Monoclonal Antibody Plus Chemotherapy in Treating Patients With Advanced Colorectal Cancer That Overexpresses HER2 - Full Text View

Purpose

Phase II trial to study the effectiveness of the monoclonal antibody trastuzumab and chemotherapy with irinotecan in treating patients who have stage IV colorectal cancer that overexpresses HER2. Monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining monoclonal antibody therapy with chemotherapy may kill more tumor cells.

Condition	Intervention	Phase
Colorectal Cancer	Biological: trastuzumab Drug: irinotecan hydrochloride	Phase 2


Study Type:	Interventional
Study Design:	Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment
Official Title:	Phase II and Pharmacokinetic Study of CPT-11 and Trastuzumab (RhuMab HER2, Herceptin) in Advanced Colo-Rectal Cancer With p185 HER 2 Overexpression

Resource links provided by NLM:

MedlinePlus related topics: Colorectal Cancer

Drug Information available for: Irinotecan Irinotecan hydrochloride Trastuzumab

U.S. FDA Resources

Further study details as provided by National Cancer Institute (NCI):


Enrollment:	32
Study Start Date:	September 1999
Primary Completion Date:	March 2006 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Arm I Patients receive a loading dose of trastuzumab IV over 90 minutes on week 1, and over 30-90 minutes weekly thereafter. Patients receive irinotecan IV over 90 minutes following trastuzumab weekly for 4 weeks. Courses are repeated every 6 weeks in the absence of disease progression or unacceptable toxicity.	Biological: trastuzumab Drug: irinotecan hydrochloride

Detailed Description:

OBJECTIVES:

I. Determine the objective response rate of irinotecan and trastuzumab in patients with stage IV colorectal cancer and p185 HER2 overexpression.

II. Evaluate the safety and toxic effects of this treatment regimen in these patients.

III. Determine the overall survival and time to progression in these patients in response to this treatment regimen.

IV. Determine the pharmacokinetics of trastuzumab in combination with irinotecan and antibodies to trastuzumab in these patients.

V. Determine the expression of HER2/neu in these patients.

OUTLINE: This is a multicenter study.

Patients receive a loading dose of trastuzumab IV over 90 minutes on week 1, and over 30-90 minutes weekly thereafter. Patients receive irinotecan IV over 90 minutes following trastuzumab weekly for 4 weeks. Courses are repeated every 6 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months.

Eligibility


Ages Eligible for Study:	Child, Adult, Senior
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

DISEASE CHARACTERISTICS:

Histologically confirmed stage IV colorectal cancer with p185 HER2 overexpression
Bidimensionally measurable disease Indicator lesion must be outside of irradiated field No symptomatic CNS brain metastases

PATIENT CHARACTERISTICS:

Performance status: ECOG 0-2
Absolute granulocyte count at least 1,500/mm3
Platelet count at least 100,000/mm3
Bilirubin no greater than 1.5 times upper limit of normal (ULN)
SGOT no greater than 3.0 times ULN
Creatinine no greater than 2.0 mg/dL
LVEF at least 45% by MUGA or ECHO
No myocardial infarction within the past 6 months
No congestive heart failure
No unstable angina
No clinically significant pericardial effusion or arrhythmia
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 6 months after study
No other prior malignancy within the past 5 years, except:
- Curatively treated basal or squamous cell skin cancer
- Curatively treated carcinoma in situ of the cervix
- No active serious infection or serious underlying medical condition that would prevent compliance
- No dementia or significantly altered mental status

PRIOR CONCURRENT THERAPY:

Concurrent filgrastim (G-CSF), sargramostim (GM-CSF), or epoetin alfa allowed
No prior trastuzumab
No more than 1 prior chemotherapy regimen for advanced disease (if progressed during or within 6 months of adjuvant therapy considered to have had 1 regimen for advanced disease)
No prior irinotecan
Concurrent contraception, estrogen replacement therapy, or megestrol acetate for anorexia allowed
Greater than 3 weeks since prior radiotherapy and recovered
Greater than 3 weeks since major surgery (except simple biopsy or venous access placement) and recovered
At least 3 weeks since prior investigational nonneoplastic drugs

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: NCT00003995

Locations


United States, New York
Albert Einstein Comprehensive Cancer Center
Bronx, New York, United States, 10461
United States, Pennsylvania
University of Pittsburgh Cancer Institute
Pittsburgh, Pennsylvania, United States, 15213
United States, Rhode Island
Lifespan: The Miriam Hospital
Providence, Rhode Island, United States, 02906
United States, Tennessee
Sarah Cannon-Minnie Pearl Cancer Center
Nashville, Tennessee, United States, 37203
United States, Texas
University of Texas - MD Anderson Cancer Center
Houston, Texas, United States, 77030

Sponsors and Collaborators

National Cancer Institute (NCI)

Investigators


Study Chair:	Ramesh K. Ramanathan, MD	University of Pittsburgh

More Information

Publications:

Ramanathan RK, Hwang JJ, Zamboni WC, Sinicrope FA, Safran H, Wong MK, Earle M, Brufsky A, Evans T, Troetschel M, Walko C, Day R, Chen HX, Finkelstein S. Low overexpression of HER-2/neu in advanced colorectal cancer limits the usefulness of trastuzumab (Herceptin) and irinotecan as therapy. A phase II trial. Cancer Invest. 2004;22(6):858-65.


Responsible Party:	National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:	NCT00003995 History of Changes
Other Study ID Numbers:	NCI-2012-02307 PCI-98-056 NCI-T98-0078 CDR0000067205 ( Registry Identifier: PDQ (Physician Data Query) )
Study First Received:	November 1, 1999
Last Updated:	February 7, 2013

Keywords provided by National Cancer Institute (NCI):


stage IV colon cancer stage IV rectal cancer recurrent colon cancer recurrent rectal 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 Trastuzumab Antineoplastic Agents, Phytogenic Antineoplastic Agents Topoisomerase I Inhibitors Topoisomerase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 19, 2017