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A Trial of mFOLFIRI With MEK162 in Patients With Advanced RAS (HRAS, NRAS, or KRAS) Positive Metastatic Colorectal Cancers

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: NCT02613650
Recruitment Status : Recruiting
First Posted : November 24, 2015
Last Update Posted : April 22, 2022
Sponsor:
Collaborator:
Pfizer
Information provided by (Responsible Party):
University of Utah

Tracking Information
First Submitted Date  ICMJE November 12, 2015
First Posted Date  ICMJE November 24, 2015
Last Update Posted Date April 22, 2022
Actual Study Start Date  ICMJE August 19, 2016
Estimated Primary Completion Date April 30, 2023   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: February 15, 2017)
Incidence of dose limiting toxicities (DLTs) of combination MEK162 and mFOLFIRI [ Time Frame: Patient safety will be evaluated throughout the treatment period (treatment with MEK162 and mFOLFIRI which is expected to last 6-10 months for each patient) ]
Original Primary Outcome Measures  ICMJE
 (submitted: November 23, 2015)
Incidence of dose limiting toxicities (DLTs) of combination MEK162 and FOLFIRI [ Time Frame: Patient safety will be evaluated throughout the treatment period (treatment with MEK162 and FOLFIRI which is expected to last 6-10 months for each patient) ]
Change History
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE A Trial of mFOLFIRI With MEK162 in Patients With Advanced RAS (HRAS, NRAS, or KRAS) Positive Metastatic Colorectal Cancers
Official Title  ICMJE A Phase 1b Trial of a Combination of mFOLFIRI With MEK162 in Patients With Advanced RAS (HRAS, NRAS, or KRAS) Positive Metastatic Colorectal Cancers
Brief Summary This is a Phase 1b, open label, dose-finding study to determine the Maximum Tolerated Dose (MTD) of MEK162 in combination with mFOLFIRI, and to evaluate the response rate, clinical benefit rate and additional safety parameters of the treatment combination
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Advanced KRAS Positive Metastatic Colorectal Cancer
Intervention  ICMJE Drug: MEK162 and mFOLFIRI

MEK162 in combination with mFOLFIRI in a 14 day cycle

MEK162 will be given single agent 6 day lead in and then will be given in combination with mFOLFIRI

mFOLFIRI Administered Day 1 of each cycle Irinotecan 180mg/m2 iv over 90 minutes on day 1 5-fluoruracil 1200mg/m2 continuous infusion for 48 hours (2400mg/m2 in 48 hours)

Followed by MEK162 - Taken twice daily orally on Days 1-12 of each cycle

Level -1: mFOLFIRI at 80% + MEK162 30 mg twice daily 1 week on and 1 week off Level 1: mFOLFIRI + MEK162 30 mg twice daily Level 2: mFOLFIRI + MEK162 45 mg twice daily

Other Name: Binimetinib
Study Arms  ICMJE Experimental: MEK162 and mFOLFIRI, all patients
Intervention: Drug: MEK162 and mFOLFIRI
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: November 23, 2015)
30
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE April 30, 2023
Estimated Primary Completion Date April 30, 2023   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Age > 18 years old
  • Patients with histologically confirmed RAS (HRAS, NRAS, or KRAS) positive metastatic colorectal cancer.
  • Patients must have progressed during or after first-line treatment for metastatic disease with oxaliplatin and fluoropyrimidines based chemotherapy (with failure within six months) or not be a candidate for oxaliplatin (i.e. neuropathy).
  • ECOG Performance Status 0-1
  • Able to provide informed consent and willing to sign an approved consent form that conforms to federal and institutional guidelines.
  • Adequate bone marrow, organ function and laboratory parameters as defined by the protocol
  • Adequate cardiac function as defined by the protocol
  • Must have recovered from adverse effects of any prior surgery, radiotherapy or other antineoplastic therapy. Alopecia and CTCAE grade 1 peripheral neuropathy is acceptable
  • Willingness and ability to comply with all study procedures and able to take oral medications

Dose Expansion Phase Additional Inclusion Criteria

  • Patients must be willing to undergo biopsy according to the institute's own guidelines and requirements for such procedures unless deemed unsafe by the investigator
  • Patients must have measurable disease as defined by RECIST v1.1 (at least one lesion ≥ 10mm in at least one dimension when assessed by CT or MRI, or a cutaneous lesion with clearly defined margins that measures ≥ 10 mm in at least one dimension)
  • Patients must be irinotecan refractory. Patients must have progressed on prior irinotecan therapy but must be able to tolerate standard irinotecan doses.

