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    Clinical Trial Results:
    EFFICACY AND SAFETY of aflibercept ASSOCIATED WITH A FOLFIRI CHEMOTHERAPY IN 1ST LINE TREATMENT OF PATIENTS SUFFERING FROM METASTATIC COLORECTAL CANCER Phase II - single arm - multicenter

    Summary
    EudraCT number
    2013-004081-33
    Trial protocol
    FR  
    Global end of trial date
    25 Sep 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    24 Jul 2024
    First version publication date
    24 Jul 2024
    Other versions
    Summary report(s)
    FFCD 1302 Princeps Publication

    Trial information

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    Trial identification
    Sponsor protocol code
    FFCD1302
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02181556
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Fédération Francophonce de Cancérologie Digestive (FFCD)
    Sponsor organisation address
    7 bd Jeanne d'ARC, Dijon, France, 21079
    Public contact
    FFCD, Fédération Francophone de cancérologie digestive, marie.moreau@u-bourgogne.fr
    Scientific contact
    FFCD, Fédération Francophone de cancérologie digestive, marie.moreau@u-bourgogne.fr
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    25 Sep 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    15 Feb 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    25 Sep 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the patients rate without progression or death at 6 months (RECIST version 1.1) according to the investigator
    Protection of trial subjects
    The trial was conducted in accordance with the European Directive 2001/20/EC. The investigator obtained the patient's consent for the clinical and the biological studies after providing them adequate information.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    06 Jan 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 40
    Worldwide total number of subjects
    40
    EEA total number of subjects
    40
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    21
    From 65 to 84 years
    19
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was planned to be a 2-steps study. it was stopped at step 1. 41 patients were included by 9 centers between October 2014 and February 2017, including 33 patients from step 1, and 9 patients included in the trial during the 6-month follow-up period. One patient withdrew his consent and was not analyzed

    Pre-assignment
    Screening details
    -

    Pre-assignment period milestones
    Number of subjects started
    40
    Number of subjects completed
    40

    Period 1
    Period 1 title
    mITT (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    Open study

    Arms
    Arm title
    Folfiri + Aflibercept
    Arm description
    Every 14 days, eligible patients received 4 mg/kg of aflibercept intravenously [IV], over 1 hour, followed immediately by the FOLFIRI regimen (irinotecan 180mg/m2 IV over 90 minutes, with leucovorin 400 mg/m2 IV over 2 hours, followed by 5-FU 400 mg/m2 bolus and 5-FU 2400 mg/m2 continuous infusion over 46 hours). Patients were treated until occurrence of disease progression or unacceptable toxicity according to physician judgment.
    Arm type
    Experimental

    Investigational medicinal product name
    FOLFIRI
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Every 14 days, FOLFIRI regimen (irinotecan 180mg/m2 IV over 90 minutes, with leucovorin 400 mg/m2 IV over 2 hours, followed by 5-FU 400 mg/m2 bolus and 5-FU 2400 mg/m2 continuous infusion over 46 hours)

    Investigational medicinal product name
    Aflibercept
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Every 14 days, eligible patients received 4 mg/kg of aflibercept intravenously

    Number of subjects in period 1
    Folfiri + Aflibercept
    Started
    40
    Completed
    40

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    mITT
    Reporting group description
    -

    Reporting group values
    mITT Total
    Number of subjects
    40 40
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    21 21
        From 65-84 years
    19 19
        85 years and over
    0 0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    64.85 (61.15 to 71.30) -
    Gender categorical
    Units: Subjects
        Female
    23 23
        Male
    17 17

    End points

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    End points reporting groups
    Reporting group title
    Folfiri + Aflibercept
    Reporting group description
    Every 14 days, eligible patients received 4 mg/kg of aflibercept intravenously [IV], over 1 hour, followed immediately by the FOLFIRI regimen (irinotecan 180mg/m2 IV over 90 minutes, with leucovorin 400 mg/m2 IV over 2 hours, followed by 5-FU 400 mg/m2 bolus and 5-FU 2400 mg/m2 continuous infusion over 46 hours). Patients were treated until occurrence of disease progression or unacceptable toxicity according to physician judgment.

    Subject analysis set title
    mITT set
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The modified intent-to-treat population wasdefined as all patients included in the study, regardless of eligibility criteria and treatment received, with at least a radiological evaluation during the 6 months of treatment.

