Phase 2
N=376
Study of Bevacizumab + mFOLFOX6 Versus Bevacizumab + FOLFIRI With Biomarker Stratification in Participants With Previously Untreated Metastatic Colorectal Cancer (mCRC)
Colorectal Cancer
Bottom Line
View on ClinicalTrials.gov: NCT01374425 ↗Enrolled (actual)
376
Serious AEs
45.1%
Results posted
Aug 2016
Primary outcome: Primary: Progression-Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 — 10.09; 12.55 months — p=0.0555
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- 5-Fluorouracil (Drug); Bevacizumab (Drug); Irinotecan (Drug); Leucovorin (Drug); Oxaliplatin (Drug); Capecitabine (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Genentech, Inc.
- Primary completion
- May 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Progression-Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 |
10.09; 12.55 | 0.0555 |
| PRIMARY PFS According to RECIST Version 1.1 in Participants With High ERCC-1 Levels |
9.92; 11.17 | 0.3944 |
| PRIMARY PFS According to RECIST Version 1.1 in Participants With Low ERCC-1 Levels |
10.97; 12.68 | 0.0786 |
| PRIMARY PFS According to RECIST Version 1.1 in Participants With High ERCC-1 Levels Versus Participants With Low ERCC-1 Levels |
10.87; 11.56 | 0.9576 |
| PRIMARY PFS According to RECIST Version 1.1 in Participants With High Vascular Endothelial Growth Factor (VEGF)-A Levels Versus Participants With Low VEGF-A Levels |
10.02; 12.68 | 0.1658 |
| SECONDARY PFS According to RECIST Version 1.1 in Participants With High ERCC-1 and High VEGF-A Levels |
8.80; 11.17 | 0.3019 |
| SECONDARY PFS According to RECIST Version 1.1 in Participants With High ERCC-1 and Low VEGF-A Levels |
12.52; 12.68 | 0.6035 |
| SECONDARY PFS According to RECIST Version 1.1 in Participants With Low ERCC-1 and High VEGF-A Levels |
9.76; 11.07 | 0.4032 |
| SECONDARY PFS According to RECIST Version 1.1 in Participants With Low ERCC-1 and Low VEGF-A Levels |
11.10; 14.32 | 0.0647 |
| SECONDARY Overall Survival (OS) |
23.85; 27.47 | 0.0861 |
| SECONDARY OS in Participants With High ERCC-1 Levels |
22.54; 26.51 | 0.3295 |
| SECONDARY OS in Participants With Low ERCC-1 Levels |
25.53; 27.93 | 0.1519 |
| SECONDARY OS in Participants With High ERCC-1 Levels Versus Participants With Low ERCC-1 Levels |
23.23; 27.27 | 0.2774 |
| SECONDARY Percentage of Participants With Objective Response According to RECIST Version 1.1 |
61.2; 65.4 | — |
| SECONDARY Percentage of Participants With Objective Response According to RECIST Version 1.1 in Participants With High ERCC-1 Levels |
56.3; 65.7 | — |
| SECONDARY Percentage of Participants With Objective Response According to RECIST Version 1.1 in Participants With Low ERCC-1 Levels |
63.7; 65.8 | — |
| SECONDARY Percentage of Participants With Objective Response According to RECIST Version 1.1 in Participants With High ERCC-1 Levels Versus Participants With Low ERCC-1 Levels |
61.1; 64.8 | — |
| SECONDARY Percentage of Participants With Disease Control According to RECIST Version 1.1 |
93.1; 91.0 | — |
| SECONDARY Percentage of Participants With Disease Control According to RECIST Version 1.1 in Participants With High ERCC-1 Levels |
93.8; 85.1 | — |
| SECONDARY Percentage of Participants With Disease Control According to RECIST Version 1.1 in Participants With Low ERCC-1 Levels |
92.7; 95.0 | — |
| SECONDARY Percentage of Participants With Disease Control According to RECIST Version 1.1 in Participants With High ERCC-1 Levels Versus Participants With Low ERCC-1 Levels |
89.3; 93.9 | — |
| SECONDARY Percentage of Participants With Liver Metastasis Resection |
14.9; 10.9 | — |
| SECONDARY Percentage of Participants With Complete Liver Metastasis Resection |
11.9; 5.5 | — |
| SECONDARY Percentage of Participants With Liver Metastasis Resection in Participants With High ERCC-1 Levels |
17.6; 6.7 | — |
| SECONDARY Percentage of Participants With Complete Liver Metastasis Resection in Participants With High ERCC-1 Levels |
17.6; 6.7 | — |
| SECONDARY Percentage of Participants With Liver Metastasis Resection in Participants With Low ERCC-1 Levels |
10.5; 7.5 | — |
| SECONDARY Percentage of Participants With Complete Liver Metastasis Resection in Participants With Low ERCC-1 Levels |
8.9; 3.3 | — |
| SECONDARY Percentage of Participants With Liver Metastasis Resection in Participants With High ERCC-1 Levels Versus Participants With Low ERCC-1 Levels |
4.6; 9.0 | — |
| SECONDARY Percentage of Participants With Complete Liver Metastasis Resection in Participants With High ERCC-1 Levels Versus Participants With Low ERCC-1 Levels |
4.6; 6.1 | — |
