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The general objectives are to evaluate activity and the safety of regorafenib in a population of patients bearing advanced, refractory colorectal cancers and to explore the different downstream molecular pathways to identify tumor response and resistance mechanisms.
The primary objective is to identify in a population of patients bearing advanced, refractory colorectal cancers, those who draw no benefit from treatment with regorafenib. There is no specific hypothesis underlying sample size and the study is therefore to be seen as exploratory.
Secondary objectives:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Regorafenib | Experimental | A treatment cycle is defined as a 4 weeks period. Regorafenib will be administered once a day orally at a dose of 160 mg (4 tablets of 40 mg), for 3 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| regorafenib | Drug | Patients will receive 160 mg regorafenib 1/day 3 weeks out of 4. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival (OS) | 2 years from first patient in |
| Measure | Description | Time Frame |
|---|---|---|
| Occurence of Adverse events | Assessment of safety will follow the WHO guidelines and classified according to NCI-CTCAE v. 4.0 and will be performed every 28 days until 28 days (safety follow up visit) after stopping therapy. Reasons for stopping therapy may include progression of disease or unbearable toxicities, or patient's decision. | Every 28 days till 28 days after stopping therapy. An average of 2 months is expected. |
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Inclusion Criteria:
Histologically proven colorectal adenocarcinoma that is metastatic or unresectable and for which standard treatments do not exist or are no longer effective.
Age ≥ 18 years.
Life expectancy of greater than 12 weeks.
ECOG performance status ≤ 1.
Participants must have normal organ and bone marrow function as defined below:
Women of childbearing potential and men must agree to use adequate contraception prior to study entry, until at least 3 months after the last study drug administration.
Signed Written Informed Consent (IC).
Presence of a previously collected or freshly obtained at the time of study entry frozen metastatic tumor biopsy in a FDG-PET targetable lesion.
Presence of at least one metabolically measurable tumoral lesion on FDG PET-CT
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alain Hendlisz, MD | Jules Bordet Institute | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UZA | Antwerp | Edegem | 2650 | Belgium | ||
| Jules Bordet Institute |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30744591 | Derived | Charette N, Vandeputte C, Ameye L, Bogaert CV, Krygier J, Guiot T, Deleporte A, Delaunoit T, Geboes K, Van Laethem JL, Peeters M, Demolin G, Holbrechts S, Flamen P, Paesmans M, Hendlisz A. Prognostic value of adipose tissue and muscle mass in advanced colorectal cancer: a post hoc analysis of two non-randomized phase II trials. BMC Cancer. 2019 Feb 12;19(1):134. doi: 10.1186/s12885-019-5319-8. | |
| 25753361 |
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| Evaluation of tumour response | RECIST 1.1-based radiological assessment (CT or MRI) will be made every 2 cycles, starting at day 28 of the second cycle till demonstration of progressive disease. An average of 2 months is expected. | Every 2 months till progression of the disease. An average of 2 months is expected. |
| Metabolic response assessed by FDG PET | FDGPET will be done twice during the study course : at baseline (at day 0, before treatment begin) and after 2 weeks. | 2 FDGPET will be perfomed : at Baseline (day 0) and at D14 |
| Molecular aberrations | Genetic, epigenetic and molecular aberrations will be investigated using gene expression profiling, RNA and exome sequencing, and methylation profiling on the tumor biopsies and repeated blood samples collected during the trial. The relationship between the molecular aberrations,the patient's outcome (PFS, OS) and with metabolic response after treatment with regorafenib will be studied. | at day 0 (before treatment begins) and at D14, then repeated every 2 months until progression. An average of 2 months is expected. |
| Brussels |
| 1000 |
| Belgium |
| Hopital Erasme | Brussels | 1070 | Belgium |
| Cliniques Universitaires Saint Luc | Brussels | Belgium |
| Grand Hopital de Charleroi | Charleroi | 6000 | Belgium |
| UZ Ghent | Ghent | Belgium |
| AZ groeninge | Kortrijk | 8500 | Belgium |
| Centre Hospitalier Universitaire de Liège | Liège | 4000 | Belgium |
| Clinique St Joseph | Liège | 4000 | Belgium |
| Centre hospitalier de Jolimont | Lobbes | 6540 | Belgium |
| CHU Ambroise Paré | Mons | 7000 | Belgium |
| Centre Hospitalier Régional de Namur | Namur | 5000 | Belgium |
| Clinique et Maternité Sainte Elisabeth | Namur | 5000 | Belgium |
| Clinique Saint Pierre | Ottignies | 1340 | Belgium |
| Hartziekenhuis Roeselare-Menen (HHRM) | Roeselare | 8800 | Belgium |
| AZ Turnhout | Turnhout | 2300 | Belgium |
| Cliniques Universitaires UCL de Mont-Godinne | Yvoir | 5530 | Belgium |
| Derived |
| Hendlisz A, Deleporte A, Vandeputte C, Charette N, Paesmans M, Guiot T, Garcia C, Flamen P. Regorafenib assessment in refractory advanced colorectal cancer: RegARd-C study protocol. BMJ Open. 2015 Mar 9;5(3):e007189. doi: 10.1136/bmjopen-2014-007189. |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| ID | Term |
|---|---|
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C559147 | regorafenib |
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