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A Phase IB/II Study of Second Line Therapy With Panitumumab, Irinotecan and Everolimus (PIE) in Metastatic Colorectal Cancer With KRAS WT


Phase 1/Phase 2
18 Years
N/A
Open (Enrolling)
Both
Colorectal Cancer, Colorectal Carcinoma, Colorectal Tumors, Neoplasms, Colorectal

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Trial Information

A Phase IB/II Study of Second Line Therapy With Panitumumab, Irinotecan and Everolimus (PIE) in Metastatic Colorectal Cancer With KRAS WT


This is an open label uncontrolled phase IB/II study to determine the maximum tolerated dose
(MTD) and assess the efficacy of everolimus, irinotecan and panitumumab when given in
combination for patients with metastatic colorectal cancer and KRAS WT. Patients with
metastatic colorectal cancer that have failed 5FU and oxaliplatin will be included. It is
anticipated that approximately 50 patients will be enrolled over a period of 12 months


Inclusion Criteria:



- Age > 18 years

- Histological diagnosis of colorectal cancer that is KRAS wild type

- Metastatic disease not amenable to resection

- Measurable disease as assessed by CT scan using RECIST criteria

- Received and failed fluoropyrimidine therapy

- Received and failed oxaliplatin therapy

- Radiographically documented disease progression per RECIST criteria

- For phase 1b group only, ECOG PS 0-1

- For phase 2 group only, ECOG PS 0-2

- Adequate bone marrow function with haemoglobin > 100 g/L, platelets > 100 X 109/l;
neutrophils > 1.5 X 109/l within 7 days of enrolment

- Adequate renal function, with calculated creatinine clearance >40 ml/min (Cockcroft
and Gault) within 7 days of enrolment

- Adequate hepatic function with serum total bilirubin < 1.25 X upper limit of normal
range and ALT or AST<2.5xULN (<5xULN if liver metastases present) within 7 days of
enrolment

- Magnesium ≥ lower limit of normal within 7 days of enrolment.

- Fasting serum cholesterol ≤ 7.75mmol/L AND fasting triglycerides ≤ 2.5 x ULN. Note:
In case one or both of these thresholds are exceeded, the patient can only be
included after initiation of appropriate lipid lowering medication.

- Life expectancy of at least 12 weeks

- Negative pregnancy test ≤ 72 hours before commencing study treatment (women of
childbearing potential only).

- Written informed consent including consent for biomarker studies

Exclusion Criteria:

- Presence of KRAS mutation in tumour sample

- For Phase 1b group only, patients with prior pelvic radiotherapy.

- Systemic chemotherapy, immunotherapy, approved proteins/antibodies or any
investigational agent within 4 weeks prior to commencing study treatment

- Radiotherapy within 14 days of commencing study treatment.

- Unresolved toxicities from prior systemic therapy or radiotherapy

- Medical or psychiatric conditions that compromise the patient's ability to give
informed consent or to complete the protocol

- Prior treatment with drugs targeting EGFR such as cetuximab, panitumumab or erlotinib

- Prior therapy with mTOR inhibitors (sirolimus, temsirolimus, everolimus)

- Prior therapy with irinotecan

- CYP3A4 enzyme inducing anti-convulsant medication ≤ 14 days prior to study treatment.

- Ketoconazole ≤ 7 days before study treatment.

- Uncontrolled diabetes mellitus defined by fasting glucose >1.5 x ULN.

- Known cirrhosis, chronic active hepatitis, or chronic persistent hepatitis

- Patients with known interstitial lung disease or severely impaired lung function

- Patients with active bleeding diatheses.

- Any uncontrolled clinically significant cardiac disease, arrhythmias or angina
pectoris

- Active inflammatory bowel disease or other bowel disease causing chronic diarrhoea

- Chronic treatment with immunosuppressives

- Patients with a known history of HIV seropositivity

- Patients who have any severe and/or uncontrolled medical conditions or infections

- Untreated or symptomatic CNS metastases

- Patients who have a history of another primary malignant disease

- Pregnancy or lactation.

- Women and partners of women of childbearing potential who are not using effective
contraception.

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Dose limiting toxicities

Outcome Description:

To determine the maximum tolerated dose (MTD)of everolimus, irinotecan and panitumumab when given in combination for patients with Kras WT mCRC

Outcome Time Frame:

at end of cycle 2 (each cycle is 14 days)

Safety Issue:

Yes

Principal Investigator

Amanda Townsend, MBBS

Investigator Role:

Principal Investigator

Investigator Affiliation:

Queen Elizabeth Hospital

Authority:

Australia: Human Research Ethics Committee

Study ID:

AU-2009-0003/CRAD001CAU06T

NCT ID:

NCT01139138

Start Date:

June 2010

Completion Date:

June 2015

Related Keywords:

  • Colorectal Cancer
  • Colorectal Carcinoma
  • Colorectal Tumors
  • Neoplasms, Colorectal
  • Colorectal Cancer
  • Colorectal Carcinoma
  • Colorectal Tumors
  • Neoplasms, Colorectal
  • Neoplasms
  • Carcinoma
  • Colorectal Neoplasms

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