Colonic Neoplasms
Conditions
Brief summary
Enzastaurin given daily to participants with colorectal cancer who have Stage 4 disease and have not received prior chemotherapy for advanced colorectal cancer
Interventions
1200 milligrams (mg) loading dose orally, then 500 mg, orally, daily, up to six 28-day cycles.
Sponsors
Study design
Eligibility
Inclusion criteria
* diagnosed with colorectal cancer that is advanced or metastatic (has spread to other parts of the body); able to visit the doctor's office every 28 days for at least 6 months; able to swallow tablets
Exclusion criteria
* women cannot be pregnant or breastfeeding; no history of significant heart disease or any other significant medical problems as determined by the participant's physician
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Progression Free Survival (PFS) at 6 Months | Baseline to 6 months | PFS defined as time from date of first dose of enzastaurin to first date of documented progressive disease (PD) or date of death (any cause), whichever occurred first. Using Response Evaluation Criteria in Solid Tumors (RECIST v1.0) PD defined as ≥20% increase in sum of the longest diameter (LD) of target lesions, taking as reference smallest sum LD recorded since treatment started or appearance of ≥1 new lesions. Participants not known to have died as of data-inclusion cut-off date and who did not have PD, PFS was censored at date of last progression-free disease assessment prior to date of any post discontinuation anticancer therapy. Participants who took any subsequent systemic anticancer therapy prior to PD or death, PFS was censored at date of last progression-free disease assessment prior to the date of any post discontinuation anticancer therapy. PFS at 6 months = participants who were progression free and alive at 6 months divided by the number of treated participants x 100. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Complete Response (CR) or Partial Response (PR) [Objective Response Rate (ORR)] | Baseline to measured progressive disease (PD) up to 24 months | Objective response rate during treatment was defined as the number of participants with documented complete response (CR) or partial response (PR) divided by the total number of participants. CR and PR defined using Response Evaluation Criteria in Solid Tumors (RECIST v1.0). CR defined as the disappearance of all target and non-target lesions and normalization of tumor marker levels in non-target lesions. PR defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. Percentage of participants with CR or PR (ORR) was the number of participants with documented CR or PR divided by the total number of treated participants x 100. |
| Overall Survival (OS) | Baseline to date of death from any cause up to 24 months | OS was defined as the time from the date of the first dose of enzastaurin to the date of death from any cause. Survival time was censored at the date of the last contact for participants who were still alive. |
| Progression Free Survival (PFS) | Baseline to measured PD up to 9 months | PFS was defined as the time from the date of the first dose of enzastaurin to the first date of documented progressive disease (PD) or the date of death from any cause, whichever occurred first. Participants who were not known to have died as of the data-inclusion cut-off date, and who did not have PD, PFS was censored at the date of the last progression-free disease assessment date prior to the date of any post discontinuation anticancer therapy. Participants who took any subsequent systemic anticancer therapy prior to PD or death, PFS was censored at the date of the last progression-free disease assessment prior to the date of any post discontinuation anticancer therapy. |
| Duration of Stable Disease (SD) | Time from SD to measured PD up to 9 months | Duration of SD measured from date of first dose of enzastaurin to date of documented progressive disease (PD) or date of death from any cause, whichever occurred first, using Response Evaluation Criteria in Solid Tumors (RECIST v1.0). PD was defined as ≥20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD since treatment began or appearance of ≥1 new lesions. SD was defined as no improvement and not meeting the requirements of PD using smallest sum LD since treatment began as reference. Participants with SD (or better) who had not died at data-inclusion cut-off date without PD, or participants who took subsequent systemic anticancer therapy prior to PD or death, duration was censored at date of last progression-free disease assessment prior to the date of post discontinuation anticancer therapy. |
| Time to Treatment Response | Baseline to date of confirmed response up to 24 months | Time to treatment response was defined as date of first dose of study drug to the date of confirmed complete response (CR) or partial response (PR) using Response evaluation Criteria in Solid Tumors (RECIST v1.0) criteria. CR was defined as the disappearance of all target and non-target lesions and normalization of tumor marker levels in non-target lesions. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. Time to treatment response was not evaluable, as there were no participants with CR or PR. |
