A Study Evaluating Regorafenib Following Completion of Standard Chemotherapy for Patients With Colon Cancer
NCT ID: NCT02664077
Last Updated: 2022-04-14
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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TERMINATED
PHASE3
34 participants
INTERVENTIONAL
2016-06-30
2019-10-31
Brief Summary
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Detailed Description
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Eligible patients in this double-blind study will be randomized to take either regorafenib 120 mg or placebo orally, once daily for 21 consecutive days of a 28 day cycle for 26 cycles (2 years).
Accrual for this study will be approximately 1118 randomized patients. These 1118 patients will provide approximately 313 DFS events at the time of primary analysis. An initial futility analysis will be performed when 312 patients have been on study at least 3 months. The decision to continue the trial will be determined by success of both early stopping endpoints defined as follows:
* The toxicity profile of regorafenib compared to placebo is acceptable.
* The regorafenib regimen is tolerable for prolonged administration.
An estimated compliance rate of 60% at 6 months for regorafenib will be required for continuation of the study.
If toxicity is acceptable and compliance with regorafenib is at least 60% nominally, then accrual will continue.
The second futility analysis will be conducted when approximately 67 DFS events are observed. Trial conduct and accrual will continue unless the primary endpoint (DFS) trends too far in the opposite direction (hazard ratio greater than or equal to 1.1).
Toxicity will be graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
NSABP C-13 will include a Behavioral and Health Outcomes correlative science component. A C-13 Quality of Life (QOL) questionnaire will be administered at baseline (after consent and prior to randomization) and at 3 months, 6 months, 12 months, 18 months, 24 months, and 30 months.
Submission of blood samples for C-13 correlative science studies will be a study requirement for all patients. Submissions will also include archived primary tumor tissue from the resected colon primary. Blood samples for pharmacokinetics (PK) will be collected on Day 15 of Cycle 1 and Day 15 of Cycle 2, with additional blood samples for biomarkers collected at various time points for future analysis.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
QUADRUPLE
Study Groups
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Group 1: Regorafenib
Patients receive regorafenib orally once daily for 21 days of a 28 day cycle for a total of 26 cycles.
Regorafenib
3 tablets once a day by mouth for 21 consecutive days of 28 day cycle for 26 cycles
Group 2: Placebo
Patients receive placebo orally once daily for 21 days of a 28 day cycle for a total of 26 cycles.
Placebo
3 tablets once a day by mouth for 21 consecutive days of 28 day cycle for 26 cycles
Interventions
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Regorafenib
3 tablets once a day by mouth for 21 consecutive days of 28 day cycle for 26 cycles
Placebo
3 tablets once a day by mouth for 21 consecutive days of 28 day cycle for 26 cycles
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* There must be histologic confirmation of high risk, adenocarcinoma of the colon defined as AJCC 7th Edition Stage IIIB or IIIC.
* The patient must have had an en bloc complete gross resection of tumor (curative resection) by open laparotomy or laparoscopically-assisted colectomy. The distal extent of the tumor must have been greater than or equal to 12 cm from the anal verge. (Patients who have had a two-stage surgical procedure to first provide a decompression colostomy and then in a later procedure to have a surgical resection are eligible.)
* Imaging (positron emission tomography/computed tomography (PET/CT) scan, CT scan, or magnetic resonance imaging (MRI)) of chest, abdomen, and pelvis must be performed within 90 days prior to randomization and must demonstrate no evidence of metastatic disease. If findings noted in imaging study reports are equivocal, the determination of whether or not the findings represent metastatic disease will be at the investigator's discretion.
* The patient must be able to swallow oral medication.
* The patient must have completed at least 4 months of adjuvant chemotherapy (i.e., FOLFOX, CapeOx, or other, such as 5-fluorouracil, leucovorin, oxaliplatin (FLOX), 5-fluorouracil/leucovorin (5FU/LV), capecitabine).
* The interval between completion of standard adjuvant chemotherapy and randomization must be less than or equal to 60 days.
* Blood counts performed within 28 days prior to randomization must meet the following criteria:
* Absolute neutrophil count (ANC) must be greater than or equal to 1500/mm3;
* platelet count must be greater than or equal to 100,000/mm3; and
* hemoglobin must be greater than or equal to 9 g/dL.
* The following criteria for evidence of adequate hepatic function performed within 4 weeks prior to randomization must be met:
* total bilirubin must be less than or equal to 1.5 x upper limit of normal (ULN); and
* alkaline phosphatase must be less than or equal to 2 x ULN; and
* Asparate aminotransferase (AST) and alanine aminotransferase (ALT) must be less than or equal to 2 x ULN for the lab. (Note: If AST and/or ALT greater than ULN, serologic testing for Hepatitis B and C must be performed and results must be negative.)
