A Study to Investigate Efficacy and Safety of Cobimetinib Plus Atezolizumab and Atezolizumab Monotherapy Versus Regorafenib in Participants With Metastatic Colorectal Adenocarcinoma (COTEZO IMblaze370)

NCT ID: NCT02788279

Last Updated: 2019-12-11

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

363 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-07-05

Study Completion Date

2018-12-26

Brief Summary

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This is a Phase III, multicenter, open-label, three-arm, randomized study in participants with unresectable locally advanced or metastatic colorectal cancer (CRC) who have received at least two prior regimens of cytotoxic chemotherapy for metastatic disease. The study compares regorafenib, a standard of care therapy in this setting, to cobimetinib plus atezolizumab and atezolizumab monotherapy.

Detailed Description

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Conditions

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Colorectal Cancer

Keywords

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Locally advanced or Metastatic colorectal adenocarcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Atezolizumab

Participants will receive atezolizumab monotherapy 1200 milligrams (mg) intravenous (IV) on Day 1 in a 21-day cycle until disease progression according to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Group Type EXPERIMENTAL

Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody

Intervention Type DRUG

Participants will receive atezolizumab IV at 840 mg on Day 1 and Day 15 in a 28-day cycle as a combination therapy or at 1200 mg on Day 1 in a 21-day cycle as a monotherapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Cobimetinib + Atezolizumab

Participants will receive cobimetinib 60 mg orally on Days 1 to 21 plus atezolizumab 840 mg IV on Day 1 and Day 15 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Group Type EXPERIMENTAL

Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody

Intervention Type DRUG

Participants will receive atezolizumab IV at 840 mg on Day 1 and Day 15 in a 28-day cycle as a combination therapy or at 1200 mg on Day 1 in a 21-day cycle as a monotherapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Cobimetinib

Intervention Type DRUG

Participants will receive cobimetinib 60 mg orally on Days 1 to 21 in a 28-day cycle as a combination therapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Regorafenib

Participants will receive regorafenib 160 mg orally on Days 1 to 21 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Group Type ACTIVE_COMPARATOR

Regorafenib

Intervention Type DRUG

Participants will receive regorafenib 160 mg orally on Days 1 to 21 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Interventions

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Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody

Participants will receive atezolizumab IV at 840 mg on Day 1 and Day 15 in a 28-day cycle as a combination therapy or at 1200 mg on Day 1 in a 21-day cycle as a monotherapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Intervention Type DRUG

Cobimetinib

Participants will receive cobimetinib 60 mg orally on Days 1 to 21 in a 28-day cycle as a combination therapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Intervention Type DRUG

Regorafenib

Participants will receive regorafenib 160 mg orally on Days 1 to 21 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed adenocarcinoma originating from the colon or rectum (Stage 4 American Joint Committee on Cancer \[AJCC\] 7th edition)
* Experienced disease progression or was intolerant to at least two systemic chemotherapy regimens for metastatic colorectal cancer that must have included fluroropyrimidines, irinotecan, and oxaliplatin; adjuvant regimen can be considered as one chemotherapy regimen for metastatic disease if the participant had disease recurrence within 6 months of completion; disease progression must have occurred within 3 months of the last systemic therapy administration


* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
* Anticipated life expectancy greater than or equal to (\>=) 3 months
* Adequate hematologic and end organ function
* Women of childbearing potential must agree to appropriately use an effective form of contraception (failure rate of less than \[\<\] 1 percent \[%\] per year) during the treatment period, within 5 months after the last dose of atezolizumab, and within 3 months after the last dose of cobimetinib and regorafenib
* Men must agree not to donate sperm or have intercourse with a female partner without using appropriate barrier contraception during the treatment period and for 3 months after the last dose of either cobimetinib or regorafenib
* Provide an archival or newly obtained tumor tissue sample

