Trial Outcomes & Findings for Panitumumab, Regorafenib, or TAS-102, in Treating Patients With Metastatic and/or Unresectable RAS Wild-Type Colorectal Cancer (NCT NCT03992456)

NCT ID: NCT03992456

Last Updated: 2024-05-21

Results Overview

OS is defined as the Time from randomization to death from any cause. The distribution of overall survival will be estimated using the method of Kaplan-Meier. Overall survival will be compared between the 2 treatment arms using the un-stratified log-rank test will be used.

Recruitment status

ACTIVE_NOT_RECRUITING

Study phase

PHASE2

Target enrollment

12 participants

Primary outcome timeframe

2 years

Results posted on

2024-05-21

Participant Flow

Participant milestones

Participant milestones
Measure
Arm A (Panitumumab)
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity.\> \> Panitumumab: Given IV\> \> Quality-of-Life Assessment: Ancillary studies\> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity.\> \> Quality-of-Life Assessment: Ancillary studies\> \> Questionnaire Administration: Ancillary studies\> \> Regorafenib: Given PO\> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Overall Study
STARTED
5
6
Overall Study
COMPLETED
0
0
Overall Study
NOT COMPLETED
5
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Arm A (Panitumumab)
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity.\> \> Panitumumab: Given IV\> \> Quality-of-Life Assessment: Ancillary studies\> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity.\> \> Quality-of-Life Assessment: Ancillary studies\> \> Questionnaire Administration: Ancillary studies\> \> Regorafenib: Given PO\> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Overall Study
Withdrawal by Subject
1
0
Overall Study
Disease progression
4
5
Overall Study
Emergency surgery unrelated to treatment
0
1

Baseline Characteristics

Panitumumab, Regorafenib, or TAS-102, in Treating Patients With Metastatic and/or Unresectable RAS Wild-Type Colorectal Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm A (Panitumumab)
n=5 Participants
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity.\> \> Panitumumab: Given IV\> \> Quality-of-Life Assessment: Ancillary studies\> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 Participants
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity.\> \> Quality-of-Life Assessment: Ancillary studies\> \> Questionnaire Administration: Ancillary studies\> \> Regorafenib: Given PO\> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Total
n=11 Participants
Total of all reporting groups
Age, Continuous
61.4 years
STANDARD_DEVIATION 11.17 • n=5 Participants
64.0 years
STANDARD_DEVIATION 6.75 • n=7 Participants
62.8 years
STANDARD_DEVIATION 8.64 • n=5 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Sex: Female, Male
Male
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
4 Participants
n=5 Participants
6 Participants
n=7 Participants
10 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
3 Participants
n=7 Participants
8 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
5 participants
n=5 Participants
6 participants
n=7 Participants
11 participants
n=5 Participants
Body Mass Index (BMI)
27.7 kg/m^2
STANDARD_DEVIATION 8.82 • n=5 Participants
24.1 kg/m^2
STANDARD_DEVIATION 4.57 • n=7 Participants
25.8 kg/m^2
STANDARD_DEVIATION 6.72 • n=5 Participants
Primary Tumor Site
Left
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Primary Tumor Site
Right
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 2 years

OS is defined as the Time from randomization to death from any cause. The distribution of overall survival will be estimated using the method of Kaplan-Meier. Overall survival will be compared between the 2 treatment arms using the un-stratified log-rank test will be used.

Outcome measures

Outcome measures
Measure
Arm A (Panitumumab)
n=5 Participants
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Panitumumab: Given IV \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 Participants
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies \> \> Regorafenib: Given PO \> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Overall Survival (OS)
7.5 months
Interval 7.2 to
Due to an insufficient number of participants with events, the upper confidence interval was not able to be estimated
8.3 months
Interval 4.9 to
Due to an insufficient number of participants with events, the upper confidence interval was not able to be estimated

SECONDARY outcome

Timeframe: 1 year

PFS is defined as the time from randomization to documentation of disease progression or death due to any cause, whichever is first. If the patient did not have any disease evaluation post randomization, PFS will be censored at one day after randomization. The distribution of progression free survival will be estimated using the method of Kaplan-Meier. Progression free survival will be compared between the 2 treatment arms using the log-rank test which is used for the primary endpoint analysis.