| SECONDARY PFS According to RECIST Version 1.1 in Participants With Wild-Type V-Ki-ras2 Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) Versus Participants With Mutant KRAS |
12.45; 10.94 | 0.0593 |
| SECONDARY OS in Participants With High VEGF-A Levels Versus Participants With Low VEGF-A Levels |
22.83; 27.93 | 0.0020 sig |
| SECONDARY OS in Participants With Wild-Type KRAS Versus Participants With Mutant KRAS |
28.75; 24.64 | 0.0955 |
| SECONDARY Percentage of Participants With Objective Response According to RECIST Version 1.1 in Participants With High VEGF-A Levels Versus Participants With Low VEGF-A Levels |
60.5; 66.5 | — |
| SECONDARY Percentage of Participants With Objective Response According to RECIST Version 1.1 in Participants With Wild-Type KRAS Versus Participants With Mutant KRAS |
66.3; 60.9 | — |
| SECONDARY Percentage of Participants With Disease Control According to RECIST Version 1.1 in Participants With High VEGF-A Levels Versus Participants With Low VEGF-A Levels |
91.9; 93.0 | — |
| SECONDARY Percentage of Participants With Liver Metastasis Resection in Participants With High VEGF-A Levels Versus Participants With Low VEGF-A Levels |
5.9; 9.2 | — |
| SECONDARY Percentage of Participants With Complete Liver Metastasis Resection in Participants With High VEGF-A Levels Versus Participants With Low VEGF-A Levels |
3.2; 8.1 | — |
Summary
This will be a randomized, open-label, multicenter, Phase II study with primary objectives to assess whether expression of select chemotherapy markers is associated with progression-free survival (PFS) in participants treated with bevacizumab plus leucovorin, 5-fluorouracil, and oxaliplatin (mFOLFOX6) or bevacizumab plus leucovorin, 5-fluorouracil, and irinotecan (FOLFIRI). The study population will consist of participants with first-line mCRC.
Eligibility Criteria
Inclusion Criteria
- Histologically or cytologically confirmed colorectal cancer (CRC) with at least one measurable metastatic lesion by RECIST Version 1.1
- Archival tumor tissue sample must be requested and available prior to study entry. If no archival tumor tissue sample is available, a fresh biopsy tissue sample must be obtained but should be discussed first with the medical monitor. A copy of the local pathology report must be submitted along with the specimens.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Participants with treated brain metastases are eligible for study participation. Participants may not receive ongoing treatment with steroids at Screening. Anticonvulsants (at stable dose) are allowed. Treatment for brain metastases may be whole-brain radiotherapy, radiosurgery, neurosurgery, or a combination as deemed appropriate by the treating physician. Radiotherapy and stereotactic radiosurgery must be completed at least 28 days prior to randomization.
- Female participants should not be pregnant or breastfeeding. Female participants with childbearing potential should agree to use effective, non-hormonal means of contraception during the study and for a period of at least 6 months following the last administration of study drugs. Female participants with an intact uterus (unless amenorrheic for the last 24 months) must have a negative serum pregnancy test within 7 days prior to randomization into the study.
- Male participants must agree to use effective contraception during the study and for a period of at least 6 months following the last administration of study drugs, even if they have been surgically sterilized.
Exclusion Criteria
- Any prior systemic treatment for mCRC
- Adjuvant chemotherapy for CRC completed <12 months
- Evidence of Gilbert's syndrome or of homozygosity for the UGT1A1*28 allele
- Known positivity for human immunodeficiency virus (HIV)
- Malignancies other than mCRC within 5 years prior to randomization, except for adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer treated surgically with curative intent, and ductal carcinoma in situ treated surgically with curative intent
- Radiotherapy to any site for any reason within 28 days prior to randomization, except for palliative radiotherapy to bone lesions within 14 days prior to randomization
- Clinically detectable third-space fluid collections that cannot be controlled by drainage or other procedures prior to study entry
- Treatment with any other investigational agent, or participation in another investigational drug trial within 28 days prior to randomization
Data sourced from ClinicalTrials.gov (NCT01374425). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.