Exclusion Criteria

* After the approximate 5% cap for microsatellite (MSI)-high participants is reached, only MSI-stable participants will be eligible
* Once the 50% cap for wild-type RAS has been reached, only extended RAS-mutant participants will be eligible
* Major surgery or radiotherapy within 21 days prior to Cycle 1 Day 1 or anticipation of needing such procedure while receiving study treatment
* Treatment with any anti-cancer agent within 14 days prior to Cycle 1 Day 1
* Uncontrolled tumor-related pain. Participants requiring narcotic pain medication must be on a stable regimen at study entry
* Uncontrolled pleural effusion, pericardial effusion or ascites requiring repeated drainage more than once every 28 days. Indwelling drainage catheters (e.g., PleurX®) are allowed
* Active or untreated central nervous system (CNS) metastases are excluded
* Prior therapy with any cancer immunotherapy, MEK inhibitor, or regorafenib
* Participants with active malignancy (other than CRC) or a prior malignancy within the past 3 years are excluded. Participants with completely resected cutaneous melanoma (early stage), basal cell carcinoma, cutaneous squamous cell carcinoma, cervical carcinoma in-situ, breast carcinoma in-situ, and localized prostate cancer are eligible
* Unstable angina, new onset angina within last 3 months, myocardial infarction within last 6 months and current congestive heart failure New York Heart Association Class II or higher
* Left ventricular ejection fraction (LVEF) below institutional lower limit of normal or below 50%, whichever is lower
* Poorly controlled hypertension, defined as a blood pressure consistently above 150/90 millimeters of Mercury (mmHg) despite optimal medical management
* Human immunodeficiency virus (HIV) infection
* Active tuberculosis infection
* Severe infections within 2 weeks prior to Cycle 1 Day 1
* Active or chronic viral hepatitis B or C infection
* History of or evidence of retinal pathology on ophthalmologic examination that is considered a risk factor for central serous retinopathy, retinal vein occlusion, or neovascular macular degeneration
* Participants will be excluded if they currently have any of the risk factors as defined in the study protocol for retinal vein occlusion
* History of autoimmune disease
* History of idiopathic pulmonary fibrosis, organizing pneumonia, bronchiolitis obliterans, drug-induced pneumonitis, or idiopathic pneumonitis
* History of organ transplantation including allogeneic bone marrow transplantation
* Inability to swallow medications
* Malabsorption condition that would alter the absorption of orally administered medications
* Pregnant, lactating, breastfeeding, or intending to become pregnant during the study
* Administration of a live, attenuated vaccine within 4 weeks before randomization or anticipation of a live attenuated vaccine will be required during the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hoffmann-La Roche

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Trials

Role: STUDY_DIRECTOR

Hoffmann-La Roche

Locations

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City of Hope Comprehensive Cancer Center

Duarte, California, United States

Site Status

Yale Cancer Center; Medical Oncology

New Haven, Connecticut, United States

Site Status

Georgetown University

Washington D.C., District of Columbia, United States

Site Status

Florida Cancer Specialists; SCRI

Fort Myers, Florida, United States

Site Status

Cancer Specialists; North Florida ;Jacksonville (AC Skinner Pkwy)

Jacksonville, Florida, United States

Site Status

Florida Cancer Specialists.

St. Petersburg, Florida, United States

Site Status

Ingalls Cancer Research Center

Harvey, Illinois, United States

Site Status

Southdale Cancer Clinic U of M Medical Center, Fairview- Edina

Edina, Minnesota, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

North Shore Hem Onc Associates

East Setauket, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

INTEGRIS Cancer Inst of OK

Oklahoma City, Oklahoma, United States

Site Status

University of Pittsburgh Cancer Institute; Division of Medical Oncology

Pittsburgh, Pennsylvania, United States

Site Status

SCRI Tennessee Oncology Chattanooga

Chattanooga, Tennessee, United States

Site Status

Sarah Cannon Research Inst.

Nashville, Tennessee, United States

Site Status

MD Anderson Cancer Center

Houston, Texas, United States

Site Status

Medical Oncology Associates

Spokane, Washington, United States

Site Status

Port Macquarie Base Hospital;North Coast Cancer Institute

Port Macquarie, New South Wales, Australia

Site Status

Northern Cancer Institute

St Leonards, New South Wales, Australia

Site Status

Sydney Adventist Hospital; Clinical Trial Unit

Sydney, New South Wales, Australia

Site Status

Monash Medical Centre; Oncology

Clayton, Victoria, Australia

Site Status

Peninsula and South Eastern Haematology and Oncology Group

Frankston, Victoria, Australia

Site Status

Austin Health; Cancer Clinical Trial Centre

Heidelberg, Victoria, Australia

Site Status

Imeldaziekenhuis

Bonheiden, , Belgium

Site Status

Cliniques Universitaires St-Luc

Brussels, , Belgium

Site Status

GHdC Site Notre Dame

Charleroi, , Belgium

Site Status

AZ Groeninge

Kortrijk, , Belgium

Site Status

UZ Leuven Gasthuisberg

Leuven, , Belgium

Site Status

Tom Baker Cancer Centre-Calgary

Calgary, Alberta, Canada

Site Status

Cross Cancer Institute; Clinical Trials

Edmonton, Alberta, Canada

Site Status

BCCA-Vancouver Cancer Centre

Vancouver, British Columbia, Canada

Site Status

The Ottawa Hospital

Ottawa, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

McGill University Health Center, Cedar Cancer Center

Montreal, Quebec, Canada

Site Status

Hopital du Sacre-Coeur

Montreal, Quebec, Canada

Site Status

CHU de Québec

Québec, Quebec, Canada

Site Status

Queen Mary Hospital; Dept. of Clinical Oncology

Hong Kong, , Hong Kong

Site Status

Tuen Mun Hospital; Clinical Oncology

Hong Kong, , Hong Kong

Site Status

Prince of Wales Hosp; Dept. Of Clinical Onc

Shatin, , Hong Kong

Site Status

IRCCS Ospedale Casa Sollievo Della Sofferenza; Oncologia

San Giovanni Rotondo, Apulia, Italy

Site Status

Azienda Osp Uni Seconda Università Degli Studi Di Napoli; Unità Operativa Oncologia Medica

