Study of Magrolimab Given Together With FOLFIRI/BEV in Patients With Previously Treated Advanced Inoperable Metastatic Colorectal Cancer (mCRC)
- Conditions
- Metastatic Colorectal Cancer
- Interventions
- Registration Number
- NCT05330429
- Lead Sponsor
- Gilead Sciences
- Brief Summary
The goals of this clinical study are to learn more about the safety, tolerability and effectiveness of magrolimab in combination with bevacizumab and 5-fluorouracil, irinotecan, and leucovorin (FOLFIRI) in previously treated participants with advanced inoperable metastatic colorectal cancer (mCRC).
The primary objectives of this study are: (safety run-in cohort) to evaluate safety and tolerability, and the recommended Phase 2 dose (RP2D) and (randomized cohort) to evaluate the efficacy of magrolimab in combination with bevacizumab and 5-fluorouracil, irinotecan, and leucovorin (FOLFIRI) in previously treated participants with advanced inoperable metastatic colorectal cancer (mCRC).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 77
- Previously treated individuals with inoperable metastatic colorectal cancer (mCRC) who are ineligible for checkpoint inhibitor therapy (microsatellite instability (MSI)-H or mismatch repair deficient (dMMR) and are excluded).
- Histologically or cytologically confirmed adenocarcinoma originating in the colon or rectum (excluding appendiceal and anal canal cancers) who have progressed on or after 1 prior systemic therapy in the setting where curative resection is not indicated. This therapy must have included chemotherapy based on 5-FU or capecitabine with oxaliplatin and either bevacizumab, or for patients with RAS wild-type and left-sided tumors, bevacizumab, cetuximab, or panitumumab.
- Measurable disease (RECIST V1.1 criteria).
- Individuals must have an eastern cooperative oncology group (ECOG) performance status of 0 or 1.
- Life expectancy of at least 12 weeks.
- Laboratory measurements, blood counts: adequate hemoglobin, neutrophil, and platelet counts
- Adequate liver function.
- Adequate renal function.
Key
- Prior anticancer therapy including chemotherapy, hormonal therapy, or investigational agents within 3 weeks or within at least 4 half-lives prior to magrolimab dosing (up to a maximum of 4 weeks), whichever is shorter.
- Known v-raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E or MSI-H mutations or dMMR.
- Persistent Grade 2 or more gastrointestinal bleeding.
- Individuals with prior irinotecan therapy.
- Clinically significant coronary artery disease or myocardial infarction within 6 months prior to inclusion.
- Peripheral neuropathy of more than Grade 2 (CTCAE Version 5.0).
- Known dihydropyrimidine dehydrogenase deficiency.
- Acute intestinal obstruction or subobstruction, history of inflammatory intestinal disease or extended resection of the small intestine. Presence of a colonic prosthesis.
- Unhealed wound, active gastric or duodenal ulcer, or bone fracture.
- History of abdominal fistulas, trachea-oesophageal fistulas, any other Grade 4 gastrointestinal perforations, nongastrointestinal fistulas, or intra-abdominal abscesses 6 months prior to screening.
- Uncontrolled arterial hypertension.
- Thromboembolic event in the 6 months before inclusion (eg, transitory ischemic stroke, stroke, subarachnoid hemorrhage) except peripheral deep vein thrombosis treated with anticoagulants.
- Active central nervous system (CNS) disease. Individuals with asymptomatic and stable, treated CNS lesions (radiation and/or surgery and/or other CNS-directed therapy who have not received corticosteroids for at least 4 weeks) are allowed.
- Red blood cell (RBC) transfusion dependence, defined as requiring more than 2 units of packed RBC transfusions during the 4-week period prior to screening.
- History of hemolytic anemia, autoimmune thrombocytopenia, or Evans syndrome in the last 3 months.
- Known hypersensitivity to any of the study drugs, the metabolites, or formulation excipient.
- Known inherited or acquired bleeding disorders.
- Significant disease or medical conditions, as assessed by the investigator and sponsor, that would substantially increase the risk-benefit ratio of participating in the study.
- Second malignancy, except treated basal cell or localized squamous skin carcinomas, or localized prostate cancer.
- Uncontrolled pleural effusion.
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI Magrolimab Participants will receive magrolimab in de-escalating doses to establish recommended Phase 2 dose (RP2D) in combination with + bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI Bevacizumab Participants will receive magrolimab in de-escalating doses to establish recommended Phase 2 dose (RP2D) in combination with + bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI Leucovorin Participants will receive magrolimab in de-escalating doses to establish recommended Phase 2 dose (RP2D) in combination with + bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI Bevacizumab Participants will receive the RP2D determined in the Safety Run-in cohort of magrolimab in combination with bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI Leucovorin Participants will receive the RP2D determined in the Safety Run-in cohort of magrolimab in combination with bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Bevacizumab + FOLFIRI Bevacizumab Participants will receive bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Bevacizumab + FOLFIRI Irinotecan Participants will receive bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Bevacizumab + FOLFIRI Leucovorin Participants will receive bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI Irinotecan Participants will receive magrolimab in de-escalating doses to establish recommended Phase 2 dose (RP2D) in combination with + bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI Fluorouracil Participants will receive magrolimab in de-escalating doses to establish recommended Phase 2 dose (RP2D) in combination with + bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI Irinotecan Participants will receive the RP2D determined in the Safety Run-in cohort of magrolimab in combination with bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI Fluorouracil Participants will receive the RP2D determined in the Safety Run-in cohort of magrolimab in combination with bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Bevacizumab + FOLFIRI Fluorouracil Participants will receive bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle). Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI Magrolimab Participants will receive the RP2D determined in the Safety Run-in cohort of magrolimab in combination with bevacizumab (5 mg/kg every 2 weeks) + FOLFIRI (irinotecan 180 mg/m\^2 + leucovorin 400 mg/m\^2 + fluorouracil 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous on Days 1, 2, 15, and 16 of a 28-Day Cycle).
- Primary Outcome Measures
Name Time Method Safety Run-in Cohort: Percentage of Participants Experiencing Dose-limiting Toxicities (DLTs) According to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 First dose date up to 28 days Safety Run-in Cohort: Percentage of Participants Experiencing Adverse Events (AEs) According to the NCI-CTCAE Version 5.0 First dose date up to 3 years Safety Run-in Cohort: Percentage of Participants Experiencing Laboratory Abnormalities According to NCI-CTCAE Version 5.0 First dose date up to 3 years Randomized Cohort: Progression-free Survival (PFS) as Determined by Investigator Assessment Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 Up to 3 years PFS is defined as the time from the date of randomization until the earliest date of documented disease progression, or death from any cause, whichever occurs first.
- Secondary Outcome Measures
Name Time Method Randomized Cohort: Objective Response Rate (ORR) as Determined by Investigator Assessment Using RECIST Version 1.1 Up to 3 years Confirmed ORR is defined as the proportion of participants with complete response (CR) or partial response (PR) on 2 consecutive assessments, at least 28 days apart.
Randomized Cohort: Duration of Response (DOR) as Assessed by Investigator Assessment Per RECIST Version 1.1 Up to 3 years DOR is defined as time from first documentation of CR or PR to the earliest date of documented disease progression, or death from any cause, whichever occurs first.
Randomized Cohort: Overall Survival (OS) Up to 3 years OS is defined as time from date of randomization to death from any cause.
Randomized Cohort: Change From Baseline of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core Questionnaire EORTC-QLQ-C30 Score Baseline, up to 3 years The EORTC QLQ-C30 is a questionnaire to assess quality of life of cancer patients, it is composed of 30 questions (items) resulting in 5 functional scales, 1 global health status scale, 3 symptom scales, and 6 single items. Scoring of the QLQ-C30 is performed according to QLQ-C30 Scoring manual. All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status denote a better level of functioning (i.e. a better state of the participant), while higher scores on the symptom and single-item scales indicate a higher level of symptoms (i.e. a worse state of the participant).
Randomized Cohort: Change From Baseline of the 5-level EuroQol 5 dimensions questionnaire (EQ-5D-5L) Score Baseline, up to 3 years EQ-5D-5L is an instrument for use as a measure of health outcome.The EQ-5D-5L consists of 2 sections: the EuroQoL (5 dimensions) (EQ-5D) descriptive system and the EuroQoL visual analogue scale (EQ-VAS). The descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. Rating gets recorded on a vertical VAS in which the endpoints are labeled best imaginable health state is 100 (on the top) and worst imaginable health state is 0 (on the bottom). Higher scores of EQ-VAS indicate better health.
Randomized Cohort: the Change From Baseline of the Functional Assessment of Cancer Therapy (FACT) Colorectal Symptom Index (FCSI) Score Baseline, up to 3 years The FCSI is a set of brief, clinically relevant, colorectal cancer symptoms for assessing symptomatic response. It comprises the most important symptoms associated with colorectal cancer, including energy, pain, weight, diarrhea, nausea, swelling or cramps in the stomach area, appetite, ability to enjoy life, and overall quality of life.
