A Phase 2 Study of Lamivudine in Patients With p53 Mutant Metastatic Colorectal Cancer
Condition: Colorectal Cancer Metastatic
MeSH terms: Colorectal Neoplasms
Intervention: Lamivudine
Intervention description: This drug may help prevent the growth and spread of the cancer cells to other parts of the body.
Intervention MeSH terms: Lamivudine
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 36.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Colorectal Cancer

Summary:

      This research study is studying a drug as a possible treatment for p53 mutant metastatic
      colorectal cancer.

      The drug involved in this study is:

      -Lamivudine
    

Eligibility criteria:

        Inclusion Criteria:

          -  Patients must have histologically confirmed adenocarcinoma of the colon that has
             metastasized (stage 4) and is TP53 mutant/deleted by a CLIA approved genetic test.
             Only known loss of function TP53 mutation/deletion will be eligible for this study.

          -  Participants must have measureable disease, defined as at least on lesion that can be
             accurately measured in at least one dimension (longest diameter to be recorded for
             non-nodal lesions and short axis for nodal lesions) as > 20mm with conventional
             techniques or > 10 mm with spiral CT scan, MRI or calipers by clinical exam. See
             section 11 for evaluation of measurable disease

          -  Patients must be resistant to or intolerant of 5FU, oxaliplatin, irinotecan,
             bevacizumab and cetuximab/panitumumab (if RAS wild type)

          -  Age 18 or older.

          -  ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A)

          -  Life expectancy of greater than 8 weeks.

          -  Participants must have normal organ and marrow function as defined below:

               -  absolute neutrophil count ≥1,200/mcL

               -  platelets ≥75,000/mcL

               -  total bilirubin ≤1.5 × institutional upper limit of normal within normal

               -  AST(SGOT)/ALT(SGPT) ≤5 × institutional upper limit of normal

               -  creatinine within normal institutional limits OR

               -  creatinine clearance ≥60 mL/min/1.73 m2 for participants with creatinine levels
                  above institutional normal.

          -  The effects of lamivudine on the developing human fetus are known to be teratogenic.
             For this reason, 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 she or her partner is participating in this study, she
             should inform her treating physician immediately. Men treated or enrolled on this
             protocol must also agree to use adequate contraception prior to the study, for the
             duration of study participation, and 4 months after completion of lamivudine
             administration.

          -  Ability to understand and the willingness to sign a written informed consent document.

        Exclusion Criteria:

          -  Participants who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for
             nitrosourea 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.

          -  Participants who are receiving any other investigational agents.

          -  Participants with known brain metastases should be excluded from this clinical trial
             because of their poor prognosis and because they often develop progressive neurologic
             dysfunction that would confound the evaluation of neurologic and other adverse events.

          -  History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to lamivudine.

          -  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 lamivudine is an agent with 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 lamivudine, breastfeeding should be discontinued if the mother is treated
             with lamivudine.

          -  HIV-positive participants on combination antiretroviral therapy are ineligible because
             of the potential for pharmacokinetic interactions with lamivudine

          -  HBV positive participants will be excluded given the known effects of lamivudine on
             HBV.