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COLUMBIA-1: Novel Oncology Therapies in Combination With Chemotherapy and Bevacizumab as First- Line Therapy in MSS-CRC

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: NCT04068610
Recruitment Status : Recruiting
First Posted : August 28, 2019
Last Update Posted : February 25, 2020
Sponsor:
Information provided by (Responsible Party):
MedImmune LLC

Brief Summary:
COLUMBIA-1 is a Phase 1b/2 platform study to evaluate the safety and efficacy of standard of care (FOLFOX plus bevacizumab) alone and in combination with novel oncology therapies in first-line metastatic microsatellite-stable colorectal cancer (MSS-CRC).

Condition or disease Intervention/treatment Phase
Metastatic Microsatellite-stable Colorectal Cancer Drug: Standard of Care Drug: Experimental Phase 1 Phase 2

Detailed Description:
COLUMBIA-1 is a Phase 1b/2, open-label, multicenter, randomized, multidrug platform study to evaluate the safety and efficacy of standard of care (FOLFOX plus bevacizumab) in combination with novel oncology therapies in patients with first-line metastatic MSS-CRC. The study is designed to concurrently evaluate potential novel combinations with clinical promise using a 2-part approach. Part 1 is a Phase 1b study of safety, and Part 2 is a Phase 2 study of efficacy and safety.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 112 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:

The study is designed to concurrently evaluate potential novel combinations with clinical promise using a 2-part approach.

Part 1 is a Phase 1b study of safety, and Part 2 is a Phase 2 study of efficacy and safety. The treatment regimens evaluated in Part 2 will depend on the evaluation of safety outcomes in Part 1.

Following a screening period of up to 28 days, subjects will be centrally assigned (Part 1) or randomized (Part 2) to one of the open study arms. In both study parts, study treatment may be administered until disease progression or any discontinuation criteria are met.

In Part 2, experimental arms may be closed early based on futility from results of a planned interim analysis for each study arm. In both parts, new experimental arms consisting of FOLFOX and bevacizumab plus novel agent(s) may be added based on emerging nonclinical and clinical data via protocol amendment.

Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1b/2, Open-label, Multicenter Study of Novel Oncology Therapies in Combination With Chemotherapy and Bevacizumab as First-line Therapy in Metastatic Microsatellite-stable Colorectal Cancer (COLUMBIA-1)
Actual Study Start Date : September 13, 2019
Estimated Primary Completion Date : February 22, 2024
Estimated Study Completion Date : February 22, 2024

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: Control Arm (FOLFOX + Bevacuzimab)
Parts of FOLFOX are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 2400 mg/m2 administered by continuous IV infusion over 46 to 48 hours Q2W (Day 1-2 of every 14-day cycle). Note: 5-FU will be administered as infusion only. Bevacizumab 5 mg/kg IV infusion Q2W (Day 1 of every 14-day cycle)
Drug: Standard of Care

Parts of FOLFOX are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 2400 mg/m2 administered by continuous IV infusion over 46 to 48 hours Q2W (Day 1-2 of every 14-day cycle). Note: 5-FU will be administered as infusion only.

Bevacizumab 5 mg/kg IV infusion Q2W (Day 1 of every 14-day cycle)

Other Names:
  • FOLFOX (Oxaliplatin, Folinic acid (leucovorin), Fluorouracil (5-FU))
  • Bevacizumab (Avastin)

Experimental: Exp. Arm (FOLFOX + Bevacuzimab + Durvalumab + Oleclumab)

Parts of FOLFOX are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 2400 mg/m2 administered by continuous IV infusion over 46 to 48 hours Q2W (Day 1-2 of every 14-day cycle). Note: 5-FU will be administered as infusion only.

