Study of FOLFIRI Plus Cetuximab Plus IMO-2055 in Patients With Colorectal Cancer

This study has been terminated.
(Sponsor will discontinue further development of EMD 1201081)
Sponsor:
Information provided by (Responsible Party):
EMD Serono
ClinicalTrials.gov Identifier:
NCT00719199
First received: July 17, 2008
Last updated: October 21, 2013
Last verified: October 2013
  Purpose

Open-label phase 1b trial. Study treatment will be administered in 3 week cycles.

There are two distinct parts in this study:

  • Part 1: Dose escalation from IMO-2055
  • Part 2: Once a recommended phase 2 dose is found additional tolerability and pharmacodynamics will be explored

Condition Intervention Phase
Colorectal Cancer
Drug: IMO-2055
Drug: Cetuximab
Drug: FOLFIRI
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Open-label Phase 1b Study of FOLFIRI Plus Cetuximab Plus IMO-2055 in Patients With Colorectal Cancer Who Have Progressed Following Chemotherapy for Advanced or Metastatic Disease

Resource links provided by NLM:


Further study details as provided by EMD Serono:

Primary Outcome Measures:
  • • The primary objective of this study is to determine the recommended phase 2 dose of IMO 2055 when combined with FOLFIRI and cetuximab in patients with histologically proven advanced or metastatic colorectal cancer (CRC). [ Time Frame: 10 months from first patient in, Oct 2010 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • • To evaluate the safety of weekly IMO 2055 combined with FOLFIRI plus cetuximab. [ Time Frame: Assessed weekly at patient visits ] [ Designated as safety issue: Yes ]
  • • To investigate the pharmacokinetics (PK) of IMO-2055. [ Time Frame: Assessed weekly at patient visits until Cycle 4 ] [ Designated as safety issue: Yes ]
  • • To investigate the tolerability and pharmacodynamic (PD) effects of dexamethasone scheduling with IMO 2055 and FOLFIRI. [ Time Frame: Assessed weekly at patient visits until Cycle 4 ] [ Designated as safety issue: Yes ]
  • • To investigate potential signs of efficacy using the Response Evaluation Criteria for Solid Tumors (RECIST) response rate in patients with measurable disease. [ Time Frame: Every six weeks ] [ Designated as safety issue: No ]
  • • To investigate progression-free survival (PFS) and overall survival for up to one year in all patients. [ Time Frame: Every three months ] [ Designated as safety issue: No ]
  • • To investigate results of subsequent therapy (if any) in all patients. [ Time Frame: Every three months ] [ Designated as safety issue: No ]
  • • To investigate potential markers of IMO 2055 immune activation and effect on cellular immunity. [ Time Frame: Assessed weekly at patient visits until Cycle 4 ] [ Designated as safety issue: No ]

Enrollment: 21
Study Start Date: January 2009
Study Completion Date: August 2011
Primary Completion Date: April 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
IMO 2055 is a novel phosphorothioate oligodeoxynucleotide that is an agonist of Toll-like Receptor 9 (TLR9).
Drug: IMO-2055
SC weekly injections
Drug: Cetuximab
given weekly through intravenous administration. Cycle 1 Day 1 dose given at 400mg/m2, all subsequent doses given at 250 mg/m2.
Drug: FOLFIRI
Given day 1 of each cycle

Detailed Description:
  • Part 1: Dose escalation of IMO-2055, including 3 dose groups. Once a recommended phase 2 dosage (RP2D) of IMO-2055 given concomitantly with FOLFIRI and cetuximab is found the selected cohort will be expanded by an additional 6 to 9 patients (to a total of 12 patients) for confirmation of the RP2D and combination treatment regimen.
  • Part 2: A final cohort of 12 patients (Cohort 6) will be enrolled simultaneously to explore tolerability and pharmacodynamics in patients treated with the RP2D of IMO-2055 in combination with FOLFIRI with cetuximab.
  Eligibility

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

Inclusion Criteria:

Patients must satisfy all the following inclusion criteria in order to be eligible for the study:

  1. Signed written informed consent prior to any study-specific screening procedures, with the understanding that the patient has the right to withdraw from the study at any time, without prejudice.
  2. Male or female patients aged ≥ 18 years.
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  4. Histologically confirmed adenocarcinoma of the colon or rectum with advanced or metastatic disease.
  5. Patients whose disease has recurred or progressed during or after completion of at least one (1) standard regimen of cytotoxic agents. Patients may have had any number of prior regimens as long as the other entry criteria are met. Preferred patients are those who have progressed on first line FOLFIRI or FOLFOX with or without bevacizumab. Patients may have had prior exposure to monoclonal antibodies such as cetuximab, bevacizumab or panitumumab.
  6. All clinically significant adverse events of any prior chemotherapy, surgery or radiotherapy must have resolved to CTCAE v3.0 grade ≤ 1. Neuropathy of CTCAE v3.0 grade ≤ 2 will be allowed but the neuropathy should be closely monitored throughout the trial.
  7. A minimum of 4 weeks must occur between last receipt of chemotherapy, biotherapy, radiotherapy, or major surgery and registration.
  8. Be willing and able to comply with the protocol for the duration of the study.
  9. If prior malignancy was diagnosed, other than colorectal, no evidence of disease from that cancer, off all therapy for that cancer and recovered to grade 1 or less toxicity from prior treatment.

