Study of REOLYSIN® in Combination With FOLFIRI in Patients With Oxaliplatin Refractory/Intolerant KRAS Mutant Colorectal Cancer
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Purpose
This is a Phase 1 dose-escalation study with three dose levels to determine the maximum tolerated dose of REOLYSIN combined with FOLFIRI.
| Condition | Intervention | Phase |
|---|---|---|
|
Oxaliplatin Refractory/Intolerant KRAS Mutant Colorectal Cancer |
Biological: REOLYSIN Drug: Irinotecan Drug: Leucovorin Drug: Fluorouracil (5-FU) |
Phase 1 |
| 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: | A Multicenter Phase 1 Study of Intravenous Administration of REOLYSIN® (Reovirus Type 3 Dearing) in Combination With Irinotecan/Fluorouracil/Leucovorin (FOLFIRI) in Patients With KRAS Mutant Metastatic Colorectal Cancer |
- Dose limiting toxicity to define maximum tolerated dose and recommended Phase 2 dose [ Time Frame: During the first cycle of treatment (4 week cycle) ] [ Designated as safety issue: Yes ]
- Pharmacokinetic parameters for irinotecan and 5-FU when combined with REOLYSIN® [ Time Frame: During the first cycle of treatment (4 week cycle) ] [ Designated as safety issue: No ]
- Objective response, clinical benefit rate, progression-free survival, and overall survival [ Time Frame: Assessed every 8 weeks until disease progression or death ] [ Designated as safety issue: No ]
- Safety and tolerability of study treatment [ Time Frame: During study and within 30 days of the last dose of REOLYSIN ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 20 |
| Study Start Date: | December 2010 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
-
Biological: REOLYSIN
Reovirus Serotype 3 - Dearing Strain (REOLYSIN) is a naturally occurring, ubiquitous, non-enveloped human reovirus. Reovirus has been shown to replicate selectively in Ras-transformed cells causing cell lysis. Activating mutations in ras or mutation in oncogenes signaling through the ras pathway may occur in as many as 80% of human tumors. The specificity of the reovirus for Ras-transformed cells, coupled with its relatively nonpathogenic nature in humans, makes it an attractive anti-cancer therapy candidate. Eligible patients for this study include those with histologically confirmed cancer of the colon or rectum with Kras mutation and measurable disease.
Cetuximab and panitumumab have shown to be ineffective in patients whose tumors have a KRAS mutation. Therefore, currently, for patients with a KRAS mutation, the only option after failure of front-line therapy is irinotecan or FOLFIRI, and there is no drug that can be combined with it to improve clinical outcomes.
The trial is a Phase I dose escalation study with four dose levels, comprising cohorts of three to six patients, to determine a maximum tolerated dose and dose-limiting toxicities with the combination of REOLYSIN and FOLFIRI. FOLFIRI will be administered on the first day of a two week (14-day) cycle, while REOLYSIN will be administered on days one through five of a four week (28-day) cycle.
The study is expected to enroll 12 to 20 patients.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria: Each patient MUST:
- Have histologically confirmed cancer of the colon or rectum with radiologically documented and measurable metastases (high CEA alone is insufficient for study entry).
- Have received 3 or fewer regimens in the metastatic setting.
- Have his/her tumor assessed for KRAS status and found to be mutation positive.
- Have NO continuing acute toxic effects (except alopecia) of any prior radiotherapy, chemotherapy, or surgical procedures, i.e., all such effects must have resolved.
- Have an ECOG Performance Score of ≤ 2.
- Have a life expectancy of at least 3 months.
Have baseline laboratory results as follows:
- Absolute neutrophil count (ANC) ≥ 1.5 x 10^9 [SI unit 10^9/L]
- Platelets ≥ 100 x10^9 [SI units 10^9/L] (without platelet transfusion)
- Hemoglobin ≥ 9.0 g/dL [SI units gm/L] (with or without RBC transfusion)
- Serum creatinine ≤ 1.5 x upper limit of normal (ULN)
- Bilirubin ≤ ULN
- AST/ALT ≤ 2.5 x ULN (≤ 5 x ULN if with liver metastases)
- Negative pregnancy test for females with childbearing potential.
- Have signed an informed consent indicating that the patient is aware of the neoplastic nature of their disease and have been informed of the procedures of the protocol, the experimental nature of the therapy, alternatives, potential benefits, side effects, risks, and discomforts.
- Be willing and able to comply with scheduled visits, the treatment plan, and laboratory tests.
Exclusion Criteria: No patient may:
- Receive concurrent therapy with any other investigational anticancer agent while on study.
- Have received more than 3 chemotherapy regimens in the metastatic setting.
- Have brain metastases.
- Be on immunosuppressive therapy or have known HIV infection or active hepatitis B or C.
- Have received chemotherapy, radiotherapy, immunotherapy or hormonal therapy or had surgery (except biopsies) within 28 days prior to receiving the study drug.
- Be a pregnant or breast-feeding woman. Female patients of childbearing potential must agree to use effective contraception, be surgically sterile, or be postmenopausal. Male patients must agree to use effective contraception or be surgically sterile. Barrier methods are a recommended form of contraception.
- Have clinically significant cardiac disease (New York Heart Association, Class III or IV) including pre-existing arrhythmia, uncontrolled angina pectoris, myocardial infarction within 1 year prior to study entry, or Grade 2 or higher compromised left ventricular ejection fraction.
- Have dementia or altered mental status that would prohibit informed consent.
- Have any other acute, or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration or may interfere with the interpretation of study results and, in the judgment of the Principal Investigator, would make the patient inappropriate for this study.
Contacts and Locations| United States, New York | |
| Montefiore Medical Center/Albert Einstein College of Medicine | |
| Bronx, New York, United States, 10461 | |
| New York Presbyterian Hospital/ Weill Cornell Medical College | |
| New York, New York, United States, 10065 | |
| United States, Ohio | |
| The Ohio State University | |
| Columbus, Ohio, United States, 43210 | |
More Information
No publications provided
| Responsible Party: | Oncolytics Biotech |
| ClinicalTrials.gov Identifier: | NCT01274624 History of Changes |
| Other Study ID Numbers: | REO 022 |
| Study First Received: | January 7, 2011 |
| Last Updated: | August 16, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Oncolytics Biotech:
|
Colorectal Cancer REOLYSIN Chemotherapy FOLFIRI |
Reovirus Oncolytic virus Fluorouracil Irinotecan Leucovorin |
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 Fluorouracil Irinotecan Leucovorin Levoleucovorin |
Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antimetabolites, Antineoplastic Antineoplastic Agents Therapeutic Uses Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Vitamin B Complex Vitamins Micronutrients Growth Substances Antidotes Protective Agents |
ClinicalTrials.gov processed this record on May 19, 2013