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SPIRITT - Second-Line Panitumumab Irinotecan Treatment Trial
This study is ongoing, but not recruiting participants.

First Received on January 4, 2007.   Last Updated on July 21, 2011   History of Changes
Sponsor: Amgen
Information provided by: Amgen
ClinicalTrials.gov Identifier: NCT00418938
  Purpose

This is a multi-center, open-label, randomized, phase 2, two-arm clinical trial to be conducted in the United States. Approximately 210 eligible KRAS wild-type expressing metastatic colorectal cancer subjects who have failed first-line oxaliplatin-based chemotherapy (with at least 4 doses of oxaliplatin-based chemotherapy) with at least 4 doses of bevacizumab (failure is defined as toxicity due to oxaliplatin-based chemotherapy or progression of disease on first-line treatment) will be randomized in a 1:1 ratio to receive either a once-every-two-weeks (Q2W) FOLFIRI regimen plus panitumumab 6 mg/kg or a Q2W FOLFIRI regimen plus bevacizumab (either 5 mg/kg or 10 mg/kg, depending on physician choice and institutional standard of care).


Condition Intervention Phase
Cancer
Colon Cancer
Colorectal Cancer
Metastatic Cancer
Rectal Cancer
Metastatic Colorectal Cancer
Drug: FOLFIRI - Panitumumab
Drug: FOLFIRI - Bevacizumab
Phase II

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Multi-center, Open-label, Randomized, Phase 2 Clinical Trial Evaluating Safety and Efficacy of FOLFIRI With Either Panitumumab or Bevacizumab as Second-Line Treatment in Subjects With Metastatic Colorectal Cancer With Wild-type KRAS Tumors

Resource links provided by NLM:


Further study details as provided by Amgen:

Primary Outcome Measures:
  • Progression-free survival (PFS) [ Time Frame: Participants are followed until death or 78 weeks after the last randomized participant. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Objective Response Rate [ Time Frame: Participants are followed until death or 78 weeks after the last randomized participant. ] [ Designated as safety issue: No ]
  • Time to response [ Time Frame: Participants are followed until death or 78 weeks after the last randomized participant. ] [ Designated as safety issue: No ]
  • Time to Progression [ Time Frame: Participants are followed until death or 78 weeks after the last randomized participant. ] [ Designated as safety issue: No ]
  • Disease Control [ Time Frame: Participants are followed until death or 78 weeks after the last randomized participant. ] [ Designated as safety issue: No ]
  • Overall Survival [ Time Frame: Participants are followed until death or 78 weeks after the last randomized participant. ] [ Designated as safety issue: No ]
  • Duration of Response [ Time Frame: Participants are followed until death or 78 weeks after the last randomized participant. ] [ Designated as safety issue: No ]

Enrollment: 266
Study Start Date: November 2006
Estimated Study Completion Date: August 2012
Estimated Primary Completion Date: June 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Bevacizumab Drug: FOLFIRI - Bevacizumab
FOLFIRI (All components given IV (in the vein): Irinotecan at 180mg/m^2 on Day 1, Leucovorin at 400mg/m^2 on Day 1 and 5-Fluorouracil at 400mg/m^2 bolus IV over 2-4 min, followed by 2400mg/m^2 continuous IV over 46 hours for the first 2 cycles, increased to 3000mg/m^2 thereafter if no significant side effects) plus Bevacizumab (either 5mg/kg OR 10mg/kg)
Experimental: Panitumumab Drug: FOLFIRI - Panitumumab
FOLFIRI (All components given IV (in the vein): Irinotecan at 180mg/m^2 on Day 1, Leucovorin at 400mg/m^2 on Day 1 and 5-Fluorouracil at 400mg/m^2 bolus IV over 2-4 min, followed by 2400mg/m^2 continuous IV over 46 hours for the first 2 cycles, increased to 3000mg/m^2 thereafter if no significant side effects) plus Panitumumab 6mg/kg

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  • Diagnosis of metastatic adenocarcinoma of the colon or rectum that cannot, in the opinion of the investigator, be cured by surgical resection at the time of randomization
  • Wild-type KRAS expressing mCRC from the primary tumor or metastasis.
  • Failure of prior first-line oxaliplatin-based chemotherapy with bevacizumab (at least four therapeutic doses of oxaliplatin-based chemotherapy and bevacizumab) for mCRC.
  • At least one uni-dimensionally measurable lesion per modified RECIST criteria.
  • Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Man or woman 18 years of age or older
  • Hematology, chemistry, coagution, metabolic functions within normal or protocol-defined limits