    Primary: Rate of patients alive and without progression 6 months after inclusion

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    End point title
    Rate of patients alive and without progression 6 months after inclusion [1]
    End point description
    Progression wasdefined by : • Progression assessed by CT scan, according to the RECIST version 1.1 criteria; • Death from any cause. Patients without an assessment at 6 months were reviewed according to the following rules: • If the patient had a later evaluation (7 months or more) and was not progressing at that time, then the patient was considered progression-free at 6 months; • If the patient presented a documented progression within 2 months of the 6 month assessment then the patient was considered to be progressing at 6 months. If the progression wasdocumented beyond 8 months then the patient was not considered progressive at 6 months; • If a progression wasdocumented prior to the 6-month assessment, the patient was considered progressive at 6 months.
    End point type
    Primary
    End point timeframe
    6 months after inclusion
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: This study is a one-arm study so no statistical inference analysis was done.
    End point values
    Folfiri + Aflibercept
    Number of subjects analysed
    40
    Units: patients
        Patients alive without progression
    18
        Patients with progression and/or death
    15
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    It was defined as the time interval between the inclusion date and the date of death (regardless of cause). Patients lost to follow-up or alive at the time of analysis were censored as of the date of last news.
    End point type
    Secondary
    End point timeframe
    30 months
    End point values
    Folfiri + Aflibercept
    Number of subjects analysed
    40
    Units: months
        median (confidence interval 95%)
    18.63 (14.69 to 30.65)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events are collected before each cycle od chemotherapy systematically during the whole protocol of treatment
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    NCI-CTC
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    mITT patients
    Reporting group description
    -

    Serious adverse events
    mITT patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    21 / 40 (52.50%)
         number of deaths (all causes)
    25
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    infected neoplasm
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Hypertension
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Phlebitis
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebellar infraction
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile bone narrow aplasia
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Small bowel perforation
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal vein thrombosis
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Device related infection
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    mITT patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    40 / 40 (100.00%)
    Investigations
    ALAT Increased
         subjects affected / exposed
    24 / 40 (60.00%)
         occurrences all number
    24
    ASAT Increased
         subjects affected / exposed
    25 / 40 (62.50%)
         occurrences all number
    25
    Creatinine increased
         subjects affected / exposed
    13 / 40 (32.50%)
         occurrences all number
    13
    GGT increased
         subjects affected / exposed
    36 / 40 (90.00%)
         occurrences all number
    36
    Leucopenia
         subjects affected / exposed
    20 / 40 (50.00%)
         occurrences all number
    20
    Neutropenia
         subjects affected / exposed
    26 / 40 (65.00%)
         occurrences all number
    26
    Weight loss
         subjects affected / exposed
    8 / 40 (20.00%)
         occurrences all number
    8
    PAL increased
         subjects affected / exposed
    29 / 40 (72.50%)
         occurrences all number
    29
    Thrombopenia
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    6
    Vascular disorders
    Haemorrhage
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Hypertension
         subjects affected / exposed
    20 / 40 (50.00%)
         occurrences all number
    20
    Nervous system disorders
    Cephalgia
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Peripheral neuropathy
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Paresthesia
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    6
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    30 / 40 (75.00%)
         occurrences all number
    30
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    34 / 40 (85.00%)
         occurrences all number
    34
    Fever
         subjects affected / exposed
    14 / 40 (35.00%)
         occurrences all number
    14
    Inferior member oedema
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    5
    Diarrhoea
         subjects affected / exposed
    31 / 40 (77.50%)
         occurrences all number
    31
    Abdominal pain
         subjects affected / exposed
    18 / 40 (45.00%)
         occurrences all number
    18
    Dyspepsia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Rectal haemorrhage
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Mucositis
         subjects affected / exposed
    23 / 40 (57.50%)
         occurrences all number
    23
    Rectal mucositis
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Nausea
         subjects affected / exposed
    29 / 40 (72.50%)
         occurrences all number
    29
    Vomiting
         subjects affected / exposed
    16 / 40 (40.00%)
         occurrences all number
    16
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Epistaxis
         subjects affected / exposed
    10 / 40 (25.00%)
         occurrences all number
    10
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    14 / 40 (35.00%)
         occurrences all number
    14
    Cutaneous dryness
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Palmo-palmar syndrom
         subjects affected / exposed
    9 / 40 (22.50%)
         occurrences all number
    9
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    13 / 40 (32.50%)
         occurrences all number
    13
    Musculoskeletal and connective tissue disorders
    Dorsalgia
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    12 / 40 (30.00%)
         occurrences all number
    12
    Hypoalbuminemia
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Hypocalcemia
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Hypokaliemia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Hyponatremia
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    03 May 2017
    Inclusions were stopped at the interim analysis because the combination was considered as non-efficient
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/32921581
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