Single-Arm, Multicenter, Prospective, Phase 2 Study for the Evaluation of Biomarkers in Patients With Advanced &/or Metastatic Colorectal Cancer With Wild Type KRAS Treated Biweekly With Chemotherapy and Cetuximab as First-Line Treatment
Inclusion Criteria:
- Male or female, age ≥ 18 years
- Able to sign an informed consent form
- Advanced and/or metastatic colorectal cancer
- Colorectal cancer with KRAS wild type genotype
- At least one unidimensionally measurable lesion according to RECIST criteria (1.1
revised) (to be assessed ≤ 28 days prior to the study treatment)
- All patients with the following features will be included:
1. Progression free survival > 6 months after adjuvant treatment +/- radiotherapy
2. "De novo" diagnosis of the disease
- Performance ECOG status of 0-2
- Life expectancy ≥ 3 months
- Adequate bone marrow function: neutrophils ≥1,5 x 10^9/L; platelets ≥ 100 x 10^9/L;
hemoglobin ≥9 g/dL.
- Adequate liver, renal and hematological function as follows:
1. Adequate liver function: SGOT and SGPT 2.5 x ULN (5 x ULN in case of hepatic
metastasis). Total bilirubin < 1,5 x ULN. Alkaline phosphatase 2,5 x LSN (5 x
ULN if hepatic metastasis or 10 x ULN if bone metastasis)
2. Creatinine clearance or creatinine clearance during 24 hours ≥ 50 mL/min
3. Magnesium ≥ LLN, calcium ≥ LLN
Exclusion Criteria:
- PS > 2 or elderly patients with fragility criteria
- Previous surgery for metastasis
- Previous systemic treatment for the metastatic colorectal cancer
- Previous treatment with antibodies anti-EGFR or treatment with small-molecule EGFR
tyrosine kinase inhibitors or EGFR signal transduction inhibitors. Subjects who
suspend their first dose due to a reaction to the infusion can participate
- Central nervous system metastasis (except: treated subjects with asymptomatic CNS
metastasis who have not received steroids within the 30 days prior to inclusion)
- Prior malignant tumor in the last 5 years, except: basal cell carcinoma of the skin
or pre-invasive cervical cancer
- Unresolved toxicities from a prior systemic treatment which do not qualify the
patient for inclusion
- Presence of peripheral neuropathy (degree > 1 in the ctc version 3.0) and serious
nonhealing wound, ulcer, or bone fracture
- Hormonal treatment, immunotherapy or experimental or approved antibodies/proteins ≤
30 days before the inclusion
- Uncontrolled serious cardiovascular disease or: congestive cardiac failure NYHA lll
or lV, unstable angina pectoris, myocardial infarction precedents in the past 12
months, significant arrhythmias
- Interstitial pneumonitis or pulmonary fibrosis precedents, or interstitial
pneumonitis or pulmonary fibrosis signs on the thoracic CT-scan
- Treatment for systemic infection within the 14 days prior to treatment
- Acute/subacute intestinal occlusion and/or active inflammatory bowel disease or any
other bowel disease producing chronic diarrhea
- Precedent of Gilbert's syndrome or dihydropyrimidine dehydrogenase deficiency
- Precedent of any disease which can increase the risks associated to the participation
in the study or interfere in the study results
- Known positive test for the following infections: HIV, Hepatitis C + abnormal liver
enzymes values, active chronic Hepatitis B (except Hepatitis C seropositive with
normal liver enzymes)
- All concurrent diseases which can increase the toxicity risk
- The individual presents a disorder of any kind which jeopardizes their ability to
give their written consent form and/or fulfill the study procedures
- Any investigational agent within 30 days before enrolment
- Pregnant or breastfeeding woman, or planning to get pregnant within the 6 months
after treatment
- Surgery (excluding the diagnostic biopsy or placing of a central venous catheter)
- Woman or man of childbearing potential not consenting to use adequate contraceptive
precautions during the study and 6 months after de last administration for women, and
1 month for men
- Unability to fulfill the study requirements by the patients
- Psychological, family, sociological or geographical conditions that may interfere
with the fulfillment of the study protocol and the follow-up calendar