| Duration of Complete Response (CR) or Partial Response (PR) (Duration of Response) | Time from response to PD | The duration CR or PR was defined as the time from first objective status assessment of CR or PR to the first date of documented progressive disease (PD) or death from any cause. CR and PR were determined using Response evaluation Criteria in Solid Tumors (RECIST v1.0) criteria. CR was defined as the disappearance of all target and non-target lesions and normalization of tumor marker levels in non-target lesions. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. PD defined as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions. Duration of response was not evaluable, as there were no participants with CR or PR. |
| Number of Participants With Adverse Events (AEs) or Who Died | Baseline to study completion up to 24 months and 30-day post-study discontinuation | Clinically significant events were defined as serious AEs (SAEs) and other non-serious AEs (regardless of causality). A summary of SAEs and other non-serious adverse events (AEs) regardless of causality is located in the Reported Adverse Events module. The number of participants who died included those who died due to an SAE (any cause) while on study and those who died due to progressive disease (PD) during the 30-day post-study discontinuation follow-up. |
| Change From Baseline in QTc Interval | Baseline, Cycle 1 Day 1 and Cycle 2 Day 1 of 28-day cycles | QTc interval was a measure of time between the start of the Q wave and the end of the T wave and is dependent on the heart rate. A QTc interval adjusted using Bazette's correction (QTcB) was used in order to aid interpretation. |
| Pharmacokinetics-Minimum Observed Concentration (Cmin) of Total Analytes | Cycle 1 Day 2-predose, Cycle 2 Day 1-predose and Cycle 3 Day 1-predose of 28-day cycles | Cmin of enzastaurin + LSN326020 (a metabolite of LY317615) after loading dose in Cycle 1 and at a steady state during Cycles 2 and 3. |
| Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle | Baseline and Cycles 1, 2, 3, 4, 5, 6 (28-day cycles) | CEA levels were measured to detect potentially rapid-growing tumors in participants who received enzastaurin. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Vascular Endothelial Growth Factor (VEGF) to Cycle 2 and Cycle 3 | Baseline, Cycle 2 and Cycle 3 (28-day cycles) | VEGF levels were measured to detect potentially rapid-growing tumors in participants who received enzastaurin. |
Countries
Denmark, Sweden
Participant flow
Pre-assignment details
Participant flow reports those who discontinued from study drug.
Participants by arm
| Arm | Count |
|---|---|
| Enzastaurin HCl 1200 milligrams (mg) administered orally as a loading dose, then 500 mg administered orally, once daily, for up to six 28-day cycles. | 28 |
| Total | 28 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 2 |
| Overall Study | Clinical Progression | 2 |
| Overall Study | Death | 1 |
| Overall Study | Objective Tumor Progression | 19 |
Baseline characteristics
| Characteristic | Enzastaurin HCl |
|---|---|
| Age, Continuous | 68.75 years STANDARD_DEVIATION 8.8 |
| Eastern Cooperative Oncology Group (ECOG) 0 | 24 Participants |
| Eastern Cooperative Oncology Group (ECOG) 1 | 4 Participants |
| Pathological Diagnosis Adenocarcinoma colon | 16 Participants |
| Pathological Diagnosis Adenocarcinoma rectum | 10 Participants |
| Pathological Diagnosis Colorectal Cancer | 1 Participants |
| Pathological Diagnosis Other | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 28 Participants |
| Region of Enrollment Denmark | 13 Participants |
| Region of Enrollment Sweden | 15 Participants |
| Sex: Female, Male Female | 12 Participants |
| Sex: Female, Male Male | 16 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 22 / 28 |
| serious Total, serious adverse events | 4 / 28 |
Outcome results
Percentage of Participants With Progression Free Survival (PFS) at 6 Months
PFS defined as time from date of first dose of enzastaurin to first date of documented progressive disease (PD) or date of death (any cause), whichever occurred first. Using Response Evaluation Criteria in Solid Tumors (RECIST v1.0) PD defined as ≥20% increase in sum of the longest diameter (LD) of target lesions, taking as reference smallest sum LD recorded since treatment started or appearance of ≥1 new lesions. Participants not known to have died as of data-inclusion cut-off date and who did not have PD, PFS was censored at date of last progression-free disease assessment prior to date of any post discontinuation anticancer therapy. Participants who took any subsequent systemic anticancer therapy prior to PD or death, PFS was censored at date of last progression-free disease assessment prior to the date of any post discontinuation anticancer therapy. PFS at 6 months = participants who were progression free and alive at 6 months divided by the number of treated participants x 100.
