Phase I Study of Biweekly SIRB Regimen for Metastatic Colorectal Cancer

NCT ID: NCT03380689

Last Updated: 2021-03-08

Basic Information

• Recruitment Status: WITHDRAWN
• Clinical Phase: PHASE1
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-01-05
• Study Completion Date: 2019-01-05

Brief Summary

Phase I Study of biweekly combination therapy with S-1, Irinotecan, and Bevacizumab as 1-line Chemotherapy in Patients With Advanced Colorectal Cancer.

Detailed Description

In several clinical studies from Japan and South Korea, the combination regimen of S-1 and irinotecan has shown efficacy in the treatment of advanced colorectal cancer, and a Phase III study（TRICOLORE） showed that the combination therapy with S-1/irinotecan/bevacizumab (a 3-week regimen [SIRB] or 4-week regimen [IRIS/bevacizumab]) is not inferior to the oxaliplatin-based standard treatment (mFOLFOX6/bevacizumab or CapeOX/bevacizumab) in patients with metastatic colorectal cancer who had not previously received chemotherapy. Here, we design this phase I study to explore the Chinese population's tolerability and efficacy of Biweekly SIRB Regimen(S-1/irinotecan/bevacizumab) and to explore the recommended dose of irinotecan in this regimen.

Conditions

Metastatic Colorectal Cancer

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

SIRB2

Biweekly combination therapy with S-1, Irinotecan, and Bevacizumab

Group Type: EXPERIMENTAL

S-1

Intervention Type: DRUG

\- S-1 is administered orally on days 1 to 7 of a 14-day cycle. Patients are assigned on the basis of body surface area (BSA) to receive one of the following oral doses twice daily: 40 mg (BSA \<1.25m2), 50 mg (BSA \>1.25 to \<1.50 m2), or 60 mg (BSA \>1.50 m2).

Irinotecan

Intervention Type: DRUG

\- CPT-11 was administrated as a 90-min intravenous infusion on day 1 of a 14-day cycle. Five escalating dose levels of CPT-11 were prepared, at an initial dose of 75mg/m2/day (level 1), stepping up to 100 (level 2), 125 (level 3), 150 (level 4) or 175 (level 5) mg/m2/day.

Bevacizumab

Intervention Type: DRUG

\- Bevacizumab (5 mg/kg) is administered by intravenous infusion over the course of 30 to 90 min on day 1 of each 2-week cycle.

Interventions

S-1

\- S-1 is administered orally on days 1 to 7 of a 14-day cycle. Patients are assigned on the basis of body surface area (BSA) to receive one of the following oral doses twice daily: 40 mg (BSA \<1.25m2), 50 mg (BSA \>1.25 to \<1.50 m2), or 60 mg (BSA \>1.50 m2).

Intervention Type: DRUG

Irinotecan

\- CPT-11 was administrated as a 90-min intravenous infusion on day 1 of a 14-day cycle. Five escalating dose levels of CPT-11 were prepared, at an initial dose of 75mg/m2/day (level 1), stepping up to 100 (level 2), 125 (level 3), 150 (level 4) or 175 (level 5) mg/m2/day.

Intervention Type: DRUG

Bevacizumab

\- Bevacizumab (5 mg/kg) is administered by intravenous infusion over the course of 30 to 90 min on day 1 of each 2-week cycle.

Intervention Type: DRUG

Other Intervention Names

S1; CPT-11; Avastin

Eligibility Criteria

Inclusion Criteria

• Histologically confirmed colorectal carcinoma with inoperable, locally advanced, or metastatic disease, not amenable to curative therapy
• Measurable disease or non-measurable but assessable disease according to the Response Evaluation Criteria in Solid Tumors (RECIST)
• Patients with no previous treatment (radiotherapy or chemotherapy). Patients who have received postoperative adjuvant chemotherapy are eligible if relapse is diagnosed more than 180 days after the end of such treatment.
• Age ≥20 years
• Life expectancy of at least 3 months
• ECOG PS of 0 or 1
• Adequate function of major organs as defined below:

• Hemoglobin ≥9.0g/dL
• White blood cell count ≥3,500/mm3
• Neutrophil count ≥1,500/mm3
• Platelet count ≥100,000/mm3
• AST and ALT ≤100 U/L (<200 U/L in patients with liver metastasis)
• Serum creatinine ≤1.2 mg/dL

• Creatinine clearance estimate by the Cockcroft-Gault method >50 mL/min (reduce initial dosage by one step if ≥50 but <80 mL/min)
• Able to take capsules orally.
• No electrocardiographic abnormalities within 28 days before enrollment that would clinically preclude the execution of the study, as judged by the investigator.
• Voluntary written informed consent.

Exclusion Criteria

• Serious drug hypersensitivity or a history of drug allergy
• Active double cancer
• Active infections (e.g., patients with pyrexia of 38℃ or higher)
• History of gastrointestinal perforation, intestinal tract paralysis, or ileus within 1 year.
• Uncontrolled hypertension
• Serious complications (e.g., pulmonary fibrosis, interstitial pneumonitis, heart failure, renal failure, hepatic failure, or poorly controlled diabetes)
• Moderate or severe ascites or pleural effusion requiring treatment
• Watery diarrhea
• Treatment with flucytosine or atazanavir sulfate
• Metastasis to the CNS
• Pregnant women, possibly pregnant women, women wishing to become pregnant, and nursing mothers. Men who are currently attempting to conceive children.
• Severe mental disorder
• Continuous treatment with steroids
• Urine dipstick for proteinuria should be <2+
• Patient with a past history of thrombosis, cerebral infarction, myocardial infarction, or pulmonary embolism
• Major surgical procedure, open biopsy, or clinically significant traumatic injury within 4 weeks
• Long-term daily treatment with aspirin (>325 mg/day)
• History or evidence of inherited bleeding diathesis or coagulopathy with the risk of bleeding
• Judged ineligible for participation in the study by the investigator for safety reasons.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Fujian Cancer Hospital

OTHER_GOV

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Rongbo Lin, MD

Role: STUDY_CHAIR

Fujian Cancer Hospital

Locations

Rongbo Lin

Fuzhou, Fujian, China

Countries

China

Other Identifiers

FNF008

Identifier Type: -

Identifier Source: org_study_id