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| Name | Class |
|---|---|
| Vall d'Hebron Institute of Oncology | OTHER |
| Agendia | INDUSTRY |
| European Organisation for Research and Treatment of Cancer - EORTC | NETWORK |
| Azienda Ospedaliera Niguarda Cà Granda |
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Vecchione et al showed that suppression of RANBP2 results in mitotic defects only in BRAF-like colon cancer (CC) cells, which leads to cell death. Mechanistically, RANBP2 silencing reduces microtubule outgrowth from the kinetochores, thereby inducing spindle perturbations, providing an explanation for the observed mitotic defects. Vinorelbine mimics RANPB2 silencing in BRAF-like and BRAFV600E CC cell lines.
These preclinical data represent a strong rationale to also explore the anti-tumor activity of vinorelbine in patients with advanced BRAF-like (both BRAFm and BRAF wild type) CC. Tumors having this gene signature are referred to as "BRAF-like" and have a similar poor prognosis irrespective of the presence of BRAF(V600E) mutation. Since vinorelbine is standard of care in advanced breast and NSCLC, there is ample experience with the dose and schedule as well as with the safety profile and supportive measures required to prevent side-effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort A; KRASmt, BRAFwt, BRAF-like CC | Experimental | Patients with KRAS mutant and BRAF wildtype colon cancer that met the BRAF-like signature according to the validated test of Agendia will be treated with vinorelbine tartrate. |
|
| Cohort B; KRASwt, BRAFmt, BRAF-like CC | Experimental | Patients with KRAS wildtype and BRAF mutant colon cancer that met the BRAF-like signature according to the validated test of Agendia will be treated with vinorelbine tartrate. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vinorelbine Tartrate | Drug | Intravenous administration of vinorelbine on day 1 and day 8 in a dose of 30 mg/m2. One treatment cycle is 21 days. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Doubling of progression free survival | This means that by vinorelbine treatment the rate of progression drops to 25%. | 15 months |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence and severity of adverse events | 15 months | |
| Overall response rate | 15 months | |
| Duration of response |
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate of vinorelbine in patients with KRAS mutant, BRAF wildtype, BRAF-like colon cancer vs. KRAS wildtype, BRAF mutant, BRAF-like colon cancer. | 15 months |
Inclusion Criteria:
Written informed consent for this clinical trial (+ TR (translational research)) must be given according to ICH/GCP and national/local regulations
Written documentation of BRAF-like signature CC, including BRAFm and BRAFwt, as determined by the validated assay of Agendia
Written documentation of KRAS and BRAF mutational status.
Age > 18 years
Histologically proven and measurable (RECIST criteria v.1.1) metastatic adenocarcinoma of the colon not in a previously irradiated area, treated with at least one or two lines of standard of care therapy, including BRAF inhibitors, for advanced disease
WHO performance status of 0-1
Able and willing to undergo blood sampling for pharmacodynamic (PD) analysis;
Able and willing to undergo tumor biopsy prior to, during and upon treatment;
Life expectancy > 3 months allowing adequate follow up of toxicity evaluation and antitumor activity
Minimal acceptable safety laboratory values:
Negative urine or serum pregnancy test (serum or urine) for female patients with childbearing potential
Exclusion Criteria:
10. Patients who have undergone any major surgery within the last 2 weeks prior to starting study drug or who would not have fully recovered from previous surgery 11. Uncontrolled infectious disease or known Human Immunodeficiency Virus HIV-1 or HIV-2 type patients 12. Patients with a known history of hepatitis B or C 13. Patients with cardiac comorbidities (myocardial infarct within 6 months of study start, NYHA class ≥ III, congestive heart failure or instable angina pectoris), uncontrolled hypertension (systolic blood pressure > 150 mm Hg and/or diastolic pressure > 90 mm Hg) or prolonged QT-interval (> 440 ms for men, > 460 ms for women) 14. Other severe, acute, or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration or that may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for the study 15. Known hypersensitivity to study drug or excipients
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| Name | Affiliation | Role |
|---|---|---|
| N Steeghs, MD, PhD | NKI-AvL | Principal Investigator |
| J Tabernero, Prof | VHIO | Principal Investigator |
| R Salazar, MD, PhD | ICO | Principal Investigator |
| R Bernards, Prof | Agendia | Principal Investigator |
| S Siena, Prof | ONCG | Principal Investigator |
| A Cervantes, Prof | Instituto de Investigacion Sanitaria INCLIVA | Principal Investigator |
| F Ciardiello, Prof | Instituto de Investigacion Sanitaria INCLIVA | Principal Investigator |
| A Bardelli, Prof | UNITO | Principal Investigator |
| S Tejpar, Prof | UZ Leuven | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Antoni van Leeuwenhoek | Amsterdam | North Holland | 1066 CX | Netherlands |
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| Label | URL |
|---|---|
| general information | View source |
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| ID | Term |
|---|---|
| D003110 | Colonic Neoplasms |
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
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| ID | Term |
|---|---|
| D000077235 | Vinorelbine |
| ID | Term |
|---|---|
| D014748 | Vinca Alkaloids |
| D046948 | Secologanin Tryptamine Alkaloids |
| D026121 | Indole Alkaloids |
| D000470 | Alkaloids |
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| OTHER |
| Fundación para la Investigación del Hospital Clínico de Valencia | OTHER |
| University of Campania Luigi Vanvitelli | OTHER |
| University of Turin, Italy | OTHER |
| Eli Lilly and Company | INDUSTRY |
| Catalan Institute of Health | OTHER_GOV |
| Universitaire Ziekenhuizen KU Leuven | OTHER |
This is a two-stage, single-arm, multi-center, open-label, two-cohort, clinical, phase II, proof of principal study.
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|
| 15 months |
| Time to response | 15 months |
| Overall survival | 15 months |
| Baseline molecular status (mutation/ expression) in tumor tissue of potential predictive markers of tumor response | The molecular status will be measured by NGS and IHC in tumor tissue. | 15 months |
| Gene alterations/expression profiles (i.e. baseline, relapse) in tumor tissue upon progression | The molecular status will be measured by NGS and IHC in tumor tissue. | 15 months |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D006571 |
| Heterocyclic Compounds |
| D007211 | Indoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D054836 | Indolizidines |
| D007212 | Indolizines |