Exclusion Criteria:

  • UGT1A1 *28 homozygous patients
  • Previous treatment with any MEK inhibitor
  • Treatment with systemic antineoplastic therapy (including unconjugated therapeutic antibodies and toxin immunoconjugates) or any investigational therapy ≤ 4 weeks (<6 weeks for nitrosurea or mitomycin-C, antibodies except for trastuzumab) or ≤ 5-half lives of the investigational therapy prior to starting study treatment, whichever is longer
  • Patient received radiotherapy ≤ 2 weeks prior to the first dose of study treatment except localized radiation therapy for symptomatic bone metastasis.
  • Have had a diagnosis of another malignancy, unless the patient has been disease-free for at least 3 years following the completion of curative intent therapy, with the following exceptions:

    • Patients with treated non-melanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia, regardless of the disease-free duration, are eligible for this study if definitive treatment for the condition has been completed.
    • Patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on prostate-specific antigen (PSA) values are also eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed.
  • History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g. uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes.
  • Personal history of Gilbert's syndrome.
  • Uncontrolled arterial hypertension defined by blood pressure >150 mmHg systolic and/or 100 mmHg diastolic at rest (average 3 consecutive readings at least 5 minutes apart) despite appropriate medical therapy.
  • Impaired cardiovascular function or clinically significant cardiovascular diseases, including any of the following:

    • History of acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass grafting, coronary angioplasty, or stenting) <6 months prior to screening,
    • Symptomatic chronic heart failure; evidence of clinically significant cardiac arrhythmias and/or conduction abnormalities < 6 months prior to screening except atrial fibrillation and paroxysmal supraventricular tachycardia.
  • Known positive serology for HIV, active Hepatitis B, and/or active Hepatitis C infection (Note: if not suspected, testing is not required at baseline).
  • Patients who have neuromuscular disorders that are associated with elevated CK (e.g., inflammatory myopathies, muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy).
  • Patients who are planning on embarking on a new strenuous exercise regimen after first dose of study treatment. Muscular activities, such as strenuous exercise, that can result in significant increases in plasma CK levels should be avoided while on MEK162 treatment.
  • Impairment of gastrointestinal function or gastrointestinal disease (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection that under the judgment of the PI may impair absorption of study drugs).
  • Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures, e.g., infection/inflammation, intestinal obstruction, unable to swallow medication.(patients may not receive drug through a feeding tube), social/ psychological issues, etc.
  • Patients who have undergone major surgery ≤ 3 weeks prior to starting study drug or who have not recovered from side effects of such procedure.
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test.

    • A positive β-hCG result will not be exclusionary if it is suspected to originate from a malignancy and the patient has undergone a confirmatory ultrasound within 72 hours prior to starting MEK162 therapy.
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception from screening through 30 days after the last dose of study drug/treatment discontinuation.
  • Sexually active males, unless they use a condom during intercourse while taking the drug through 90 days after the end of systemic exposure to study drug/treatment. In addition, male participants should not father a child in this period and must refrain from donating sperm during the study through 90 days after the end of systemic exposure of study drug/treatment. A condom is required to be used also by vasectomized men in order to prevent delivery of the drug via seminal fluid.
  • Medical, psychiatric, cognitive or other conditions that may compromise the patient's ability to understand the patient information, give informed consent, comply with the study protocol or complete the study.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Arun Athithan 801-587-4624 arun.athithan@hci.utah.edu
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT02613650
Other Study ID Numbers  ICMJE HCI87144
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Current Responsible Party University of Utah
Original Responsible Party Same as current
Current Study Sponsor  ICMJE University of Utah
Original Study Sponsor  ICMJE Same as current
Collaborators  ICMJE Pfizer
Investigators  ICMJE Not Provided
PRS Account University of Utah
Verification Date April 2022

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP