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Irinotecan and Cetuximab With or Without Bevacizumab in Treating Patients With Metastatic Colorectal Cancer That Progressed During First-Line Therapy

Phase III Trial of Irinotecan-Based Chemotherapy Plus Cetuximab (NSC-714692) or Bevacizumab (NSC-704865) as Second-Line Therapy for Patients With Metastatic Colorectal Cancer Who Have Progressed on Bevacizumab With Either FOLFOX, OPTIMOX or XELOX

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00499369
Enrollment
72
Registered
2007-07-11
Start date
2007-06-30
Completion date
2012-11-30
Last updated
2014-07-31

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IVA Colon Cancer, Stage IVA Rectal Cancer, Stage IVB Colon Cancer, Stage IVB Rectal Cancer

Brief summary

This randomized phase III trial is studying giving irinotecan and cetuximab together with bevacizumab to see how well it works compared with giving irinotecan and cetuximab alone in treating patients with metastatic colorectal cancer that progressed during first-line therapy. Drugs used in chemotherapy, such as irinotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab and bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. It is not yet known whether irinotecan and cetuximab are more effective with or without bevacizumab in treating metastatic colorectal cancer.

Detailed description

PRIMARY OBJECTIVES: I. Compare progression-free survival of patients with metastatic colorectal cancer that progressed on first-line therapy comprising bevacizumab and FOLFOX, OPTIMOX, or XELOX treated with irinotecan hydrochloride-based chemotherapy and cetuximab with vs without bevacizumab. II. Compare overall survival of patients treated with these regimens. III. Compare objective tumor response (confirmed and unconfirmed, complete and partial response) in patients with measurable disease treated with these regimens. IV. Compare the tolerability and safety profile of these regimens in these patients. OUTLINE: This is a multicenter, randomized study. Patients are stratified according to Zubrod performance status (0 vs 1 or 2), discontinuation of oxaliplatin during first-line therapy (yes vs no), planned concurrent chemotherapy (FOLFIRI vs single-agent irinotecan hydrochloride), and time from last dose of bevacizumab (14-42 days vs \>= 43 days). All patients receive 1 of the following chemotherapy regimens: SINGLE AGENT IRINOTECAN HYDROCHLORIDE: Patients receive irinotecan hydrochloride intravenously (IV) over 90 minutes on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. FOLFIRI: Patients receive irinotecan hydrochloride IV over 90 minutes and leucovorin calcium IV over 2 hours on day 1 and fluorouracil IV continuously over 46-48 hours on days 1 and 2. Treatment repeats every 14 days in the absence of disease progression or unacceptable toxicity. Patients are then randomized to 1 of 3 treatment arms. ARM I: Patients receive single-agent irinotecan hydrochloride or FOLFIRI as outlined above and cetuximab IV over 1-2 hours on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen) in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive single-agent irinotecan hydrochloride or FOLFIRI as outlined above and cetuximab as in arm I. Patients also receive bevacizumab IV over 30 minutes on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen) in the absence of disease progression or unacceptable toxicity. ARM III (closed to accrual as of 4/20/2009): Patients receive single-agent irinotecan hydrochloride or FOLFIRI as outlined above and cetuximab as in arm I. Patients also receive a higher dose of bevacizumab (higher than in arm II) IV over 30 minutes on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen) in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed every 6 months for 2 years and then once a year for 3 years.

Interventions

DRUGirinotecan hydrochloride

Given IV

DRUGleucovorin calcium

Given IV

DRUGfluorouracil

Given IV

BIOLOGICALcetuximab

Given IV

BIOLOGICALbevacizumab

Given IV

Sponsors

North Central Cancer Treatment Group
CollaboratorNETWORK
Cancer and Leukemia Group B
CollaboratorNETWORK
Eastern Cooperative Oncology Group
CollaboratorNETWORK
NCIC Clinical Trials Group
CollaboratorNETWORK
National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Patients must have metastatic colorectal cancer that has been histologically or cytologically confirmed; confirmation may be from either the primary tumor or a metastasis; patients must have wild type KRAS * Patients must be registered within 28 days of documented disease progression on first line chemotherapy with bevacizumab plus either FOLFOX, OPTIMOX, or XELOX; this progression must have occurred within 90 days after the last dose of bevacizumab; patients who discontinued oxaliplatin, continued with 5-FU/LV or capecitabine and bevacizumab and then had subsequent progression while on fluoropyrimidine and bevacizumab are eligible; patients who discontinued bevacizumab due to adverse events in the first-line setting are not eligible * Measurable or nonmeasurable disease * At least 14 days must have elapsed since the last dose of first line chemotherapy and bevacizumab * Patients must not have received prior treatment with irinotecan (either as adjuvant or metastatic treatment) * Patients must have no history of prior treatment with cetuximab or other agents targeting VEGF or EGFR (except for bevacizumab) * Prior radiotherapy is allowed, provided at least 28 days have elapsed since the last treatment; all adverse events related to radiation therapy must be resolved * Prior surgery is allowed, provided at least 28 days have elapsed since any major surgery and patient has recovered from all effects * Zubrod performance status 0-2 * Absolute neutrophil count (ANC) \>= 1,500/mm\^3 * Platelet count \>= 100,000/mm\^3 * Hemoglobin \>= 9 g/dL * Total bilirubin =\< 1.5 times upper limit of normal (ULN) * Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamic pyruvate transaminase (SGPT) =\< 2.5 x IULN; if there are known liver metastases, SGOT or SGPT must be =\< 5 x IULN; these results must be obtained within 28 days prior to registration * Serum creatinine =\< IULN or measured or estimated creatinine clearance \>= 60 mL/min * Patients must not have a history or known presence of brain metastasis * Patients may be on full dose anticoagulation with warfarin provided that the patient has an acceptable International Normalized Ratio (INR) (between 2 and 3), obtained within 28 days prior to registration * No clinically relevant bleeding diathesis or coagulopathy * Patients must not have experienced nephrotic range proteinuria from prior bevacizumab therapy; urine protein must be screened by urine analysis for Urine Protein Creatinine (UPC) ratio; for UPC ratio \> 0.5, 24-hour urine protein must be obtained and the level must be \< 1,000 mg for patient enrollment; urine protein and creatinine used in calculating the UPC ratio must be obtained within 28 days prior to registration * No uncontrolled high blood pressure (BP) (i.e., systolic BP \> 150 mm Hg and diastolic BP \> 90 mm Hg) * No cardiovascular event within the past 6 months, including any of the following: * Arterial thrombosis * Unstable angina * Myocardial infarction * Cerebrovascular accident * Patients must not have New York Heart Association (NYHA) \>= Grade 2 congestive heart failure * Patients must not have unstable symptomatic arrhythmia requiring medication; (patients with chronic, controlled arrhythmias such as atrial fibrillation or paroxysmal supraventricular tachycardia \[PSVT\] are eligible) * No clinically significant peripheral vascular disease * No serious or nonhealing active wound, ulcer, or bone fracture * No history of gastrointestinal (GI) perforation while on prior bevacizumab * No significant bleeding episodes (e.g., hemoptysis or upper or lower GI bleeding) within the past 6 months unless the source of bleeding has been resected * No known hypersensitivity to bevacizumab or known potential hypersensitivity to cetuximab * No other concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or any other type of anticancer treatment * Due to the possibility of harm to a fetus or nursing infant from this treatment regimen, patients must not be pregnant or nursing; women and men of reproductive potential must have agreed to use an effective contraceptive method * No other malignancy within the past 5 years except for adequately treated basal or squamous cell skin cancer or cervical cancer in situ * All patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines * At the time of patient registration, the treating institution's name and identification (ID) number must be provided to the Data Operations Center in Seattle in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered into the data base

Design outcomes

Primary

MeasureTime frameDescription
Progression-free Survival (PFS)Up to 5 yearsPFS is measured from date of registration to first documentation of progression or symptomatic deterioration, or death due to any cause. Patients last known to be alive and progression free are censored at date of last contact.

Secondary

MeasureTime frameDescription
Overall SurvivalUp to 5 yearsTime to death is from date of registration to date of death due to any cause. Patients last known to be alive are censored at date of last contact.
Objective Tumor ResponseUp to 5 years
ToxicityUp to 5 yearsNumber of patients with Grade 3 through 5 adverse events that are related to study drug. Only adverse events that are possibly, probably or definitely related to study drug are reported.

