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    Clinical Trial Results:
    Phase II study of Regorafenib as single agent for the treatment of patients with metastatic colorectal cancer (mCRC) with any RAS or BRAF mutation previously treated with FOLFOXIRI plus bevacizumab.

    Summary
    EudraCT number
    2014-000703-26
    Trial protocol
    ES  
    Global end of trial date
    24 May 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Jul 2020
    First version publication date
    16 Jul 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    TTD-14-01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02175654
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    GRUPO DE TRATAMIENTO DE TUMORES DIGESTIVOS (TTD)
    Sponsor organisation address
    PLAZA DE CASTILLA 3, PTA 8, MADRID, Spain, 28023
    Public contact
    TTD group, TTD, +34 91378 82 75, ttd@ttdgroup.org
    Scientific contact
    TTD group, TTD, +34 91378 82 75, ttd@ttdgroup.org
    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
    20 Jun 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    24 May 2016
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    -To assess the efficacy of single-agent regorafenib in the second-line treatment in metastatic colorectal cancer with any RAS or BRAF mutation previously treated with FOLFOXIRI plus bevacizumab in terms of progression-free survival at 6 months.
    Protection of trial subjects
    While on trial, teh patients´best interest was always tried to be ensured, but no specific protection measures were adopted.
    Background therapy
    Currently, the first-line treatment strategy established for patients with metastatic colorectal cancer without mutations in RAS (native RAS) is based on the administration of a biological drug (anti-EGFR or an antiangiogenic), in combination with a chemotherapy regimen based on fluoropyrimidines and oxaliplatin or irinotecan. The therapeutic options after the failure of this strategy depend on the treatment used in the first-line environment, therefore oxaliplatin-based regimens are used in patients who have received chemotherapy based on irinotecan in the first line and regimens based on irinotecan in those who have received oxaliplatin in the first line. This treatment strategy, however, is limited in patients with mutated RAS tumors because they are not eligible for anti-EGFR treatment.
    Evidence for comparator
    The concomitant treatment of three of the most active chemotherapeutic agents in mCRC (5-FU, oxaliplatin and irinotecan) in combination with bevacizumab has shown high activity and efficacy as a first-line treatment in patients with mCRC, with manageable toxicity. However, there is no scientific evidence about the best treatment option for patients with mCRC and mutations in RAS or BRAF who have failed a first-line treatment with FOLFOXIRI plus bevacizumab.
    Actual start date of recruitment
    12 Sep 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
    Spain: 15
    Worldwide total number of subjects
    15
    EEA total number of subjects
    15
    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)
    9
    From 65 to 84 years
    6
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    - Recruitment dates: 12/09/14 to 27/11/15. - A total of 15 patients were recruited in 10 Spanish hospitals.

    Pre-assignment
    Screening details
    - Eligibility criteria: Patients with metastatic colon/rectum adenocarcinoma with mutations in any gen RAS or BRAF, who have had progression disease after a firstt line treatment with FOLFOXIRI, have measurable disease according to RECIST 1.1, an ECOG 0-1, adequate bone narrow, kidney and liver function and had not recieved regorafenib.

    Period 1
    Period 1 title
    OVERALL TRIAL (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    This trial was not blinded.

    Arms
    Arm title
    TREATMENT OVEALL POPULATION
    Arm description
    Regorafenib at the initial dose of 160 mg dadily, 3 weeks on and one off, with cycles of 28 days. Treatment will maintained until progressive disease, unacceptable toxicity, withdrawal of the consent or investigator´s decision.
    Arm type
    Experimental

    Investigational medicinal product name
    REGORAFENIB
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Regorafenib was administres at an initial dose o 160 mg/day, three weeks on and one week off.

