An Open-label, Randomized, Controlled, Multicenter, Phase I/II Trial Investigating 2 EMD 525797 Doses in Combination With Cetuximab and Irinotecan Versus Cetuximab and Irinotecan Alone, as Second-line Treatment for Subjects With K-ras Wild Type Metastatic Colorectal Cancer.
Inclusion Criteria:
Subjects with histologically confirmed k ras wildtype (WT) colorectal carcinoma (CRC) with
documented distant metastasis;
- Prior oxaliplatin/fluoropyrimidine-containing regimen for the first-line treatment of
metastatic disease;
- Failed an oxaliplatin regimen for metastatic colorectal carcinoma (mCRC). Failure is
defined as either progressive disease (PD) (clinical or radiologic) within 6 months
of the last dose of any agent of an oxaliplatin-based regimen or intolerance to an
oxaliplatin regimen. Intolerance to an oxaliplatin regimen is defined as
discontinuation due to any of the following: severe allergic reaction, persistent
severe neurotoxicity, or delayed recovery from toxicity preventing retreatment;
- At least 1 radiographically documented measurable lesion in a previously non
irradiated area according to Response Evaluation Criteria In Solid Tumors (RECIST,
Version 1.0), i.e., this lesion must be adequately measurable in at least 1 dimension
(longest diameter to be recorded) as ≥2 cm by conventional techniques or ≥1 cm by
spiral CT scan;
- Eastern Cooperative Oncology Group (ECOG) performance status 0 1, or KPS ≥80%;
- Absolute Neutrophil Count(ANC) ≥1.5 x 10E9/L;
- Platelets ≥100 x 10E9/L;
- Hemoglobin ≥9 g/dL (without transfusions);
- Bilirubin ≤1.5 x ULN;
- ASAT ≤5 x ULN and ALAT ≤5 x ULN;
- Serum creatinine ≤1.25 x Upper limit of normal (ULN) and/or creatinine clearance ≥50
ml/min;
- International Nationalized Ratio (INR), and partial thromboplastin time (PTT) within
normal limits;
- Sodium and potassium within normal limits or ≤10% above or below (supplementation
permitted);
Exclusion Criteria:
- Previous treatment with any inhibitor of Epidermal Growth Factor Receptor (EGFR);
- Known brain metastasis and/or leptomeningeal disease;
- Radiotherapy (except localized radiotherapy for pain relief), major surgery, or any
investigational drug in the 30 days before the start of trial treatment entry;
planned major surgery during the trial;
- Concurrent chronic systemic immune or hormone therapy not indicated in this trial
protocol (except for physiologic replacement; steroids up to 10 mg of prednisone
equivalent or topical and inhaled steroids are allowed);
- Clinically relevant coronary artery disease (New York Heart Association [NYHA]
functional angina classification III/IV), congestive heart failure (NYHA III/IV),
clinically relevant cardiomyopathy, history of myocardial infarction in the last 12
months, or high risk of uncontrolled arrhythmia;
- Uncontrolled hypertension defined as systolic blood pressure ≥160 mmHg and/or
diastolic blood pressure ≥100 mmHg under resting conditions;
- History of coagulation disorder associated with bleeding or recurrent thrombotic
events;
- History of recent peptic ulcer disease (endoscopically proven gastric, duodenal or
esophageal ulcer) within 6 months of trial treatment start;
- Chronic inflammatory bowel disease, or acute/chronic ileus;
- Active infection (requiring i.v. antibiotics), including active tuberculosis, active
or chronic Hepatitis B or C, or ongoing HIV infection