Time frame: Baseline to 6 months
Population: All randomized participants who received at least 1 dose of study drug. Censored participants =5
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Enzastaurin HCl | Percentage of Participants With Progression Free Survival (PFS) at 6 Months | 27.50 percentage of participants |
Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle
CEA levels were measured to detect potentially rapid-growing tumors in participants who received enzastaurin.
Time frame: Baseline and Cycles 1, 2, 3, 4, 5, 6 (28-day cycles)
Population: All participants with both baseline and post baseline CEA measurements.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Enzastaurin HCl | Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle | Cycle 6 | 0.35 micrograms per liter (mcg/L) |
| Enzastaurin HCl | Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle | Cycle 1 | 0.20 micrograms per liter (mcg/L) |
| Enzastaurin HCl | Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle | Cycle 2 | 0.30 micrograms per liter (mcg/L) |
| Enzastaurin HCl | Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle | Cycle 3 | 0.90 micrograms per liter (mcg/L) |
| Enzastaurin HCl | Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle | Cycle 4 | 0.80 micrograms per liter (mcg/L) |
| Enzastaurin HCl | Change From Baseline in Carcinoembryonic Antigen (CEA) Response at Each Cycle | Cycle 5 | 0.80 micrograms per liter (mcg/L) |
Change From Baseline in QTc Interval
QTc interval was a measure of time between the start of the Q wave and the end of the T wave and is dependent on the heart rate. A QTc interval adjusted using Bazette's correction (QTcB) was used in order to aid interpretation.
Time frame: Baseline, Cycle 1 Day 1 and Cycle 2 Day 1 of 28-day cycles
Population: All randomized participants who received at least 1 dose of study drug.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Enzastaurin HCl | Change From Baseline in QTc Interval | Cycle 1 Day 1 | 2.07 milliseconds (msec) | Standard Deviation 16.21 |
| Enzastaurin HCl | Change From Baseline in QTc Interval | Cycle 2 Day 1 | 7.30 milliseconds (msec) | Standard Deviation 15.76 |
Duration of Complete Response (CR) or Partial Response (PR) (Duration of Response)
The duration CR or PR was defined as the time from first objective status assessment of CR or PR to the first date of documented progressive disease (PD) or death from any cause. CR and PR were determined using Response evaluation Criteria in Solid Tumors (RECIST v1.0) criteria. CR was defined as the disappearance of all target and non-target lesions and normalization of tumor marker levels in non-target lesions. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. PD defined as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions. Duration of response was not evaluable, as there were no participants with CR or PR.
Time frame: Time from response to PD
Population: Zero participants were analyzed.
Duration of Stable Disease (SD)
Duration of SD measured from date of first dose of enzastaurin to date of documented progressive disease (PD) or date of death from any cause, whichever occurred first, using Response Evaluation Criteria in Solid Tumors (RECIST v1.0). PD was defined as ≥20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD since treatment began or appearance of ≥1 new lesions. SD was defined as no improvement and not meeting the requirements of PD using smallest sum LD since treatment began as reference. Participants with SD (or better) who had not died at data-inclusion cut-off date without PD, or participants who took subsequent systemic anticancer therapy prior to PD or death, duration was censored at date of last progression-free disease assessment prior to the date of post discontinuation anticancer therapy.
Time frame: Time from SD to measured PD up to 9 months
Population: Subset of all randomized participants who received at least 1 dose of study drug who achieved complete response (CR), partial response (PR) or SD. Censored participants =5.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzastaurin HCl | Duration of Stable Disease (SD) | 6.13 months |
Number of Participants With Adverse Events (AEs) or Who Died
Clinically significant events were defined as serious AEs (SAEs) and other non-serious AEs (regardless of causality). A summary of SAEs and other non-serious adverse events (AEs) regardless of causality is located in the Reported Adverse Events module. The number of participants who died included those who died due to an SAE (any cause) while on study and those who died due to progressive disease (PD) during the 30-day post-study discontinuation follow-up.
Time frame: Baseline to study completion up to 24 months and 30-day post-study discontinuation
Population: All randomized participants who received at least 1 dose of study drug.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Enzastaurin HCl | Number of Participants With Adverse Events (AEs) or Who Died | Died due to SAE while on study | 1 Participants |
| Enzastaurin HCl | Number of Participants With Adverse Events (AEs) or Who Died | Died due to PD during 30-day follow-up | 2 Participants |
| Enzastaurin HCl | Number of Participants With Adverse Events (AEs) or Who Died | Serious AEs | 4 Participants |
| Enzastaurin HCl | Number of Participants With Adverse Events (AEs) or Who Died | AEs | 22 Participants |
Overall Survival (OS)
OS was defined as the time from the date of the first dose of enzastaurin to the date of death from any cause. Survival time was censored at the date of the last contact for participants who were still alive.
