Status:

COMPLETED

Study to Assess the Efficacy and Safety of Treatment With FOLFIRI-aflibercept Compared to Initial Treatment With FOLFIRI-aflibercept (for 6 Cycles) Followed by Maintenance With 5FU-aflibercept, in an Elderly Population With mCRC After Failure of an Oxaliplatin-based Regimen

Lead Sponsor:

Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD)

Collaborating Sponsors:

Sanofi

Conditions:

Metastatic Colorectal Cancer

Eligibility:

All Genders

70+ years

Phase:

PHASE2

Brief Summary

The purpose of this study is to assess the efficacy and safety of treatment with FOLFIRI-aflibercept compared to initial treatment with FOLFIRI-aflibercept (for 6 cycles) followed by maintenance with ...

Eligibility Criteria

Inclusion

  • Signed and dated informed consent, and willing and able to comply with protocol requirements,
  • Histologically proven adenocarcinoma of the colon and/or rectum,
  • Existence of at least one measurable unidimensional lesion using CT or MRI based on the RECIST criteria, version 1.1
  • Patients with metastatic colorectal cancer (mCRC) that is resistant to or has progressed after a first line oxaliplatin-containing regimen for metastatic disease.
  • Age ≥70 years
  • World Health Organization (WHO) Performance status (PS) 0-2,
  • Hematological status: neutrophils (ANC) ≥1.5x109 /L; platelets ≥100x109 /L; haemoglobin ≥9 g/dL
  • Adequate renal function: Creatinine clearance ≥50 mL/min as calculated using the Cockcroft-Gault equation.
  • Adequate liver function: serum bilirubin ≤1.5 x upper normal limit (ULN), alkaline phosphatase (ALP) \<5xULN
  • Proteinuria \<2+ (dipstick urinalysis) or ≤1g/24hour.
  • Regular follow-up feasible.
  • Male patients with a partner of childbearing potential must agree to use contraception in addition to having their partner use another contraceptive method during the trial.

Exclusion

  • Uncontrolled hypercalcemia,
  • Pre-existing permanent neuropathy (NCI grade \>2)
  • Uncontrolled hypertension (defined as systolic blood pressure \>150 mmHg and/or diastolic blood pressure \>100 mmHg), or history of hypertensive crisis, or hypertensive encephalopathy,
  • Concomitant protocol unplanned antitumor therapy (e.g. chemotherapy, molecular targeted therapy, immunotherapy),
  • Treatment with any other investigational medicinal product within 28 days prior to study entry.
  • Other serious and uncontrolled non-malignant disease,
  • History or evidence upon physical examination of CNS metastasis unless adequately treated (e.g. non irradiated CNS metastasis, seizure not controlled with standard medical therapy),
  • Patients classified as fragile or delicate according to the following criteria:
  • Dependence in one or more activities of daily living according to the Katz Index of Independence in Activities of Daily Living (ADL) scale
  • Three or more comorbidities when assessing the presence of the following processes: congestive heart failure; heart valve disease; coronary artery disease; chronic (obstructive or restrictive) pulmonary disease; cerebrovascular disease; peripheral neuropathy, chronic kidney failure; hypertension; diabetes; concomitant cancers; collagen vascular disease; chronic liver disease; and disabling arthritis
  • Presence of geriatric syndromes: moderate-severe dementia; delirium in stressful situations (urinary or respiratory tract infection, angina or drugs); moderate-severe depression that interferes with the patient's usual activity; frequent falls (three or more per month); inattentiveness (who could help you in the event of an emergency?); urinary incontinence in the absence of stress, infection, diuretics or prostatic hyperplasia; faecal incontinence in the absence of diarrhoea or laxatives; osteoporotic fractures of large bones or vertebral compression fractures
  • Known Gilbert's syndrome
  • Intolerance to atropine sulfate or loperamide
  • Known dihydropyrimidine dehydrogenase deficiency
  • Treatment with CYP3A4 inducers unless discontinued \> 7 days prior to inclusion
  • Any of the following in 3 months prior to inclusion: grade 3-4 gastrointestinal bleeding (unless due to resected tumor), treatment resistant peptic ulcer disease, erosive esophagitis or gastritis, infectious or inflammatory bowel disease, or diverticulitis.
  • Other concomitant or previous malignancy, except: i/ adequately treated insitu carcinoma of the uterine cervix, ii/ basal or squamous cell carcinoma of the skin, iii/ cancer in complete remission for \>5 years,
  • Any other serious and uncontrolled non-malignant disease, major surgery or traumatic injury within the last 28 days
  • Patients with known allergy to any excipient to study drugs,
  • History of myocardial infarction and/or stroke within 6 months prior to inclusion, NYHA class III and IV congestive heart failure
  • Bowel obstruction.
  • Less than 28 days elapsed from prior radiotherapy
  • Patients with pernicious anemia or other megaloblastic anemias due to vitamin B12 deficiency
  • Patients with severe infections

Key Trial Info

Start Date :

October 25 2017

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

February 9 2023

Estimated Enrollment :

170 Patients enrolled

Trial Details

Trial ID

NCT03279289

Start Date

October 25 2017

End Date

February 9 2023

Last Update

April 13 2023

Active Locations (1)

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Spanish Cooperative Group for Digestive Tumour Therapy (TTD)

Madrid, Spain, 28046