The 9 questions are combined in three algorithms to provide information for 3 domains: colorectal cancer symptoms, physical well-being, and functional well-being. Each of the 9 items are scored from "0" to "4" representing "Not at All" through to "Very Much True". The raw score for all items is transformed to a 0-100 scale, and the average for each of the 3 subscales is calculated; high scores illustrate an improved state.Safety Run-in and Randomized Cohorts: Magrolimab Concentration Versus Time Up to end of treatment (approximately 3 years) Safety Run-in and Randomized Cohorts: Antidrug Antibodies (ADA) to Magrolimab Up to end of treatment (approximately 3 years)
Trial Locations
- Locations (51)
Fort Wayne Medical Oncology and Hematology, Inc.
🇺🇸Fort Wayne, Indiana, United States
Virginia Cancer Specialists, PC
🇺🇸Arlington, Virginia, United States
Seattle Cancer Care Alliance (SCCA)
🇺🇸Seattle, Washington, United States
Centre Hospitalizer De L'Ardenne
🇧🇪Libramont-Chevigny, Belgium
Kinghorn Cancer Centre
🇦🇺Darlinghurst, New South Wales, Australia
Princess Margaret Cancer Centre
🇨🇦Toronto, Canada
University of Kansas
🇺🇸Westwood, Kansas, United States
Hematology Oncology Associates of Central New York, PC
🇺🇸East Syracuse, New York, United States
AdventHealth
🇺🇸Rochester, New York, United States
Hôpital de Jolimont
🇧🇪Haine-Saint-Paul, Belgium
San Bortolo General Hospital- Oncology Department
🇮🇹Vicenza, Italy
Institut Català d'Oncologia- Hospital Duran I Reynals
🇪🇸L'Hospitalet de Llobregat, Spain
The Ottawa Hospital Cancer Centre
🇨🇦Ottawa, Canada
Queen Mary Hospital
ðŸ‡ðŸ‡°Hong Kong, Hong Kong
Texas Oncology
🇺🇸Dallas, Texas, United States
The Alfred Hospital
🇦🇺Melbourne, Victoria, Australia
Klinikum rechts der Isar der TU Munchen Zentrum fur klinische Studien der Klinik und Poliklinik fur Innere Medizin III
🇩🇪Munchen, Germany
Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - Medical Oncology Department
🇮🇹Meldola, Italy
CHU de Tours
🇫🇷Tours, France
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain
Hospital HM Sanchinarro
🇪🇸Madrid, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Hong Kong Integrated Oncology Centre
ðŸ‡ðŸ‡°Hong Kong, Hong Kong
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
Roswell Park Cancer Institute
🇺🇸Buffalo, New York, United States
University of California Los Angeles (UCLA)
🇺🇸Santa Monica, California, United States
Austin Health
🇦🇺Heidelberg, Victoria, Australia
Princess Alexandra Hospital
🇦🇺Woolloongabba, Queensland, Australia
Flinders Medical Centre
🇦🇺Bedford Park, South Australia, Australia
Centre Hospitalier Regional Universitaire Hopital Besancon
🇫🇷Besançon, France
Hopital franco brittanique
🇫🇷Paris, France
Centre Léon Bérard - Centre de Lutte contre le Cancer
🇫🇷Lyon, France
Carl Gustav Carus Management GMBH
🇩🇪Dresden, Germany
Istituto Oncologico Veneto (IOV)- IRCCS
🇮🇹Padova, Italy
Azienda Ospedaliera Universitaria Pisana- UO Oncologia Medica
🇮🇹Pisa, Italy
Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Clinico Humanitas
🇮🇹San Giovanni Rotondo, Italy
Pan American Center for Oncology Trials, LLC
🇵🇷San Juan, Puerto Rico
Torrance Memorial Physician Network
🇺🇸Redondo Beach, California, United States
City of Hope ( City of Hope National Medical Center, City of Hope Medical Center )
🇺🇸Duarte, California, United States
Stanford Cancer Center
🇺🇸Palo Alto, California, United States
USC Norris Comprehensive Cancer Center
🇺🇸Los Angeles, California, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
Genesis Care North Shore
🇦🇺St Leonards, New South Wales, Australia
Pennsylvania Hospital
🇺🇸Philadelphia, Pennsylvania, United States
Southside Cancer Care Centre
🇦🇺Miranda, New South Wales, Australia
Hospital General Universitario Gregorio Marañón
🇪🇸Madrid, Spain
Westmead Hospital
🇦🇺Blacktown, New South Wales, Australia
Orlando Health Cancer Institute
🇺🇸Orlando, Florida, United States
University of Michigan
🇺🇸Ann Arbor, Michigan, United States
Sarah Cannon Research Institute
🇺🇸Nashville, Tennessee, United States
Baylor College of Medicine Medical Center
🇺🇸Houston, Texas, United States