Bevacizumab 5 mg/kg IV infusion Q2W (Day 1 of every 14-day cycle) Durvalumab 1500 mg IV Q4W Oleclumab 3000mg IV Q2W x 4 then Q4W

Drug: Experimental
Parts of FOLFOX are: Oxaliplatin 85 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Folinic acid (leucovorin) 400 mg/m2 IV infusion Q2W (Day 1 of every 14-day cycle), Fluorouracil (5-FU) 2400 mg/m2 administered by continuous IV infusion over 46 to 48 hours Q2W (Day 1-2 of every 14-day cycle). Note: 5-FU will be administered as infusion only. Bevacizumab 5 mg/kg IV infusion Q2W (Day 1 of every 14-day cycle) Durvalumab 1500 mg IV Q4W Oleclumab 3000mg IV Q2W x 4 then Q4W
Other Names:
  • Durvalumab (MEDI-4736)
  • Oleclumab (MEDI-9447)




Primary Outcome Measures :
  1. Part 1 of the study: Number of participants with Dose Limiting Toxicities (DLTs) as a measure of safety. [ Time Frame: From the time of first dose through 28 days during the Part 1 of the study. ]
    The primary endpoint is safety as assessed by the presence of adverse events and serious adverse events

  2. Part 2 of the study: Objective Response (OR) rate as a measure of antitumor activity of FOLFOX plus bevacizumab plus novel oncology therapy combinations versus FOLFOX plus bevacizumab. [ Time Frame: From randomization/enrollment until progression, or the last evaluable disease assessment in the absence of PD prior to the initiation of subsequent anticancer therapy or discontinuation from the study, whichever occurs first, assessed up to 5 years. ]
    Best overall response of confirmed CR or confirmed PR according to RECIST v1.1


Secondary Outcome Measures :
  1. Incidence of Adverse Events as a measure of safety during the treatment period [ Time Frame: From time of informed consent through treatment period (24 months) or up to 3 months post last dose of study treatment ]
    The secondary endpoint of safety as assessed by the presence of adverse events and serious adverse events

  2. Incidence of clinically significant vital sign values as a measure of safety during the treatment period [ Time Frame: From time of informed consent through treatment period (12 months) or up to 3 months post last dose of study treatment ]
    Assess the presence of clinically significant vital sign values from baseline

  3. Incidence of clinically significant laboratory values as a measure of safety during the treatment period [ Time Frame: From time of informed consent through treatment period (12 months) or up to 3 months post last dose of study treatment ]
    The secondary endpoint of safety as assessed by the presence of clinically significant laboratory values

  4. Duration of Response (DoR) as a measure of efficacy of FOLFOX plus bevacizumab plus novel oncology therapy combinations versus FOLFOX plus bevacizumab [ Time Frame: From time of first documented response until disease progression or up to a maximum of 5 years after randomization ]
    The duration from the first documentation of a subsequently confirmed OR to the first documentation of a disease progression according to RECIST v1.1 or death due to any cause, whichever occurs first. Only subjects who have achieved OR (confirmed CR or confirmed PR) will be evaluated for DoR

  5. Disease Control Rate (DCR) as a measure of efficacy of FOLFOX plus bevacizumab plus novel oncology therapy combinations versus FOLFOX plus bevacizumab [ Time Frame: From time of randomization until disease progression or up to a maximum of 5 years ]
    confirmed CR, confirmed PR, or SD based on RECIST v1.1

  6. Progression-Free Survival (PFS) as a measure of efficacy of FOLFOX plus bevacizumab plus novel oncology therapy combinations versus FOLFOX plus bevacizumab [ Time Frame: From time of randomization until disease progression or up to a maximum of 5 years ]
    From randomization until the first documentation of disease progression according to RECIST v1.1 or death due to any cause, whichever occurs first

  7. Progression-Free Survival 12 month landmark rate (PFS-12) as a measure of efficacy of FOLFOX plus bevacizumab plus novel oncology therapy combinations versus FOLFOX plus bevacizumab [ Time Frame: From time of randomization until disease progression or up to a maximum of 12 months ]
    From randomization until the first documentation of disease progression according to RECIST v1.1 or death due to any cause, whichever occurs first

  8. Overall Survival (OS) as a measure of efficacy of FOLFOX plus bevacizumab plus novel oncology therapy combinations versus FOLFOX plus bevacizumab [ Time Frame: From time of randomization until death ]
    From randomization until death due to any cause.