Time frame: Baseline to date of death from any cause up to 24 months
Population: All randomized participants who received at least 1 dose of study drug. Censored participants =23.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzastaurin HCl | Overall Survival (OS) | 23.38 months |
Percentage of Participants With Complete Response (CR) or Partial Response (PR) [Objective Response Rate (ORR)]
Objective response rate during treatment was defined as the number of participants with documented complete response (CR) or partial response (PR) divided by the total number of participants. CR and PR defined using Response Evaluation Criteria in Solid Tumors (RECIST v1.0). CR defined as the disappearance of all target and non-target lesions and normalization of tumor marker levels in non-target lesions. PR defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. Percentage of participants with CR or PR (ORR) was the number of participants with documented CR or PR divided by the total number of treated participants x 100.
Time frame: Baseline to measured progressive disease (PD) up to 24 months
Population: All randomized participants who received at least 1 dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Enzastaurin HCl | Percentage of Participants With Complete Response (CR) or Partial Response (PR) [Objective Response Rate (ORR)] | 0 percentage of participants |
Pharmacokinetics-Minimum Observed Concentration (Cmin) of Total Analytes
Cmin of enzastaurin + LSN326020 (a metabolite of LY317615) after loading dose in Cycle 1 and at a steady state during Cycles 2 and 3.
Time frame: Cycle 1 Day 2-predose, Cycle 2 Day 1-predose and Cycle 3 Day 1-predose of 28-day cycles
Population: All randomized participants who received at least 1 dose of study drug.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Enzastaurin HCl | Pharmacokinetics-Minimum Observed Concentration (Cmin) of Total Analytes | Cycle 1 Day 2 | 2180 nanomoles per liter (nmol/L) | Standard Deviation 1343 |
| Enzastaurin HCl | Pharmacokinetics-Minimum Observed Concentration (Cmin) of Total Analytes | Cycle 2 Day 1 | 1723 nanomoles per liter (nmol/L) | Standard Deviation 2042 |
| Enzastaurin HCl | Pharmacokinetics-Minimum Observed Concentration (Cmin) of Total Analytes | Cycle 3 Day 1 | 1374 nanomoles per liter (nmol/L) | Standard Deviation 936 |
Progression Free Survival (PFS)
PFS was defined as the time from the date of the first dose of enzastaurin to the first date of documented progressive disease (PD) or the date of death from any cause, whichever occurred first. Participants who were not known to have died as of the data-inclusion cut-off date, and who did not have PD, PFS was censored at the date of the last progression-free disease assessment date prior to the date of any post discontinuation anticancer therapy. Participants who took any subsequent systemic anticancer therapy prior to PD or death, PFS was censored at the date of the last progression-free disease assessment prior to the date of any post discontinuation anticancer therapy.
Time frame: Baseline to measured PD up to 9 months
Population: All randomized participants who received at least 1 dose of study drug. Censored participants =5.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzastaurin HCl | Progression Free Survival (PFS) | 1.89 months |
Time to Treatment Response
Time to treatment response was defined as date of first dose of study drug to the date of confirmed complete response (CR) or partial response (PR) using Response evaluation Criteria in Solid Tumors (RECIST v1.0) criteria. CR was defined as the disappearance of all target and non-target lesions and normalization of tumor marker levels in non-target lesions. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. Time to treatment response was not evaluable, as there were no participants with CR or PR.
Time frame: Baseline to date of confirmed response up to 24 months
Population: Zero participants were analyzed.
Change From Baseline in Vascular Endothelial Growth Factor (VEGF) to Cycle 2 and Cycle 3
VEGF levels were measured to detect potentially rapid-growing tumors in participants who received enzastaurin.
Time frame: Baseline, Cycle 2 and Cycle 3 (28-day cycles)
Population: Participants with both baseline and post-baseline VEGF measurements.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Enzastaurin HCl | Change From Baseline in Vascular Endothelial Growth Factor (VEGF) to Cycle 2 and Cycle 3 | Cycle 2 | 0.50 picograms per liter (pg/L) |
| Enzastaurin HCl | Change From Baseline in Vascular Endothelial Growth Factor (VEGF) to Cycle 2 and Cycle 3 | Cycle 3 | -0.10 picograms per liter (pg/L) |