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Phase 3 N=702 Randomized Treatment

Study of Encorafenib + Cetuximab Plus or Minus Binimetinib vs. Irinotecan/Cetuximab or Infusional 5-Fluorouracil (5-FU)/Folinic Acid (FA)/Irinotecan (FOLFIRI)/Cetuximab With a Safety Lead-in of Encorafenib + Binimetinib + Cetuximab in Patients With BRAF V600E-mutant Metastatic Colorectal Cancer

BRAF V600E-mutant Metastatic Colorectal Cancer

Enrolled (actual)
702
Serious AEs
46.3%
Results posted
Jul 2020
Primary outcome: Primary: (Safety Lead-in) Number of Participants With Dose-Limiting Toxicities (DLTs) — 5 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Encorafenib (Drug); Binimetinib (Drug); Cetuximab (Drug); Irinotecan (Drug); Folinic Acid (Drug); 5-Fluorouracil (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Pfizer
Primary completion
Feb 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
(Safety Lead-in) Number of Participants With Dose-Limiting Toxicities (DLTs)
5
PRIMARY
(Safety Lead-in) Number of Participants With Adverse Events (AEs)
37
PRIMARY
(Safety Lead-in) Incidence of Dose Interruptions, Dose Modifications and Discontinuations Due to Adverse Events (AEs) - Interim Analysis
26
PRIMARY
(Safety Lead-in) Incidence of Dose Interruptions, Dose Modifications and Discontinuations Due to Adverse Events (AEs) - Final Analysis
30; 16; 8
PRIMARY
(Phase 3) Overall Survival (OS) of Triplet Arm vs. Control Arm - Interim Analysis
9.03; 5.42 <0.0001 sig
PRIMARY
(Phase 3) Objective Response Rate (ORR) by Blinded Independent Central Review (BICR) Per Response Evaluation Criteria in Solid Tumors (RECIST), v1.1 of Triplet Arm vs. Control Arm
26.1; 1.9 <0.0001 sig
SECONDARY
(Safety Lead-in) Objective Response Rate (ORR) by Investigator
52.8
SECONDARY
(Safety Lead-in) Objective Response Rate (ORR) by BICR
41.7
SECONDARY
(Safety Lead-in) Duration of Response (DOR) by Investigator
6.47
SECONDARY
(Safety Lead-in) Duration of Response (DOR) by BICR
8.15
SECONDARY
(Safety Lead-in) Time to Response by Investigator
1.45
SECONDARY
(Safety Lead-in) Time to Response by BICR
1.45
SECONDARY
(Safety Lead-in) Progression-Free Survival (PFS) by Investigator
8.08
SECONDARY
(Safety Lead-in) Progression-Free Survival (PFS) by BICR
5.59
SECONDARY
(Phase 3) Overall Survival (OS) in Doublet Arm vs. Control Arm
9.40; 5.88 <0.0001 sig
SECONDARY
(Phase 3) Overall Survival (OS) in Triplet Arm vs. Doublet Arm
9.82; 9.40 0.5958
SECONDARY
(Phase 3) Comparison of Progression-Free Survival (PFS) in Triplet Arm vs Control Arm Per BICR
4.30; 1.51 <0.0001 sig
SECONDARY
(Phase 3) Comparison of Progression-free Survival (PFS) in Triplet Arm vs Control Arm Per Investigator
4.47; 1.58 <0.0001 sig
SECONDARY
(Phase 3) Comparison of Progression-Free Survival (PFS) in Doublet Arm vs Control Arm Per BICR
4.21; 1.51 <0.0001 sig
SECONDARY
(Phase 3) Comparison of Progression-Free Survival (PFS) in Doublet Arm vs Control Arm Per Investigator
4.27; 1.58 <0.0001 sig
SECONDARY
(Phase 3) Comparison of Progression-Free Survival (PFS) in Triplet Arm vs Doublet Arm Per BICR
4.30; 4.21 0.1004
SECONDARY
(Phase 3) Comparison of Progression-Free Survival (PFS) in Triplet Arm vs Doublet Arm Per Investigator