* Lipase performed within 28 days of randomization must be less than or equal to 1.5 x ULN for the lab.
* Serum creatinine performed within 28 days of randomization must be less than or equal to 1.5 x ULN for the lab.
* Urinalysis dipstick for urinary protein performed within 28 days prior to randomization must be 0-1+ protein. If urine dipstick result is greater than or equal to 2+ protein, a 24-hour urine protein must be less than 1.0 g/24 hours.
* Glomerular filtration rate (GFR) must be greater than or equal to 30 mL/min/1.73 m2 according to the Modified Diet in Renal Disease (MDRD) abbreviated formula.
* International normalized ratio of prothrombin time must be less than or equal to 1.5 times the ULN. Patients who are therapeutically treated with an agent such as warfarin or heparin will be allowed to participate if no underlying abnormality in coagulation parameters exists per medical history.
* Patients (male or female) of reproductive potential must agree to use an effective method of contraception (as discussed with treating physician) from the time consent is signed, during study therapy, and for at least 90 days after the last dose of study therapy.
* Patients with prior malignancies are eligible if they have been disease-free for at least 5 years and are deemed by their physician to be at low risk for recurrence. Patients with squamous or basal cell carcinoma of the skin, melanoma in situ, carcinoma in situ of the cervix, or carcinoma in situ of the colon or rectum that have been effectively treated are eligible, even if these conditions were diagnosed within 5 years of randomization.
Exclusion Criteria
* Colon cancer other than adenocarcinoma (e.g., sarcoma, lymphoma, carcinoid).
* Prior history of invasive adenocarcinoma of colon or rectum.
* Patients with active autoimmune disease. (Patients with endocrine autoimmune diseases requiring replacement therapy alone are allowed.)
* Gastroduodenal ulcer(s) determined by endoscopy to be active.
* Any malabsorption condition.
* Known history of human immunodeficiency virus (HIV) infection or chronic or active hepatitis B or hepatitis C requiring treatment with antiviral therapy.
* Any concomitant systemic therapy or radiation therapy initiated for this malignancy.
* Active infection, or chronic infection requiring chronic suppressive antibiotics.
* Persistent CTCAE v4.0 greater than or equal to grade 2 diarrhea regardless of etiology.
* Know history of allografts (including corneal transplant).
* Chronic daily treatment with corticosteroids with a dose of greater than or equal to 10 mg/day methylprednisolone equivalent (excluding inhaled steroids), or any other immunosuppressive drugs.
* Any significant bleeding (greater than or equal to grade 3, hemorrhage) that is not related to the primary colon tumor within 6 months before randomization.
* Any of the following cardiac conditions:
* documented New York Heart Association (NYHA) Class III or IV congestive heart failure;
* myocardial infarction within 6 months prior to randomization;
* unstable angina (angina symptoms at rest) within less than or equal to 3 months prior to randomization; and
* clinically significant symptomatic arrhythmia despite anti-arrhythmic therapy.
* Uncontrolled blood pressure (systolic pressure greater than 150 mmHg or diastolic pressure greater than 90 mmHg on repeated measurements).
* Symptomatic brain or meningeal tumors.
* Patients with seizure disorder requiring medication.
* Presence of non-healing wound, non-healing ulcer, or bone fracture.
* Symptomatic interstitial lung disease or definitive evidence of interstitial lung disease described on CT scan, MRI, or chest x-ray in asymptomatic patients; dyspnea at rest requiring current continuous oxygen.
* Arterial or venous thrombotic or embolic events such as cerebral vascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within 6 months before randomization (except for adequately treated catheter-related venous thrombosis occurring within 6 months before randomization).
* Symptomatic peripheral ischemia.
* Psychiatric or addictive disorders or other conditions or unresolved toxicities of prior therapy greater than grade 2 that, in the opinion of the investigator, would preclude the patient from meeting the study requirements, or interfere with interpretation of study results.
* Pregnancy or lactation at the time of study entry. (Note: Pregnancy testing must be performed within 14 days prior to randomization according to institutional standards for women of childbearing potential.)
* Major surgery (including ostomy reversal), open biopsy or significant trauma injury, within 28 days prior to randomization.
* Anticipation of need for major surgical procedures during the course of study.
* Known hypersensitivity to study drug, study drug classes or excipients of the formulation.
* Use of any vascular endothelial growth factor (VEGF) targeted therapy or previous use of regorafenib.
* Patients taking strong inducers or inhibitors of cytochrome P450 3A4 (CYP3A4) who cannot interrupt therapy from the time the C-13 consent is signed through 30 days after the last dose of study therapy.
