Study Evaluating the Safety and Efficacy of FOLFIRI Plus Cetuximab or FOLFOX Plus Cetuximab as First-line Therapy in Subjects With KRAS Wild-type Metastatic Colorectal Cancer (APEC-Study)

This study has been completed.
Sponsor:
Collaborator:
Merck Pte. Ltd., Singapore
Information provided by (Responsible Party):
Merck KGaA
ClinicalTrials.gov Identifier:
NCT00778830
First received: October 22, 2008
Last updated: June 5, 2014
Last verified: June 2014
  Purpose

This is an open-label, non-randomized, multicenter phase II study evaluating folinic acid + fluorouracil + irinotecan (FOLFIRI) plus cetuximab (Erbitux) or folinic acid + fluorouracil + oxaliplatin (FOLFOX) plus cetuximab as first-line therapy of patients with KRAS wild-type metastatic colorectal cancer.

Only subjects with k-ras oncogene (KRAS) wild-type tumors are eligible. Efficacy will be assessed every 8 weeks. Treatment will be continued until progressive disease or unacceptable adverse events occur. After the end of study treatment, information on further anticancer treatment and survival will be collected every 3 months.


Condition Intervention Phase
Metastatic Colorectal Cancer
Drug: Cetuximab
Drug: FOLFIRI regimen
Drug: FOLFOX regimen
Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Asia Pacific Non-randomized, Open-label Phase II Study Evaluating the Safety and Efficacy of FOLFIRI Plus Cetuximab (Erbitux) or FOLFOX Plus Cetuximab as First-line Therapy in Subjects With KRAS Wild-type Metastatic Colorectal Cancer (APEC-Study)

Resource links provided by NLM:


Further study details as provided by Merck KGaA:

Primary Outcome Measures:
  • Percentage of Participants With Best Overall Confirmed Response (BOCR) [ Time Frame: Up to 5 years ] [ Designated as safety issue: No ]
    Response rate is defined as the percentage of subjects with BOCR (confirmed complete response [CR] or partial response [PR]) according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria. As per RECIST criteria for target lesions and assessed by magnetic resonance imaging (MRI): CR = disappearance of all target lesions; PR = at least 30 percent (%) decrease in the sum of the longest diameter of target lesions. Response rate will be assessed every 8 weeks from start of study drug until documented disease progression or up to 5 years.


Secondary Outcome Measures:
  • Progression-Free Survival (PFS) Time [ Time Frame: Up to 5 years ] [ Designated as safety issue: No ]
    PFS time is defined as the time from first administration of study drug until first observation of disease progression or death when death occurs within 90 days of the last tumor assessment or first study drug dose whichever occurs first up to 5 years.

  • Overall Survival (OS) Time [ Time Frame: Up to 5 years ] [ Designated as safety issue: No ]
    OS time is defined as the time from first administration of study drug until date of death, assessed up to 5 years. If the subject has not died, OS time will be censored on the last date the subject was known to be alive.

  • Number of subjects with adverse events (AEs) and serious adverse events (SAEs) [ Time Frame: Up to 5 years ] [ Designated as safety issue: Yes ]

Enrollment: 289
Study Start Date: February 2009
Study Completion Date: April 2014
Primary Completion Date: April 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cetuximab plus FOLFIRI/FOLFOX
Cetuximab (Erbitux) will be administered in combination with modified FOLFIRI regimen or modified FOLFOX regimen as per Investigator's suitability until disease progression, death, or consent withdrawal.
Drug: Cetuximab
Cetuximab will be administered intravenously at a dose of 500 milligram per square meter (mg/m^2) biweekly until disease progression, death, or consent withdrawal.
Other Name: Erbitux
Drug: FOLFIRI regimen
Irinotecan will be administered intravenously at a dose of 180 mg/m^2 along with folinic acid intravenously at a dose of 400 mg/m^2 (racemic) or 200 mg/m^2 (L-form) and 5-fluorouracil at a dose of 400 mg/m^2 bolus followed by a 46-hour continuous infusion of 2,400 mg/m^2 given biweekly until disease progression, death, or consent withdrawal.
Drug: FOLFOX regimen
Oxaliplatin will be administered intravenously at a dose of 100 mg/m^2 along with folinic acid intravenously at a dose of 400 mg/m^2 (racemic) or 200 mg/m^2 (L-form) and 5-fluorouracil at a dose of 400 mg/m^2 bolus followed by a 46-hour continuous infusion of 2,400 mg/m^2 given biweekly until disease progression, death, or consent withdrawal.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Signed written informed consent

