Advanced Colorectal Cancer
Conditions
Brief summary
This trial will evaluate the efficacy of PM060184 in terms of progression-free survival at 12 weeks (PFS3) in advanced or metastatic Colorectal Cancer (CRC) patients with any KRAS mutation status (wild- type; mutated; or unknown status) progressing after standard treatments (fluoropyrimidine, irinotecan, and oxaliplatin). Patients in this trial will receive PM060184 at a dose of 9.3 mg/m2 as a 30-minute intravenous (i.v.) infusion on Days 1 and 8 q3wk.
Interventions
DRUGPM060184
PM060184: 9.3 mg/m2 PM060184 i.v. as a 30-minute infusion via a central or peripheral venous catheter.Dose can be rounded to the first decimal point. PM060184 will be administered on Day 1 and Day 8 q3wk. (Three weeks=one treatment cycle).
Sponsors
PharmaMar
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Voluntarily written informed consent, obtained before the beginning of any study-specific procedures. 2. Age ≥ 18 years. 3. Histologically-cytologically documented adenocarcinoma of colon or rectum that has progressed to the last prior treatment before inclusion. 4. Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) v.1.1. If the only tumor lesion is situated in a previously irradiated area or in an area subjected to other loco-regional therapy, regression in the lesion must be demonstrated radiologically. 5. Previous treatment in any setting with fluoropyrimidine, oxaliplatin and irinotecan in any combination (unless any is contraindicated). 1. Adjuvant chemotherapy-based treatments count as prior therapy, as long as relapse had occurred during or within six months of completion of such therapies. 2. Cumulative dose of prior oxaliplatin (if any) must be known. 3. Prior cetuximab, panitumumab, bevacizumab, aflibercept, and regorafenib are allowed. 6. No more than two prior therapies for metastatic disease. 7. Washout periods for prior therapies (defined in relation to planned start of study treatment \[first dose administration\]): 1. At least three weeks since the last administration of an antineoplastic treatment (chemotherapy, biological, targeted or investigational therapies). 2. At least three weeks since radiotherapy involving up to 35% of bone marrow (radiotherapy involving \> 35% of bone marrow is not allowed) or two weeks since the end of palliative radiotherapy including single doses. 3. At least four weeks since any major surgical procedure, open biopsy, or significant traumatic injury. 8. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1. 9. Life expectancy ≥ 3 months. 10. Adequate bone marrow, liver, and kidney function: 1. Hemoglobin ≥ 9 g/dL. 2. Absolute neutrophil count ≥ 1.5 × 109/L. 3. Platelet count ≥ 100 × 109/L. 4. Serum creatinine ≤ 1.5 mg/dL or calculated creatinine clearance ≥ 40 mL/min (Cockcroft-Gault formula). 5. Albumin ≥ 2.5 g/dL. 6. Total serum bilirubin ≤ 1.5 times the upper limit of normal (ULN), except in case of Gilbert syndrome. 7. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 × ULN (≤ 5.0 × ULN in the case of liver metastases). 11. Recovery to grade ≤ 1 from any toxicity due to previous therapy (including peripheral sensory/motor neuropathy but excluding alopecia). 12. Left ventricular ejection fraction (LVEF) by echocardiography (ECHO) or multiple-gated acquisition (MUGA) scan within normal range (according to institutional standards). 13. Evidence of non-childbearing status for women of childbearing potential (WOCBP). WOCBP must agree to use a highly effective contraceptive measure during the trial and up to six months after treatment discontinuation, and fertile male patients must agree to refrain from fathering a child or donating sperm during the trial and up to four months after treatment discontinuation.
