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Palbociclib and Cetuximab in Metastatic Colorectal Cancer

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. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03446157
Recruitment Status : Recruiting
First Posted : February 26, 2018
Last Update Posted : January 10, 2020
Sponsor:
Collaborators:
Amgen
Pfizer
Information provided by (Responsible Party):
UNC Lineberger Comprehensive Cancer Center

Brief Summary:
This research study is designed to provide a better understanding of study drugs cetuximab (Erbitux®) and palbociclib when used in combination to treat patients with metastatic colon cancer.

Condition or disease Intervention/treatment Phase
Cancer of the Colon Colon Cancer Colon Neoplasms Colonic Cancer Neoplasms, Colonic Drug: Cetuximab Drug: Palbociclib Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 57 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: This is a multicenter, single-arm, phase II clinical trial of combination therapy with cetuximab and palbociclib in refractory KRAS, NRAS, and BRAF wild-type metastatic colorectal cancer (CRC) patients
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase II Single-arm Study of the Combination of Palbociclib and Cetuximab in KRAS/NRAS/BRAF Wild-type Metastatic Colorectal Cancer
Actual Study Start Date : March 13, 2018
Estimated Primary Completion Date : July 13, 2020
Estimated Study Completion Date : July 13, 2023

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Open-label, single arm, Phase II
Cetuximab and palbociclib
Drug: Cetuximab
Loading dose on day 1 of week 1 of 400 mg/m2 via IV over 2 hours Subsequent doses of 250 mg/m2 via IV over 1 hour weekly for 4 weeks (28 days) in combination with palbociclib
Other Name: Erbitux

Drug: Palbociclib
125 mg taken orally once daily on days 1-21, then 7 days off
Other Name: Ibrance




Primary Outcome Measures :
  1. Disease Control Rate [ Time Frame: 4 months ]
    To estimate the disease control rate at four months (DCR: CR, PR or SD) after a treatment regimen of cetuximab and palbociclib in patients with refractory KRAS/NRAS/BRAF wild-type metastatic CRC in both a cohort of anti-EGFR naïve therapy patients, and a cohort of patients who might benefit from a re-challenge of anti-EGFR therapy.


Secondary Outcome Measures :
  1. Overall Response rate [ Time Frame: 4 months ]
    Overall Response Rate (ORR) = CR + PR Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions and assessed by CT scan: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions

  2. Length of Overall Survival [ Time Frame: Up to 3 years ]
    Time from first day of treatment until death from any cause

  3. Length of progression free survival [ Time Frame: Up to 3 years ]
    Time from first day of treatment until disease progression as defined by RECIST or death from any cause

  4. Toxicity of Treatment [ Time Frame: From day 1 of treatment until grade 3 or 4 events are resolved or deemed irreversible or 3 years ]
    The number of treatment-emergent grade 3 and 4 toxicities as defined by National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI CTCAE v4.03)



Information from the National Library of Medicine

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, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 99 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

4.1.1 Written informed consent obtained to participate in the study and HIPAA authorization for release of personal health information.

4.1.2 Age ≥ 18 years at the time of consent.

4.1.3 ECOG Performance Status of 0-2

4.1.4 Histologically-confirmed metastatic CRC

4.1.5 Measurable disease according to RECIST v1.1 for solid tumors.

4.1.6 Documented wild-type in KRAS and NRAS (codons 12, 13, 59, 61, 117, and 146) and in BRAF codon 600, based on tumor tissue taken from primary or metastatic site and tested for biomarkers

4.1.7 Previously treated with at least two prior regimens of systemic chemotherapy for metastatic or locally advanced, unresectable disease, including fluoropyrimidines (5-fluorouracil and/or capecitabine), oxaliplatin, and irinotecan.

A maintenance regimen of 5-fluorouracil or capecitabine, with or without bevacizumab, should not be counted as a separate line of treatment For patients who experienced disease recurrence during or within 6 months of completion of adjuvant chemotherapy with fluoropyrimidine and oxaliplatin, only one regimen of systemic chemotherapy for metastatic disease is required

4.1.8 Demonstrate adequate organ function as defined in the table below; all screening labs to be obtained prior to initiating study medications.

System Laboratory Value Hematological* Hemoglobin (Hgb) ≥ 9 g/dL Absolute Neutrophil Count (ANC) ≥ 1500/mm3 Platelets ≥ 100,000/mm3

Renal* Creatinine OR Calculated creatinine clearance ≤1.5 x ULN

  • 60 mL/min by Cockcroft-Gault formula Hepatic* Bilirubin ≤ 1.0 × upper limit of normal (ULN) Aspartate aminotransferase (AST) ≤ 3 × ULN OR

    • 5 × ULN (if liver metastases present) Alanine aminotransferase (ALT) ≤ 3 × ULN OR
    • 5 × ULN (if liver metastases present)

      • Note: Hematology and other lab parameters that are ≤ grade 2 BUT still meet criteria for study entry are allowed. Furthermore, changes in laboratory parameters during the study should not be considered adverse events unless they meet criteria for dose modification(s) of study medication outlined by the protocol and/or worsen from baseline during therapy.

4.1.9 Females of childbearing potential must have a negative serum pregnancy test within 72 hours prior to initiating study medications. NOTE: Females are considered of childbearing potential unless they are surgically sterile (have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or they are naturally postmenopausal for at least 12 consecutive months. Documentation of postmenopausal status must be provided.

