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    Clinical Trial Results:
    PHASE II STUDY EVALUATION OF EFFICACITY AND TOLERANCE OF REGORAFENIB FOR 70 YEARS OLD AND MORE PATIENTS WITH A METASTATIC COLORECTAL ADENOCARCIMA

    Summary
    EudraCT number
    2015-002086-29
    Trial protocol
    FR  
    Global end of trial date
    17 Oct 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    02 Apr 2022
    First version publication date
    02 Apr 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    FFCD1404
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02788006
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Fédération Francophone de Cancérologie Digestive (FFCD)
    Sponsor organisation address
    7 Bd Jeanne d'Arc, Dijon, France, 21000
    Public contact
    Karine Le Malicot - Head of Biostatistics, FEDERATION FRANCOPHONE DE CANCEROLOGIE DIGESTIVE, 33 380393479, karine.le-malicot@u-bourgogne.fr
    Scientific contact
    Karine Le Malicot - Head of Biostatistics, FEDERATION FRANCOPHONE DE CANCEROLOGIE DIGESTIVE, 33 380393479, karine.le-malicot@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
    21 Dec 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Aug 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    17 Oct 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This multicenter single-arm phase II enrolled patients ≥70 years old after the failure of fluoropyrimidine-based chemotherapy, anti-VEGF, and anti-EGFR treatment. The primary endpoint was disease control rate (DCR) 2 months after initiation of regorafenib (160 mg/day, 3 weeks on/1 week off). The mai objective is to assess the efficacy and safety of regorafenib at its approved dose in the older population.
    Protection of trial subjects
    The study was done in accordance with the Declaration of Helsinki (amended 2000) and the International Conference on Harmonization of Technical Requirements of Pharmaceuticals for Human Use (ICH) Note for Guidance on Good Clinical Practice and approved by the appropriate Ethics Committees.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    16 Nov 2015
    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: 43
    Worldwide total number of subjects
    43
    EEA total number of subjects
    43
    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)
    0
    From 65 to 84 years
    39
    85 years and over
    4

    Subject disposition

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    Recruitment
    Recruitment details
    Between January 2016 to April 2017, 43 patients were enrolled in the trial by 25 centers in France.

    Pre-assignment
    Screening details
    Before enrollement, standard examinations (biological, clinical, ECG) as well as geriatric questionnaires were done. In terms of imaging, abdominal and thoracic computed tomography scan or MRI were also done.

    Period 1
    Period 1 title
    Enrolled patients (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Regorafenib
    Arm description
    Regorafenib monotherapy at an initial dose of 160 mg once daily orally (21 days on, 7 days off treatment)
    Arm type
    Experimental

    Investigational medicinal product name
    Regorafenib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Dose of 160 mg once daily orally (21 days on, 7 days off treatment)

    Number of subjects in period 1
    Regorafenib
    Started
    43
    Treated patients
    42
    Completed
    42
    Not completed
    1
         Non treated patient
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Enrolled patients
    Reporting group description
    -

    Reporting group values
    Enrolled patients Total
    Number of subjects
    43 43
    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
    39 39
        85 years and over
    4 4
    Gender categorical
    Units: Subjects
        Female
    15 15
        Male
    28 28
    Subject analysis sets

    Subject analysis set title
    mITT for efficacy
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The modified intention-to-treat population for efficacy was defined as all patients included in the study who received at least one regorafenib tablet and had imaging or clinical evaluation within 2 months (+1 month) of starting treatment.

    Subject analysis set title
    mITT Population
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT population was defined as all patients included in the study who received at least one regorafenib tablet.

    Subject analysis sets values
    mITT for efficacy mITT Population
    Number of subjects
    35
    42
    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
    32
    38
        85 years and over
    3
    4
    Age continuous
    Units:
        
    ( )
    ( )
    Gender categorical
    Units: Subjects
        Female
        Male

    End points

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    End points reporting groups
    Reporting group title
    Regorafenib
    Reporting group description
    Regorafenib monotherapy at an initial dose of 160 mg once daily orally (21 days on, 7 days off treatment)

    Subject analysis set title
    mITT for efficacy
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The modified intention-to-treat population for efficacy was defined as all patients included in the study who received at least one regorafenib tablet and had imaging or clinical evaluation within 2 months (+1 month) of starting treatment.

    Subject analysis set title
    mITT Population
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT population was defined as all patients included in the study who received at least one regorafenib tablet.

    Primary: Disease control rate (DCR) under treatment

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    End point title
    Disease control rate (DCR) under treatment [1]
    End point description
    It was defined as the number of patients with a complete or partial response, or stable disease 2 months post-initiation of study therapy.
    End point type
    Primary
    End point timeframe
    At 2 months post-initiation of study therapy.
    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 single-arm study so no comparison with a another arm.
    End point values
    mITT for efficacy
    Number of subjects analysed
    35
    Units: patients
        Disease Control
    11
        No disease control
    24
    No statistical analyses for this end point

    Secondary: Progression-Free Survival

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    End point title
    Progression-Free Survival
    End point description
    End point type
    Secondary
    End point timeframe
    until the end of the follow-up or the apperance of progression or death
    End point values
    mITT Population
    Number of subjects analysed
    42
    Units: months
        median (confidence interval 95%)
    2.19 (1.97 to 3.29)
    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
    Until the end of the follow-up or death (Whatever the cause)
    End point values
    mITT Population
    Number of subjects analysed
    42
    Units: months
        median (confidence interval 95%)
    7.54 (5.52 to 10.58)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs (related and unrelated, expected and unexpected) occurring in the course of the study, from the signature of the informed consent form and until 30 days after the last dose of the study drug were reported by the investigator.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    NCI-CTC
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    mITT population
    Reporting group description
    All the patients included in the study having taken at least one dose of regorafenib.

    Serious adverse events
    mITT population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    17 / 42 (40.48%)
         number of deaths (all causes)
    36
         number of deaths resulting from adverse events
    0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Pulmonary embolism
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Hypertension
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Haematoma
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Tachycardia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebrovascular ischemia
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    5 / 42 (11.90%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Deshydratation
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    mITT population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    42 / 42 (100.00%)
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    21 / 42 (50.00%)
         occurrences all number
    21
    Alanine aminotransferase increased
         subjects affected / exposed
    12 / 42 (28.57%)
         occurrences all number
    12
    Total Bilirubin increased
         subjects affected / exposed
    22 / 42 (52.38%)
         occurrences all number
    22
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    31 / 42 (73.81%)
         occurrences all number
    31
    White blood cell count decreased
         subjects affected / exposed
    4 / 42 (9.52%)
         occurrences all number
    4
    Lipase increased
         subjects affected / exposed
    7 / 42 (16.67%)
         occurrences all number
    7
    Neutrophils decreased
         subjects affected / exposed
    4 / 42 (9.52%)
         occurrences all number
    4
    Lymhocytes decreased
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Phosphatases Alcalines increased
         subjects affected / exposed
    21 / 42 (50.00%)
         occurrences all number
    21
    Platelets decreased
         subjects affected / exposed
    20 / 42 (47.62%)
         occurrences all number
    20
    Cardiac disorders
    Hypertension
         subjects affected / exposed
    12 / 42 (28.57%)
         occurrences all number
    12
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Dysgueusia
         subjects affected / exposed
    4 / 42 (9.52%)
         occurrences all number
    4
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    19 / 42 (45.24%)
         occurrences all number
    19
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    34 / 42 (80.95%)
         occurrences all number
    34
    Pyrexia
         subjects affected / exposed
    7 / 42 (16.67%)
         occurrences all number
    7
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    13 / 42 (30.95%)
         occurrences all number
    13
    Diarrhoea
         subjects affected / exposed
    17 / 42 (40.48%)
         occurrences all number
    17
    Abdominal pain
         subjects affected / exposed
    9 / 42 (21.43%)
         occurrences all number
    9
    Stomatitis
         subjects affected / exposed
    7 / 42 (16.67%)
         occurrences all number
    7
    Nausea
         subjects affected / exposed
    5 / 42 (11.90%)
         occurrences all number
    5
    Respiratory, thoracic and mediastinal disorders
    Dysphonia
         subjects affected / exposed
    11 / 42 (26.19%)
         occurrences all number
    11
    Skin and subcutaneous tissue disorders
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    18 / 42 (42.86%)
         occurrences all number
    18
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    9 / 42 (21.43%)
         occurrences all number
    9
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    9 / 42 (21.43%)
         occurrences all number
    9
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Myalgia
         subjects affected / exposed
    6 / 42 (14.29%)
         occurrences all number
    6
    Hypokaliemia
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    23 / 42 (54.76%)
         occurrences all number
    23
    Hyperkalaemia
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Hypoalbuminaemia
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Hypocalcaemia
         subjects affected / exposed
    15 / 42 (35.71%)
         occurrences all number
    15
    Hypomagnesaemia
         subjects affected / exposed
    5 / 42 (11.90%)
         occurrences all number
    5
    Hyponatremia
         subjects affected / exposed
    9 / 42 (21.43%)
         occurrences all number
    9
    Hypophosphataemia
         subjects affected / exposed
    9 / 42 (21.43%)
         occurrences all number
    9

    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? No

    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/32334940
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