  9. Serum concentration levels of novel agents in combination with FOLFOX + bevacuzimab [ Time Frame: From Day 1 up to 90 days post last dose ]
    Pharmacokinetics of novel agents in combination with FOLFOX + bevacuzimab

  10. Number of subjects with detectable anti-drug antibody (ADA) to novel agents in combination with FOLFOX + bevacuzimab [ Time Frame: From Day 1 up to 90 days post last dose ]
    Immunogenicity of novel agents in combination with FOLFOX + bevacuzimab



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 101 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Written informed consent and any locally required authorization obtained from the subject/legal representative prior to performing any protocol-related procedures, including screening evaluations.
  2. Age ≥ 18 years at the time of screening.
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  4. Subjects must have histologic documentation of advanced or metastatic CRC and: (a) A documented mutation test during screening and confirmed tumor locations from disease assessment for enrollment. (b) Subjects must NOT have defective DNA mismatch repair (MSI) as documented by testing. (c) Subjects must not have received any prior systemic therapy for recurrent/metastatic disease (prior adjuvant chemotherapy or radio-chemotherapy is acceptable so long as progression was not within 6 months of completing the adjuvant regimen).
  5. Subjects must have at least one lesion that is measurable by RECIST v1.1 (Eisenhauer et al, 2009).
  6. Subjects must have adequate organ function.
  7. Subjects with medical conditions requiring systemic anticoagulation (eg, atrial fibrillation) are eligible provided that both of the following criteria are met: - The subject has an in-range INR on a stable dose of oral anticoagulant or be on a stable dose of low molecular weight heparin. - The subject has no active bleeding or pathological condition that carries a high risk of bleeding.

8 Body weight >35 kg. 9. Adequate method of contraception per protocol

Exclusion Criteria:

  1. History of allogeneic organ transplantation.
  2. Active or prior documented autoimmune disorders within the past 5 years.
  3. History of venous thrombosis within the past 3 months.
  4. Cardiovascular criteria: (a) Presence of acute coronary syndrome including myocardial infarction or unstable angina pectoris, other arterial thrombotic event including cerebrovascular accident or transient ischemic attack or stroke within the past 6 months. (b) New York Heart Association (NYHA) class II or greater congestive heart failure, serious cardiac arrhythmia requiring medication, or uncontrolled hypertension. (c) History of hypertensive crisis/hypertensive encephalopathy within the past 6 months.
  5. Mean QT interval corrected for heart rate using Fridericia's formula (QTcF) ≥ 470 ms.
  6. No significant history of bleeding events or gastrointestinal perforation.
  7. Uncontrolled intercurrent illness.
  8. History of another primary malignancy except for: (a) Malignancy treated with curative intent and with no known active disease ≥ 5 years of low potential risk for recurrence. (b) Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease. (c) Adequately treated carcinoma in situ without evidence of disease.
  9. History of active primary immunodeficiency.
  10. Active infection including tuberculosis, hepatitis B, hepatitis C, or human immunodeficiency virus.
  11. Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
  12. Any unresolved toxicity NCI CTCAE Grade > 1 from previous anticancer therapy.
  13. History of leptomeningeal disease or cord compression.
  14. Untreated central nervous system (CNS) metastases.
  15. Lack of physical integrity of the upper gastrointestinal tract, malabsorption syndrome, or inability to take oral medication.
  16. Known dihydropyrimidine dehydrogenase (DPD) deficiency.
  17. Prior immunotherapy or anti-angiogenics.
  18. Receipt of live attenuated vaccine within the past 30 days.
  19. Major surgical procedure, open biopsy, or significant traumatic injury within the past 28 days.
  20. Current or prior use of immunosuppressive medication within the past 14 days, with exceptions per protocol.

