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FOLFOXIRI With or Without Panitumumab in Metastatic Colorectal Cancer (VOLFI) (VOLFI)

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.
 
ClinicalTrials.gov Identifier: NCT01328171
Recruitment Status : Active, not recruiting
First Posted : April 4, 2011
Last Update Posted : August 7, 2018
Sponsor:
Collaborators:
Amgen
ClinAssess GmbH
Information provided by (Responsible Party):
AIO-Studien-gGmbH

Brief Summary:

The aim of the trial is to optimize response rates and rates of secondary resections of metastases in patients with initially non-resectable metastatic colorectal cancer of RAS wildtype. The patients will be treated in two therapy groups:

Experimental arm A: Chemotherapy with FOLFOXIRI + panitumumab Standard arm B: Chemotherapy with FOLFOXIRI


Condition or disease Intervention/treatment Phase
Metastatic Colorectal Cancer Drug: FOLFOXIRI + Panitumumab Drug: FOLFOXIRI Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 93 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-label 2:1 Randomized Phase II Study of Panitumumab Plus FOLFOXIRI or FOLFOXIRI Alone as First-line Treatment of Patients With Non-resectable Metastatic Colorectal Cancer and RAS Wild Type
Actual Study Start Date : April 2011
Actual Primary Completion Date : June 2017
Estimated Study Completion Date : January 2022

Resource links provided by the National Library of Medicine

Drug Information available for: Panitumumab

Arm Intervention/treatment
Experimental: A (FOLFOXIRI + Panitumumab)
FOLFOXIRI + Panitumumab
Drug: FOLFOXIRI + Panitumumab
irinotecan 150 mg/m² + oxaliplatin 85 mg/m² + leucovorin 200 mg/m² + 5-FU 3000 mg/m² cont. inf. + panitumumab, iv, 6 mg/kg BW all on day 1 of each 2 weeks cycle until PD or resectability or to max. 12 cycles
Other Names:
  • Vectibix (Panitumumab)
  • folic acid
  • 5-FU
  • oxaliplatin
  • irinotecan

Active Comparator: B (FOLFOXIRI)
FOLFOXIRI
Drug: FOLFOXIRI
irinotecan 165 mg/m² + oxaliplatin 85 mg/m² + leucovorin 200 mg/m² + 5-FU 3200 mg/m² cont. inf. all on day 1 of each 2 weeks cycle until PD or resectability or to max. 12 cycles
Other Names:
  • folic acid
  • 5-FU
  • oxaliplatin
  • irinotecan




Primary Outcome Measures :
  1. overall response rate [ Time Frame: up to about 6 month ]
    RECIST


Secondary Outcome Measures :
  1. overall response rate in each cohort [ Time Frame: up to about 6 month ]
    RECIST

  2. secondary resection rate with curative intent for patients cohort I [ Time Frame: up to about 6 month ]
  3. pathological response in liver surgery specimen [ Time Frame: up to about 6 month ]
    metrics: Pathological complete response (pCR): no residual cancer cells;major response (pPR): 1% to 49% residual cancer cells remaining; minor response (pMR): 50% to 99% residual cancer cells remaining; no response (pNR): 100% residual cancer cells remaining

  4. disease control rate [ Time Frame: up to about 6 month ]
    CR + PR + SD rate according to RECIST

  5. progression free survival [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 4 years ]
  6. duration of response [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 4 years ]
    analyzed for responders only

  7. time to response [ Time Frame: up to about 6 month ]
  8. overall survival [ Time Frame: From date of randomization until the date of death from any cause assessed up to 4 years ]
  9. time to recurrence (cohort II in case of secondary resection) [ Time Frame: up to 4 years ]
  10. toxicity and feasibility [ Time Frame: up to about 6 month ]
    number of patients with adverse events and severity according to NCI CTC 3.0

  11. liver toxicity for resected patients (central histological review); biopsies should be obtained for all patients pre-treatment [ Time Frame: up to 1 year ]
    histological findings according to CASH/SOS scores

  12. QL (QLQ C30) [ Time Frame: Pre-treatment, before start of every 3rd cycle and at the end of treatment ]
    scores according to EORTC QLQ-C30 scoring manual (Quality of life)

  13. translational research (EGFR genetics and proteomics): prognostic and predictive impact on efficacy outcomes [ Time Frame: up to 4 years ]
    Determination of EGFR mutations (exons 18, 19, 20, 21) in tumor tissue; determination of PIK3CA mutations (exon 9, 20) in tumor tissue; determination of EGFR, ERCC1, TS, MTHFR, OPRT, DHFR and CDKN polymorphism from normal and tumor tissue; determination of ERCC1, PTEN and TS protein expression in tumor tissue; epigenetic candidates; further exploratory studies such as miRNA analysis as approved by the AIO review board



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Cohort I: Histologically confirmed and definitively inoperable or irresectable metastatic colorectal cancer. Focus on patients with large tumor load at metastatic sites and/or symptomatic metastatic disease
  • Cohort II: Chance of secondary resection with curative intent defined and reviewed by expert panel
  • Adult patients (≥ 18 years of age)
  • RAS wild-type tested in