  • Inpatient or outpatient subjects, 18 years of age
  • Diagnosis of histologically confirmed adenocarcinoma of the colon or rectum
  • Metastatic disease (M1)
  • Life expectancy of at least 12 weeks
  • Presence of at least 1 measurable index lesion (not lie in an irradiated area) by computed tomography (CT) scan or MRI
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at study entry
  • Effective contraception for both male and female subjects if the risk of conception exists
  • White blood cell count greater than or equal to (>=) 3,000 per cubic millimeter (/mm^3) with neutrophils >=1,500/mm3, platelet count >=100,000/mm3, hemoglobin >=5.6 millimole per liter (mmol/L) (9 gram per deciliter [g/dL])
  • Total bilirubin less than or equal to (<=) 1.5 x upper reference range
  • Aspartate aminotransferase (AST) <=2.5 x upper reference range, or <=5 x upper reference range in case of liver metastasis
  • Serum creatinine <=1.5 x upper reference range
  • Recovery from relevant toxicity to previous treatment before study entry
  • KRAS wild-type status of tumor tissue

Exclusion Criteria:

  • Previous chemotherapy for colorectal cancer except adjuvant treatment if terminated >6 months before the start of treatment in this study
  • Radiotherapy, surgery (excluding prior diagnostic biopsy) or any investigational drug in the 30 days before the start of treatment in this study
  • Concurrent chronic systemic immune therapy, targeted therapy, anti-vascular endothelial growth factor (VEGF) therapy, or epidermal growth factor receptor (EGFR-) pathway targeting therapy not indicated in this study protocol
  • Concurrent hormone therapy not indicated in this study protocol except for physiologic replacement or contraception
  • Known hypersensitivity reaction to any of the components of study treatments
  • Pregnancy (absence to be confirmed by beta human choriongonadotrophin [beta-hCG] test) or lactation period
  • Brain metastasis and/or leptomeningeal disease (known or suspected)
  • Clinically relevant coronary artery disease, history of myocardial infarction in the last 12 months, or high risk of uncontrolled arrhythmia
  • Acute or sub-acute intestinal occlusion or history of inflammatory bowel disease
  • Peripheral neuropathy > grade 1
  • Previous malignancy other than colorectal cancer in the last 5 years except basal cell cancer of the skin or preinvasive cancer of the cervix
  • Known alcohol or drug abuse
  • Medical or psychological conditions that would not permit the patient to complete the study or sign informed consent
  • Participation in another clinical study within the past 30 days
  • Significant disease which, in the investigator's opinion, would exclude the patient from the study
  • Legal incapacity or limited legal capacity
  • KRAS mutated status of tumor tissue
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00778830

Locations
Singapore
Research Site
Singapore, Singapore
Sponsors and Collaborators
Merck KGaA
Merck Pte. Ltd., Singapore
Investigators
Principal Investigator: Andrew Ann-Lii Cheng, MD, PhD National Taiwan University Hospital
  More Information

No publications provided

Responsible Party: Merck KGaA
ClinicalTrials.gov Identifier: NCT00778830     History of Changes
Other Study ID Numbers: EMR 62202-505
Study First Received: October 22, 2008
Last Updated: June 5, 2014
Health Authority: Australia: Department of Health and Ageing Therapeutic Goods Administration
China: Food and Drug Administration
Hong Kong: Department of Health
India: Drugs Controller General of India
Indonesia: Indonesia Drugs and Foods Regulatory Authority
Korea: Food and Drug Administration
Malaysia: Ministry of Health
Singapore: Health Sciences Authority
Taiwan: Department of Health
Thailand: Food and Drug Administration
Pakistan: Ministry of Health
Philippines: Bureau of Food and Drugs

Keywords provided by Merck KGaA:
mCRC

Additional relevant MeSH terms:
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Cetuximab
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on September 11, 2014