Ph2 Biomarker (Mechanism of K-ras Dependency) in Wt KRAS Metastatic Colorectal Cancer Patients
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Purpose
This is a global, multicenter, open-label phase 2 study designed to evaluate the mechanism(s) of resistance to the anti-EGFR (epidermal growth factor receptor) antibody panitumumab given in combination with irinotecan in mCRC (metastatic colorectal carcinoma) subjects with wild-type KRAS (Kirsten rat Sarcoma-2 virus) tumor status at the time of initial diagnosis. In Part 1, all subjects will undergo a baseline tumor biopsy and will receive panitumumab with irinotecan. Subjects that respond or have stable disease will continue to receive treatment until radiographically-confirmed disease progression. These subjects will then undergo a second tumor biopsy and blood sampling and then proceed to Part 2 of the study. In Part 2, all subjects will receive panitumumab with AMG 479. In both parts of the study, panitumumab and irinotecan (Part 1) and panitumumab and AMG 479 (Part 2) will be administered every 2 weeks until disease progression, intolerability, withdrawal of consent, death, or unless otherwise indicated by the study team.
| Condition | Intervention | Phase |
|---|---|---|
|
Metastatic Colorectal Cancer |
Drug: Panitumumab plus AMG 479 Drug: Panitumumab plus Irinotecan |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase 2 Study of Panitumumab Plus Irinotecan Followed by Panitumumab Plus AMG 479 in Subjects With Metastatic Colorectal Carcinoma Expressing Wild Type KRAS and Refractory to Oxaliplatin-or Irinotecan- and Oxaliplatin-containing Regimens to Evaluate Mechanisms of Acquired Resistance to Panitumumab |
- Emergence of Mutant KRAS: KRAS mutation status changed from wild-type at baseline to mutant at the time of the second biopsy following the radiographic evidence of acquired disease resistance to panitumumab given in combination with irinotecan (Part 1) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- Objective Response Rate (ORR) in Part 2: Confirmed complete or partial response (per modified RECIST) to panitumumab and AMG 479 (Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: Yes ]
- Objective Response Rate (Part 1) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- Time to Response (TTR) (both Part 1 and Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- Progression-free Survival (PFS) (both Part 1 and Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- Overall Survival (OS) (both Part 1 and Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- Incidence and severity of adverse events (both Part 1 and Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- significant changes in laboratory values (both Part 1 and Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- incidence of anti-antibody formation (both Part 1 and Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
- Duration of Response (DOR) (both Part 1 and Part 2) [ Time Frame: approximately 4 years ] [ Designated as safety issue: No ]
| Enrollment: | 76 |
| Study Start Date: | May 2009 |
| Estimated Study Completion Date: | April 2013 |
| Estimated Primary Completion Date: | April 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Part 1 |
Drug: Panitumumab plus Irinotecan
Panitumumab 6mg/kg plus Irinotecan 180mg/m2 Panitumumab will be administered via IV infusion is over 60 minutes +/- 15 minutes
|
| Experimental: Part 2 |
Drug: Panitumumab plus AMG 479
Panitumumab 6mg/kg plus AMG 479 12mg/kg. Panitumumab will be administered via IV infusion is over 60 minutes +/- 15 minutes AMG 479 will be administered by an IV infusion over a 60 +/- 15 minutes
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria: Histologically or cytologically confirmed metastatic adenocarcinoma of the colon or rectum; Subjects with wild-type KRAS tumor status confirmed by an Amgen approved central laboratory assessment or an experienced local laboratory assessment of archival tumor tissue (preferably from the primary tumor); Radiographic evidence of disease progression while on or ≤ 6months after completion of treatment with irinotecan- and oxaliplatin- or oxaliplatin-based chemotherapy for mCRC; Radiographic measurement of tumor burden done within 28 days prior to Day 1 (start of treatment with investigational product); At least 1 uni-dimensionally measurable lesion ≥ 20 mm using conventional CT or MRI or ≥ 10 mm by spiral CT scan per modified RECIST v1.0. Lesion must not be chosen from a previously irradiated field, unless there has been documented disease progression in that field after irradiation and prior to enrollment. All sites of disease must be evaluated; At least 1 tumor (preferably a metastasis or unresected primary tumour) that is amenable to core biopsy, as determined by the clinician who will perform the biopsy; Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; Male or female ≥ 18 years of age at the time of informed consent; A life expectancy estimate of ≥ 3 months; Willing