Exclusion Criteria

  • Previous irinotecan, anti-EGFr therapy (eg, cetuximab, panitumumab, erlotinib, gefitinib, lapatinib) or vaccine for the treatment of mCRC
  • Radiotherapy ≤ 14 days before randomization
  • Evidence of central nervous system (CNS) metastases
  • Unresolved toxicities from prior anti-cancer therapy that, in the opinion of the investigator, precludes subject from participation
  • History of other invasive primary cancer, except:
  • Curatively resected or treated non-melanomatous skin cancer
  • Curatively treated cervical carcinoma in situ
  • Other primary solid tumor treated curatively and no treatment administered ≤ 2 years before randomization and, in the investigator's opinion, it is unlikely that there will be a recurrence ≤ 2 years post randomization

Medications

  • C hronic daily treatment (as determined by the investigator) with aspirin (> 325 mg/day) or non steroidal anti inflammatory agents known to inhibit platelet function
  • Infection requiring a course of systemic anti-infectives that was completed ≤ 14 days before randomization (exception can be made at the judgment of the investigator for oral treatment of an uncomplicated urinary tract infection [UTI])
  • Subjects concurrently receiving any investigational agent or therapy ≤ 30 days before randomization

General:

  • Significant cardiovascular risk as defined by the protocol
  • History of peripheral arterial ischemia ≤ 24 weeks before randomization (subjects with brief, reversible, exercise-induced claudication are eligible)
  • History of visceral arterial ischemia ≤ 24 weeks before randomization
  • Significant bleeding risk:
  • Major surgical procedure, open biopsy, or significant traumatic injury ≤ 28 days before randomization
  • Anticipation of need for major surgical procedures during the course of the study
  • C ore biopsy or other minor procedure, excluding placement of a vascular access device ≤ 7 days before randomization
  • A ny significant bleeding that is not related to the primary colon tumor ≤ 24 weeks before randomization
  • P re-existing bleeding diathesis or coagulopathy with the exception of well-controlled chronic anticoagulation therapy
  • Serious or non-healing wounds, skin ulcers, or unhealed bone fractures
  • Gastroduodenal ulcer(s) determined by endoscopy to be active or uncontrolled gastrointestinal ulcer ≤ 28 days before randomization
  • History of interstitial lung disease (eg, pneumonitis or pulmonary fibrosis) or evidence of interstitial lung disease on baseline chest x-ray (CXR) or computed tomography (CT) scan
  • Clinically significant ascites
  • Subjects known to be human immunodeficiency virus (HIV) positive or known to have chronic or active hepatitis B or C infection
  • Men and women of childbearing potential (women who are post-menopausal < 52 weeks, not surgically sterilized, or not abstinent) who do not consent to use adequate contraception (according to institutional standard of care) during the course of the study and after the last date of receiving second-line treatment (24 weeks for women, 4 weeks for men)
  • Women who test positive for serum or urine pregnancy test ≤ 72 hours before randomization or are breast-feeding
  • Subjects allergic to any component that is part of the treatment regimen
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00418938

Sponsors and Collaborators
Amgen
Investigators
Study Director: MD Amgen
  More Information

Additional Information:
No publications provided

Responsible Party: Global Development Leader, Amgen Inc.
ClinicalTrials.gov Identifier: NCT00418938     History of Changes
Other Study ID Numbers: 20060141
Study First Received: January 4, 2007
Last Updated: July 21, 2011
Health Authority: United States: Institutional Review Board;   United States: Food and Drug Administration;   United States: Quorom Institutional Review Board;   United States: US Oncology Institutional Review Board;   United States: Western Institutional Review Board

Keywords provided by Amgen:
EGFR
FOLFIRI
2nd Line Therapy
2nd Line mCRC Therapy
mCRC
Irinotecan
panitumumab
bevacizumab

Additional relevant MeSH terms:
Colonic Neoplasms
Rectal Neoplasms
Colorectal Neoplasms
Neoplasm Metastasis
Neoplasms
Neoplasms, Second Primary
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Neoplastic Processes
Pathologic Processes
Irinotecan
Bevacizumab
Antibodies, Monoclonal
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Radiation-Sensitizing Agents
Physiological Effects of Drugs
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on February 09, 2012