Clinical trial NCT02465502: Regorafenib in Subjects With Antiangiogenic-naive and Chemotherapy-refractory Advanced Colorectal Cancer
Official title: An Uncontrolled, Open-label Phase IIb Trial of Regorafenib in Subjects With Antiangiogenic-naive and Chemotherapy-refractory Advanced Colorectal Cancer
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Colorectal Neoplasms
Keywords: Colorectal cancer
Regorafenib
Lead sponsor: Bayer
Sponsor class: INDUSTRY
First posted: 2015-06-08
Enrollment: 59
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: To determine the efficacy (as measured by progression-free survival \[PFS\] rate at 8 weeks) of regorafenib in subjects with metastatic colorectal cancer (CRC) whose disease is refractory to standard therapies and who were never exposed to antiangiogenic therapy.


Eligibility criteria: Inclusion Criteria:

* Male or female subjects ≥18 years of age;
* Histological or cytological confirmation of adenocarcinoma of the colon or/and rectum;
* Subjects with metastatic colorectal cancer (CRC) whose disease progressed or who were intolerant to standard chemotherapy based on fluoropyrimidine, oxaliplatin, irinotecan, and an anti-EGFR therapy if RAS wild-type. This progression must be during or within 4 months following the last administration of standard therapies.
* Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria, Version 1.1.
* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
* Adequate bone-marrow, liver, and renal function
* Women of childbearing potential and men must agree to use adequate contraception when sexually active during the study and for at least 8 weeks after the last study drug administration.

Exclusion Criteria:

* Prior treatment with an antiangiogenic agent;
* Congestive heart failure of New York Heart Association (NYHA) class 2 or worse;
* Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months). Myocardial infarction less than 6 months before start of study drug;
* Cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted)
* Uncontrolled hypertension (systolic blood pressure \>140 mmHg or diastolic pressure \>90 mmHg despite optimal medical management);
* Ongoing acute or chronic infection (\> Grade 2 NCI-CTCAE v 4.03);
* Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism (except for adequately treated catheter-related venous thrombosis occurring more than one month before the start of study medication) events within 6 months of study enrollment. Subjects being treated with low-weight heparin are allowed to participate as long as dose is limited to prophylactic use.
* Any history of or currently known brain metastases (head CT/MRI will be performed during screening period if brain metastases are suspected)
* Previous or concurrent cancer that is distinct in primary site or histology from colorectal cancer within 5 years before study entry, except for curatively treated cervical cancer in situ, in situ ductal breast cancer, non-melanoma skin cancer and superficial bladder tumors;
* Last chemotherapy dose or any other anti-cancer therapy administered in less than 4 weeks from start of study treatment;
* Use of therapeutic anticoagulation;
* Proteinuria \> 3.5 g/24 hours measured by urine protein-creatinine ratio from a random urine sample (Grade 3, NCI-CTCAE v 4.03) on urinalysis screening result. If there is medical history of proteinuria, previous urinalysis results should be considered and/or performed so at least 2 results separated by at least 2 weeks are available;
* History of interstitial lung disease with ongoing signs and symptoms at the time of informed consent;
* Non-healing wound, non-healing ulcer, or non-healing bone fracture;
* Subjects with evidence or history of any bleeding diathesis, irrespective of severity;
* Any hemorrhage or bleeding event ≥ Grade 3 NCI-CTCAE v 4.03 within 4 weeks prior to the start of study medication;
* Known history of human immunodeficiency virus (HIV) infection;
* History of active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy;
* Pregnancy or breastfeeding.

Primary outcomes:
measure: Percentage of participants without disease progression or death at the end of 8 weeks
timeFrame: At week 8
Secondary outcomes:
measure: Progression-Free Survival (PFS)
timeFrame: Approximately 2 months
measure: Overall Survival (OS)
timeFrame: Approximately 2 months
measure: Overall Response Rate (ORR)
timeFrame: Approximately 2 months
measure: Disease Control Rate (DCR)
timeFrame: Approximately 2 months
measure: Metabolic response measured by [18F] fluorodeoxyglucose positron emission tomography (FDG PET)
timeFrame: Approximately 2 months
measure: Percentage of participants with grade 1 or higher adverse events, using NCI Common Terminology Criteria for Adverse Events (CTC-AE) Version 4.03
timeFrame: Approximately 2 months
Other outcomes:
Locations:
city: São Paulo
country: Brazil
Study officials:
affiliation: Bayer
name: Bayer Study Director
role: STUDY_DIRECTOR
References:
citation: Riechelmann RP, Leite LS, Bariani GM, Glasberg J, Rivelli TG, da Fonseca LG, Nebuloni DR, Braghiroli MI, Queiroz MA, Isejima AM, Kappeler C, Kikuchi L, Hoff PM. Regorafenib in Patients with Antiangiogenic-Naive and Chemotherapy-Refractory Advanced Colorectal Cancer: Results from a Phase IIb Trial. Oncologist. 2019 Sep;24(9):1180-1187. doi: 10.1634/theoncologist.2019-0067. Epub 2019 Jun 7.