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Open-label Phase 1b Study of FOLFIRI Plus Cetuximab Plus IMO-2055 in Patients With Colorectal Cancer Who Have Progressed Following Chemotherapy for Advanced or Metastatic Disease


Phase 1
18 Years
N/A
Not Enrolling
Both
Colorectal Cancer

Thank you

Trial Information

Open-label Phase 1b Study of FOLFIRI Plus Cetuximab Plus IMO-2055 in Patients With Colorectal Cancer Who Have Progressed Following Chemotherapy for Advanced or Metastatic Disease


- Part 1: Dose escalation of IMO-2055, including 3 dose groups. Once a recommended
phase 2 dosage (RP2D) of IMO-2055 given concomitantly with FOLFIRI and cetuximab is
found the selected cohort will be expanded by an additional 6 to 9 patients (to a total
of 12 patients) for confirmation of the RP2D and combination treatment regimen.

- Part 2: A final cohort of 12 patients (Cohort 6) will be enrolled simultaneously to
explore tolerability and pharmacodynamics in patients treated with the RP2D of IMO-2055
in combination with FOLFIRI with cetuximab.


Inclusion Criteria:



Patients must satisfy all the following inclusion criteria in order to be eligible for the
study:

1. Signed written informed consent prior to any study-specific screening procedures,
with the understanding that the patient has the right to withdraw from the study at
any time, without prejudice.

2. Male or female patients aged ≥ 18 years.

3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

4. Histologically confirmed adenocarcinoma of the colon or rectum with advanced or
metastatic disease.

5. Patients whose disease has recurred or progressed during or after completion of at
least one (1) standard regimen of cytotoxic agents. Patients may have had any number
of prior regimens as long as the other entry criteria are met. Preferred patients are
those who have progressed on first line FOLFIRI or FOLFOX with or without
bevacizumab. Patients may have had prior exposure to monoclonal antibodies such as
cetuximab, bevacizumab or panitumumab.

6. All clinically significant adverse events of any prior chemotherapy, surgery or
radiotherapy must have resolved to CTCAE v3.0 grade ≤ 1. Neuropathy of CTCAE v3.0
grade ≤ 2 will be allowed but the neuropathy should be closely monitored throughout
the trial.

7. A minimum of 4 weeks must occur between last receipt of chemotherapy, biotherapy,
radiotherapy, or major surgery and registration.

8. Be willing and able to comply with the protocol for the duration of the study.

9. If prior malignancy was diagnosed, other than colorectal, no evidence of disease from
that cancer, off all therapy for that cancer and recovered to grade 1 or less
toxicity from prior treatment.

Exclusion Criteria:

Patients with any of the following will be excluded from participation in the study:

Disease

1. Known central nervous system (CNS) metastases unless controlled for ≥ 4 months
without the use of steroids.

2. Patients who are candidates for neoadjuvant "conversion" therapy followed by curative
surgery.

Prior Treatments

3. Prior pelvic irradiation.

4. Administration of any investigational agent (therapeutic or diagnostic), within 4
weeks prior to first study dosing.

5. Patients with a prior history of cetuximab hypersensitivity may be admitted to Part 1
of the study only.

Other Concomitant Medications

6. Chronic oral or intravenous corticosteroids. (Note: Doses ≤ 5 mg/day of prednisone
or equivalent are permitted. Topical, inhaled and intra-articular corticosteroids
are allowed.)

7. Therapeutic anticoagulation (warfarin > 1 mg/day or heparin). Low-dose warfarin for
port prophylaxis and low-molecular weight heparin at therapeutic doses are allowed.

Laboratory

8. The following laboratory results:

- Hemoglobin < 9.0 g/dL Absolute neutrophil count < 1.5 x 109/L Platelet count <
100 x 109/L

- Total bilirubin > 1.5 x upper limit of normal (ULN)

- ALT or AST > 2.5 x ULN (> 5 x ULN if liver metastases present)

- Alkaline phosphatase > 2.5 x ULN (> 5 x ULN if liver metastases present, or > 10
x ULN in case of the presence of bone metastases)

- Serum creatinine > 1.5 x ULN

- Albumin < 2.5 g/dL Other Conditions or Procedures

9. Grade 3 or 4 non-hematological toxicity or febrile neutropenia related to previous
irinotecan-based regimens.

10. Homozygous for the UGT1A1*28 allele.

11. Known hypersensitivity to murine proteins or oligonucleotides.

12. Pregnant or breast-feeding women.

13. Women of childbearing potential with either positive or no pregnancy test at
baseline. Postmenopausal women must have been amenorrheic for at least 12 months to
be considered of non-childbearing potential.

14. Men or women of childbearing potential who refuse or who are unable to use an
acceptable means of contraception during the study.

15. History of uncontrolled seizures, central nervous system disorders or psychiatric
disability judged by the Investigator to be clinically significant precluding
informed consent or interfering with compliance.

16. Pre existing autoimmune or antibody-mediated diseases, including, but not limited to,
the following: organ allografts, systemic lupus erythematosus, rheumatoid arthritis,
multiple sclerosis, Sjogren's syndrome and autoimmune thrombocytopenia, known
Gilbert's syndrome.

17. Signs/symptoms of bowel obstruction or pseudo-obstruction or history of inflammatory
bowel disease.

18. Clinically significant (i.e., active) cardiac disease (e.g., congestive heart
failure, symptomatic coronary artery disease and cardiac arrhythmias not well
controlled with medication) or myocardial infarction within the last 6 months.

19. Interstitial pneumonia or extensive symptomatic fibrosis of the lungs.

20. Serious uncontrolled concomitant disease, intercurrent infections, or other known
medical conditions that in the opinion of the Investigator puts the patient at
increased risk for significant toxicities from treatment, such as hypertension,
uncontrolled by medication, chronic hepatitis (viral or other) or cirrhosis, known
human immunodeficiency virus (HIV) infection, or uncontrolled diabetes.

21. Legal incapacity or limited legal capacity.

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

• The primary objective of this study is to determine the recommended phase 2 dose of IMO 2055 when combined with FOLFIRI and cetuximab in patients with histologically proven advanced or metastatic colorectal cancer (CRC).

Outcome Time Frame:

10 months from first patient in, Oct 2010

Safety Issue:

Yes

Principal Investigator

Phil Breitfeld, MD

Investigator Role:

Study Director

Investigator Affiliation:

EMD Serono

Authority:

United States: Food and Drug Administration

Study ID:

IMO-2055-210

NCT ID:

NCT00719199

Start Date:

September 2008

Completion Date:

Related Keywords:

  • Colorectal Cancer
  • Colorectal cancer
  • metastatic cancer
  • prior therapy
  • 1b
  • Colorectal Neoplasms

Name

Location

Vanderbilt-Ingram Cancer Center Nashville, Tennessee  37232-6838
Dana-Farber Cancer Institute Boston, Massachusetts  02115
Cancer Therapy & Research Center San Antonio, Texas  78229
Cancer Therapy and Research Center San Antonio, Texas  78229
Georgetown University Lombardi Cancer Center Washington, District of Columbia  20007