Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
This is a multicentric, phase II and open label study.75 patients are expected to be randomized in 35 centers. The main objective is to assess the efficacy and safety of Afatinib -cetuximab combo versus cetuximab alone in treatment of patients with refractory wtKRAS metastatic colorectal cancer.
Patients who will sign the inform consent will be enrolled into one of two groups. Group A will receive Afatinib ( 40mg per day) and Cetuximab (500mg/m2)every two weeks until progression. Group B will receive Cetuximab (500mg/m2) alone every two weeks until progression and after progression,patients from group B will receive afatinib (group A treatment) until progression. The criteria for evaluation will be tumor response and progression documented by CT scan and according to RECIST criteria version 1.1.
Patient will also sign a inform consent before participating in biological study. The aim of this translational study is to collect tumor and blood sample in order to determine, the biological factors which are predictive of the response to treatment.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A: Cetuximab + Afatinib | Experimental | Afatinib 40 mg daily Cetuximab 500 mg/m2 every 2 weeks until progression |
|
| Arm B : Cetuximab alone | Active Comparator | Cetuximab 500mg/m2 every 2 weeks until progression After progression: Cetuximab 500mg/m2 + Afatinib 40 mg per day until progression |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cetuximab + Afatinib | Drug | Afatinib taken orally, cetuximab administered intravenously |
|
| Measure | Description | Time Frame |
|---|---|---|
| Non progression rate at 6 months | The progression rate is defined as percentage of patients without progression at 6 months after observation of all patients at 6 months | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate (OR) | Overall response rate is defined as percentage of subjects with a confirmed complete or partial response as per RECIST V1.1 criteria | 6 months |
| Progression free survival |
Not provided
Inclusion Criteria:
Metastatic colorectal cancer expressing the wtKRAS status
No previous EGFR targeted therapy.
Must have failed a prior regimen containing irinotecan for metastatic disease and a prior regimen containing oxaliplatin for metastatic disease
Must have previously received a thymidylate synthase inhibitor (eg, fluorouracil, capecitabine, raltitrexed, or fluorouracil-uracil) at any point for treatment of colorectal cancer (CRC)
Life expectancy of at least 3 months.
Patient with ECOG ≤ 1
Patients aged ≥ 18.
Patient with measurable lesions according to RECIST criteria (version 1.1) with spiral CT scan and defined as ≥ 10 mm in longest diameter and 2X the slice thickness for extra nodal lesions and/or > 15 mm in short axis diameter for nodal lesions
Patient able to receive adequate oral nutrition of ≥ 1500 calories per day and free of significant nausea and vomiting
Patient with adequate organ function:
Adequate contraception if applicable.
Ability to take oral medication in the opinion of the investigator
Patient able and willing to comply with study procedures as per protocol
Patient able to understand and willing to sign and date the written voluntary informed consent form at screening visit prior to any protocol-specific procedures
Patient affiliated to a social security regimen
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Helene SENELLART, Dr | Centre René Gauducheau- Nantes Saint herbelain | Principal Investigator |
| Evelyne BOUCHER, Dr | Centre Eugène Marquis-Rennes | Principal Investigator |
| Eric FRANCOIS, Dr | Centre Antoine Lacassagne, Nice | Principal Investigator |
| Emmanuelle SAMALIN SCALZI, Dr | Centre Val d'Aurel-Paul Lamarque-Montpellier | Principal Investigator |
| Meher BEN ABDELGHANI, Dr | Centre Paul Strauss-Strasbourg | Principal Investigator |
| Antoine ADENIS, Pr | Centre Oscar Lambret_Lille | Principal Investigator |
| Christelle DE LA FOUCHARDIERE, Dr | Centre Léon Bérard, Lyon | Principal Investigator |
| François GHIRENGHELLI, Dr | Centre Georges Leclerc-Dijon | Principal Investigator |
| Olivier DUBROEUCQ, Dr | Centre Jean Godinot-Reims | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute de Cancérologie de la Loire | Nantes | 44805 | France |
Not provided
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
Not provided
Not provided
| ID | Term |
|---|---|
| D000068818 | Cetuximab |
| D000077716 | Afatinib |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Cetuximab | Drug | Cetuximab administered intravenously |
|
|
It is define as the time of from randomization to date of first documented progression or any cause of death
| until progression or death, expected average approximately 4 months |
| Overall and specific survival | Overall and specific survival is defined from time of randomization to the date of documented death | until death, on average approximately 14 months |
| Quality of life | EORTC QLQ-C30 and QLQ-CR29 are questionnaires developed to assess the quality of life of cancer patients | During treatment, on average approximately 4 months |
| Tolerance of the treatment | Safety of the study treatment will be assessed on occurrence of Adverse Events (AEs) | until progression, expected approximately 4 months |
| Emmanuelle MITRY, Dr | Hopital Rene Huguenin_Intitut Curie_Paris | Principal Investigator |
| Christophe BORG, Pr | Hôpital Jean Minjoz-Besaçon | Principal Investigator |
| Yves BOUCARN, Dr | Institut Bergonié Bordeaux | Principal Investigator |
| Christophe BORG, Pr | Centre Hospitalier de Belfort-Montbelliard | Principal Investigator |
| Marion CHAUVENET, Dr | Centre Hospitalier Lyon Sud-Pierre Benite | Principal Investigator |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D007162 |
| Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |