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    Clinical Trial Results:
    A randomised, open-label, multi-centre, two-arm Phase 3 study comparing futuximab/modotuximab in combination with trifluridine/tipiracil to trifluridine/tipiracil single agent with a Safety Lead-In part in participants with KRAS/NRAS and BRAF wild type metastatic colorectal cancer previously treated with standard treatment and anti-EGFR therapy

    Summary
    EudraCT number
    2021-003151-41
    Trial protocol
    DK   BE   FI   HU   PL  
    Global end of trial date
    21 Jun 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    25 Jan 2024
    First version publication date
    25 Jan 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CL3-95026-001
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05223673
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Institut de Recherches Internationales Servier (I.R.I.S.)
    Sponsor organisation address
    50 rue Carnot, Suresnes Cedex, France, 92284
    Public contact
    Clinical Studies Department, Institut de Recherches Internationales Servier, +33 155724366, clinicaltrials@servier.com
    Scientific contact
    Clinical Studies Department, Institut de Recherches Internationales Servier, +33 155724366, clinicaltrials@servier.com
    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 Jun 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    21 Jun 2023
    Global end of trial reached?
    Yes
    Global end of trial date
    21 Jun 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Safety Lead-In part: - Assessment of safety and tolerability of futuximab/modotuximab in combination with trifluridine/tipiracil according to National Cancer Institute Comment Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0. Phase III part: - Compare overall survival (OS) of futuximab/modotuximab in combination with trifluridine/tipiracil versus trifluridine/tipiracil monotherapy in participants with tumours that are KRAS/NRAS and BRAF wild-type (WT) (Double negative). This phase III part did not start due to study discontinuation during the safety Lead-In part.
    Protection of trial subjects
    The study was conducted in accordance with the ethical principles stated in the Declaration of Helsinki, 1964, as revised in 2013 in Fortaleza, with the GCP and with the applicable regulatory requirements. All the patients were to freely give their written informed consent before their selection in the study.
    Background therapy
    Not applicable
    Evidence for comparator
    Not applicable
    Actual start date of recruitment
    21 Apr 2022
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Belgium: 2
    Country: Number of subjects enrolled
    Finland: 1
    Country: Number of subjects enrolled
    Hungary: 2
    Country: Number of subjects enrolled
    Japan: 1
    Country: Number of subjects enrolled
    United States: 1
    Worldwide total number of subjects
    7
    EEA total number of subjects
    5
    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)
    1
    From 65 to 84 years
    6
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Investigators were oncologists.

    Pre-assignment
    Screening details
    Participants must have histologically or cytologically confirmed adenocarcinoma of mCRC not amenable to surgical intervention. The participants must have received at least 2 prior regimens of standard chemotherapy and had demonstrated progressive disease or intolerance.

    Period 1
    Period 1 title
    Treatment period in Safety Lead-in Part (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    Not applicable

    Arms
    Arm title
    futuximab/modotuximab + trifluridine/tipiracil
    Arm description
    Patients received trifluridine/tipiracil in combination with futuximab/modotuximab
    Arm type
    Experimental

    Investigational medicinal product name
    trifluridine/tipiracil
    Investigational medicinal product code
    S95005
    Other name
    TAS-102; Lonsurf ®
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Trifluridine/tipiracil was administered, before futuximab/modotuximab administration, at a dose 35 mg/m²/dose, orally twice a day (BID), within 1 hour after completion of morning and evening meals, 5 days on/2 days off, over 14 days (2 weeks), followed by a 14-day (2 weeks) rest. This treatment cycle was repeated every 28-days (4 weeks).

    Investigational medicinal product name
    futuximab/modotuximab
    Investigational medicinal product code
    S95026
    Other name
    Sym004
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Futuximab/modotuximab was administered at a dose 9 mg/kg on Cycle 1 Day 1 (C1D1) (loading dose) and then at a 6 mg/kg weekly beginning on C1D8 (maintenance doses) for all subsequent administrations, by intravenous (IV) infusion, after trifluridine/tipiracil intake. The first infusion on C1D1 (9 mg/kg in 500 mL) had to be administered over 1 hour. The maximum rate of infusion of 500 mL/hour should not be exceeded throughout the administration. Subsequent infusions (6 mg/kg in 250 mL) could be delivered over 30 minutes, maintaining the maximum infusion rate of 500 mL/hour. Premedication for prophylaxis of infusion related reactions was mandatory prior to each dose of futuximab/modotuximab.

