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Phase II, Multicentric Randomized Trial, Evaluating the Efficacy of Fluoropyrimidine-based Standard Chemotherapy, Associated to Either Cetuximab or Bevacizumab, in KRAS Wild-type Metastatic Colorectal Cancer Patients With Progressive Disease After Receiving First-line Treatment With Bevacizumab


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

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Trial Information

Phase II, Multicentric Randomized Trial, Evaluating the Efficacy of Fluoropyrimidine-based Standard Chemotherapy, Associated to Either Cetuximab or Bevacizumab, in KRAS Wild-type Metastatic Colorectal Cancer Patients With Progressive Disease After Receiving First-line Treatment With Bevacizumab


Inclusion Criteria:



- Histologically or cytologically proven adenocarcinoma of the colon expressing
non-mutated (wild-type) KRAS.

- Progressive metastatic disease after first-line treatment with chemotherapy alone:
based on 5-FU (iv or per os) with irinotecan or oxaliplatin associated to
bevacizumab.

- Prior adjuvant chemotherapy (of the primary tumor) with fluoropyrimidine and
oxaliplatin is allowed if the time interval between the end of this chemotherapy and
the beginning of the first-line metastatic treatment is ≥ 6 months.

- Measurable disease (at least one measurable metastatic lesion) according to the
RECIST V1.1 criteria (the lesion should not be located in a previous field of
radiation).

- Previous radiotherapy is authorized if discontinued ≥ 15 days prior to randomization
and if the measurable metastatic lesions are outside the radiation area.

- Sites of disease evaluated within 28 days prior to randomization with
thoracic-abdominal-pelvic CT scan (or abdominal-pelvic MRI plus Chest Xray)

- Age ≥18 years

- Patient with ECOG 0 or 1

- Life Expectancy ≥ 3 months

- Hematologic function (polynuclear neutrophiles ≥ 1.5.109/L ; platelets ≥ 100.109/L ;
hemoglobin ≥ 9 g/dL

- Hepatic transaminases ≤ 2.5 times upper limit of normal (ULN) (≤ 5 ULN in case of
hepatic metastases), alkaline phosphatases ≤ 2.5 ULN (≤ 5 ULN in case of hepatic
metastases), total bilirubinemia ≤ 1.5 ULN

- Renal function (creatinemia ≤1.5 ULN; creatine clearance ≥ 50 mL/mn (Cockcroft and
Gault) ; urine test strip < 2+. If proteinuria is ≥ +2 at inclusion, the serum urea
test must be redone and show proteinuria ≤ 1 g/L within 24 h)

- Completion of the EORTC QLQ-C30 quality of life form

- Negative pregnancy test for women of child-bearing age

- Information given to the patient and signed informed consent

- Public Health insurance coverage

Exclusion Criteria:

- Known meningeal or brain metastases

- Pre-treatment with anti-EGFR

- Specific contraindication or known hypersensitivity to one treatment product

- Patient with known allergy or hypersensitivity to monoclonal antibodies (bevacizumab,
cetuximab

- Clinically significant affection of the coronaries or myocardial infarction within 6
months prior to inclusion.

- Peripheral neuropathy of grade > 1 (CTCAE scale version 4.0).

- Known depletion of the dihydropyrimidine dehydrogenase (DPD).

- Acute intestinal obstruction or sub-obstruction, history of inflammatory intestinal
disease or extended resection of the small intestine. Presence of a colic prosthesis.

- Uncontrolled Arterial hypertension (systolic pressure > 150 mmHg and/or diastolic
pressure > 100 mmHg with and without antihypertensive medication. Patients with high
hypertension are eligible if antihypertensive medication lowers their arterial
pressure to the level of acceptability specified by the inclusion criteria.

- History of hypertensive crisis or hypertensive encephalopathy

- Other concomitant malignancy or history cancer (except carcinoma in situ of the
cervix, or non melanoma skin cancer, with curative intent treatment, when considered
in complete remission for at least 5 years before randomization.

- Any treatment including an experimental drug, or participation in another clinical
trial within 28 days preceding inclusion.

- Persons deprived of liberty or under guardianship.

- Psychological, familial, sociological or geographical condition potentially hampering
compliance with the study protocol and follow-up schedule.

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression-free survival (PFS) at 4 months

Outcome Description:

Progression-free survival is defined as the time from randomization to progression (RECIST v1.1 criteria) or death. Patients alive without progression will be censored at the last follow-up.

Outcome Time Frame:

4 months

Safety Issue:

Yes

Principal Investigator

Jaafar BENNOUNA, Dr

Investigator Role:

Principal Investigator

Investigator Affiliation:

Centre René Gauducheau

Authority:

France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Study ID:

PRODIGE 18 / ACCORD 22/0906

NCT ID:

NCT01442649

Start Date:

December 2010

Completion Date:

December 2018

Related Keywords:

  • Colorectal Cancer
  • Adenocarcinoma
  • Metastatic
  • Second-line treatment
  • Progressive disease after first-line treatment with bevacizumab
  • Non-mutated (wild-type) KRAS.
  • Colorectal Neoplasms

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