Outcome measures

Outcome measures
Measure
Arm A (Panitumumab)
n=5 Participants
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Panitumumab: Given IV \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 Participants
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies \> \> Regorafenib: Given PO \> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Progression Free Survival (PFS)
5.1 months
Interval 2.0 to
Due to an insufficient number of participants with events, the upper confidence interval was not able to be estimated
3.7 months
Interval 2.0 to
Due to an insufficient number of participants with events, the upper confidence interval was not able to be estimated

SECONDARY outcome

Timeframe: 2 years

Defined as the number of patients with a complete response (CR) or partial response (PR) (as defined by the Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1) divided by the number of evaluable patients in each arm. ORR will be compared between the 2 treatment arms. Confidence intervals for the true success proportion will be calculated according to the approach of Clopper and Pearson.

Outcome measures

Outcome measures
Measure
Arm A (Panitumumab)
n=5 Participants
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Panitumumab: Given IV \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 Participants
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies \> \> Regorafenib: Given PO \> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Overall Response Rate (ORR)
20.0 percent
Interval 0.51 to 71.6
0.0 percent
Interval 0.0 to 45.93

SECONDARY outcome

Timeframe: 4 months

Defined as the number of patients with a complete response (CR), partial response (PR), or stable disease for \>= 4 months (as defined by the RECIST 1.1) divided by the number of evaluable patients in each arm. Confidence intervals for the true success proportion will be calculated according to the approach of Clopper and Pearson.

Outcome measures

Outcome measures
Measure
Arm A (Panitumumab)
n=5 Participants
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Panitumumab: Given IV \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 Participants
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies \> \> Regorafenib: Given PO \> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Clinical Benefit Rate
20.0 percent
Interval 0.51 to 71.6
16.67 percent
Interval 0.42 to 64.12

SECONDARY outcome

Timeframe: 2 years

The maximum grade for each type of adverse event will be recorded for each patient in each cycle. The number of patients experiencing grade 3 or higher adverse events will be compared using Chi-Square or Fisher's Exact tests.

Outcome measures

Outcome measures
Measure
Arm A (Panitumumab)
n=5 Participants
Patients receive panitumumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Panitumumab: Given IV \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 Participants
Patients receive trifluridine and tipiracil hydrochloride PO BID on days 1-5 and 8-12, or regorafenib PO QD on days 1-21, at the discretion of the treating physician. Treatment repeats every 28 days for a maximum of 24 cycles in the absence of disease progression or unacceptable toxicity. \> \> Quality-of-Life Assessment: Ancillary studies \> \> Questionnaire Administration: Ancillary studies \> \> Regorafenib: Given PO \> \> Trifluridine and Tipiracil Hydrochloride: Given PO
Incidence of Adverse Events
1 Participants
3 Participants

SECONDARY outcome

Timeframe: 2 years

Population: This analysis was not conducted due to no patient response rates.

Patients reported quality of life (QOL) outcomes will be collected using the Linear Analog Self-Assessment (LASA) Questionnaire. Data will be collected each cycle. Mean values of the first question (regarding overall QOL) at each cycle will be plotted, and stratified by arm. Additional analyses using data collected from the LASA questionnaire may be performed. Score from 0-10, 0 is worse and 10 is better.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, at restaging, and at disease progression

A report will be generated for each clinical specimen, which may include (but not limited to) the presence or absence of relevant gene mutations or amplifications, along with the allele frequency. Mutations of interest include KRAS and NRAS exons 2, 3, and 4, BRAF, PIK3CA, EGFR, AKT, PTEN, MAP2K1, and MET. Amplifications of interest include MET, EGFR, KRAS, and ERBB2. Genes and alterations analyzed will be based on best available science at the time of analysis.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 3 years

Plasma samples will be analyzed for multiple soluble protein analytes, which may include (but not limited to) HGF, c-MET, EGF, HBEGF, TGF-alpha, EGFR, HER2, and CD73.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 3 years

Comprehensive mutational analysis will be performed on archived formalin fixed paraffin embedded (FFPE) tumor samples. This analysis may include, but is not limited to Next Generation Sequencing (NGS) and IHC where appropriate.

