A Study of Ramucirumab or Icrucumab in Colorectal Cancer

• ClinicalTrials.gov Identifier: NCT01111604
• Recruitment Status: Completed
• First Posted: April 27, 2010
• Results First Posted: August 6, 2019
• Last Update Posted: August 6, 2019
• Sponsor: Eli Lilly and Company
• Information provided by (Responsible Party): Eli Lilly and Company

Study Description

Brief Summary:

The purpose of this study is to determine if participants with metastatic colorectal cancer live longer without their cancer progressing when treated with standard chemotherapy, standard chemotherapy plus ramucirumab, or standard chemotherapy plus icrucumab.

Condition or disease	Intervention/treatment	Phase
Colon Cancer; Rectal Cancer	Biological: Ramucirumab; Biological: Icrucumab; Drug: mFOLFOX-6	Phase 2

Detailed Description:

The purpose of this study is to evaluate the progression-free survival (PFS) in participants with metastatic colorectal cancer when treated with 1 of 3 modified FOLFOX-6 (folinic acid [FA] + fluorouracil [5-FU] + oxaliplatin [mFOLFOX-6])-based regimens, as second-line therapy.

During 2010, there has been an identified shortage of injectable folinic acid (FA) in the United States. Levo-folinic acid (LFA) will be allowed as a substitute for FA in the mFOLFOX-6 chemotherapy regimen in circumstances in which FA is not available, to facilitate continuity of participant care.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 158 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: An Open-label, Multicenter, Randomized Phase 2 Study Evaluating the Safety and Efficacy of 5 FU/FA and Oxaliplatin (Modified FOLFOX 6) in Combination With Ramucirumab or IMC-18F1 or Without Investigational Therapy as Second Line Therapy in Patients With Metastatic Colorectal Cancer Following Disease Progression on First Line Irinotecan-based Therapy
• Study Start Date: August 2010
• Actual Primary Completion Date: December 2013
• Actual Study Completion Date: December 2013

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: mFOLFOX-6; mFOLFOX-6	Drug: mFOLFOX-6; Oxaliplatin: 85 milligram per square meter (mg/m²) IV every 2 weeks (Q2W) FA: 400 mg/m² IV Q2W (or LFA: 200 mg/m² Q2W if FA is unavailable). 5FU: 400 mg/m² bolus + 2400 mg/m² IV Q2W
Experimental: mFOLFOX-6 + Ramucirumab; mFOLFOX-6 + Ramucirumab	Biological: Ramucirumab; 8 mg/kg IV Q2W; Other Names: IMC-1121B; LY3009806; Drug: mFOLFOX-6; Oxaliplatin: 85 milligram per square meter (mg/m²) IV every 2 weeks (Q2W) FA: 400 mg/m² IV Q2W (or LFA: 200 mg/m² Q2W if FA is unavailable). 5FU: 400 mg/m² bolus + 2400 mg/m² IV Q2W
Experimental: mFOLFOX-6 + Icrucumab; mFOLFOX-6 + Icrucumab	Biological: Icrucumab; 15 mg/kg IV Q2W; Other Names: IMC-18F1; LY3012212; Drug: mFOLFOX-6; Oxaliplatin: 85 milligram per square meter (mg/m²) IV every 2 weeks (Q2W) FA: 400 mg/m² IV Q2W (or LFA: 200 mg/m² Q2W if FA is unavailable). 5FU: 400 mg/m² bolus + 2400 mg/m² IV Q2W

Outcome Measures

Primary Outcome Measures :

1. Progression-Free Survival (PFS) [ Time Frame: Baseline until Disease Progression or Death from Any Cause (Up to 95 Weeks) ]
   PFS is defined as the time from baseline until the date of disease progression as defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1), or death from any cause, whichever was first. Participants who die without a reported prior progression will be considered to have progressed on the day of their death. Participants who did not progress, are lost to follow-up, or have missed two or more scheduled tumor assessments will be censored at the day of their last radiographic tumor assessment, if there are no post-baseline tumor measurements for a randomized and treated participant, the participant will be censored at the date of randomization. If death or progressive disease (PD) occurs after 2 or more missing radiographic visits, censoring will occur at the date of the last radiographic visit prior to the last visit.

Secondary Outcome Measures :

1. Percentage of Participants Achieving Complete Response (CR) or Partial Response (PR) (Objective Response Rate [ORR]) [ Time Frame: Baseline until Disease Progression (Up to 95 Weeks) ]
   The ORR is the percentage of participants with Complete Response (CR, the disappearance of target lesions and any pathological lymph nodes [target or non-target] taking as reference the baseline sum of diameters in response to treatment) or Partial Response (PR, at least a 30% decrease in the sum of diameter of target lesions, taking as reference the baseline sum diameters in response to treatment) according to RECIST v1.1 from the start of the treatment until disease progression.
2. Overall Survival (OS) [ Time Frame: Baseline Until Death from Any Cause (Up to 163 Weeks) ]
   Overall survival is defined as the time from baseline to the date of death from any cause. If the participant is alive at the end of the follow-up period or is lost to follow-up, OS will be censored on the last date the participant is known to be alive.
3. Duration of Response (DoR) [ Time Frame: Criteria First Met for CR or PR until Disease Progression or Death from Any Cause (Up to 95 Weeks) ]
   DoR was measured from the time measurement criteria are first met for Complete Response or Partial Response or until the first date that the criteria for disease progression or death from any cause. whichever is first recorded. As defined according to RECIST v1.1, CR is the disappearance of all non-nodal target lesions, and PR is the short axes of any target lymph nodes reduced to < 10 mm and at least a 30% decrease in the sum of the diameters of target lesions including the short axes of any target lymph nodes.)
4. Pharmacokinetics (PK): Maximum Concentration (Cmax) at Cycle 5 [ Time Frame: Cycle 5, 1 Hour Post End of Infusion ]
   Maximum concentration (1 hour post end of infusion, Cmax) is the concentration measured in serum.
5. Pharmacokinetics (PK): Trough Serum Concentrations (Ctrough) at Cycle 5 [ Time Frame: Cycle 5, Prior to Infusion ]
   Trough (prior to infusion, Ctrough) concentrations measured in serum.
6. Maximum Concentration (Cmax) at Day 8 [ Time Frame: Day 8 (cycles 1 and 5) ]
   Maximum concentration (Cmax) is the maximum peak concentration measured in blood plasma after drug infusion.
7. Maximum Concentration (Cmax) at Day 15 [ Time Frame: Day 15 (Cycles 1 and 5) ]
   Cmax is the maximum peak concentration measured in blood plasma after drug infusion.
8. Minimum Concentration (Cmin) at Day 1 [ Time Frame: Day 1 (cycles 1, 5, 9, and 13) ]
   Cmin is the minimum peak concentration measured in blood plasma after drug infusion.
9. Minimum Concentration (Cmin) at Day 4 [ Time Frame: Day 4 (cycles 1 and 5) ]
   Cmin is the minimum peak concentration measured in blood plasma after drug infusion.
10. Minimum Concentration (Cmin) at Day 8 [ Time Frame: Day 8 (cycles 1 and 5) ]
    Minimum concentration (Cmin) is the minimum peak concentration measured in blood plasma after drug infusion.
11. Minimum Concentration (Cmin) at Day 15 [ Time Frame: Day 15 (cycles 1 and 5) ]
    Minimum concentration (Cmin) is the minimum peak concentration measured in blood plasma after drug infusion.
12. Number of Participants With Serum Ramucirumab Antibody Assessment [ Time Frame: 31 Weeks ]
    A sample will be considered positive for anti-Ramucirumab antibodies if it exhibits a post-baseline antibody level exceeding the normal anti-Ramucirumab antibody level seen in healthy untreated individuals.
13. Serum Anti-Icrucumab Antibody Assessment [ Time Frame: 31 Weeks ]
    A sample will be considered positive for anti-icrucumab antibodies if it exhibits a post-baseline antibody level exceeding the normal anti-icrucumab antibody level seen in healthy untreated individuals.
14. Number of Participants With Adverse Events [ Time Frame: Baseline up to 165 weeks ]
    A summary of serious AEs (SAEs) and all other non-serious AEs regardless of causality, is located in the Reported Adverse Events module.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Disease progression on an irinotecan-based first-line chemotherapy regimen (ie FOLFIRI or CAPIRI [capecitabine + irinotecan], with or without bevacizumab)
• Age ≥ 18 years
• Life expectancy of ≥ 6 months
• Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1 at study entry
• Agrees to adequate contraception during the study period and for 12 weeks after the last dose of study medication
• Provided signed informed consent

Exclusion Criteria:

• Has received prior oxaliplatin-based chemotherapy for locally advanced unresectable or metastatic Colorectal Cancer (CRC) (Prior oxaliplatin-based adjuvant chemotherapy is allowed if the last dose of oxaliplatin was administered > 12 months prior to randomization)
• Has documented and/or symptomatic brain or leptomeningeal metastases
• Has an ongoing or active infection, symptomatic or poorly controlled cardiac arrhythmia, psychiatric illness/social situations, or any other serious uncontrolled medical disorders
• On chronic non-topical corticosteroid treatment. A participant discontinuing such treatment > 3 months prior to randomization is eligible
• Has uncontrolled or poorly controlled hypertension on a standard regimen of antihypertensive therapy
• Has a concurrent active malignancy. A participant with previous history of malignancy is eligible, provided that he/she has been disease free for > 3 years
• If female, is pregnant (confirmed by serum beta human chorionic gonadotropin [βHCG] test) or lactating
• Has received a prior autologous or allogeneic organ or tissue transplantation
• Has undergone major surgery within 28 days prior to randomization
• Has had a serious nonhealing wound, ulcer, or bone fracture within 28 days prior to randomization
• Has an elective or planned major surgery to be performed during the course of the trial
• Has a history of inflammatory bowel disease requiring pharmacological and/or surgical intervention in the 12 months prior to randomization

Contacts and Locations

Locations

United States, Ohio

ImClone Investigational Site

Cincinnati, Ohio, United States, 45242

United States, South Carolina

ImClone Investigational Site

Columbia, South Carolina, United States, 29210

United States, Tennessee

ImClone Investigational Site

Nashville, Tennessee, United States, 37232

Canada, Alberta

ImClone Investigational Site

Calgary, Alberta, Canada, T2N 4N2

ImClone Investigational Site

Edmonton, Alberta, Canada, T6G 1Z2

Canada, British Columbia

ImClone Investigational Site

Kelowna, British Columbia, Canada, V1Y 5L3

ImClone Investigational Site

Surrey, British Columbia, Canada, V3V 1Z2

ImClone Investigational Site

Vancouver, British Columbia, Canada, V5Z 4E6

Canada, Nova Scotia

ImClone Investigational Site

Halifax, Nova Scotia, Canada, B3H 1V7

Canada, Ontario

ImClone Investigational Site

Hamilton, Ontario, Canada, L8V 5C2

ImClone Investigational Site

London, Ontario, Canada, N6A 4L6

ImClone Investigational Site

Mississauga, Ontario, Canada, L5M 2N1

ImClone Investigational Site

Oshawa, Ontario, Canada, L1G 2B9

ImClone Investigational Site

Ottawa, Ontario, Canada, K1H 8L6

ImClone Investigational Site

Toronto, Ontario, Canada, M5G 2M9

ImClone Investigational Site

Windsor, Ontario, Canada, N8W 2X3

Canada, Quebec

ImClone Investigational Site

Montreal, Quebec, Canada, H2W 156

Sponsors and Collaborators

Eli Lilly and Company

Investigators

• Study Director: Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST); Eli Lilly and Company

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Moore M, Gill S, Asmis T, Berry S, Burkes R, Zbuk K, Alcindor T, Jeyakumar A, Chan T, Rao S, Spratlin J, Tang PA, Rothenstein J, Chan E, Bendell J, Kudrik F, Kauh J, Tang S, Gao L, Kambhampati SR, Nasroulah F, Yang L, Ramdas N, Binder P, Strevel E. Randomized phase II study of modified FOLFOX-6 in combination with ramucirumab or icrucumab as second-line therapy in patients with metastatic colorectal cancer after disease progression on first-line irinotecan-based therapy. Ann Oncol. 2016 Dec;27(12):2216-2224. doi: 10.1093/annonc/mdw412. Epub 2016 Oct 11.

• Responsible Party: Eli Lilly and Company
• ClinicalTrials.gov Identifier: NCT01111604
• Other Study ID Numbers: 13942; CP20-0801 ( Other Identifier: ImClone Systems ); I4Y-IE-JCDB ( Other Identifier: Eli Lilly and Company )
• First Posted: April 27, 2010
• Results First Posted: August 6, 2019
• Last Update Posted: August 6, 2019
• Last Verified: July 2019

Keywords provided by Eli Lilly and Company:

Colonic Neoplasms; Rectal Neoplasms; Adenocarcinoma; Antibodies, Monoclonal

Additional relevant MeSH terms:

Colorectal Neoplasms; Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases; Ramucirumab; Antineoplastic Agents