* Patients taking herbal remedies (e.g., St. John's Wort \[Hypericum perforatum\]) who cannot interrupt therapy from the time the C-13 consent is signed through 30 days after the last dose of study therapy.
* Use of immune modulators and/or any immunosuppressive drugs.
* Use of any investigational agent within 28 days of randomization.
* Patients receiving erythropoiesis-stimulating agents or other hematopoietic growth factors.
18 Years
ALL
No
Sponsors
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Bayer
INDUSTRY
NSABP Foundation Inc
NETWORK
Responsible Party
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Principal Investigators
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Norman Wolmark, MD
Role: PRINCIPAL_INVESTIGATOR
NSABP Foundation
Locations
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St. Joseph Hospital of Orange
Orange, California, United States
St. Joseph Heritage Healthcare
Santa Rosa, California, United States
Kaiser Permanente Medical Center - Vallejo
Vallejo, California, United States
Colorado Cancer Research Program
Denver, Colorado, United States
Yale University
New Haven, Connecticut, United States
University of Florida
Gainesville, Florida, United States
Mount Sinai Comprehensive Cancer Center
Miami Beach, Florida, United States
Memorial Health University Medical Center
Savannah, Georgia, United States
Cancer Care Specialists of Illinois - Decatur Memorial Hospital
Decatur, Illinois, United States
Edward Hospital Cancer Center
Naperville, Illinois, United States
Carle Cancer Center
Urbana, Illinois, United States
Northern Indiana Cancer Research Consortium
South Bend, Indiana, United States
Oncology Associates at Mercy Medical Center
Cedar Rapids, Iowa, United States
Genesis Medical Center - West Campus
Davenport, Iowa, United States
University of Iowa
Iowa City, Iowa, United States
Covenant Cancer Treatment Center
Waterloo, Iowa, United States
Norton Cancer Institute, Norton Healthcare Pavilion
Louisville, Kentucky, United States
Tulane University Health Sciences Center
New Orleans, Louisiana, United States
New England Cancer Specialists
Scarborough, Maine, United States
Berkshire Medical Center Cancer and Infusion Center
Pittsfield, Massachusetts, United States
Breslin Cancer Center
Lansing, Michigan, United States
Metro Minnesota Community Oncology Research Consortium
Saint Louis Park, Minnesota, United States
Missouri Valley Cancer Consortium
Omaha, Nebraska, United States
Nevada Cancer Research Foundation, Inc.
Las Vegas, Nevada, United States
MD Anderson Cancer Center at Cooper
Camden, New Jersey, United States
Monmouth Medical Center
Long Branch, New Jersey, United States
Newark Beth Israel Medical Center
Newark, New Jersey, United States
Community Medical Center
Toms River, New Jersey, United States
Waverly Hematology Oncology
Cary, North Carolina, United States
CaroMont Regional Medical Center
Gastonia, North Carolina, United States
Margaret R. Pardee Memorial Hospital
Hendersonville, North Carolina, United States
First Health of the Carolinas Cancer Center
Pinehurst, North Carolina, United States
Wake Forest Baptist Health
Winston-Salem, North Carolina, United States
James Cancer Hospital and Solove Research Institute at the Ohio State University Comprehensive Cancer Center
Columbus, Ohio, United States
Toledo Clinic Cancer Center
Toledo, Ohio, United States
Abington Hospital -Jefferson South
Abington, Pennsylvania, United States
Penn State Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, United States
Allegheny General Hospital
Pittsburgh, Pennsylvania, United States
UPMC Cancer Centers
Pittsburgh, Pennsylvania, United States
Guthrie Medical Group, PC
Sayre, Pennsylvania, United States
Scranton Hematology Oncology
Scranton, Pennsylvania, United States
Reading Hospital - McGlinn Cancer Institute
West Reading, Pennsylvania, United States
AnMed Health Cancer Center
Anderson, South Carolina, United States
McLeod Cancer Center for Treatment and Research
Florence, South Carolina, United States
Wellmont Medical Associates Oncology and Hematology
Kingsport, Tennessee, United States
Thompson Cancer Survival Center
Knoxville, Tennessee, United States
Joe Arrington Cancer Research and Treatment Center
Lubbock, Texas, United States
Virginia Commonwealth University
Richmond, Virginia, United States
West Virginia University
Morgantown, West Virginia, United States
Green Bay Oncology, Ltd. - St. Vincent Hospital
Green Bay, Wisconsin, United States
Countries
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Other Identifiers
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17808
Identifier Type: OTHER
Identifier Source: secondary_id
NSABP C-13
Identifier Type: -
Identifier Source: org_study_id
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