Napoli, Campania, Italy

Site Status

A.O. Universitaria Policlinico Di Modena; Oncologia

Modena, Emilia-Romagna, Italy

Site Status

Istit. Naz. per la Ricerca sul Cancro - Az. Osped. S. Martino

Genoa, Liguria, Italy

Site Status

Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 1

Milan, Lombardy, Italy

Site Status

Asst Grande Ospedale Metropolitano Niguarda; Dipartimento Di Ematologia Ed Oncologia

Milan, Lombardy, Italy

Site Status

A.O. Universitaria Pisana; Oncologia

Pisa, Tuscany, Italy

Site Status

Centrum Onkologii im. Prof. F. Lukaszczyka w Bydgoszczy

Bydgoszcz, , Poland

Site Status

Uniwersyteckie Centrum Kliniczne; Klinika Onkologii i Radioterapii

Gdansk, , Poland

Site Status

Szpitale Pomorskie Sp. z o. o.

Gdynia, , Poland

Site Status

Szpital Uniwersytecki w Krakowie, Oddział Kliniczny Kliniki Onkologii

Krakow, , Poland

Site Status

Woj.Wielospecjalistyczne Centrum Onkologii i Traumatologii; Oddz.Hematologii Pododz.Chemioterapii

Lodz, , Poland

Site Status

Arkhangelsk Regional Clinical Oncology Dispensary

Arkhangelsk, , Russia

Site Status

N.N.Burdenko Main Military Clinical Hospital; Oncology Dept

Moscow, , Russia

Site Status

BHI of Omsk region Clinical Oncology Dispensary

Omsk, , Russia

Site Status

National Cancer Center

Gyeonggi-do, , South Korea

Site Status

Chonnam National University Hwasun Hospital

Jeollanam-do, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Asan Medical Center - Oncology

Seoul, , South Korea

Site Status

Samsung Medical Center

Seoul, , South Korea

Site Status

Yonsei University Health System/Severance Hospital

Seoul, , South Korea

Site Status

Hospital de Navarra; Servicio de Oncologia

Navarra, Navarre, Spain

Site Status

Hospital Univ Vall d'Hebron; Servicio de Oncologia

Barcelona, , Spain

Site Status

Hospital Ramon y Cajal; Servicio de Oncologia

Madrid, , Spain

Site Status

Hospital Clinico San Carlos; Servicio de Oncologia

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre; Servicio de Oncologia

Madrid, , Spain

Site Status

Hospital Clínico Universitario de Valencia; Servicio de Oncología

Valencia, , Spain

Site Status

Birmingham Heartlands Hospital; Dept of Oncology

Birmingham, , United Kingdom

Site Status

Royal Marsden Hospital - Fulham; Oncology Department

London, , United Kingdom

Site Status

The Christie; GI Research Office

Manchester, , United Kingdom

Site Status

Churchill Hospital; Department of Oncology

Oxford, , United Kingdom

Site Status

Queen's Hospital

Romford, , United Kingdom

Site Status

Weston Park Hospital; Cancer Clinical Trials Centre

Sheffield, , United Kingdom

Site Status

Royal Marsden Hospital; Dept of Medical Oncology

Sutton, , United Kingdom

Site Status

Countries

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France Germany United States Australia Belgium Canada Hong Kong Italy Poland Russia South Korea Spain United Kingdom

References

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Taraborrelli L, Senbabaoglu Y, Wang L, Lim J, Blake K, Kljavin N, Gierke S, Scherl A, Ziai J, McNamara E, Owyong M, Rao S, Calviello AK, Oreper D, Jhunjhunwala S, Argiles G, Bendell J, Kim TW, Ciardiello F, Wongchenko MJ, de Sauvage FJ, de Sousa E Melo F, Yan Y, West NR, Murthy A. Tumor-intrinsic expression of the autophagy gene Atg16l1 suppresses anti-tumor immunity in colorectal cancer. Nat Commun. 2023 Sep 23;14(1):5945. doi: 10.1038/s41467-023-41618-7.

Reference Type DERIVED
PMID: 37741832 (View on PubMed)

Barteselli G, Goodman GR, Patel Y, Caro I, Xue C, McCallum S. Characterization of Serous Retinopathy Associated with Cobimetinib: Integrated Safety Analysis of Four Studies. Drug Saf. 2022 Dec;45(12):1491-1499. doi: 10.1007/s40264-022-01248-2. Epub 2022 Oct 30.

Reference Type DERIVED
PMID: 36310331 (View on PubMed)

Eng C, Kim TW, Bendell J, Argiles G, Tebbutt NC, Di Bartolomeo M, Falcone A, Fakih M, Kozloff M, Segal NH, Sobrero A, Yan Y, Chang I, Uyei A, Roberts L, Ciardiello F; IMblaze370 Investigators. Atezolizumab with or without cobimetinib versus regorafenib in previously treated metastatic colorectal cancer (IMblaze370): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol. 2019 Jun;20(6):849-861. doi: 10.1016/S1470-2045(19)30027-0. Epub 2019 Apr 16.

Reference Type DERIVED
PMID: 31003911 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2016-000202-11

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

GO30182

Identifier Type: -

Identifier Source: org_study_id