    Number of subjects in period 1
    TREATMENT OVEALL POPULATION
    Started
    15
    Completed
    15

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    OVERALL TRIAL
    Reporting group description
    -

    Reporting group values
    OVERALL TRIAL Total
    Number of subjects
    15 15
    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)
    0 0
        From 65-84 years
    0 0
        85 years and over
    0 0
        From 18 years
    15 15
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    64.73 ± 8.81 -
    Gender categorical
    Units: Subjects
        Female
    2 2
        Male
    13 13
    KRAS STATUS
    Units: Subjects
        KRAS MUTATED
    9 9
        KRAS WILD-TYPE
    6 6
        KRAS ND
    0 0
    BRAF STATUS
    Units: Subjects
        BRAF MUTATED
    2 2
        BRAF WILD-TYPE
    12 12
        BRAF ND
    1 1
    NRAS STATUS
    Units: Subjects
        NRAS MUTATED
    3 3
        NRAS WILD-TYPE
    3 3
        NRAS ND
    9 9
    RAS STATUS
    RAS status considering both genes, KRAS and NRAS
    Units: Subjects
        RAS MUTATED
    12 12
        RAS WILD-TYPE
    2 2
        RAS ND
    1 1
    Subject analysis sets

    Subject analysis set title
    INTENT-TO-TREAT POPULAITON
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT- populations includes all those patients who were enrolled in the trial and recieved, at least, one dose of the study drug.

    Subject analysis sets values
    INTENT-TO-TREAT POPULAITON
    Number of subjects
    15
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
        From 18 years
    15
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    64.73 ± 8.81
    Gender categorical
    Units: Subjects
        Female
    2
        Male
    13
    KRAS STATUS
    Units: Subjects
        KRAS MUTATED
    9
        KRAS WILD-TYPE
    6
        KRAS ND
    0
    BRAF STATUS
    Units: Subjects
        BRAF MUTATED
    2
        BRAF WILD-TYPE
    12
        BRAF ND
    1
    NRAS STATUS
    Units: Subjects
        NRAS MUTATED
        NRAS WILD-TYPE
        NRAS ND
    RAS STATUS
    RAS status considering both genes, KRAS and NRAS
    Units: Subjects
        RAS MUTATED
    12
        RAS WILD-TYPE
    2
        RAS ND
    1

    End points

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    End points reporting groups
    Reporting group title
    TREATMENT OVEALL POPULATION
    Reporting group description
    Regorafenib at the initial dose of 160 mg dadily, 3 weeks on and one off, with cycles of 28 days. Treatment will maintained until progressive disease, unacceptable toxicity, withdrawal of the consent or investigator´s decision.

    Subject analysis set title
    INTENT-TO-TREAT POPULAITON
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT- populations includes all those patients who were enrolled in the trial and recieved, at least, one dose of the study drug.

    Primary: PFS at 6 months of study entry

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    End point title
    PFS at 6 months of study entry
    End point description
    PFS at 6 months of study entry
    End point type
    Primary
    End point timeframe
    Overall trial
    End point values
    TREATMENT OVEALL POPULATION INTENT-TO-TREAT POPULAITON
    Number of subjects analysed
    15
    15
    Units: Percentage
    0
    0
    Statistical analysis title
    PFS at 6 months of study entry
    Comparison groups
    TREATMENT OVEALL POPULATION v INTENT-TO-TREAT POPULAITON
    Number of subjects included in analysis
    30
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.05
    Method
    CI estimation
    Confidence interval

    Secondary: PROGRESSION-FREE SURVIVAL (PFS)

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    End point title
    PROGRESSION-FREE SURVIVAL (PFS)
    End point description
    End point type
    Secondary
    End point timeframe
    Defined as time from the study entry to first radiographic progression disease or death. Those patients not fulfilling these creteria were censored at the time of the last evaluable visit of the patient.
    End point values
    TREATMENT OVEALL POPULATION INTENT-TO-TREAT POPULAITON
    Number of subjects analysed
    15
    15
    Units: Months
        median (confidence interval 95%)
    2.24 (1.18 to 2.70)
    2.24 (1.18 to 2.70)
    No statistical analyses for this end point

    Secondary: TIME TO PROGRESSION

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    End point title
    TIME TO PROGRESSION
    End point description
    End point type
    Secondary
    End point timeframe
    Time from study entry to the date of the first progression disease or death. Those patients not fulfilling these criteria were censored at the time of the last evaluable visit.
    End point values
    INTENT-TO-TREAT POPULAITON
    Number of subjects analysed
    15
    Units: Months
        median (confidence interval 95%)
    2.01 (1.18 to 2.66)
    No statistical analyses for this end point