4.47; 4.27 0.3724
SECONDARY
(Phase 3) Comparison of Objective Response Rate (ORR) in Triplet Arm vs Control Arm Per Investigator
26.1; 3.7 <0.0001 sig
SECONDARY
(Phase 3) Comparison of Objective Response Rate (ORR) in Doublet Arm vs Control Arm Per BICR
20.4; 1.9 <0.0001 sig
SECONDARY
(Phase 3) Comparison of Objective Response Rate (ORR) in Doublet Arm vs Control Arm Per Investigator
15.9; 3.7 <0.0001 sig
SECONDARY
(Phase 3) Comparison of Objective Response Rate (ORR) in Triplet Arm vs Doublet Arm Per BICR
26.1; 20.4 0.1928
SECONDARY
(Phase 3) Comparison of Objective Response Rate (ORR) in Triplet Arm vs Doublet Arm Per Investigator
26.1; 15.9 0.0357 sig
SECONDARY
(Phase 3) Comparison of Duration of Response (DOR) in Triplet Arm vs Control Arm Per BICR
4.80; NA
SECONDARY
(Phase 3) Comparison of Duration of Response (DOR) in Triplet Arm vs Control Arm Per Investigator
4.80; 5.75
SECONDARY
(Phase 3) Comparison of Duration of Response (DOR) in Doublet Arm vs Control Arm Per BICR
6.06; NA
SECONDARY
(Phase 3) Comparison of Duration of Response (DOR) in Doublet Arm vs Control Arm Per Investigator
5.70; 5.75
SECONDARY
(Phase 3) Comparison of Duration of Response (DOR) in Triplet Arm vs Doublet Arm by BICR
4.80; 6.06
SECONDARY
(Phase 3) Comparison of Duration of Response (DOR) in Triplet Arm vs Doublet Arm by Investigator
4.80; 5.70
SECONDARY
(Phase 3) Comparison of Time to Response in Triplet Arm vs Control Arm Per BICR
1.43; 1.45
SECONDARY
(Phase 3) Comparison of Time to Response in Triplet Arm vs Control Arm Per Investigator
1.48; 2.63
SECONDARY
(Phase 3) Comparison of Time to Response in Doublet Arm vs Control Arm Per BICR
1.48; 1.45
SECONDARY
(Phase 3) Comparison of Time to Response in Doublet Arm vs Control Arm Per Investigator
1.48; 2.63
SECONDARY
(Phase 3) Comparison of Time to Response in Triplet Arm vs Doublet Arm Per BICR
1.43; 1.48
SECONDARY
(Phase 3) Comparison of Time to Response in Triplet Arm vs Doublet Arm Per Investigator
1.48; 1.48
SECONDARY
(Phase 3) Change From Baseline in the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire for Cancer Participants (QLQ-C30) Triplet Arm vs Control Arm, Doublet Arm vs Control, and Triplet vs Doublet
62.8; 60.7; 62.8; -2.4; -4.3; -3.4
SECONDARY
(Phase 3) Change From Baseline in the Functional Assessment of Cancer Therapy-Colon Cancer (FACT-C) in Triplet Arm vs Control Arm, Doublet Arm vs Control, and Triplet vs Doublet
16.3; 16.2; 16.8; -0.2; -0.9; -1.4
SECONDARY
(Phase 3) Change From Baseline in the EuroQol-5D-5L Visual Analog Scale (EQ-5D-5L VAS) in Triplet Arm vs Control Arm, Doublet Arm vs Control, and Triplet vs Doublet
69.0; 66.5; 68.3; 0.8; -0.9; -2.1
SECONDARY
(Phase 3) Change From Baseline in the Participant Global Impression of Change (PGIC) in Triplet Arm vs Control Arm, Doublet Arm vs Control, and Triplet vs Doublet
3.8; 3.8; 3.9; -0.1; 0.1; 0.0
SECONDARY
(Safety Lead-in) Evaluation of the Area Under the Concentration-Time Curve From Zero to the Last Measurable Time Point (AUClast) for Cetuximab
841000; 970000
SECONDARY
(Safety Lead-in) Evaluation of the Area Under the Concentration-Time Curve From Zero to the Last Measurable Time Point (AUClast) for Encorafenib
11300; 6660
SECONDARY
(Safety Lead-in) Evaluation of the Area Under the Concentration-Time Curve From Zero to the Last Measurable Time Point (AUClast) for Binimetinib
1960; 1540
SECONDARY
(Safety Lead-in) Evaluation of the Area Under the Concentration-time Curve From Zero to the Last Measurable Time Point (AUClast) for Metabolite of Binimetinib (AR00426032)
206; 70.0
SECONDARY
(Safety Lead-in) Evaluation of the Maximum Concentration (Cmax) for Cetuximab
195000; 199000
SECONDARY
(Safety Lead-in) Evaluation of the Maximum Concentration (Cmax) for Encorafenib
3360; 2490
SECONDARY
(Safety Lead-in) Evaluation of the Maximum Concentration (Cmax) for Binimetinib
654; 524
SECONDARY
(Safety Lead-in) Evaluation of the Maximum Concentration (Cmax) for Metabolite of Binimetinib (AR00426032)
59.9; 20.5
SECONDARY
(Safety Lead-in) Evaluation of the Time of Maximum Observed Concentration (Tmax) for Cetuximab
3.77; 3.05
SECONDARY
(Safety Lead-in) Evaluation of the Time of Maximum Observed Concentration (Tmax) for Encorafenib
2.00; 2.00
SECONDARY
(Safety Lead-in) Evaluation of the Time of Maximum Observed Concentration (Tmax) for Binimetinib
1.98; 1.04
SECONDARY
(Safety Lead-in) Evaluation of the Time of Maximum Observed Concentration (Tmax) for Metabolite of Binimetinib (AR00426032)
2.00; 1.58
SECONDARY
(Safety Lead-in) Evaluation of the Steady-State Concentration Measured Just Before the Next Dose of Study Drug (Ctrough) for Binimetinib
55.3
SECONDARY
(Safety Lead-in) Evaluation of the Steady-State Concentration Measured Just Before the Next Dose of Study Drug (Ctrough) for Encorafenib
18.9
SECONDARY
(Safety Lead-in) Evaluation of the Steady-State Concentration Measured Just Before the Next Dose of Study Drug (Ctrough) for Cetuximab
55400
SECONDARY
(Safety Lead-in) Evaluation of the Steady-State Concentration Measured Just Before the Next Dose of Study Drug (Ctrough) for a Metabolite of Binimetinib
3.41
SECONDARY
(Phase 3) Evaluation of the Model-Based Oral Clearance (CL/F) for Encorafenib
16.4
SECONDARY
(Phase 3) Evaluation of the Model-Based Oral Clearance (CL/F) for Binimetinib
19.0
SECONDARY
(Phase 3) Evaluation of the Model-Based Clearance (CL) for Cetuximab
0.0154
SECONDARY
Phase 3: Number of Participants With Clinically Notable Shifts in Hematology and Coagulation Laboratory Parameters
9; 9; 4; 0; 0; 0
SECONDARY
Phase 3: Number of Participants With Clinically Notable Shifts in Serum Chemistry Laboratory Parameters
11; 7; 10; 50; 16; 17
SECONDARY
Phase 3: Number of Participants With Clinically Notable Shifts in Urinalysis Laboratory Parameters
8; 8; 5
SECONDARY
Phase 3: Number of Participants With Newly Occurring Clinically Notable Vital Sign Abnormalities
8; 6; 7; 21; 27; 5
SECONDARY
Phase 3: Number of Participants With Newly Occurring Clinically Notable Electrocardiogram (ECG) Values
1; 4; 0; 27; 24; 28
SECONDARY
Phase 3: Number of Participants With Shift in Visual Acuity Logarithm of the Minimum Angle of Resolution (LogMAR) Score
33; 8; 0; 15; 3; 0
SECONDARY
Phase 3: Number of Participants With Shifts in Left Ventricular Ejection Fraction (LVEF) From Baseline to Maximum Grade On-treatment
27; 0; 0; 1; 1; 0

