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Cetuximab and/or Dasatinib in Treating Patients With Colorectal Cancer and Liver Metastases That Can Be Removed by Surgery
This study is currently recruiting participants.
Verified July 2011 by Vanderbilt-Ingram Cancer Center

First Received on February 3, 2009.   Last Updated on July 18, 2011   History of Changes
Sponsor: Vanderbilt-Ingram Cancer Center
Collaborator: National Cancer Institute (NCI)
Information provided by: Vanderbilt-Ingram Cancer Center
ClinicalTrials.gov Identifier: NCT00835679
  Purpose

RATIONALE: Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Dasatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving cetuximab and/or dasatinib before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

PURPOSE: This early phase I trial is studying how well cetuximab and/or dasatinib works in treating patients with colorectal cancer and liver metastases that can be removed by surgery.


Condition Intervention
Colorectal Cancer
Metastatic Cancer
Biological: cetuximab
Drug: dasatinib
Procedure: therapeutic conventional surgery

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Preoperative Biological Trial of Cetuximab, Dasatinib or the Combination in Colorectal Cancer Patients With Resectable Liver Metastases

Resource links provided by NLM:


Further study details as provided by Vanderbilt-Ingram Cancer Center:

Primary Outcome Measures:
  • Biological changes in the tumor as measured by the proportion of patients with a biologic response, defined as a pre-to-post treatment reduction in at least 1 biomarker of the pathway inhibited (e.g., EGFR and/or Src) [ Time Frame: 30 days after surgery. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Biomarker analysis of tumor tissue, serum, and peripheral blood mononuclear cell samples for total and φEGFR (Tyr845 and Tyr1068), φMAPK, φAkt, Ki67, φFAK (Tyr861), φpaxillin (Tyr118), φSrc (Tyr419), TGFα, amphiregulin, and epiregulin [ Time Frame: 30 days after surgery ] [ Designated as safety issue: No ]
  • Frequency, severity, and duration of adverse events during study drug administration [ Time Frame: 30 days after surgery ] [ Designated as safety issue: Yes ]
  • Frequency, severity, and duration of post-operative complications [ Time Frame: 30 days after surgery ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 12
Study Start Date: December 2009
Estimated Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Cohort A
Patients receive no systemic neoadjuvant therapy between the time of diagnostic biopsy and definitive surgical resection of liver metastases.
Procedure: therapeutic conventional surgery
definitive surgical resection of liver metastases
Experimental: Cohort B
Patients receive cetuximab IV over 60-120 minutes on days 1 and 8.
Biological: cetuximab
Given IV
Procedure: therapeutic conventional surgery
definitive surgical resection of liver metastases
Experimental: Cohort C
Patients receive oral dasatinib once daily on days 1-14.
Drug: dasatinib
Given orally
Procedure: therapeutic conventional surgery
definitive surgical resection of liver metastases
Experimental: Cohort D
Patients receive cetuximab IV over 60-120 minutes on days 1 and 8 and oral dasatinib once daily on days 1-14.
Biological: cetuximab
Given IV
Drug: dasatinib
Given orally
Procedure: therapeutic conventional surgery
definitive surgical resection of liver metastases

Detailed Description:

OBJECTIVES:

  • To evaluate the biological effects of cetuximab and/or dasatinib on EGFR- and Src-signaling pathways in patients with colorectal cancer and resectable liver metastases.

OUTLINE: This is a multicenter study. Patients are initially enrolled in cohort A. Once cohort A is completed, additional patients are enrolled and randomized to treatment in either cohorts B or C. If a significant biological effect is seen in cohorts B or C, additional patients are enrolled in cohort D.

  • Cohort A: Patients receive no systemic neoadjuvant therapy between the time of diagnostic biopsy and definitive surgical resection of liver metastases.
  • Cohort B: Patients receive cetuximab IV over 60-120 minutes on days 1 and 8.
  • Cohort C: Patients receive oral dasatinib once daily on days 1-14.
  • Cohort D: Patients receive cetuximab IV over 60-120 minutes on days 1 and 8 and oral dasatinib once daily on days 1-14.

All patients undergo definitive surgical resection of liver metastases on day 15.

Patients undergo tumor tissue (from initial liver tumor biopsies and liver resection samples), serum, and peripheral blood mononuclear cell sample collection periodically for biomarker analysis via IHC.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria
  • Patients must have histologically confirmed adenocarcinoma arising from the large intestine that has metastasized to the liver. Liver metastases may be synchronous or metachronous.
  • The liver metastases must be considered surgically resectable prior to the initiation of study drugs.
  • Prior chemotherapy or chemoradiotherapy for colorectal cancer is allowed provided that toxicities from prior therapy have resolved to Grade 1 or less. No prior anti-EGFR or anti-Src therapy is allowed.
  • Age >18 years.
  • ECOG performance status < 1 (Karnofsky >60%)
  • Patients must have organ and marrow function within the parameter defined below:

    • absolute neutrophil count >1.5 x 109/L
    • hemoglobin ≥ 9.0 Gm/dL
    • platelets >100 x 109/L
    • total bilirubin ≤ 1.5 x IULN
    • AST(SGOT)/ALT(SGPT)< 5 x institutional upper limit of normal
    • creatinine <1.5 institutional ULN
  • Women must have a negative pregnancy test. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  • Ability to understand and the willingness to sign a written informed consent document.
  • Although K-Ras status will be evaluated in the tumor, wild type K-Ras status is not an eligibility criterion.

Exclusion Criteria

  • Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier.
  • Patients receiving any other investigational agents.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to cetuximab or dasatinib.
  • Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Pregnant women are excluded from this study because of the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with cetuximab or dasatinib, breastfeeding should be discontinued if the mother is treated with cetuximab or dasatinib.
  • Patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy. Therefore, HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with cetuximab or dasatinib. Appropriate studies will be undertaken in patients receiving combination anti-retroviral therapy when indicated.
  • Patients on potent CYP3A4 inducers and inhibitors.

Inclusion of Women and Minorities Both men and women and members of all races and ethnic groups are eligible for this trial.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00835679

Locations
United States, Florida
Moffitt Cancer Center Active, not recruiting
Tampa, Florida, United States, 33612
United States, Tennessee
Vanderbilt-Ingram Cancer Center - Cool Springs Recruiting
Nashville, Tennessee, United States, 37064
Contact: Clinical Trials Information Program     800-811-8480        
Vanderbilt-Ingram Cancer Center Recruiting
Nashville, Tennessee, United States, 37232-6838
Contact: Clinical Trials Office - Vanderbilt-Ingram Cancer Center     800-811-8480        
Sponsors and Collaborators
Vanderbilt-Ingram Cancer Center
Investigators
Principal Investigator: Emily Chan, MD, Ph.D. Vanderbilt-Ingram Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Emily Chan, M.D., Ph.D., Vanderbilt-Ingram Cancer Center
ClinicalTrials.gov Identifier: NCT00835679     History of Changes
Other Study ID Numbers: VICC GI 0838, P30CA068485, VU-VICC-GI-0838, 081338, 8069
Study First Received: February 3, 2009
Last Updated: July 18, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by Vanderbilt-Ingram Cancer Center:
adenocarcinoma of the colon
recurrent colon cancer
stage IV colon cancer
adenocarcinoma of the rectum
recurrent rectal cancer
stage IV rectal cancer
liver metastases

Additional relevant MeSH terms:
Colorectal Neoplasms
Neoplasm Metastasis
Neoplasms
Neoplasms, Second Primary
Liver Neoplasms
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
Liver Diseases
Cetuximab
Dasatinib
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on February 09, 2012