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An Investigator Initiated, Phase II Study of Linifanib in Patients With Advanced, Refractory Colorectal Cancer Expressing Mutated kRas


Phase 2
18 Years
N/A
Not Enrolling
Both
Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IVA Colon Cancer, Stage IVA Rectal Cancer, Stage IVB Colon Cancer, Stage IVB Rectal Cancer

Thank you

Trial Information

An Investigator Initiated, Phase II Study of Linifanib in Patients With Advanced, Refractory Colorectal Cancer Expressing Mutated kRas


PRIMARY OBJECTIVES:

I. To achieve an overall response rate of 15% or more.

SECONDARY OBJECTIVES:

I. Determine progression free survival. II. Determine overall survival. III. Evaluate
toxicity profile of ABT 869 (linifanib) in this patient population.

OUTLINE:

Patients receive Linifanib orally (PO) once daily (QD). Courses repeat every 28 days in the
absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 days, every 3 months for
2 years, and then every 6 months for 3 years.


Inclusion Criteria:



- Histologically confirmed colorectal cancer refractory to at least 1 but no more than
3 systemic chemotherapy regimens

- Patients must have received one standard chemotherapy regimen in the metastatic
setting

- Established Ras-mutant tumor status (archived specimens are okay and this test can
have been performed at local laboratories)

- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2

- The subject must have adequate bone marrow and organ function, defined as follows:

- Hemoglobin ≥ 9g/dL

- Platelets >100,000,

- Absolute neutrophil count (ANC) > 1000/uL,

- Serum creatinine < 1.5 x upper limit of normal,

- Total bilirubin < 1.5 x the upper limit of normal,

- AST and ALT ≤ 2.0 x upper limit of normal (or ≤ 5 x ULN in the presence of liver
metastases)

- Measurable disease, defined as at least 1 unidimensionally measurable lesion on a
computed tomography (CT) scan or magnetic resonance imaging (MRI) as defined by
Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

- Female subjects of childbearing potential must have a negative urine or serum
pregnancy test within 7 days of study treatment; surgically sterile and/or
postmenopausal women must be amenorrheic for at least 12 months to be considered of
non-child-bearing potential

- Female subjects of child-bearing potential and male subjects must agree to use
adequate contraception prior to study entry, for the duration of study participation
and up to two months after the last dose of ABT 869; adequate contraception methods
should be used consistently and correctly and include the following:

- Total abstinence from sexual intercourse (minimum one complete menstrual cycle)

- A vasectomized partner

- Hormonal contraceptives (oral, parenteral or transdermal) for at least 3 months prior
to study drug administration

- Double-barrier method (condoms, contraceptive sponge, diaphragm or vaginal ring with
spermicidal jellies or cream)

- The subject must be willing and able to comply with the protocol for the duration of
the study, including undergoing treatment and scheduled visits and examinations

- The subject must have given written informed consent prior to the initiation of any
screening or study-specific procedures

- Ability to understand and the willingness to sign a written informed consent; a
signed informed consent must be obtained prior to any study-specific procedures

- Patients must be at least 14 days status post last day of prior chemotherapy (at
least 28 days since last dose of bevacizumab) and have recovered to grade =< 1 from
all chemotherapy-associated side effects

- Patients must have the ability to swallow pills

Exclusion Criteria:

- Untreated central nervous system (CNS) metastases; patients may have CNS metastases
from any timeframe as long as they are treated and not progressing; brain imaging is
not required if there is no clinical suspicion of brain metastases

- Pregnant or lactating females are excluded

- Uncontrolled hypertension defined as systolic blood pressure (BP) > 140 and/or
diastolic BP > 90 initially evaluated on day of study eligibility determination (when
laboratory parameters are assessed), but must be maintained on day of study
initiation; (If a patient is found to have a value outside the range above, repeat BP
may be assessed and if at subsequent readings x 2 (taken in clinic at least 15
minutes apart) criteria are met, the patient can then be eligible; initiation or
modification of antihypertensives is allowed to achieve adequate BP for eligibility;
finally, in the case that subsequent determinations are required, the BP assessment
that counts towards eligibility is the reading on the day of study initiation);
(note: a clinic BP reading without the patient having been at rest for 15 minutes or
with the wrong cuff size can be repeated the same day for eligibility criteria to be
determined

- Active bleeding or history of bleeding from cancer related events

- History of cerebral vascular accident (CVA) or transient ischemic attack (TIA) or
recent myocardial infarction (MI) (< 6 months)

- Active ulcerative colitis, Crohn's disease or Celiac disease that could interfere
with the absorption of the drug

- Current use of therapeutic anticoagulation; low dose anticoagulation for catheter
prophylaxis is permitted; Lovenox is permitted for prophylaxis; (Note: patients who
develop thrombosis and are placed on anticoagulation while on this trial may continue
on study at the discretion of the investigator)

- The subject has had major surgery within 28 days of Study Day 1

- The subject has had radiation therapy within 14 days of Study Day 1

- The subject had prior bevacizumab within 28 days of study day 1

- No prior treatment with vascular endothelial growth factor (VEGF) receptor tyrosine
kinase inhibitors; prior treatment with other investigational agents is allowed

- The subject has a medical condition, which in the opinion of the study investigator,
places them at unacceptably high risk for toxicities

- Other active malignancy for which the patient has been treated within the past one
year

- Subjects with known human immunodeficiency virus (HIV) infection are excluded

- Subject has documented left ventricular ejection fraction (LVEF) < 50%

- Subject has Proteinuria > grade 1 at baseline measured by urine dipstick (2+ or
greater) and confirmed by 24 hour (hr) urine collection (> = 1g/24hrs)

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Overall response rate with a target of at least 15%

Outcome Description:

Defined as the best response recorded from the start of the treatment until disease progression/recurrence, the exact two-sided 95% confidence intervals will be reported.

Outcome Time Frame:

Baseline, day 1 of each odd numbered course, and at end of study

Safety Issue:

No

Principal Investigator

Jordan Berlin, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Vanderbilt-Ingram Cancer Center

Authority:

United States: Food and Drug Administration

Study ID:

VICC GI 1058

NCT ID:

NCT01365910

Start Date:

June 2011

Completion Date:

March 2018

Related Keywords:

  • Recurrent Colon Cancer
  • Recurrent Rectal Cancer
  • Stage IVA Colon Cancer
  • Stage IVA Rectal Cancer
  • Stage IVB Colon Cancer
  • Stage IVB Rectal Cancer
  • Colonic Neoplasms
  • Rectal Neoplasms
  • Colorectal Neoplasms

Name

Location

Vanderbilt-Ingram Cancer Center Nashville, Tennessee  37232-6838
Vanderbilt Cool Springs Nashville, Tennessee  37067