Exclusion Criteria:

Patients with any of the following will be excluded from participation in the study:

Disease

  1. Known central nervous system (CNS) metastases unless controlled for ≥ 4 months without the use of steroids.
  2. Patients who are candidates for neoadjuvant "conversion" therapy followed by curative surgery.

    Prior Treatments

  3. Prior pelvic irradiation.
  4. Administration of any investigational agent (therapeutic or diagnostic), within 4 weeks prior to first study dosing.
  5. Patients with a prior history of cetuximab hypersensitivity may be admitted to Part 1 of the study only.

    Other Concomitant Medications

  6. Chronic oral or intravenous corticosteroids. (Note: Doses ≤ 5 mg/day of prednisone or equivalent are permitted. Topical, inhaled and intra-articular corticosteroids are allowed.)
  7. Therapeutic anticoagulation (warfarin > 1 mg/day or heparin). Low-dose warfarin for port prophylaxis and low-molecular weight heparin at therapeutic doses are allowed.

    Laboratory

  8. The following laboratory results:

    • Hemoglobin < 9.0 g/dL Absolute neutrophil count < 1.5 x 109/L Platelet count < 100 x 109/L
    • Total bilirubin > 1.5 x upper limit of normal (ULN)
    • ALT or AST > 2.5 x ULN (> 5 x ULN if liver metastases present)
    • Alkaline phosphatase > 2.5 x ULN (> 5 x ULN if liver metastases present, or > 10 x ULN in case of the presence of bone metastases)
    • Serum creatinine > 1.5 x ULN
    • Albumin < 2.5 g/dL Other Conditions or Procedures
  9. Grade 3 or 4 non-hematological toxicity or febrile neutropenia related to previous irinotecan-based regimens.
  10. Homozygous for the UGT1A1*28 allele.
  11. Known hypersensitivity to murine proteins or oligonucleotides.
  12. Pregnant or breast-feeding women.
  13. Women of childbearing potential with either positive or no pregnancy test at baseline. Postmenopausal women must have been amenorrheic for at least 12 months to be considered of non-childbearing potential.
  14. Men or women of childbearing potential who refuse or who are unable to use an acceptable means of contraception during the study.
  15. History of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the Investigator to be clinically significant precluding informed consent or interfering with compliance.
  16. Pre existing autoimmune or antibody-mediated diseases, including, but not limited to, the following: organ allografts, systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome and autoimmune thrombocytopenia, known Gilbert's syndrome.
  17. Signs/symptoms of bowel obstruction or pseudo-obstruction or history of inflammatory bowel disease.
  18. Clinically significant (i.e., active) cardiac disease (e.g., congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmias not well controlled with medication) or myocardial infarction within the last 6 months.
  19. Interstitial pneumonia or extensive symptomatic fibrosis of the lungs.
  20. Serious uncontrolled concomitant disease, intercurrent infections, or other known medical conditions that in the opinion of the Investigator puts the patient at increased risk for significant toxicities from treatment, such as hypertension, uncontrolled by medication, chronic hepatitis (viral or other) or cirrhosis, known human immunodeficiency virus (HIV) infection, or uncontrolled diabetes.
  21. Legal incapacity or limited legal capacity.
  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: NCT00719199

Locations
United States, District of Columbia
Georgetown University Lombardi Cancer Center
Washington, DC, District of Columbia, United States
United States, Massachusetts
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
United States, Tennessee
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, United States, 37232
United States, Texas
Cancer Therapy & Research Center
San Antonio, Texas, United States, 78229
Cancer Therapy and Research Center
San Antonio, Texas, United States
Sponsors and Collaborators
EMD Serono
Investigators
Study Director: Phil Breitfeld, MD EMD Serono
  More Information

No publications provided

Responsible Party: EMD Serono
ClinicalTrials.gov Identifier: NCT00719199     History of Changes
Other Study ID Numbers: IMO-2055-210, EMR200068_210
Study First Received: July 17, 2008
Last Updated: October 21, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by EMD Serono:
Colorectal cancer
metastatic cancer
prior therapy
1b

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 22, 2014