Exclusion criteria
1. Prior exposure to PM060184. 2. Known hypersensitivity to the study drug class or study drug excipient in the formulation. 3. Patients with locally advanced disease amenable to local and/or curative therapy (surgery or radiotherapy) at study entry. 4. Other serious and/or relevant diseases or clinical situations that, in the opinion of the Investigator, are incompatible with the protocol (including any of the following): 1. History of another neoplastic disease (except for basal cell carcinoma of the skin, superficial bladder tumors, or properly treated carcinoma in situ of the uterine cervix or melanoma in situ) unless in remission for at least five years and with no recurrence. 2. Symptomatic cerebral and/or leptomeningeal metastasis, spinal cord compression or carcinomatous meningitis. 3. Neuropathy of any etiology (other than that caused by previous antineoplastic therapy). 4. History of cardiac disease, such as myocardial infarction, in the year prior to registration in the clinical trial; symptomatic/uncontrolled angina pectoris; congestive heart failure or uncontrolled cardiac ischemia; any type of uncontrolled arrhythmia, congenital and/or prolonged QT interval or abnormal LVEF, or uncontrolled arterial hypertension (according to the standards of the World Health Organization \[WHO\]). 5. History of significant psychiatric disease. 6. Active infection requiring antibiotic, antifungal or antiviral treatment that, in the opinion of the Investigator, could compromise the patient's capacity to tolerate the therapy. 7. Known active liver (hepatitis B or C or cirrhosis) or renal disease. 8. Known human immunodeficiency virus (HIV) infection. 9. Any other concomitant pathology that could jeopardize the patient's safety or commitment to complete the clinical trial. 10. Inability or refusal to comply with the protocol or with the clinical trial procedures. 5. Pregnancy or lactation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-free Survival Rate at Three Months | Time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation, up to 3 months | Progression-free survival rate at 12 weeks (PFS3), defined as the rate estimate of the percentage of patients who are alive and progression-free at 12 weeks (\ 3 months) after the first treatment administration. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | From the first day of treatment to the date of death or last contact, up to 12 months | Overall Survival (OS), defined as the time from the first day of treatment to the date of death or last contact. |
| Progression Free Survival (PFS) | Time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation, up to 12 months | Progression-free survival (PFS), defined as the time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. |
| Overall Response Rate (ORR) | Time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation, up to 12 months | Overall Response Rate defined as the percentage of patients with either complete response (CR) or partial response (PR) according to RECIST v.1.1. CR, complete response: disappearance of all lesions; PD, disease progression: ≥10% increase in target lesion size and does not meet tumor density criteria of PR density; PR, partial response: ≥10% decrease in target lesion size or ≥15% decrease in tumor density; SD, stable disease: none of the CR, PR, or PD criteria met; RECIST, Response Evaluation Criteria in Solid Tumors |
Countries
Canada, Spain, United States
Participant flow
Recruitment details
The first informed consent was signed on 16 January 2018 and the first study treatment administration was on 8 February 2018. The cutoff date for the results was 11 February 2019 (date of last follow-up).
Participants by arm
| Arm | Count |
|---|---|
| PM060184 PM060184 was administered i.v. via a central line or a peripheral venous catheter (in 30-min administration) at a dose of 9.3 mg/m2 on Day 1 and Day 8 every three weeks (q3wk) (three weeks = one treatment cycle) (dose can be rounded to the first decimal point). | 32 |
| Total | 32 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 3 |
| Overall Study | Compassionate use | 1 |
| Overall Study | Never treated | 2 |
| Overall Study | Progressive disease | 25 |
| Overall Study | Withdrawal by Subject | 1 |
Baseline characteristics
| Characteristic | PM060184 |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 9 Participants |
| Age, Categorical Between 18 and 65 years | 23 Participants |
| Age, Continuous | 62 years |
| Best response to last prior therapy CR | 2 Participants |
| Best response to last prior therapy PD | 9 Participants |
| Best response to last prior therapy PR | 3 Participants |
| Best response to last prior therapy SD | 14 Participants |
| Best response to last prior therapy UK | 4 Participants |
| Body surface area | 1.8 m^2 |
| Eastern Cooperative Oncology Group Performance Status PS 0 | 15 Participants |
| Eastern Cooperative Oncology Group Performance Status PS 1 | 17 Participants |
| Height | 166 cm |
