A Phase I Trial of MEK Inhibitor Trametinib in Combination With Neoadjuvant 5-Fluorouracil Chemoradiation in the Treatment of KRAS, BRAF, and NRAS-MUTANT Rectal Cancers
PRIMARY OBJECTIVES:
I. To identify the maximally tolerated dose and recommended phase II dose of trametinib to
be used in combination with 5FU (fluorouracil) and radiation in patients with rectal
cancers.
II. To determine a recommended phase II dose of trametinib to be used with 5FU
chemoradiation in patients with locally advanced rectal cancer.
SECONDARY OBJECTIVES:
I. Evaluation of the tolerability and safety of the combination of trametinib and 5-FU
chemoradiation in locally advanced rectal cancer.
II. Evaluation of post-therapy pathologic response. III. Evaluation of the rate of local
control, disease-free survival and overall survival.
IV. Analysis of biomarkers - total mutations in v-Ki-ras2 Kirsten rat sarcoma viral oncogene
homolog (KRAS), v-raf murine sarcoma viral oncogene homolog B1(BRAF), and neuroblastoma RAS
viral (v-ras) oncogene homolog (NRAS), as well as RAS/mitogen-activated protein kinase
(MAPK) and phosphatidylinositol-4,5-bisphosphate 3-kinas (PI3K)/v-akt murine thymoma viral
oncogene homolog 1 (AKT) pathway signaling pathways to potentially correlate with clinical
benefit.
OUTLINE: This is a dose-escalation study of trametinib.
Patients receive trametinib orally (PO) once daily (QD) on days -14 to -10 and 1-38 and
fluorouracil intravenously (IV) continuously 5 days a week from days 1-38. Patients also
undergo radiation therapy 5 days a week on days 1-33. Patients then undergo surgery 6-10
weeks later.
Patients achieving negative surgical margins after complete resection of tumor receive
postoperative chemotherapy comprising leucovorin calcium IV over 2 hours and fluorouracil IV
continuously over 46 hours on days 1 and 15 OR oxaliplatin IV over 2 hours, leucovorin
calcium IV over 2 hours and fluorouracil IV continuously over 46 hours on days 1 and 15.
Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or
unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months for 2 years,
and then annually for 3 years.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Identify the maximally tolerated dose of Trametinib to be used in combination with 5FU and radiation in patients with rectal cancers.
up to 9 weeks
Yes
Evan Wuthrick
Principal Investigator
Ohio State University Comprehensive Cancer Center
United States: Food and Drug Administration
OSU-12054
NCT01740648
November 2012
Name | Location |
---|---|
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center | Columbus, Ohio 43210-1240 |