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): NCT04068610


Contacts
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Contact: AstraZeneca Clinical Study Information Center 1-877-240-9479 information.center@astrazeneca.com

Locations
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United States, California
Research Site Not yet recruiting
Los Angeles, California, United States, 90024
Research Site Recruiting
Sacramento, California, United States, 95817
United States, Connecticut
Research Site Not yet recruiting
New Haven, Connecticut, United States, 06520
United States, Iowa
Research Site Not yet recruiting
Ames, Iowa, United States, 50010
United States, Michigan
Research Site Recruiting
Ann Arbor, Michigan, United States, 48109
United States, Nevada
Research Site Recruiting
Las Vegas, Nevada, United States, 89169
United States, New York
Research Site Not yet recruiting
New York, New York, United States, 10065
United States, North Carolina
Research Site Not yet recruiting
Chapel Hill, North Carolina, United States, 27599
United States, Ohio
Research Site Recruiting
Canton, Ohio, United States, 44718
United States, Pennsylvania
Research Site Not yet recruiting
Philadelphia, Pennsylvania, United States, 19104
Research Site Withdrawn
Philadelphia, Pennsylvania, United States, 19104
United States, Rhode Island
Research Site Recruiting
Providence, Rhode Island, United States, 02903
United States, Tennessee
Research Site Recruiting
Chattanooga, Tennessee, United States, 37404
Research Site Recruiting
Nashville, Tennessee, United States, 37203
United States, Texas
Research Site Recruiting
Houston, Texas, United States, 77584
United States, Utah
Research Site Not yet recruiting
Salt Lake City, Utah, United States, 84112
United States, Virginia
Research Site Recruiting
Charlottesville, Virginia, United States, 22908
Australia
Research Site Recruiting
Blacktown, Australia, 2148
Research Site Recruiting
Clayton, Australia, 3168
Research Site Not yet recruiting
Heidelberg, Australia, 3084
Research Site Recruiting
Melbourne, Australia, 3000
Research Site Recruiting
Waratah, Australia, 2298
Canada, Alberta
Research Site Not yet recruiting
Calgary, Alberta, Canada, T2N 4N2
Research Site Not yet recruiting
Edmonton, Alberta, Canada, T6G 1Z2
Canada, Ontario
Research Site Not yet recruiting
Oshawa, Ontario, Canada, L1G 2B9
Research Site Recruiting
Toronto, Ontario, Canada, M5G 1X6
Canada, Quebec
Research Site Not yet recruiting
Montreal, Quebec, Canada, H3T 1M5
France
Research Site Not yet recruiting
Bordeaux, France, 33000
Research Site Not yet recruiting
Lille, France, 59000
Research Site Not yet recruiting
Nantes, France, 44000
Research Site Not yet recruiting
Paris, France, 75012
Research Site Not yet recruiting
Paris, France, 75015
Research Site Not yet recruiting
Toulouse Cedex 9, France, 31059
Research Site Not yet recruiting
Villejuif, France, 94805
Spain
Research Site Recruiting
Barcelona, Spain, 08035
Research Site Recruiting
Barcelona, Spain, 08916
Research Site Recruiting
Madrid, Spain, 28027
Research Site Recruiting
Madrid, Spain, 28046
Research Site Recruiting
Majadahonda, Spain, 28222
Research Site Not yet recruiting
Valencia, Spain, 46010
Sponsors and Collaborators
MedImmune LLC

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Responsible Party: MedImmune LLC
ClinicalTrials.gov Identifier: NCT04068610    
Other Study ID Numbers: D910CC00001
First Posted: August 28, 2019    Key Record Dates
Last Update Posted: February 25, 2020
Last Verified: February 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by MedImmune LLC:
Microsatellite
colorectal
MSS-CRC
colon cancer
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
Leucovorin
Folic Acid
Bevacizumab
Durvalumab
Oxaliplatin
Fluorouracil
Levoleucovorin
Antineoplastic Agents, Immunological
Antineoplastic Agents
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Immunosuppressive Agents
Immunologic Factors