    Secondary: TIME TO TREATMENT FAILURE

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    End point title
    TIME TO TREATMENT FAILURE
    End point description
    End point type
    Secondary
    End point timeframe
    Time from study entry to the end date of treatment, whatever the reason was.
    End point values
    INTENT-TO-TREAT POPULAITON
    Number of subjects analysed
    15
    Units: Months
        median (confidence interval 95%)
    2.27 (1.25 to 2.60)
    No statistical analyses for this end point

    Secondary: OVERALL SURVIVAL

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    End point title
    OVERALL SURVIVAL
    End point description
    End point type
    Secondary
    End point timeframe
    Time from the study entry to the date of death by any cause.
    End point values
    INTENT-TO-TREAT POPULAITON
    Number of subjects analysed
    15
    Units: Months
        median (confidence interval 95%)
    3.35 (1.94 to 4.37)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were registered from the time of the ICF signature to 28 days after the last dose of the study frug.
    Adverse event reporting additional description
    Each event was described in detail along with the start and end dates, the intensity, the relationship with the product under investigation, the measures taken and the outcome.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    OVERALL POPULATION
    Reporting group description
    The adverse events will be described in the overall population of this study because the overall population recieved at least one dose of treatment and represent the safety population.

    Serious adverse events
    OVERALL POPULATION
    Total subjects affected by serious adverse events
         subjects affected / exposed
    10 / 15 (66.67%)
         number of deaths (all causes)
    10
         number of deaths resulting from adverse events
    5
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    PROGRESSION DISEASE
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Asthenia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    THORACIC PAIN
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sudden death
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Gastrointestinal disorders
    DIARRHEA
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    ABDOMINAL PAIN
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    INTESTINAL BLEEDING
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Hepatobiliary disorders
    HEPATIC INSUFICIENCY
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Infections and infestations
    INFECTION OF THE CATHETER SITE
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0.01%
    Non-serious adverse events
    OVERALL POPULATION
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    15 / 15 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Disease progression
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    General disorders and administration site conditions
    ASTHENIA
         subjects affected / exposed
    10 / 15 (66.67%)
         occurrences all number
    10
    Proctalgia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Pyrexia
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Physical disability
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    THORACIC PAIN
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    THORACIC NOT CARDIAC PAIN
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Sudden death
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Dysphonia
         subjects affected / exposed
    5 / 15 (33.33%)
         occurrences all number
    5
    Hippus
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Epistaxis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Cough
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Respiratory disorder
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Aphonia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Insomnia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Investigations
    BILIRUBIN INCREASED
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    ALCALINE PHOSPHATASE INCREASED
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Weight decreased
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Dysgeusia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Neuropathy peripheral
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Thrombocytopenia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Ear and labyrinth disorders
    ACUPHENES
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Eye disorders
    Eye irritation
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    9 / 15 (60.00%)
         occurrences all number
    9
    Abdominal pain
         subjects affected / exposed
    8 / 15 (53.33%)
         occurrences all number
    8
    Abdominal pain upper
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Constipation
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    NAUSEA
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Vomiting
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Dyspepsia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Stomatitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Atrophic glossitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Rectal haemorrhage
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Anal inflammation
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Odynophagia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Intestinal perforation
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Proctalgia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Hepatobiliary disorders
    Hepatic failure
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    ERUPTION
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Hyperhidrosis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Pigmentation disorder
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Renal failure
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Proteinuria
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    EXTREMITY PAIN
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Myalgia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Infections and infestations
    Oral candidiasis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Gingivitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Catheter site infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Hyperglycaemia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Nov 2015
    CHANGE IP
    01 Feb 2016
    PREMATURE END OF STUDY BECAUSE OF LOW RECRUITMENT

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    01 Feb 2016
    PREMATURE END OF STUDY BECAUSE OF LOW RECRUITMENT
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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