A Study of BBI608 in Adult Patients With Advanced Colorectal Cancer
Condition: Colorectal Cancer
MeSH terms: Colorectal Neoplasms
Intervention: BBI608; Panitumumab; Capecitabine; Cetuximab
Intervention description: BBI608 is administered at 500 mg po bid continuously.; Panitumumab will be administered IV on day 8 and 22 of each 28 day cycle at 6 mg/kg over 60 minutes.; Capecitabine will be administered orally at 1000 mg/m2 bid daily on days 8-21 every three weeks.; Cetuximab will be administered IV on day 5 at 400 mg/m2 intravenous infusion over 120 minutes as the initial dose, then weekly at 250mg/m2 over 60-minutes at subsequent cycles.
Intervention MeSH terms: Capecitabine; Cetuximab; Panitumumab
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 200.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: BBI608

Summary:

      This is an open label, multi-center, Phase 2 study of BBI608 in combination with cetuximab,
      panitumumab or capecitabine in patients with advanced colorectal cancer.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Signed written informed consent must be obtained and documented according to
             International Conference on Harmonization (ICH), Good Clinical Practice(GCP), the
             local regulatory requirements, and permission to use private health information in
             accordance with the Health Insurance Portability and Accountability Act (HIPPA) prior
             to study-specific screening procedures.

          -  A histologically or cytologically confirmed colorectal cancer that is metastatic,
             unresectable, or recurrent.

          -  Patients must have received at least 2 regimens containing 5-Fluorouracil,oxaliplatin,
             or irinotecan.

          -  Patients to be enrolled in the Cetuximab or Panitumumab combination arms must have
             colorectal cancer which is K-Ras wild-type.

          -  ≥ 18 years of age.

          -  Measurable disease as defined by Response Evaluation Criteria in Solid Tumors (RECIST
             1.1).

          -  Karnofsky performance Status ≥ 70%

          -  Male or female patients of child-producing potential must agree to use contraception
             or avoidance of pregnancy measures during the study and for 30 days after the last
             BBI608 dose.

          -  Females of childbearing potential must have a negative serum pregnancy test.

          -  Aspartate transaminase (AST) and alanine transaminase (ALT) ≤1.5 × upper limit of
             normal(ULN), or ≤ 2.5 × ULN with metastatic liver disease.

          -  Hemoglobin (Hgb) ≥ 10 g/dl.

          -  Total bilirubin ≤ 1.5 × ULN.

          -  Creatinine ≤ 1.5 × ULN or creatinine clearance > 60 mL/min/1.73 m^2 for patients with
             creatinine levels above institutional normal.

          -  Absolute neutrophil count ≥ 1.5 x 10^9/L.

          -  Platelets ≥ 100 x 10^9/L.

          -  Life expectancy ≥ 3 months.

        Exclusion Criteria:

          -  Anti-cancer chemotherapy, radiotherapy, immunotherapy, or investigational agents
             within four weeks of first dose with the exception for a single dose radiation up to 8
             Gray (equal to 800 RAD) with palliative intent for pain control up to 14 days before
             beginning the administration of BBI608.

          -  Surgery within 4 weeks prior to first dose.

          -  Any known symptomatic brain metastases requiring steroids. Patients with treated brain
             metastases must be stable for 4 weeks after completion of that treatment, with image
             documentation required. Patients must have no clinical symptoms from brain metastases
             and must be either off steroids or on a stable dose of steroids for at least 2 weeks
             prior to protocol enrollment. Patients with known leptomeningeal metastases are
             excluded, even if treated.

          -  Pregnant or breastfeeding

          -  Significant gastrointestinal disorder(s), in the opinion of the Principal
             Investigator, (e.g., Crohn's disease, ulcerative colitis, extensive gastric and small
             intestine resection)

          -  Unable or unwilling to swallow BBI608 capsules daily.

          -  Uncontrolled intercurrent illness including, but not limited to ongoing or active
             infection, clinically significant non-healing or healing wounds, symptomatic
             congestive heart failure, unstable angina pectoris, cardiac arrhythmia, significant
             pulmonary disease (shortness of breath at rest or mild exertion), uncontrolled
             infection or psychiatric illness/social situations that would limit compliance with
             study requirements.