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Regorafenib Assessment in Refractory Advanced Colorectal Cancer(RegARd-C) (RegARd-C)

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ClinicalTrials.gov Identifier: NCT01929616
Recruitment Status : Completed
First Posted : August 28, 2013
Last Update Posted : June 25, 2019
Sponsor:
Information provided by (Responsible Party):
Jules Bordet Institute

Study Description
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Brief Summary:
The general objectives are to evaluate activity and the safety of regorafenib in a population of patients bearing advanced, refractory colorectal cancers and to explore the different downstream molecular pathways to identify tumor response and resistance mechanisms.

Condition or disease Intervention/treatment Phase
Advanced Chemorefractory Colorectal Adenocarcinoma Drug: regorafenib Phase 2

Detailed Description:

The primary objective is to identify in a population of patients bearing advanced, refractory colorectal cancers, those who draw no benefit from treatment with regorafenib. There is no specific hypothesis underlying sample size and the study is therefore to be seen as exploratory.

Secondary objectives:

  • To analyze PFS and response rate (RR) in relationship with the same covariates as for OS
  • To assess regorafenib efficacy (OS, PFS, RR) and safety profile in this study population.
  • To assess the Disease control rate (DCR = Complete response [CR] + partial response [PR] + stable disease [SD])
  • To compare the relative benefit (OS, PFS) of regorafenib according to history of treatment with bevacizumab.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 141 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Regorafenib Assessment in Refractory Advanced Colorectal Cancer
Study Start Date : August 2013
Actual Primary Completion Date : May 13, 2016
Actual Study Completion Date : June 17, 2019

Resource links provided by the National Library of Medicine

Drug Information available for: Regorafenib

Arms and Interventions
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Arm Intervention/treatment
Experimental: Regorafenib
A treatment cycle is defined as a 4 weeks period. Regorafenib will be administered once a day orally at a dose of 160 mg (4 tablets of 40 mg), for 3 weeks.
 Drug: regorafenib
Patients will receive 160 mg regorafenib 1/day 3 weeks out of 4.
Other Name: stivarga (registred name)


Outcome Measures
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Primary Outcome Measures :
  1. Overall survival (OS) [ Time Frame: 2 years from first patient in ]

Secondary Outcome Measures :
  1. Occurence of Adverse events [ Time Frame: Every 28 days till 28 days after stopping therapy. An average of 2 months is expected. ]
    Assessment of safety will follow the WHO guidelines and classified according to NCI-CTCAE v. 4.0 and will be performed every 28 days until 28 days (safety follow up visit) after stopping therapy. Reasons for stopping therapy may include progression of disease or unbearable toxicities, or patient's decision.

  2. Evaluation of tumour response [ Time Frame: Every 2 months till progression of the disease. An average of 2 months is expected. ]
    RECIST 1.1-based radiological assessment (CT or MRI) will be made every 2 cycles, starting at day 28 of the second cycle till demonstration of progressive disease. An average of 2 months is expected.

  3. Metabolic response assessed by FDG PET [ Time Frame: 2 FDGPET will be perfomed : at Baseline (day 0) and at D14 ]
    FDGPET will be done twice during the study course : at baseline (at day 0, before treatment begin) and after 2 weeks.

  4. Molecular aberrations [ Time Frame: at day 0 (before treatment begins) and at D14, then repeated every 2 months until progression. An average of 2 months is expected. ]
    Genetic, epigenetic and molecular aberrations will be investigated using gene expression profiling, RNA and exome sequencing, and methylation profiling on the tumor biopsies and repeated blood samples collected during the trial. The relationship between the molecular aberrations,the patient's outcome (PFS, OS) and with metabolic response after treatment with regorafenib will be studied.


Eligibility Criteria
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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:

  1. Histologically proven colorectal adenocarcinoma that is metastatic or unresectable and for which standard treatments do not exist or are no longer effective.
  2. Age ≥ 18 years.
  3. Life expectancy of greater than 12 weeks.
  4. ECOG performance status ≤ 1.