| Histology grade at diagnosis G1: Well differentiated | 8 Participants |
| Histology grade at diagnosis G2: Moderately differentiated | 18 Participants |
| Histology grade at diagnosis G4: Undifferentiated | 1 Participants |
| Histology grade at diagnosis GX: Grade cannot be assessed | 5 Participants |
| KRAS mutation status Mutated | 25 Participants |
| KRAS mutation status Not done | 6 Participants |
| KRAS mutation status Unknown | 1 Participants |
| Peripheral neuropathy No | 13 Participants |
| Peripheral neuropathy Yes | 19 Participants |
| Primary tumor side Left | 22 Participants |
| Primary tumor side Right | 10 Participants |
| Prior anticancer lines 1 line | 1 Participants |
| Prior anticancer lines 2 lines | 26 Participants |
| Prior anticancer lines 3 lines | 5 Participants |
| Prior radiotherapy Concurrent | 1 Participants |
| Prior radiotherapy No | 27 Participants |
| Prior radiotherapy Palliative | 4 Participants |
| Prior surgery No | 4 Participants |
| Prior surgery Yes | 28 Participants |
| Race/Ethnicity, Customized White | 32 Participants |
| Region of Enrollment Canada | 1 Participants |
| Region of Enrollment Spain | 31 Participants |
| Sex: Female, Male Female | 17 Participants |
| Sex: Female, Male Male | 15 Participants |
| Sites involved 1 site | 5 Participants |
| Sites involved 2 sites | 12 Participants |
| Sites involved 3 sites | 8 Participants |
| Sites involved 4 sites | 5 Participants |
| Sites involved 6 sites | 1 Participants |
| Sites involved 7 sites | 1 Participants |
| Stage at diagnosis Stage I | 1 Participants |
| Stage at diagnosis Stage IIIB | 5 Participants |
| Stage at diagnosis Stage IIIC | 2 Participants |
| Stage at diagnosis Stage IV | 17 Participants |
| Stage at diagnosis Stage IVA | 3 Participants |
| Stage at diagnosis Stage IVB | 3 Participants |
| Stage at diagnosis UK | 1 Participants |
| Time from diagnosis of advanced disease to study entry | 17.3 months |
| Time from first diagnosis to first PM060184 infusion | 22.9 months |
| Time from prior last progression before study entry | 1.2 months |
| Time from stop date of prior chemotherapy to study entry | 1.8 months |
| Weight | 67 Kg |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 16 / 30 |
| other Total, other adverse events | 30 / 30 |
| serious Total, serious adverse events | 6 / 30 |
Outcome results
Primary
Progression-free Survival Rate at Three Months
Progression-free survival rate at 12 weeks (PFS3), defined as the rate estimate of the percentage of patients who are alive and progression-free at 12 weeks (\ 3 months) after the first treatment administration. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions
Time frame: Time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation, up to 3 months
Population: 2 patients were never treated; 1 treated patient not receive 2 administrations over 2 cycles.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PM060184 | Progression-free Survival Rate at Three Months | 20.7 percentage of participants |
Secondary
Overall Response Rate (ORR)
Overall Response Rate defined as the percentage of patients with either complete response (CR) or partial response (PR) according to RECIST v.1.1. CR, complete response: disappearance of all lesions; PD, disease progression: ≥10% increase in target lesion size and does not meet tumor density criteria of PR density; PR, partial response: ≥10% decrease in target lesion size or ≥15% decrease in tumor density; SD, stable disease: none of the CR, PR, or PD criteria met; RECIST, Response Evaluation Criteria in Solid Tumors
Time frame: Time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation, up to 12 months
Population: 2 patients were never treated; 1 treated patient not receive 2 administrations over 2 cycles
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| PM060184 | Overall Response Rate (ORR) | SD <3 months | 9 Participants |
| PM060184 | Overall Response Rate (ORR) | SD ≥3 months | 7 Participants |
| PM060184 | Overall Response Rate (ORR) | PD | 13 Participants |
Secondary
Overall Survival (OS)
Overall Survival (OS), defined as the time from the first day of treatment to the date of death or last contact.
Time frame: From the first day of treatment to the date of death or last contact, up to 12 months
Population: 2 patients were never treated; 1 treated patient not receive 2 administrations over 2 cycles
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| PM060184 | Overall Survival (OS) | 9.8 months |
Secondary
Progression Free Survival (PFS)
Progression-free survival (PFS), defined as the time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time frame: Time from the first day of study treatment to the day of assessment of progression, death or last tumor evaluation, up to 12 months
Population: 2 patients were never treated; 1 treated patient not receive 2 administrations over 2 cycles
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| PM060184 | Progression Free Survival (PFS) | 2.6 months |