    Number of subjects in period 1
    futuximab/modotuximab + trifluridine/tipiracil
    Started
    7
    Completed
    0
    Not completed
    7
         Adverse event, serious fatal
    1
         Progressive disease
    6

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    futuximab/modotuximab + trifluridine/tipiracil
    Reporting group description
    Patients received trifluridine/tipiracil in combination with futuximab/modotuximab

    Reporting group values
    futuximab/modotuximab + trifluridine/tipiracil Total
    Number of subjects
    7 7
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    1 1
        From 65-84 years
    6 6
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    67.3 ± 3.7 -
    Gender categorical
    Units: Subjects
        Female
    2 2
        Male
    5 5

    End points

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    End points reporting groups
    Reporting group title
    futuximab/modotuximab + trifluridine/tipiracil
    Reporting group description
    Patients received trifluridine/tipiracil in combination with futuximab/modotuximab

    Primary: Safety and tolerability of futuximab/modotuximab in combination with trifluridine/tipiracil

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    End point title
    Safety and tolerability of futuximab/modotuximab in combination with trifluridine/tipiracil [1]
    End point description
    All participants having taken at least one dose of IMP were included in Safety Set. No Dose Limiting Toxicity was reported.
    End point type
    Primary
    End point timeframe
    Any AEs reported from the date of first administration of IMP to 30 days after the last date of IMP administration.
    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: Descriptive summary statistics was applied to this end point
    End point values
    futuximab/modotuximab + trifluridine/tipiracil
    Number of subjects analysed
    7
    Units: percent
    number (not applicable)
        Severe TEAEs
    100
        Treatment-related TEAEs
    100
        TEAE leading to trifluridine/tipiracil withdrawal
    14.3
        TEAE leading to futuximab/modotuximab withdrawal
    14.3
        Serious TEAEs
    42.9
        Treatment-related serious TEAEs
    0
        TEAE leading to death
    14.3
        Treatment-related TEAE leading to death
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment-emergent adverse events (TEAE) are defined as any AEs reported from the date of first administration of IMP to 30 days after the last date of IMP administration.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    futuximab/modotuximab + trifluridine/tipiracil
    Reporting group description
    -

    Serious adverse events
    futuximab/modotuximab + trifluridine/tipiracil
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 7 (42.86%)
         number of deaths (all causes)
    1
         number of deaths resulting from adverse events
    1
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Jaundice
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Hyperventilation
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia bacterial
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    futuximab/modotuximab + trifluridine/tipiracil
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    7 / 7 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to central nervous system
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Vascular disorders
    Orthostatic hypotension
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Device related thrombosis
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Fatigue
         subjects affected / exposed
    4 / 7 (57.14%)
         occurrences all number
    4
    Influenza like illness
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Oedema peripheral
         subjects affected / exposed
    2 / 7 (28.57%)
         occurrences all number
    2
    Pyrexia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Dysphonia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Dyspnoea
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Dyspnoea exertional
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Hyperventilation
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Oropharyngeal pain
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Creatinine renal clearance decreased
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    White blood cell count decreased
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Fall
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Infusion related reaction
         subjects affected / exposed
    4 / 7 (57.14%)
         occurrences all number
    4
    Nervous system disorders
    Aphasia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Dizziness
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Dysgeusia
         subjects affected / exposed
    2 / 7 (28.57%)
         occurrences all number
    2
    Peripheral sensory neuropathy
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Taste disorder
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Eosinophilia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Leukocytosis
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Neutropenia
         subjects affected / exposed
    5 / 7 (71.43%)
         occurrences all number
    11
    Neutrophilia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Thrombocytopenia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Tympanic membrane perforation
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Constipation
         subjects affected / exposed
    2 / 7 (28.57%)
         occurrences all number
    2
    Diarrhoea
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Dry mouth
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Haematochezia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    3 / 7 (42.86%)
         occurrences all number
    3
    Stomatitis
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Acne
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Alopecia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Dermatitis acneiform
         subjects affected / exposed
    6 / 7 (85.71%)
         occurrences all number
    6
    Dry skin
         subjects affected / exposed
    5 / 7 (71.43%)
         occurrences all number
    5
    Erythema
         subjects affected / exposed
    2 / 7 (28.57%)
         occurrences all number
    2
    Onychoclasis
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    2 / 7 (28.57%)
         occurrences all number
    2
    Rash maculo-papular
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Rash pruritic
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Renal and urinary disorders
    Nocturia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Proteinuria
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Muscle spasms
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    2
    Sacral pain
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Infections and infestations
    COVID-19
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Ear infection
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Influenza
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Otitis externa
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    2
    Paronychia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    3
    Tinea pedis
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    3 / 7 (42.86%)
         occurrences all number
    3
    Hypoalbuminaemia
         subjects affected / exposed
    1 / 7 (14.29%)
         occurrences all number
    1
    Hypocalcaemia
         subjects affected / exposed
    2 / 7 (28.57%)
         occurrences all number
    2
    Hypomagnesaemia
         subjects affected / exposed
    5 / 7 (71.43%)
         occurrences all number
    9

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    24 Jan 2022
    Amendment No. 1 This substantial amendment incorporates changes requested by the health authorities (FDA and Belgium).
    16 Aug 2022
    Amendment No. 2 Text revised regarding management of skin toxicity globally per FDA feedback; Text was revised in Sections 8.11, 8.11.1, and 8.11.2, to provide more information about dose delay and specify maximum delay periods; Text was revised in Section 6.1 regarding COVID-19; Added timepoint in Section 9.6 and investigation schedule.

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    02 Feb 2023
    During the Safety Lead-in part, the sponsor decided to discontinue the study for strategic reasons. This decision was not due to safety issue but to strategic consideration. The Phase III part was not started.
    -

    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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