Countries

United States

Participant flow

Participants by arm

ArmCount
Cohort I: Chemotherapy + Cetuximab
Single-agent irinotecan hydrochloride IV or FOLFIRI IV and cetuximab IV over 1-2 hours on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen)
14
Cohort I: Chemotherapy + Cetuximab + Lower Bevacizumab
Single-agent irinotecan hydrochloride IV or FOLFIRI IV, cetuximab IV over 1-2 hours, and a lower dose of bevacizumab IV over 30 minutes on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen)
16
Cohort I: Chemotherapy + Cetuximab + Higher Bevacizumab
Single-agent irinotecan hydrochloride IV or FOLFIRI IV, cetuximab IV over 1-2 hours, and a higher dose of bevacizumab IV over 30 minutes on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen)
16
Cohort II: Chemotherapy + Cetuximab
Single-agent irinotecan hydrochloride IV or FOLFIRI IV and cetuximab IV over 1-2 hours on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen)
8
Cohort II: Chemotherapy + Bevacizumab
Single-agent irinotecan hydrochloride IV or FOLFIRI IV and a lower dose of bevacizumab IV over 30 minutes on day 1. Courses repeat every 14-21 days (depending upon chemotherapy regimen)
12
Total66

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004
Overall StudyAdverse Event22312
Overall StudyDeath01000
Overall StudyIneligible22110
Overall StudyNot protocol specified20310
Overall StudyProgression10129610
Overall StudyWithdrawal by Subject01100

Baseline characteristics

CharacteristicCohort I: Chemotherapy + CetuximabCohort I: Chemotherapy + Cetuximab + Lower BevacizumabCohort I: Chemotherapy + Cetuximab + Higher BevacizumabCohort II: Chemotherapy + CetuximabCohort II: Chemotherapy + BevacizumabTotal
Age, Continuous60 years63 years58 years65 years59 years60 years
Discontinuation of oxaliplatin while on first-line treatment
Did not discontinue
9 participants7 participants8 participants4 participants3 participants31 participants
Discontinuation of oxaliplatin while on first-line treatment
Discontinued
5 participants9 participants8 participants4 participants9 participants35 participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants3 Participants2 Participants2 Participants2 Participants11 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
12 Participants13 Participants12 Participants6 Participants9 Participants52 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants2 Participants0 Participants1 Participants3 Participants
Performance Status
0
9 participants8 participants8 participants1 participants4 participants30 participants
Performance Status
>= 1
5 participants8 participants8 participants7 participants8 participants36 participants
Planned concurrent chemotherapy
FOLFIRI
10 participants11 participants12 participants5 participants8 participants46 participants
Planned concurrent chemotherapy
Single-agent irinotecan
4 participants5 participants4 participants3 participants4 participants20 participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants1 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants1 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
1 Participants2 Participants0 Participants0 Participants0 Participants3 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants2 Participants2 Participants1 Participants1 Participants8 Participants
Race (NIH/OMB)
White
11 Participants12 Participants12 Participants7 Participants11 Participants53 Participants
Sex: Female, Male
Female
6 Participants8 Participants5 Participants2 Participants7 Participants28 Participants
Sex: Female, Male
Male
8 Participants8 Participants11 Participants6 Participants5 Participants38 Participants
Time from last dose of bevacizumab
14-42 days
12 participants13 participants13 participants6 participants8 participants52 participants
Time from last dose of bevacizumab
43 days or higher
2 participants3 participants3 participants2 participants4 participants14 participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —
other
Total, other adverse events
14 / 1416 / 1615 / 167 / 712 / 12
serious
Total, serious adverse events
3 / 147 / 163 / 163 / 70 / 12

Outcome results

Primary

Progression-free Survival (PFS)

PFS is measured from date of registration to first documentation of progression or symptomatic deterioration, or death due to any cause. Patients last known to be alive and progression free are censored at date of last contact.

Time frame: Up to 5 years

Population: All eligible patients are included in this analysis.