  5. Participants must have normal organ and bone marrow function as defined below:

    • Leukocytes >3,000/mcL,with an absolute neutrophil count >1,500/mcL, platelets >100,000/mcL, Hb >or=9g/dl.
    • Total bilirubin≤1.5×institutional ULN.
    • AST/ALT/P-Alk levels ≤ 2.5 × institutional ULN (≤5x institutional ULN in case of liver metastatic involvement).
    • Lipase ≤1.5 institutional ULN.
    • coagulation tests ≤ 1.5 x institutional ULN.
    • Creatinine ≤ 1.5× institutional ULN or creatinine clearance >30mL/min according to the Modified Diet in Renal Disease (MDRD) abbreviated formula.
  6. Women of childbearing potential and men must agree to use adequate contraception prior to study entry, until at least 3 months after the last study drug administration.
  7. Signed Written Informed Consent (IC).
  8. Presence of a previously collected or freshly obtained at the time of study entry frozen metastatic tumor biopsy in a FDG-PET targetable lesion.
  9. Presence of at least one metabolically measurable tumoral lesion on FDG PET-CT

Exclusion Criteria:

  1. Prior treatment with sorafenib or regorafenib
  2. Patients with previous cancer that is not disease-free for at least for 5 years prior to registration, EXCEPT for curatively treated cervical cancer in situ, non-melanoma skin cancer and superficial bladder tumors [Ta (Non-invasive tumor), Tis (Carcinoma in situ) and T1 (Tumor invades lamina propria)].
  3. Participants who have had a major surgery, chemotherapy or radiotherapy within 4 weeks prior to entering the study.
  4. Unresolved toxicity higher than NCI-CTCAE (version 4.0) Grade 1 attributed to any prior therapy/procedure excluding alopecia and oxaliplatin induced neurotoxicity ≤Grade 2.
  5. Participants receiving any experimental agents.
  6. Participants with known brain metastases.
  7. Bleeding diathesis, history of cardiovascular ischemic disease or cerebrovascular incident within the last six months.
  8. Any hemorrhage or bleeding event NCI-CTCAE v.4 Grade >or= 3 within 4 weeks prior to the start of study medication.
  9. Uncontrolled concurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure (New York Heart Association (NYHA)class> or=2), unstable angina pectoris, cardiac arrhythmia requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted).
  10. Uncontrolled hypertension.
  11. Patients with seizure disorder requiring medication.
  12. Any history of organ allograft.
  13. Pleural effusion or ascites affecting respiration.
  14. Uncontrolled diabetes.
  15. Non-healing wound, ulcer, or bone fracture.
  16. Known history of human immunodeficiency virus (HIV) infection, or active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy.
  17. Interstitial lung disease with ongoing signs and symptoms.
  18. Renal failure requiring hemo-or peritoneal dialysis.
  19. Dehydration NCI-CTCAE v.4 grade >1.
  20. Medical,psychological or social conditions that may interfere with the patient's ability to understand informed consent and participation in the study or evaluation of the study results.
  21. Known hypersensitivity to the study drug or excipients in the formulation.
  22. Any illness or medical conditions that are unstable or could jeopardize the safety of the patient and his/her compliance in the study.
  23. Pregnant or lactating women.
  24. Subjects unable to swallow oral medications.
Contacts and Locations
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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): NCT01929616


Locations
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Sponsors and Collaborators
Jules Bordet Institute
Investigators
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Study Chair: Alain Hendlisz, MD Jules Bordet Institute
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Jules Bordet Institute
ClinicalTrials.gov Identifier: NCT01929616    
Other Study ID Numbers: 2012-005655-16 EUDRACT
First Posted: August 28, 2013    Key Record Dates
Last Update Posted: June 25, 2019
Last Verified: March 2017
Keywords provided by Jules Bordet Institute:
adenocarcinoma, colorectal,regorafenib
Additional relevant MeSH terms:
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Adenocarcinoma
Neoplasms
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type