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This will be a randomized phase II clinical trial of patients with histologic documentation of metastatic colorectal cancer, who have received local and currently approved standard therapies, excluding RGF.
The investigators will give VOR 400 mg PO daily and HCQ 600 mg PO daily in 4-week cycles. Patients will require imaging up to 6 weeks prior to enrollment and will be assessed for measureable evidence of mCRC. This will be a randomized, controlled phase II clinical trial of patients with histological documentation of metastatic colorectal cancer, who have received locally and currently approved standard therapies, excluding RGF. Patients will be randomized 1:1 to RGF or VOR/HCQ (see schema below). Also, crossover is optional after first progression on the initial therapy, and based on physician discretion and in the best interest of the patient. If crossover is not done, then the patient will be off study and can go on to receive other treatments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Arm - VOR with HCQ | Experimental | Patients will be given vorinostat 400 mg daily and hydroxychloroquine 600 mg daily in 4 week cycles. |
|
| Control Arm - Regorafenib | Active Comparator | Patients will be given oral RGF 160 mg daily for 3 weeks in 4 week cycles. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vorinostat | Drug | 400mg by mouth daily |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy Based on Progression Free Survival of Vorinostat and Hydroxychloroquine Compared to Regorafenib | CT Scan performed every 8 weeks to monitor progression for one year. | Baseline to 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Median Overall Survival (mOS) | Overall survival was measured in months from baseline | Baseline up to 22 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sukeshi Patel Arora, MD | University of Texas Health Science Center at the Cancer Therapy and Research Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cancer Therapy and Research Center University of Texas Health Science Center San Antonio | San Antonio | Texas | 78229 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35739299 | Derived | Arora SP, Tenner L, Sarantopoulos J, Morris J, Liu Q, Mendez JA, Curiel T, Michalek J, Mahalingam D. Modulation of autophagy: a Phase II study of vorinostat plus hydroxychloroquine versus regorafenib in chemotherapy-refractory metastatic colorectal cancer (mCRC). Br J Cancer. 2022 Oct;127(6):1153-1161. doi: 10.1038/s41416-022-01892-6. Epub 2022 Jun 23. |
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Randomized, controlled trial of VOR 400 mg and HCQ 600 mg PO daily vs RGF 160 mg PO daily (3 weeks on, 1 week off), Q4weeks, in advanced CRC patients. Crossover was optional after first progression.
Subjects were randomized to treatment for the first progression, but crossover was optional after the first progression on the initial therapy and based on physician discretion and in the best interest of the patient. For efficacy analysis: completed at least cycle 1.
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| ID | Title | Description |
|---|---|---|
| FG000 | Study Arm - VOR With HCQ | Patients will be given vorinostat 400 mg daily and hydroxychloroquine 600 mg daily in 4 week cycles. Vorinostat: 400mg by mouth daily Hydroxychloroquine: 600mg by mouth daily |
| FG001 | Control Arm - Regorafenib | Patients will be given oral RGF 160 mg daily for 3 weeks in 4 week cycles. Regorafenib: 160 mg by mouth daily |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Progression |
|
| |||||||||||||||||||||
| Optional Cross-over (MD Discretion) |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Vorinostat/Hydroxychloroquine (VOR/HCQ) | Subjects randomized to the VOR/HCQ arm |
| BG001 | Regorafenib (RGF) | subjects randomized to the RGF arm |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Efficacy Based on Progression Free Survival of Vorinostat and Hydroxychloroquine Compared to Regorafenib | CT Scan performed every 8 weeks to monitor progression for one year. | Primary endpoint: median progression-free survival (mPFS) at interim analysis after at least cycle one was completed. | Posted | Median | 95% Confidence Interval | months | Baseline to 12 months |
|
Data collected from baseline up to 22 months.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Study Arm - VOR With HCQ | All study participants that enrolled and were randomized to the study intervention |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Sukeshi Arora | UT Health San Antonio | 2104502872 | ARORAS@UTHSCSA.EDU |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 14, 2017 | Aug 24, 2020 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| D000077337 | Vorinostat |
| D006886 | Hydroxychloroquine |
| C559147 | regorafenib |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| Hydroxychloroquine | Drug | 600mg by mouth daily |
|
|
| Regorafenib | Drug | 160 mg by mouth daily |
|
|
| NOT COMPLETED |
|
| BG002 | Total | Total of all reporting groups |
| Years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Primary location of disease | Count of Participants | Participants |
|
|
|
| Secondary | Median Overall Survival (mOS) | Overall survival was measured in months from baseline | Posted | Median | 95% Confidence Interval | Months | Baseline up to 22 months |
|
|
|
| 20 |
| 20 |
| 0 |
| 20 |
| 7 |
| 20 |
| EG001 | Control Arm - Regorafenib | All study participants that enrolled and were randomized to the study control | 22 | 22 | 0 | 22 | 8 | 22 |
| Bilirubin increased | Blood and lymphatic system disorders | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
|
| Elevated transaminases | Hepatobiliary disorders | Systematic Assessment |
|
| Hand Foot Syndrome | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| Hypertension | Cardiac disorders | Systematic Assessment |
|
| Hypokalemia | Metabolism and nutrition disorders | Systematic Assessment |
|
| Fatigue | General disorders | Systematic Assessment |
|
| Thrombocytopenia | Blood and lymphatic system disorders | Systematic Assessment |
|
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| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D000588 |
| Amines |
| D006877 | Hydroxamic Acids |
| D006898 | Hydroxylamines |
| D006880 | Hydroxy Acids |
| D002264 | Carboxylic Acids |
| D002738 | Chloroquine |
| D000634 | Aminoquinolines |
| D011804 | Quinolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |