Safety and Efficacy Study of mFOLFOX-6 Plus Cetuximab for 8 Cycles Followed by mFOLFOX-6 Plus Cetuximab or Single Agent Cetuximab as Maintenance Therapy in Patients With Metastatic Colorectal Cancer and WT KRAS Tumours (MACRO-2)
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Purpose
The purpose of the study is to evaluate the efficacy and safety of the combination of mFOLFOX-6 plus cetuximab for 8 cycles followed by mFOLFOX-6 plus cetuximab or single agent (s/a) cetuximab as maintenance therapy in patients (pts) with metastatic colorectal cancer (mCRC).
| Condition | Intervention | Phase |
|---|---|---|
|
Metastatic Colorectal Cancer |
Drug: mFOLFOX-6 + cetuximab until disease progression or early withdrawal. Drug: 8 cycles of mFOLFOX-6 + cetuximab, followed by cetuximab alone until disease progression or early withdrawal. |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase-II, Randomized, Multicentre Pilot Study to Evaluate the Safety and Efficacy of the Treatment With mFOLFOX-6 Plus Cetuximab Versus Initial Treatment With mFOLFOX-6 Plus Cetuximab (for 8 Cycles), Followed by Maintenance With Cetuximab Alone as First-line Treatment in Patients With Metastatic Colorectal Cancer (mCRC) and Wild-type KRAS Tumours |
- progression-free survival [ Time Frame: 2010-2014 ] [ Designated as safety issue: No ]
- overall survival [ Time Frame: 2010-2014 ] [ Designated as safety issue: No ]
- rate of objective responses [ Time Frame: 2010-2014 ] [ Designated as safety issue: No ]
- disease's resectability (R0) [ Time Frame: 2010-2014 ] [ Designated as safety issue: No ]
- evaluate hypomagnesaemia as a predictive factor in the treatment's efficacy [ Time Frame: 2010-2014 ] [ Designated as safety issue: No ]
- Adverse events [ Time Frame: 2010-2014 ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 192 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | July 2014 |
| Estimated Primary Completion Date: | July 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Control
mFOLFOX-6 + cetuximab until disease progression or early withdrawal.
|
Drug: mFOLFOX-6 + cetuximab until disease progression or early withdrawal.
Treatment regimen: mFOLFOX-6, day 1, every two weeks; OXALIPLATIN 85 mg/m2; FOLINIC ACID 400 mg/m2; 5-FU 400 mg/m2 IV bolus; 5-FU 2400 mg/m2 continuous infusion for 46 hours Cetuximab weekly. Cetuximab 400 mg/m2 the first time the treatment is administered; 250 mg/m2 for subsequent administrations. |
|
Experimental: Experimental
8 cycles of mFOLFOX-6 + cetuximab, followed by cetuximab alone until disease progression or early withdrawal.
|
Drug: 8 cycles of mFOLFOX-6 + cetuximab, followed by cetuximab alone until disease progression or early withdrawal.
Treatment regimen. mFOLFOX-6. day 1 every two weeks. OXALIPLATIN 85 mg/m2; FOLINIC ACID 400 mg/m2; 5-FU 400 mg/m2 IV bolus; 5-FU 2400 mg/m2 continuous infusion for 46 hours Cetuximab weekly. Cetuximab 400 mg/m2 the first time the treatment is administered; 250 mg/m2 for subsequent administrations. |
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Written informed consent.
- Patients of an age ≥ 18 years and < 71
- Patients with an ECOG performance status ≤ 2
- Confirmed histological diagnosis of colorectal carcinoma with metastatic disease and wild-type KRAS.
- Presence of at least one target lesion that is measurable one-dimensionally (not located in an irradiated region).
- Life expectancy greater than 12 weeks.
- First evidence of chemotherapy-naïve metastatic disease. Adjuvant chemotherapy is allowed if it has been more than 6 months since the treatment was finished and there have been no signs of disease progression, neither during treatment nor during the 6 months following its completion.
- Adequate medullar reserve:
- Absolute neutrophil count ≥ 1.5 x 109/L
- Platelet count ≥ 100 x 109/L
- Haemoglobin ≥ 9 g/dL
- Adequate renal function: Creatinine clearance > 30 mL/min, calculated using the Cockroff-Gault formula, or a serum creatinine < 2 mg/dL or 177 umol/L
- An adequate liver function: ASAT (SGOT) and ALAT (SGPT) ≤ 2.5 x ULN (≤ 5 x ULN if there are liver metastases). Total bilirubin < 1.5 x ULN. Alkaline phosphatase ≤ 2.5 x ULN ( ≤ 5 x ULN in the case of liver metastases or ≤ 10 x ULN in the case of bone metastases)
Exclusion Criteria:
- To have received prior systemic treatment for the metastatic disease
- Diagnosis or suspicion of brain or leptomeningeal metastases
- Major surgery or radiotherapy (except for antalgic surgery that does not include measurable target lesions) during the 4 weeks prior to inclusion in the study.
- Previous administration of monoclonal antibodies, agents inhibiting EGFR signal transduction or EGFR-targeted treatment.
- Participation in another clinical trial with drugs within the previous 30 days.
- Neoplasm in the 2 years prior to entering the study, except for non-melanoma skin carcinoma or in situ cervix carcinoma.
- Evidence of previous acute hypersensitivity reaction of any degree to any of the treatment's components.
- Clinically relevant peripheral neuropathy.
- Signs and symptoms, at the moment of entering the study, of acute or subacute bowel obstruction.
- A history of an acute episode of ischemic heart disease (angina or acute myocardial infarction) within the previous 12 months or an elevated risk of heart failure decompensation or uncontrolled arrhythmia.
- Serious active infection, including active tuberculosis and HIV diagnosis.
- Chronic immunological or hormonal treatment, except for hormone replacement treatment at physiological doses.
- Known drug or alcohol abuse.
- Legal incapacity or limited legal capacity.
- Pregnancy or breastfeeding. Premenopausal women must have a negative pregnancy test in urine or blood before entering the trial. Patients and their partners must take contraceptive measures (hormonal, barrier, or abstinence) if the possibility of conception exists, during the study and for 3 months after the end of the treatment thereof.
- Any geographical or social circumstance or any medical or psychological alteration that, in the investigator's opinion, will not allow the patient to conclude the study.
Contacts and Locations| Spain | |
| Spanish Cooperative Group for Gastrointestinal Tumour Therapy | |
| Madrid, Spain, 28046 | |
| Study Chair: | Enrique Aranda | Hospital Reina Sofia. Córdoba. Spain |
| Study Chair: | Eduardo Díaz-Rubio | Hospital Clínico San Carlos. Madrid. Spain |
More Information
Additional Information:
No publications provided
| Responsible Party: | Spanish Cooperative Group for Gastrointestinal Tumour Therapy |
| ClinicalTrials.gov Identifier: | NCT01161316 History of Changes |
| Other Study ID Numbers: | TTD-09-04, 2009-017194-38 |
| Study First Received: | July 12, 2010 |
| Last Updated: | February 19, 2013 |
| Health Authority: | Spain: Spanish Agency of Medicines |
Keywords provided by Spanish Cooperative Group for Gastrointestinal Tumour Therapy:
|
metastatic colorectal cancer wild-type KRAS tumours cetuximab mFOLFOX-6 |
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 May 23, 2013