ArmMeasureValue (MEDIAN)
Cohort I: Chemotherapy + CetuximabProgression-free Survival (PFS)3.2 months
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabProgression-free Survival (PFS)4.2 months
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabProgression-free Survival (PFS)8.5 months
Cohort II: Chemotherapy + CetuximabProgression-free Survival (PFS)1.4 months
Cohort II: Chemotherapy + BevacizumabProgression-free Survival (PFS)5.6 months
Secondary

Objective Tumor Response

Time frame: Up to 5 years

Population: No participants were analyzed due to limited accrual.

Secondary

Overall Survival

Time to death is from date of registration to date of death due to any cause. Patients last known to be alive are censored at date of last contact.

Time frame: Up to 5 years

Population: No participants were analyzed due to limited accrual.

Secondary

Toxicity

Number of patients with Grade 3 through 5 adverse events that are related to study drug. Only adverse events that are possibly, probably or definitely related to study drug are reported.

Time frame: Up to 5 years

Population: Eligible patients who received any treatment and were assessed for toxicity were included in the adverse event summaries. Any CTCAE 3.0 event of Grade 3 (severe), Grade 4 (life threatening), or Grade 5 (fatal) which were deemed to be related to protocol treatment are included.

ArmMeasureGroupValue (NUMBER)
Cohort I: Chemotherapy + CetuximabToxicityBilirubin (hyperbilirubinemia)1 Participants
Cohort I: Chemotherapy + CetuximabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Abdomen NOS1 Participants
Cohort I: Chemotherapy + CetuximabToxicityMagnesium, serum-low (hypomagnesemia)0 Participants
Cohort I: Chemotherapy + CetuximabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Blood1 Participants
Cohort I: Chemotherapy + CetuximabToxicityLymphopenia0 Participants
Cohort I: Chemotherapy + CetuximabToxicityInf (clin/microbio) w/Gr 3-4 neuts - UTI1 Participants
Cohort I: Chemotherapy + CetuximabToxicityLeukocytes (total WBC)5 Participants
Cohort I: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Ab NOS0 Participants
Cohort I: Chemotherapy + CetuximabToxicityRash: acne/acneiform3 Participants
Cohort I: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - UTI0 Participants
Cohort I: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Blood1 Participants
Cohort I: Chemotherapy + CetuximabToxicityMental status1 Participants
Cohort I: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Mucosa0 Participants
Cohort I: Chemotherapy + CetuximabToxicityRash/desquamation0 Participants
Cohort I: Chemotherapy + CetuximabToxicityColitis, infectious (e.g., Clostridium difficile)0 Participants
Cohort I: Chemotherapy + CetuximabToxicityEncephalopathy1 Participants
Cohort I: Chemotherapy + CetuximabToxicityPotassium, serum-low (hypokalemia)0 Participants
Cohort I: Chemotherapy + CetuximabToxicityConfusion1 Participants
Cohort I: Chemotherapy + CetuximabToxicityThrombosis/thrombus/embolism0 Participants
Cohort I: Chemotherapy + CetuximabToxicityPneumonitis/pulmonary infiltrates1 Participants
Cohort I: Chemotherapy + CetuximabToxicityConstipation0 Participants
Cohort I: Chemotherapy + CetuximabToxicityAlbumin, serum-low (hypoalbuminemia)1 Participants
Cohort I: Chemotherapy + CetuximabToxicityPlatelets1 Participants
Cohort I: Chemotherapy + CetuximabToxicityCough0 Participants
Cohort I: Chemotherapy + CetuximabToxicityPhosphate, serum-low (hypophosphatemia)0 Participants
Cohort I: Chemotherapy + CetuximabToxicityDehydration2 Participants
Cohort I: Chemotherapy + CetuximabToxicityPain - Pain NOS0 Participants
Cohort I: Chemotherapy + CetuximabToxicityDiarrhea3 Participants
Cohort I: Chemotherapy + CetuximabToxicityNeutrophils/granulocytes (ANC/AGC)4 Participants
Cohort I: Chemotherapy + CetuximabToxicityDyspnea (shortness of breath)0 Participants
Cohort I: Chemotherapy + CetuximabToxicitySodium, serum-low (hyponatremia)0 Participants
Cohort I: Chemotherapy + CetuximabToxicityNeuropathy: sensory0 Participants
Cohort I: Chemotherapy + CetuximabToxicityEdema: limb0 Participants
Cohort I: Chemotherapy + CetuximabToxicityAlkaline phosphatase0 Participants
Cohort I: Chemotherapy + CetuximabToxicityNausea0 Participants
Cohort I: Chemotherapy + CetuximabToxicityEdema: trunk/genital0 Participants
Cohort I: Chemotherapy + CetuximabToxicityFatigue (asthenia, lethargy, malaise)0 Participants
Cohort I: Chemotherapy + CetuximabToxicityVomiting0 Participants
Cohort I: Chemotherapy + CetuximabToxicityNasal cavity/paranasal sinus reactions0 Participants
Cohort I: Chemotherapy + CetuximabToxicityFebrile neutropenia2 Participants
Cohort I: Chemotherapy + CetuximabToxicityMucositis/stomatitis (functional/symp) - Pharynx0 Participants
Cohort I: Chemotherapy + CetuximabToxicityHemoglobin1 Participants
Cohort I: Chemotherapy + CetuximabToxicityRash: hand-foot skin reaction0 Participants
Cohort I: Chemotherapy + CetuximabToxicityMucositis/stomatitis (functional/symp) - Oral cav0 Participants
Cohort I: Chemotherapy + CetuximabToxicityHemorrhage, GI - Stoma0 Participants
Cohort I: Chemotherapy + CetuximabToxicityMucositis/stomatitis (clinical exam) - Oral cavity0 Participants
