Câncer do Estado de São Paulo - ICESP, Núcleo de Pesquisa

🇧🇷

Sao Paulo, Brazil

Odense Universitetshospital - Department of Oncology

🇩🇰

Odense, Denmark

CHU Jean Minjoz, Service d'oncologie médicale

🇫🇷

Besançon, France

Hôpital Saint Antoine, oncology department

🇫🇷

Paris, France

Schwerpunktpraxis für Hämatologie und Onkologie

🇩🇪

Magdeburg, Germany

Centre René Gauducheau, Oncologie Médicale

🇫🇷

Saint-Herblain, France

Onkologische Schwerpunktpraxis Kurfürstendamm

🇩🇪

Berlin, Germany

A.O.U. SanMartino-IST, Unità Operativa Oncologia Medica 1

🇮🇹

Genova, Italy

Fondazione Poliambulanza Istituto Ospedaliero, Clinical Oncology

🇮🇹

Brescia, Italy

Städtisches Krankenhaus München Neuperlach, Klinik für Onkologie und Hämatologie

🇩🇪

Munich, Germany

Amphia Ziekenhuis, Interne Geneeskunde/Oncologie, Langendijk 75

🇳🇱

Breda, Netherlands

A.O. Ospedale Niguarda Ca' Granda-Milano, Department of Onco-Haematology- Onoclogia Falck

🇮🇹

Milan, Italy

Seconda Università degli Studi di Napoli, U.O.C. di Oncologia Medica ed Ematologia

🇮🇹

Naples, Italy

Tergooi Hilversum, Medische Oncologie, Van Riebeeckweg 212

🇳🇱

Hilversum, Netherlands

Catharina Ziekenhuis, Interne Geneeskunde/Oncologie

🇳🇱

Eindhoven, Netherlands

Martini Ziekenhuizen, Interne Geneeskunde/Oncologie, Van Swietenplein 1

🇳🇱

Groningen, Netherlands

Sint Antonius Ziekenhuis Interne Geneeskunde/Oncologie

🇳🇱

Utrecht, Netherlands

Zuyderland Medisch Centrum Interne Geneeskunde

🇳🇱

Sittard, Netherlands

Isala Klinieken, Medische oncologie, Dokter Van Heeweg 2

🇳🇱

Zwolle, Netherlands

Hospital Valle de Hebrón, Servicio de Oncología

🇪🇸

Barcelona, Spain

NZOZ MAGODENT Oddzial Onkologii Klinicznej / Chemioterapii

🇵🇱

Warszawa, Poland

Hospital Universitario Reina Sofia, Deparatmento Oncología Médica

🇪🇸

Cordoba, Spain

Russian Cancer Research Center n.a. NN Blokhin

🇷🇺

Moscow, Russian Federation

Moscow City Oncology Hospital # 62, Chemotherapy

🇷🇺

Moscow, Russian Federation

Russian Cancer Research Center n.a. NN Blokhin, Department of Research for New Antitumour Medicines

🇷🇺

Moscow, Russian Federation

Scientific Centre for Specialized Medical Care (oncological)

🇷🇺

St Petersburg, Russian Federation

Instituto Catalan De Oncología, Hospitalet de Llobregat

🇪🇸

Hospitalet de Llobregat, Spain

Hospital Universitario Gregorio Maranon

🇪🇸

Madrid, Spain

H. Universitario La Paz Oncología Médica

🇪🇸

Madrid, Spain

The Beatson West of Scotland Cancer Centre GI cancers

🇬🇧

Glasgow, United Kingdom

Hospital General Universitario, Oncología Médica

🇪🇸

Malaga, Spain

Complejo Hospitalario de Navarra, Oncología Médica

🇪🇸

Pamplona, Spain

Leicester Royal Infirmary, The HOPE Clinical Trials Unit

🇬🇧

Leicester, United Kingdom

Imperial healthcare NHS Trust Charing Cross Hospital

🇬🇧

London, United Kingdom

Hammersmith Hospital

🇬🇧

London, United Kingdom

Southampton General Hospital

🇬🇧

Southampton, United Kingdom

Mount Vernon Hospital Department of Oncology

🇬🇧

Northwood, United Kingdom

Christie Hospital NHS Foundation Trust, GI & Endocrine

🇬🇧

Manchester, United Kingdom

Austin Hospital Olivia Newton-John Cancer & Wellness Centre

🇦🇺

Heidelberg, Australia

Western Health, Sunshine Hospital

🇦🇺

Saint Albans, Australia

Instituto Nacional do Câncer - INCA Unidade de Pesquisa ClínicaInstituto Nacional do Câncer - INCA Unidade de Pesquisa Clínica

🇧🇷

Rio de Janeiro, Brazil

Hospital Ramón y Cajal, Oncología Médica

🇪🇸

Madrid, Spain

AMC Academisch Medisch Centrum Medische Oncologie

🇳🇱

Amsterdam, Netherlands

.O.U. Pisana-Ospedale Santa Chiara, U.O. di Oncologia Medica 2

🇮🇹

Pisa, Italy

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