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Temsirolimus and Irinotecan for Treatment Resistant Patients With Metastatic Colorectal Cancer and KRAS Mutations (TIRASMUS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00827684
Recruitment Status : Completed
First Posted : January 23, 2009
Last Update Posted : June 8, 2011
Information provided by:
Vejle Hospital

Brief Summary:
The purpose of this study is to investigate the safety and efficacy of temsirolimus as a single drug, and of temsirolimus in combination with irinotecan in chemotherapy resistant patients with KRAS mutated colorectal cancer.

Condition or disease Intervention/treatment Phase
Metastatic Colorectal Cancer Drug: Irinotecan Drug: Temsirolimus Phase 2

Detailed Description:

Chemotherapy resistance is a major challenge in metastatic colorectal cancer (mCRC), and EGFR inhibitors have been introduced as 3rd line treatment to chemotherapy refractory patients. However, it has recently been established that response to treatment with irinotecan and cetuximab is confined to patients with wtKRAS tumors. Therefore, downstream targets are being proposed as potential inhibitors of the EGFR signalling in tumours with KRAS mutations. mTOR is a central intracellular signalling molecule and a rational approach for potential reversion of chemotherapy resistance in these patients.

Preclinical data suggest that different solid tumors could respond to mTOR inhibitors and report on enhanced antitumor activity in combination with different traditional cytostatic drugs. Furthermore recent preclinical data suggest that mTOR inhibition may induce tumor reduction in colon cancer xenographs. Temsirolimus (CCI-779) has been widely investigated in different clinical settings and is presently registered for treatment of renal cell carcinomas. Furthermore, is has recently shown response in metastatic breast cancer patients, but at present there are no clinical data on efficacy or safety in metastatic colorectal cancer patients.

The present study aims at investigating the safety and efficacy of monotherapy temsirolimus and a combination of temsirolimus and irinotecan in chemotherapy resistant, KRAS mutated colorectal adenocarcinomas.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Primary Purpose: Treatment
Official Title: Phase II Study of Temsirolimus and Irinotecan in Chemotherapy Refractory Patients With KRAS Mutated Metastatic Colorectal Cancer
Study Start Date : March 2009
Actual Primary Completion Date : January 2011
Actual Study Completion Date : June 2011

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Response or stable disease
will receive Temsirolimus
Drug: Temsirolimus
Experimental: Progression
Will receive a combination of Temsirolimus and Irinotecan
Drug: Irinotecan
Drug: Temsirolimus

Primary Outcome Measures :
  1. Objective response rates

Secondary Outcome Measures :
  1. Progression free survival
  2. Overall survival
  3. Translational Research

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically verified colorectal adenocarcinomas
  • Age > 18 years and < 70
  • Metastatic colorectal cancer refractory 5-FU, oxaliplatin and irinotecan containing treatment regimes
  • KRAS mutation detected by DxS kit in primary tumor or metastatic lesion.
  • Measurable disease according to RECIST
  • ECOG performance status 0, 1 or 2
  • Adequate renal, hepatic and haematological function
  • Normal serum cholesterol and triglycerides
  • Blood samples and available paraffin embedded tumor material for translational research studies
  • Fertile males and females (< 2 years after last period for women) must use effective birth control
  • Signed Informed consent

Exclusion Criteria:

  • Clinically significant heart disease, active severe infections or other concurrent disease
  • Other malignant diseases within 5 years of inclusion in the study, except basal cell squamous cell carcinoma of the skin and cervical carcinoma-in-situ
  • Prior radiotherapy within 30 days of treatment start
  • Other experimental therapy within 30 days of treatment initiation
  • Patients who are breast feeding, childbearing or of childbearing potential without using dual effective contraception
  • Clinical or radiological evidence of CNS metastasis
  • Completed any major surgery, excision biopsy or significant traumatic lesion ≥ 4 weeks from start of treatment and completed any minor surgery ≥ 1 week prior to start of treatment

    • Insertion of a vascular access device is not considered major or minor surgery from the viewpoint of protocol eligibility
    • Patients must have fully recovered from the procedure and have a fully healed incision
  • Planned radiation therapy against target-lesions
  • Patients with significant non-healing wounds or ulcers
  • History or evidence of thrombotic or hemorrhagic disorders

    • Significant haemorrhage (> 30 ml/bleeding episode in previous 3 months)
    • Haemoptysis (> 5 ml fresh blood in previous 4 weeks)
  • Patients on full-dose anticoagulation (e.g., warfarin) are eligible provided that both of the following criteria are met:

    • The patient has an in-range INR (usually between 2 and 3) on a stable dose of oral anticoagulant or is on a stable dose of low molecular weight heparin
    • The patient has no active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices)
  • Previous Cerebro-Vascular Accident (CVA), Transient Ischemic Attack (TIA) or Sub-Arachnoid Hemorrhage (SAH) within 12 months prior to randomization
  • No known or history of HIV seropositivity
  • The use of ACE inhibitors is not permitted during the study
  • Known allergy to temsirolimus, sirolimus, polysorbate 80 or included agents.
  • Agents with strong CYP3A4-inhibitory potential

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00827684

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Rigshospitalet, Department of Oncology
Copenhagen, Denmark, DK-2100
Vejle Hospital, Dept. of Oncology
Vejle, Denmark
Sponsors and Collaborators
Vejle Hospital
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Study Chair: Anders Jakobsen, MD, DMSc Vejle Hospital
Principal Investigator: Karen-Lise G Spindler, MD, PhD Vejle Hospital

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Responsible Party: Professor, MD, DMSc Andes Jakobsen, Dept. of Oncology, Vejle Hospital Identifier: NCT00827684     History of Changes
Other Study ID Numbers: 2008-007665-22
First Posted: January 23, 2009    Key Record Dates
Last Update Posted: June 8, 2011
Last Verified: June 2011
Keywords provided by Vejle Hospital:
KRAS mutation
Additional relevant MeSH terms:
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Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antineoplastic
Antifungal Agents