Cohort I: Chemotherapy + CetuximabToxicityHypertension0 Participants
Cohort I: Chemotherapy + CetuximabToxicityAnorexia0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityPhosphate, serum-low (hypophosphatemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityMagnesium, serum-low (hypomagnesemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityAlkaline phosphatase0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Abdomen NOS0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityAnorexia1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityHemoglobin1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityLymphopenia0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityDehydration0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Blood0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityEncephalopathy0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityVomiting0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityLeukocytes (total WBC)4 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityPain - Pain NOS0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - UTI0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityRash: acne/acneiform2 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityFatigue (asthenia, lethargy, malaise)1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - UTI1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityMucositis/stomatitis (clinical exam) - Oral cavity1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Ab NOS1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityDiarrhea2 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicitySodium, serum-low (hyponatremia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Mucosa1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityNeutrophils/granulocytes (ANC/AGC)7 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Blood0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityNasal cavity/paranasal sinus reactions0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityMucositis/stomatitis (functional/symp) - Oral cav0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityBilirubin (hyperbilirubinemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityThrombosis/thrombus/embolism0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityRash/desquamation1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityDyspnea (shortness of breath)1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityHypertension0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityColitis, infectious (e.g., Clostridium difficile)0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityNeuropathy: sensory0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityPotassium, serum-low (hypokalemia)2 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityFebrile neutropenia2 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityRash: hand-foot skin reaction0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityConfusion0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityEdema: limb0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityPneumonitis/pulmonary infiltrates0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityMucositis/stomatitis (functional/symp) - Pharynx0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityNausea1 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityConstipation0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityMental status0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityPlatelets2 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityHemorrhage, GI - Stoma0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityEdema: trunk/genital0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityCough0 Participants
Cohort I: Chemotherapy + Cetuximab + Lower BevacizumabToxicityAlbumin, serum-low (hypoalbuminemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityHemorrhage, GI - Stoma0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityEncephalopathy0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityNausea3 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityLymphopenia1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityAlbumin, serum-low (hypoalbuminemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityAlkaline phosphatase1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityAnorexia0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityBilirubin (hyperbilirubinemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityColitis, infectious (e.g., Clostridium difficile)1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityConfusion0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityConstipation0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityCough0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityDehydration2 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityDiarrhea3 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityDyspnea (shortness of breath)0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityEdema: limb1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityEdema: trunk/genital1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityFatigue (asthenia, lethargy, malaise)3 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityFebrile neutropenia1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityHemoglobin0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityHypertension0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Abdomen NOS0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Blood0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - UTI0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Ab NOS0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Blood0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Mucosa0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - UTI0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityLeukocytes (total WBC)2 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityMagnesium, serum-low (hypomagnesemia)1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityMental status0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityMucositis/stomatitis (clinical exam) - Oral cavity1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityMucositis/stomatitis (functional/symp) - Oral cav1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityMucositis/stomatitis (functional/symp) - Pharynx0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityNasal cavity/paranasal sinus reactions0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityNeuropathy: sensory0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityNeutrophils/granulocytes (ANC/AGC)7 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityPain - Pain NOS0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityPhosphate, serum-low (hypophosphatemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityPlatelets0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityPneumonitis/pulmonary infiltrates0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityPotassium, serum-low (hypokalemia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityRash/desquamation1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityRash: acne/acneiform4 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityRash: hand-foot skin reaction1 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicitySodium, serum-low (hyponatremia)0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityThrombosis/thrombus/embolism0 Participants
Cohort I: Chemotherapy + Cetuximab + Higher BevacizumabToxicityVomiting1 Participants
Cohort II: Chemotherapy + CetuximabToxicityEdema: trunk/genital0 Participants
Cohort II: Chemotherapy + CetuximabToxicityPhosphate, serum-low (hypophosphatemia)1 Participants
Cohort II: Chemotherapy + CetuximabToxicityAlbumin, serum-low (hypoalbuminemia)0 Participants
Cohort II: Chemotherapy + CetuximabToxicityNasal cavity/paranasal sinus reactions0 Participants
Cohort II: Chemotherapy + CetuximabToxicityConstipation0 Participants
Cohort II: Chemotherapy + CetuximabToxicityNausea0 Participants
Cohort II: Chemotherapy + CetuximabToxicityPlatelets0 Participants
Cohort II: Chemotherapy + CetuximabToxicityMental status0 Participants
Cohort II: Chemotherapy + CetuximabToxicityHemoglobin1 Participants
Cohort II: Chemotherapy + CetuximabToxicityConfusion0 Participants
Cohort II: Chemotherapy + CetuximabToxicityVomiting0 Participants
Cohort II: Chemotherapy + CetuximabToxicityPneumonitis/pulmonary infiltrates0 Participants
Cohort II: Chemotherapy + CetuximabToxicityEdema: limb0 Participants
Cohort II: Chemotherapy + CetuximabToxicityHypertension0 Participants
Cohort II: Chemotherapy + CetuximabToxicityColitis, infectious (e.g., Clostridium difficile)0 Participants
Cohort II: Chemotherapy + CetuximabToxicityThrombosis/thrombus/embolism1 Participants
Cohort II: Chemotherapy + CetuximabToxicityPotassium, serum-low (hypokalemia)1 Participants
Cohort II: Chemotherapy + CetuximabToxicityMucositis/stomatitis (functional/symp) - Oral cav0 Participants
Cohort II: Chemotherapy + CetuximabToxicityDyspnea (shortness of breath)0 Participants
Cohort II: Chemotherapy + CetuximabToxicityBilirubin (hyperbilirubinemia)0 Participants
Cohort II: Chemotherapy + CetuximabToxicityHemorrhage, GI - Stoma0 Participants
Cohort II: Chemotherapy + CetuximabToxicityRash/desquamation0 Participants
Cohort II: Chemotherapy + CetuximabToxicityNeuropathy: sensory1 Participants
Cohort II: Chemotherapy + CetuximabToxicityMagnesium, serum-low (hypomagnesemia)0 Participants
Cohort II: Chemotherapy + CetuximabToxicityAnorexia0 Participants
Cohort II: Chemotherapy + CetuximabToxicityFebrile neutropenia0 Participants
Cohort II: Chemotherapy + CetuximabToxicityDiarrhea3 Participants
Cohort II: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Blood0 Participants
Cohort II: Chemotherapy + CetuximabToxicitySodium, serum-low (hyponatremia)0 Participants
Cohort II: Chemotherapy + CetuximabToxicityRash: acne/acneiform2 Participants
Cohort II: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Mucosa0 Participants
Cohort II: Chemotherapy + CetuximabToxicityNeutrophils/granulocytes (ANC/AGC)3 Participants
Cohort II: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Ab NOS0 Participants
