E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
UNRESECTABLE KRAS WILD-TYPE METASTATIC COLORECTAL CANCER PATIENTS |
PAZIENTI CON CARCINOMA COLORETTALE METASTATICO NON RESECABILE KRAS WILD-TYPE |
|
E.1.1.1 | Medical condition in easily understood language |
Patients with metastatic colorectal cancer KRAS `wild Type` |
Pazienti affetti da neoplasia del colon-retto metastica KRAS `wild Type` |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10050035 |
E.1.2 | Term | Metastatic colon cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
10 months-Progression Free Rate (10m-PFR) |
Tasso di pazienti liberi da progressione a 10 mesi (10m-PFR) |
|
E.2.2 | Secondary objectives of the trial |
• Response rate, • Resection Rate, • Time to strategy failure, • Time to 2nd PD, • Progression Free Survival (PFS), • Overall Survival (OS), • Safety profile |
• Tasso di risposte obiettive • Resezioni chirurgiche secondarie • Tempo al fallimento della strategia • Tempo alla seconda progressione • Sopravvivenza libera da progressione • Sopravvivenza globale • Profilo di tollerabilita' |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Histologically confirmed colorectal adenocarcinoma; Availability of formalin-fixed paraffin embedded tumor block from primary and/or metastasis; KRAS wild-type status of primary colorectal cancer or related metastasis; Unresectable and measurable metastatic disease according to RECIST criteria; Male or female, aged > 18 years and < 75 years; ECOG PS < 2 if aged < 71 years, ECOG PS = 0 if aged 71-75 years; Life expectancy of more than 3 months; Adequate haematological function: ANC ≥ 1.5 x 109/L; platelets ≥ 100 x 109/L, Hb ≥ 9 g/dL; Adequate liver and renal function: serum bilirubin ≤ 1.5 x ULN; alkaline phosphatase and transaminases ≤ 2.5 x ULN (in case of liver metastases < 5 x ULN); serum creatinine ≤ 1.5 x ULN; Previous adjuvant chemotherapy containing oxaliplatin is allowed if more than 12 months have elapsed between the end of adjuvant therapy and first relapse; Previous adjuvant chemotherapy with fluoropyrimidine monotherapy is allowed if more than 6 months have elapsed between the end of adjuvant and first relapse; At least 6 weeks from prior extended radiotherapy and 4 weeks from surgery; Written informed consent to experimental treatment and KRAS analysis |
Diagnosi confermata istologicamente di adenocarcinoma del colon-retto Disponibilita' di campione tissutale archiviato in paraffina da tumore primitivo e/o metastasi Stato mutazionale KRAS wild-type determinato su campione di tumore primitivo o metastasi Malattia metastatica non resecabile e misurabile secondo i criteri RECIST Sesso maschile o femminile, eta' compresa tra 18 e 75 anni ECOG PS < o = 2 se eta' < 71 anni o ECOG PS = 0 se eta' compresa tra 71 e 75 anni Aspettativa di vita superiore a 3 mesi Adeguata funzionalita' midollare: Neutrofili > o = 1.5 x 109/L; Piastrine > o = 100 x 109/L, Emoglobina >9 g/dl Adeguata funzionalita' epatica e renale: bilirubinemia < o = 1.5 x valore normale; fosfatasi alcalina e transaminasi < o = 2.5 x valore normale (in presenza di metastasi epatiche < 5 x valore normale); creatininemia < o = 1.5 x valore normale o clearance della creatinina > 50 mL/min Precedente terapia adiuvante contenente oxaliplatino e' consentita solo se sono trascorsi almeno 12 mesi tra il termine della terapia adiuvante e la ripresa di malattia Precedente terapia adiuvante con fluoropirimidina in monoterapia e' consentita purche' siano trascorsi almeno 6 mesi tra il termine della terapia adiuvante e la ripresa di malattia Precedente radioterapia su campi estesi e/o chirurgia maggiore sono consentite purche' siano trascorse almeno 6 e 4 settimane rispettivamente Consenso informato scritto al trattamento e all`analisi mutazionale di KRAS |
|
E.4 | Principal exclusion criteria |
Prior palliative chemotherapy; Prior treatment with EGFR or VEGF inhibitors; Symptomatic peripheral neuropathy > 2 grade NCIC-CTG criteria; Presence or history of CNS metastasis; Active uncontrolled infections; active disseminated intravascular coagulation; Past or current history of malignancies other than colorectal carcinoma, except for curatively treated basal and squamous cell carcinoma of the skin cancer or in situ carcinoma of the cervix; Clinically significant cardiovascular disease: cerebrovascular accidents or myocardial infarction in the 12 months before treatment start, unstable angina, grade 2 NYHA chronic heart failure, uncontrolled arrhythmia, uncontrolled hypertension; Serious, non-healing wound, ulcer, or bone fracture; Evidence of bleeding diathesis or coagulopathy; Major surgical procedure or significant traumatic injury within 28 days prior to study treatment start; Current or recent (within 10 days prior to study treatment start) ongoing treatment with anticoagulants for therapeutic purposes or chronic, daily treatment with high-dose aspirin (>325 mg/day); Subtotal colectomy, malabsorption syndrome and chronic inflammatory bowel disease (i.e. ulcerative colitis, Chron syndrome); Fertile women (<2 years after last menstruation) and men of childbearing potential not willing to use effective means of contraception. |
Precedente trattamento chemioterapico per la malattia metastatica Precedente trattamento con inibitori di EGFR o VEGF Neuropatia periferica sintomatica di grado > o = 2 secondo i criteri NCIC-CTC Presenza o storia di metastasi al SNC Infezioni attive non controllate; coagulazione intravascolare disseminata attiva Storia passata o attuale di neoplasia maligna diversa dal carcinoma colorettale, ad eccezione di carcinoma a cellule squamose e basalioma della cute trattato in modo curativo o carcinoma in situ della cervice uterina Malattia cardiovascolare clinicamente significativa: eventi cerebrovascolari o infarti miocardici occorsi entro 12 mesi dall`inizio del trattamento, angina instabile, scompenso cardiaco cronico grado NYHA > o = 2, aritmie incontrollate, ipertensione incontrollata. Presenza di ferite severe non cicatrizzate, ulcere in atto o fratture ossee Evidenza di diatesi emorragica o coagulopatie Procedura chirurgica maggiore o evento traumatico significativo entro 28 giorni prima dell`inizio del trattamento in studio |
|
E.5 End points |
E.5.1 | Primary end point(s) |
10 months-Progression Free Rate (10m-PFR) |
Tasso di pazienti liberi da progressione a 10 mesi (10m-PFR) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 31 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 30 |
E.8.9.1 | In the Member State concerned days | 0 |