    • KRAS exon 2 (codons 12/13)
    • KRAS exon 3 (codons 59/61)
    • KRAS exon 4 (codons 117/146)
    • NRAS exon 2 (codons 12/13)
    • NRAS exon 3 (codons 59/61)
    • NRAS exon 4 (codons 117/146) assessed by an institution participating in and certified by the specific working group of the Deutsche Gesellschaft für Pathologie)
  • At least one measurable lesion according to RECIST measured within 3 weeks prior to registration
  • No previous chemotherapy for metastatic disease (adjuvant chemotherapy for non-metastatic disease is allowed if terminated more than 6 months ago)
  • Performance status ECOG 0-1
  • Male and female subjects > 18 years of age
  • Adequate haematological, hepatic, renal and metabolic function parameters:

Leukocytes > 3000/mm³, ANC ≥ 1500/mm3, platelets ≥ 100,000/mm3, Hb > 9g/dl (may be transfused or treated with erythropoietin to maintain or exceed this level)Creatinine clearance ≥ 50 ml/min or serum creatinine ≤ 1.5 x upper limit of normal Bilirubin ≤ 1.5 x upper limit of normal, GOT-GPT ≤ 2.5 x upper limit of normal in absence of liver metastases, or ≤ 5 x upper limit of normal in presence of liver metastases, AP ≤ 5 x upper limit of normal Magnesium ≥ lower limit of normal; calcium ≥ lower limit of normal (may be substituted to maintain or exceed this level)

  • Negative pregnancy test and willingness to use highly effective methods of contraception (per institutional standard) during treatment and for 6 months (male or female) after the end of treatment (adequate: oral contraceptives, intrauterine device or barrier method in conjunction with spermicidal jelly).
  • Before subject registration, written informed consent must be given according to ICH-GCP, and national/local regulations.

Exclusion Criteria:

  • Past or current history of malignancies except for the indication under this study and curatively treated:
  • Basal and squamous cell carcinoma of the skin
  • In-situ carcinoma of the cervix
  • Other malignant disease without recurrence after at least 5 years of follow-up
  • Clinically significant cardiovascular disease in (incl. myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) ≤ 6 months before enrolment.
  • Clinically relevant interstitial lung disease, e.g. pneumonitis or pulmonary fibrosis or evidence of interstitial lung disease on baseline chest CT scan.
  • History of evidence upon physical examination of CNS disease unless adequately treated (e.g. primary brain tumour, seizure not controlled with standard medical therapy, brain metastases or history of stroke).
  • Pre-existing neuropathy > grade 1 (NCI CTCAE), except for loss of tendon reflex
  • Allogeneic transplantation requiring immunosuppressive therapy.
  • Severe non-healing wounds, ulcers or bone fractions.
  • Evidence of bleeding diathesis or coagulopathy.
  • Patients not receiving therapeutic anticoagulation must have an INR < 1,5 ULN and aPTT < 1,5 ULN within 7 days prior to randomization. The use of full dose anticoagulants is allowed as long as the INR or aPTT is within therapeutic limits (according to the medical standard in the institution) and the patient has been on a stable dose for anticoagulants for at least two weeks at the time of randomisation.
  • Concomitant therapy with certain anti-viral medicines (sorivudine and brivudine or analogue compounds).
  • Major surgical procedure, open biopsy, nor significant traumatic injury within 28 days prior to study treatment start, or anticipation of the need for major surgical procedure during the course of the study except for surgery for colorectal cancer with curative intent and central venous line placement for chemotherapy administration.
  • Pregnancy or breastfeeding women.
  • Subjects with known allergy to the study drugs or to any of its excipients.
  • Known DPD deficiency.
  • Current or recent (within the 28 days prior to starting study treatment) treatment of another investigational drug or participation in another investigational study.
  • Known grade III/IV allergic reaction against monoclonal antibodies.
  • Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the subject before registration in the trial.

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 ClinicalTrials.gov identifier (NCT number): NCT01328171


Locations
Show Show 19 study locations
Sponsors and Collaborators
AIO-Studien-gGmbH
Amgen
ClinAssess GmbH
Investigators
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Principal Investigator: Michael Geißler, MD, PhD Department of Oncology and Gastroenterology, Academic Teaching Hospital Esslingen

Additional Information:
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Responsible Party: AIO-Studien-gGmbH
ClinicalTrials.gov Identifier: NCT01328171    
Other Study ID Numbers: AIO KRK 0109
2009-017731-17 ( EudraCT Number )
First Posted: April 4, 2011    Key Record Dates
Last Update Posted: August 7, 2018
Last Verified: August 2018
Additional relevant MeSH terms:
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Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Folic Acid
Vitamin B Complex
Oxaliplatin
Irinotecan
Panitumumab
Antineoplastic Agents
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Hematinics
Vitamins
Micronutrients
Nutrients
Growth Substances
Antineoplastic Agents, Immunological