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Phase 2 Study of Panitumumab Plus Irinotecan Followed by Panitumumab Plus AMG 479 in Subjects With Metastatic Colorectal Carcinoma Expressing Wild Type KRAS and Refractory to Oxaliplatin-or Irinotecan- and Oxaliplatin-containing Regimens to Evaluate Mechanisms of Acquired Resistance to Panitumumab


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Metastatic Colorectal Cancer

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Trial Information

Phase 2 Study of Panitumumab Plus Irinotecan Followed by Panitumumab Plus AMG 479 in Subjects With Metastatic Colorectal Carcinoma Expressing Wild Type KRAS and Refractory to Oxaliplatin-or Irinotecan- and Oxaliplatin-containing Regimens to Evaluate Mechanisms of Acquired Resistance to Panitumumab


Inclusion Criteria:

Histologically or cytologically confirmed metastatic adenocarcinoma of
the colon or rectum; Subjects with wild-type KRAS tumor status confirmed by an Amgen
approved central laboratory assessment or an experienced local laboratory assessment of
archival tumor tissue (preferably from the primary tumor); Radiographic evidence of
disease progression while on or ≤ 6months after completion of treatment with irinotecan-
and oxaliplatin- or oxaliplatin-based chemotherapy for mCRC; Radiographic measurement of
tumor burden done within 28 days prior to Day 1 (start of treatment with investigational
product); At least 1 uni-dimensionally measurable lesion ≥ 20 mm using conventional CT or
MRI or ≥ 10 mm by spiral CT scan per modified RECIST v1.0. Lesion must not be chosen from
a previously irradiated field, unless there has been documented disease progression in
that field after irradiation and prior to enrollment. All sites of disease must be
evaluated; At least 1 tumor (preferably a metastasis or unresected primary tumour) that is
amenable to core biopsy, as determined by the clinician who will perform the biopsy;
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; Male or female ≥
18 years of age at the time of informed consent; A life expectancy estimate of ≥ 3 months;
Willing to undergo two serial core biopsy procedures of tumors (metastasis or unresected
primary); other criteria may apply Exclusion Criteria: History of other primary cancer,
unless: Malignancy treated with curative intent and with no known active disease present
for ≥ 3 years before enrollment and felt to be at low risk for recurrence by the treating
physician, Adequately treated non-melanomatous skin cancer or lentigo maligna without
evidence of disease, Adequately treated cervical carcinoma in situ without evidence of
disease, Prostatic intraepithelial neoplasia without evidence of prostate cancer; History
of prior or concurrent central nervous system (CNS) metastases; Prior treatment with
anti-EGFR (eg, panitumumab, cetuximab or small molecule inhibitors (eg, erlotinib,
gefitinib); Prior treatment with monoclonal antibodies directed against insulin-like
growth factor-1 receptor (IGF-1R) or small molecule inhibitors directed against IGF-1R;
Use of systemic chemotherapy or radiotherapy ≤ 21 days before enrollment. Subjects must
have recovered from acute toxicities related to radiotherapy; Use of any antibody therapy
(eg, bevacizumab) ≤ 42 days before enrolment; Use of anti-tumor therapies including prior
experimental agents or approved anti-tumor small molecules ≤ 30 days before enrolment;
Known allergy or hypersensitivity to any component of panitumumab, irinotecan, or AMG 479;
Known uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) polymorphisms predisposing
to increased irinotecan toxicity; History of irinotecan intolerance that may interfere
with planned treatment; History of interstitial lung disease (eg, pneumonitis, pulmonary
fibrosis) or evidence of interstitial lung disease on baseline chest computerized
tomography (CT) scan; Clinically significant cardiovascular disease (including myocardial
infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled
cardiac arrhythmia) ≤ 1 year before enrolment; Active inflammatory bowel disease or other
active bowel disease causing chronic diarrhea (defined as ≥ grade 2 per Common Terminology
Criteria for Adverse Events (CTCAE) version 3.0); Known positive test(s) for human
immunodeficiency virus (HIV) infection, hepatitis C virus, acute or chronic active
hepatitis B infection; Major surgical procedure ≤ 28 days before enrollment or minor
surgical procedure ≤ 14 days before enrollment. Subjects must have recovered from surgery
related toxicities. Core biopsy, central venous catheter placement, fine needle
aspiration, thoracentesis, or paracentesis is not considered a major or minor surgical
procedure; Other investigational procedures or drugs (ie, participation in another
clinical study) ≤ 30 days before enrolment; other criteria may apply

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Emergence of Mutant KRAS: KRAS mutation status changed from wild-type at baseline to mutant at the time of the second biopsy following the radiographic evidence of acquired disease resistance to panitumumab given in combination with irinotecan (Part 1)

Outcome Time Frame:

approximately 4 years

Safety Issue:

No

Principal Investigator

MD

Investigator Role:

Study Director

Investigator Affiliation:

Amgen

Authority:

Belgium: Federal Agency for Medicines and Health Products, FAMHP

Study ID:

20070820

NCT ID:

NCT00891930

Start Date:

May 2009

Completion Date:

April 2013

Related Keywords:

  • Metastatic Colorectal Cancer
  • wild-type KRAS
  • panitumumab
  • biomarker
  • mechanisms of acquired resistance
  • metastatic colorectal cancer
  • Colorectal Neoplasms

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