to undergo two serial core biopsy procedures of tumors (metastasis or unresected primary); other criteria may apply Exclusion Criteria: History of other primary cancer, unless: Malignancy treated with curative intent and with no known active disease present for ≥ 3 years before enrollment and felt to be at low risk for recurrence by the treating physician, Adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease, Adequately treated cervical carcinoma in situ without evidence of disease, Prostatic intraepithelial neoplasia without evidence of prostate cancer; History of prior or concurrent central nervous system (CNS) metastases; Prior treatment with anti-EGFR (eg, panitumumab, cetuximab or small molecule inhibitors (eg, erlotinib, gefitinib); Prior treatment with monoclonal antibodies directed against insulin-like growth factor-1 receptor (IGF-1R) or small molecule inhibitors directed against IGF-1R; Use of systemic chemotherapy or radiotherapy ≤ 21 days before enrollment. Subjects must have recovered from acute toxicities related to radiotherapy; Use of any antibody therapy (eg, bevacizumab) ≤ 42 days before enrolment; Use of anti-tumor therapies including prior experimental agents or approved anti-tumor small molecules ≤ 30 days before enrolment; Known allergy or hypersensitivity to any component of panitumumab, irinotecan, or AMG 479; Known uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) polymorphisms predisposing to increased irinotecan toxicity; History of irinotecan intolerance that may interfere with planned treatment; History of interstitial lung disease (eg, pneumonitis, pulmonary fibrosis) or evidence of interstitial lung disease on baseline chest computerized tomography (CT) scan; Clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) ≤ 1 year before enrolment; Active inflammatory bowel disease or other active bowel disease causing chronic diarrhea (defined as ≥ grade 2 per Common Terminology Criteria for Adverse Events (CTCAE) version 3.0); Known positive test(s) for human immunodeficiency virus (HIV) infection, hepatitis C virus, acute or chronic active hepatitis B infection; Major surgical procedure ≤ 28 days before enrollment or minor surgical procedure ≤ 14 days before enrollment. Subjects must have recovered from surgery related toxicities. Core biopsy, central venous catheter placement, fine needle aspiration, thoracentesis, or paracentesis is not considered a major or minor surgical procedure; Other investigational procedures or drugs (ie, participation in another clinical study) ≤ 30 days before enrolment; other criteria may apply
Contacts and Locations| Belgium | |
| Research Site | |
| Leuven, Belgium, 3000 | |
| France | |
| Research Site | |
| Bordeaux, France, 33075 | |
| Research Site | |
| La Roche Sur Yon Cedex 9, France, 85925 | |
| Research Site | |
| Lille cedex 01, France, 59037 | |
| Research Site | |
| Marseille, France, 13009 | |
| Germany | |
| Research Site | |
| Bielefeld, Germany, 33611 | |
| Research Site | |
| Bochum, Germany, 44892 | |
| Research Site | |
| Hannover, Germany, 30625 | |
| Research Site | |
| Leverkusen, Germany, 51375 | |
| Research Site | |
| München, Germany, 81737 | |
| Research Site | |
| München, Germany, 81737 | |
| Research Site | |
| Trier, Germany, 54290 | |
| Italy | |
| Research Site | |
| Bologna, Italy, 40138 | |
| Research Site | |
| Candiolo (TO), Italy, 10060 | |
| Research Site | |
| Milano, Italy, 20162 | |
| Spain | |
| Research Site | |
| Sevilla, AndalucÃ-a, Spain, 41013 | |
| Research Site | |
| Sevilla, Andalucía, Spain, 41013 | |
| Research Site | |
| Santander, Cantabria, Spain, 39008 | |
| Research Site | |
| Barcelona, Cataluña, Spain, 08035 | |
| Research Site | |
| Barcelona, Cataluña, Spain, 08035 | |
| Research Site | |
| Valencia, Comunidad Valenciana, Spain, 46010 | |
| Study Director: | MD | Amgen |
More Information
Additional Information:
No publications provided
| Responsible Party: | Amgen |
| ClinicalTrials.gov Identifier: | NCT00891930 History of Changes |
| Other Study ID Numbers: | 20070820 |
| Study First Received: | March 12, 2009 |
| Last Updated: | February 6, 2013 |
| Health Authority: | Belgium: Federal Agency for Medicines and Health Products (FAMHP) France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) Germany: Paul_Ehrlich-Institut Bundesamt fur Sera und Impfstoffe Italy: Ministry of Health Spain: Spanish Drug Agency United States: Food and Drug Administration |
Keywords provided by Amgen:
|
wild-type KRAS panitumumab biomarker mechanisms of acquired resistance metastatic colorectal cancer |
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 Irinotecan |
Antibodies, Monoclonal Antineoplastic Agents, Phytogenic Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Radiation-Sensitizing Agents Physiological Effects of Drugs Topoisomerase I Inhibitors Topoisomerase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Immunologic Factors |
ClinicalTrials.gov processed this record on May 22, 2013