Cohort II: Chemotherapy + CetuximabToxicityRash: hand-foot skin reaction0 Participants
Cohort II: Chemotherapy + CetuximabToxicityMucositis/stomatitis (functional/symp) - Pharynx0 Participants
Cohort II: Chemotherapy + CetuximabToxicityInf w/normal ANC or Gr 1-2 neutrophils - UTI0 Participants
Cohort II: Chemotherapy + CetuximabToxicityDehydration0 Participants
Cohort II: Chemotherapy + CetuximabToxicityInf (clin/microbio) w/Gr 3-4 neuts - UTI0 Participants
Cohort II: Chemotherapy + CetuximabToxicityMucositis/stomatitis (clinical exam) - Oral cavity0 Participants
Cohort II: Chemotherapy + CetuximabToxicityPain - Pain NOS0 Participants
Cohort II: Chemotherapy + CetuximabToxicityLeukocytes (total WBC)2 Participants
Cohort II: Chemotherapy + CetuximabToxicityEncephalopathy0 Participants
Cohort II: Chemotherapy + CetuximabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Blood0 Participants
Cohort II: Chemotherapy + CetuximabToxicityFatigue (asthenia, lethargy, malaise)0 Participants
Cohort II: Chemotherapy + CetuximabToxicityLymphopenia0 Participants
Cohort II: Chemotherapy + CetuximabToxicityCough0 Participants
Cohort II: Chemotherapy + CetuximabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Abdomen NOS0 Participants
Cohort II: Chemotherapy + CetuximabToxicityAlkaline phosphatase1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityHypertension1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityMagnesium, serum-low (hypomagnesemia)0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityHemorrhage, GI - Stoma1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityMental status0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityEdema: trunk/genital0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityMucositis/stomatitis (clinical exam) - Oral cavity0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityHemoglobin1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityRash: hand-foot skin reaction0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityMucositis/stomatitis (functional/symp) - Oral cav0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityFebrile neutropenia0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityAlbumin, serum-low (hypoalbuminemia)0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityMucositis/stomatitis (functional/symp) - Pharynx1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityFatigue (asthenia, lethargy, malaise)2 Participants
Cohort II: Chemotherapy + BevacizumabToxicityNasal cavity/paranasal sinus reactions1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityEdema: limb0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityNausea0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityDyspnea (shortness of breath)0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityVomiting1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityNeuropathy: sensory0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityDiarrhea5 Participants
Cohort II: Chemotherapy + BevacizumabToxicityNeutrophils/granulocytes (ANC/AGC)3 Participants
Cohort II: Chemotherapy + BevacizumabToxicityDehydration1 Participants
Cohort II: Chemotherapy + BevacizumabToxicitySodium, serum-low (hyponatremia)1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityPain - Pain NOS1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityCough1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityPhosphate, serum-low (hypophosphatemia)0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityConstipation1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityPlatelets0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityConfusion0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityPneumonitis/pulmonary infiltrates0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityColitis, infectious (e.g., Clostridium difficile)0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityPotassium, serum-low (hypokalemia)0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityBilirubin (hyperbilirubinemia)1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityThrombosis/thrombus/embolism0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityRash/desquamation0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityAnorexia1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityEncephalopathy0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Blood0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Ab NOS0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - Mucosa0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - UTI0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityRash: acne/acneiform0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityInf w/normal ANC or Gr 1-2 neutrophils - UTI1 Participants
Cohort II: Chemotherapy + BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Blood0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityAlkaline phosphatase0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityLeukocytes (total WBC)0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityInf (clin/microbio) w/Gr 3-4 neuts - Abdomen NOS0 Participants
Cohort II: Chemotherapy + BevacizumabToxicityLymphopenia0 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026