Phase 3
N=702
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
Bottom Line
View on ClinicalTrials.gov: NCT02928224 ↗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
| Outcome | Result | p-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
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.