4.1.10 Females of childbearing potential must be willing to abstain from heterosexual activity or to use 2 forms of effective methods of contraception from the time of informed consent until 6 months after treatment discontinuation. The two contraception methods can be comprised of two barrier methods, or a barrier method plus a hormonal method or an intrauterine device that meets <1% failure rate for protection from pregnancy in the product label.

4.1.11 Male patients with female partners must have had a prior vasectomy or agree to use an adequate method of contraception (i.e., double barrier method: condom plus spermicidal agent) starting with the first dose of study therapy through 6 months after the last dose of study therapy.

4.1.12 Subjects is willing and able to comply with study procedures based on the judgement of the investigator or protocol designee.

4.1.13 Able to swallow capsules, with no surgical or anatomic condition that will preclude the patient from swallowing and absorbing oral medications.

4.1.14 Has not undergone any major surgical procedures for at least 4 weeks, with full healing of all surgical wounds

4.1.15 At sites in the Southeastern U.S., subject must have negative serum test for galactose-alpha-1,3-galactose IgE See Appendix 12.5 for map (Note: positive test result is predictive of immediate-onset anaphylaxis reaction during first exposure to cetuximab, which is prevalent predominantly in limited geographic region of the Southeastern U.S. (Clin Mol Allergy 2012;10:1-11).

4.1.16 For Study Cohort A, has not had prior treatment with cetuximab, panitumumab, or other anti-EGFR therapy.

4.1.17 For Study Cohort B, must have had previous treatment with cetuximab or panitumumab with disease control (defined as complete response, partial response, or stable disease) lasting for ≥ 4 months in duration and completed their last anti-EGFR therapy 8 weeks prior to initiating treatment.

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Exclusion Criteria:

4.2.1 Active infection requiring systemic therapy.

4.2.2 Pregnant or breastfeeding (NOTE: breast milk cannot be stored for future use while the mother is being treated on study).

4.2.3 Presence of known, active central nervous system (CNS) metastases.

4.2.4 Treatment with any investigational drug within 28 days prior to initiating study medications.

4.2.5 Prior treatment with drug targeting cyclin-dependent kinase (CDK) family.

4.2.6 Subject is receiving prohibited medications or treatments as listed in section 5.5 of the protocol that cannot be discontinued/replaced by an alternative therapy.

4.2.7 Known hypersensitivity to the components of study drugs or analogs of study drugs.

4.2.8 Has a known additional malignancy that is active and/or progressive requiring treatment; exceptions include basal cell or squamous cell skin cancer, in situ cervical or bladder cancer, or other cancer for which the subject has been disease-free for at least five years.

4.2.9 Uncontrolled, severe concomitant comorbidity (e.g. uncontrolled hypertension, uncontrolled diabetes mellitus, clinically significant pulmonary disease, clinically significant neurological disorder, active or uncontrolled infection).

4.2.10 History of interstitial lung disease or pneumonitis.

4.2.11 Any other clinically significant heart disease, including angina pectoris, resting bradycardia, left bundle branch block, ventricular tachyarrhythmia, unstable atrial fibrillation, acute myocardial infarction, or heart disease requiring cardiac pacemaker or implantable cardioverter/defibrillator

4.2.12 Known psychiatric or substance abuse disorder that would interfere with the ability of the patient to comply with trial requirements.

4.2.13 History of long-QT syndrome.

4.2.14 Baseline QTcF ≥ 470 msec.

4.2.15 Concomitant use of drugs known to cause QT prolongation as defined in Appendix 12.4 and in section 5.5 (Note: Ondansetron at doses ≤ 16 mg or less is allowed)

4.2.16 History of any of the following cardiovascular conditions within the past 6 months:

  • Class III or IV congestive heart failure as defined by the New York Heart Association Criteria
  • Cardiac angioplasty or stenting
  • Myocardial infarction
  • Unstable angina
  • Symptomatic peripheral vascular disease or other clinically significant cardiac disease

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): NCT03446157


Contacts
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Contact: Catherine Griffin 919-966-4432 catherine_griffin@med.unc.edu
Contact: Brian Burgess 919-966-4432 brian_burgess@med.unc.edu

Locations
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United States, North Carolina
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Recruiting
Chapel Hill, North Carolina, United States, 27599-7295
Contact: Clinical Trials Office - Lineberger Comprehensive Cancer Cente    877-668-0683      
Sub-Investigator: Cheryl Carlson, MD         
Sub-Investigator: Autumn McRee, MD         
Sub-Investigator: Hanna Sanoff, MD         
Sub-Investigator: Tammy Triglianos, RN, NP         
Sponsors and Collaborators
UNC Lineberger Comprehensive Cancer Center
Amgen
Pfizer
Investigators
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Principal Investigator: Michael Lee University of North Carolina, Chapel Hill
Additional Information:
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Responsible Party: UNC Lineberger Comprehensive Cancer Center
ClinicalTrials.gov Identifier: NCT03446157    
Other Study ID Numbers: LCCC1717
First Posted: February 26, 2018    Key Record Dates
Last Update Posted: January 10, 2020
Last Verified: January 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by UNC Lineberger Comprehensive Cancer Center:
colon cancer
metastatic colon cancer
palbociclib
cetuximab
Additional relevant MeSH terms:
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Colonic Neoplasms
Neoplasms
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Cetuximab
Palbociclib
Antineoplastic Agents, Immunological
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action