Colo-rectal Cancer
Conditions
Brief summary
Patients with pretreated advanced colorectal cancer are recruited to the phase I portion of this prospective non-randomised study in an escalated dose cohort. The primary endpoint of the dose-escalation phase is to determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of anlotinib when given in combination with irinotecan. The phase II (dose-expansion) portion is designed to characterize the safety and potential efficacy of the combination therapy in pretreated advanced colorectal cancer patients.
Interventions
Dose escalation of anlotinib starts from 8mg qd d1-14/q21d in combination with fixed dose of irinotecan at 180mg/m2 d1/q14d.
Sponsors
Study design
Eligibility
Inclusion criteria
Subjects must meet all of the following inclusion criteria to be eligible for enrollment into the study: * willing and able to provide written informed consent and comply with the requirements of the study * histologically- or cytologically-confirmed advanced colorectal cancer * failed or intolerable to at least one prior therapy * have evidence of measurable disease per RECIST v1.1 * Eastern Collaborative Oncology Group (ECOG) Performance Status ≤ 1 * weight ≥40kg * life expectancy \>12 weeks
Exclusion criteria
Subjects meeting any of the following criteria are ineligible for participation in the study: * history of any anti-cancer therapy (including investigational agents) within 28 days prior to study entry * presence of toxicity of prior anti-cancer therapy that has not resolved to Grade 1, as determined by National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.03 * symptomatic brain metastasis requiring active treatment * any previous malignancy, except for non squamous-cell carcinoma of skin or carcinoma-in-situ of the uterine cervix within 5 years prior to study entry * active or clinically unstable infection requiring systemic therapy * unable to swallow oral medications or with gastrointestinal disorders that might interfere with proper absorption of oral drugs * active digestive ulcer disease, inflammatory bowel disease, intestinal obstruction or any other condition that, in the clinical judgment of the Principal Investigator, may cause severe gastrointestinal bleeding or perforation * unstable pulmonary embolism, deep vein thrombosis, or other significant arterial/venous thromboembolic event ≤2 months prior to study entry * history of stroke or transient ischemic attack (TIA) within 12 months prior to study entry * any of the following abnormal findings in organ or marrow function 1 week prior to study entry: * Leukocytes \< 1.5\*10\^9/L, or Platelets \< 100\*10\^9/L, or Hb\< 90g/L * Total bilirubin \> 1.5 × institutional upper limit of normal (ULN), or AST (aspartate amino transferase)/ALT (alanine amino transferase)\> 3 × institutional ULN for liver metastases, \> 1.5 × institutional ULN in case of no liver metastases * any electrolyte imbalance of clinical significance * creatinine \> institutional ULN and creatinine clearance \< 60 mL/min * spot urine protein ≥(2+) or 24-hour proteinuria ≥1.0g/24h * APTT (activated partial thromboplastin time) or INR (international normalized ratio for prothrombin time) \> 1.5 × institutional ULN * treatment refractory hypertension defined as a blood pressure of systolic\> 140 millimeter of mercury (mm Hg) and/or diastolic \> 90 mm Hg which cannot be controlled by a single anti-hypertensive agent * LVEF (left ventricular ejection fraction ) \<50% * history of acute coronary syndromes (including myocardial infarction and unstable angina), coronary artery bypass graft within 6 months prior to study entry, or history or evidence of current ≥ Class II congestive heart failure as defined by New York Heart Association (NYHA) * present with non-healing fractures of bone or wounds of skin * pregnant or lactating female * sexually active female (of childbearing potential) or male unwilling to adopt an effective method of birth control during the course of the study * serious and/or unstable pre-existing psychiatric disorder * familial, sociological or geographical conditions that, in the clinical judgment of the Principal Investigator, do not permit compliance with the protocol * known immediate or delayed hypersensitivity reaction to anlotinib, irinotecan or their excipients * administration of irinotecan in prior treatments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MTD | 6 months | the maximum tolerated dose (MTD) of Anlotinib when administered in combination with fixed dose of irinotecan in advanced colorectal cancer patients. |
| ORR | 18 months | the overall response rate (ORR) of Anlotinib when administered in combination with fixed dose of irinotecan in advanced colorectal cancer patients. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| DCR | 18 months | the disease control rate (DCR) of the combination of Anlotinib with Irinotecan in pretreated advanced colorectal cancer patients. |
| PFS | 18 months | the progression free survival (PFS) of the combination of Anlotinib with Irinotecan in pretreated advanced colorectal cancer patients. |
Countries
China