Summary

This is a multicenter, randomized, open-label, 3-arm Phase 3 study to evaluate encorafenib + cetuximab plus or minus binimetinib versus Investigator's choice of either irinotecan/cetuximab or FOLFIRI/cetuximab, as controls, in patients with BRAFV600E mCRC whose disease has progressed after 1 or 2 prior regimens in the metastatic setting. The study contains a Safety Lead-in Phase in which the safety and tolerability of encorafenib + binimetinib + cetuximab will be assessed prior to the Phase 3 portion of the study.

Eligibility Criteria

Key Inclusion Criteria

  • Age ≥ 18 years at time of informed consent
  • Histologically- or cytologically-confirmed CRC that is metastatic
  • Presence of BRAFV600E in tumor tissue as previously determined by a local assay at any time prior to Screening or by the central laboratory
  • Progression of disease after 1 or 2 prior regimens in the metastatic setting
  • Evidence of measurable or evaluable non-measurable disease per RECIST, v1.1
  • Adequate bone marrow, cardiac, kidney and liver function
  • Able to take oral medications
  • Female patients are either postmenopausal for at least 1 year, are surgically sterile for at least 6 weeks, or must agree to take appropriate precautions to avoid pregnancy from screening through follow-up if of childbearing potential
  • Males must agree to take appropriate precautions to avoid fathering a child from screening through follow-up

Key Exclusion Criteria

  • Prior treatment with any RAF inhibitor, MEK inhibitor, cetuximab, panitumumab or other epidermal growth factor receptor (EGFR) inhibitors
  • Prior irinotecan hypersensitivity or toxicity that would suggest an inability to tolerate irinotecan 180 mg/m2 every 2 weeks
  • Symptomatic brain metastasis or leptomeningeal disease
  • History or current evidence of retinal vein occlusion or current risk factors for retinal vein occlusion (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes)
  • Known history of acute or chronic pancreatitis
  • History of chronic inflammatory bowel disease or Crohn's disease requiring medical intervention (immunomodulatory or immunosuppressive medications or surgery) ≤12 months prior to randomization
  • Uncontrolled blood pressure despite medical treatment
  • Impaired GI function or disease that may significantly alter the absorption of encorafenib or binimetinib (e.g., ulcerative diseases, uncontrolled vomiting, malabsorption syndrome, small bowel resection with decreased intestinal absorption)
  • Concurrent or previous other malignancy within 5 years of study entry, except cured basal or squamous cell skin cancer, superficial bladder cancer, prostate intraepithelial neoplasm, carcinoma in-situ of the cervix, or other noninvasive or indolent malignancy
  • History of thromboembolic or cerebrovascular events ≤ 6 months prior to starting study treatment, including transient ischemic attacks, cerebrovascular accidents, deep vein thrombosis or pulmonary emboli
  • Concurrent neuromuscular disorder that is associated with the potential of elevated creatine (phosphor)kinase (CK) (e.g., inflammatory myopathies, muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy)
  • Residual common terminology criteria for adverse events (CTCAE) ≥ Grade 2 toxicity from any prior anticancer therapy, with the exception of Grade 2 alopecia or Grade 2 neuropathy
  • Known history of HIV infection
  • Active hepatitis B or hepatitis C infection
  • Known history of Gilbert's syndrome
  • Known contraindication to receive cetuximab or irinotecan at the planned doses
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02928224). 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.

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