Outcome measures

Outcome data not reported

Adverse Events

Arm A (Panitumumab)

Serious events: 0 serious events
Other events: 5 other events
Deaths: 5 deaths

Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)

Serious events: 2 serious events
Other events: 6 other events
Deaths: 5 deaths

Serious adverse events

Serious adverse events
Measure
Arm A (Panitumumab)
n=5 participants at risk
Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 participants at risk
Trifluridine and Tipiracil Hydrochloride: Given PO
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Musculoskeletal and connective tissue disorders
Muscle weakness lower limb
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years

Other adverse events

Other adverse events
Measure
Arm A (Panitumumab)
n=5 participants at risk
Questionnaire Administration: Ancillary studies
Arm B (Regorafenib, Trifluridine and Tipiracil Hydrochloride)
n=6 participants at risk
Trifluridine and Tipiracil Hydrochloride: Given PO
Blood and lymphatic system disorders
Anemia
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 2 • 2 years
Blood and lymphatic system disorders
Blood and lymph sys disorders - Oth Spec
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Ear and labyrinth disorders
Ear pain
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Gastrointestinal disorders
Ascites
20.0%
1/5 • Number of events 1 • 2 years
0.00%
0/6 • 2 years
Gastrointestinal disorders
Colitis
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Gastrointestinal disorders
Constipation
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Gastrointestinal disorders
Diarrhea
60.0%
3/5 • Number of events 6 • 2 years
33.3%
2/6 • Number of events 3 • 2 years
Gastrointestinal disorders
Mucositis oral
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 2 • 2 years
Gastrointestinal disorders
Nausea
20.0%
1/5 • Number of events 1 • 2 years
0.00%
0/6 • 2 years
General disorders
Fatigue
60.0%
3/5 • Number of events 12 • 2 years
66.7%
4/6 • Number of events 12 • 2 years
Infections and infestations
Paronychia
20.0%
1/5 • Number of events 1 • 2 years
0.00%
0/6 • 2 years
Investigations
Alanine aminotransferase increased
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Investigations
Aspartate aminotransferase increased
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Investigations
Blood bilirubin increased
0.00%
0/5 • 2 years
33.3%
2/6 • Number of events 3 • 2 years
Investigations
Lymphocyte count decreased
0.00%
0/5 • 2 years
33.3%
2/6 • Number of events 2 • 2 years
Investigations
Platelet count decreased
0.00%
0/5 • 2 years
50.0%
3/6 • Number of events 3 • 2 years
Investigations
Weight loss
0.00%
0/5 • 2 years
33.3%
2/6 • Number of events 3 • 2 years
Metabolism and nutrition disorders
Blood bicarbonate decreased
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Metabolism and nutrition disorders
Hyperglycemia
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Metabolism and nutrition disorders
Hypocalcemia
0.00%
0/5 • 2 years
33.3%
2/6 • Number of events 2 • 2 years
Metabolism and nutrition disorders
Hypokalemia
20.0%
1/5 • Number of events 1 • 2 years
0.00%
0/6 • 2 years
Metabolism and nutrition disorders
Hypomagnesemia
40.0%
2/5 • Number of events 4 • 2 years
0.00%
0/6 • 2 years
Metabolism and nutrition disorders
Hyponatremia
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Musculoskeletal and connective tissue disorders
Arthritis
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Musculoskeletal and connective tissue disorders
Rotator cuff injury
20.0%
1/5 • Number of events 1 • 2 years
0.00%
0/6 • 2 years
Nervous system disorders
Dizziness
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Nervous system disorders
Headache
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Nervous system disorders
Peripheral sensory neuropathy
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Psychiatric disorders
Depression
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Psychiatric disorders
Insomnia
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Respiratory, thoracic and mediastinal disorders
Cough
20.0%
1/5 • Number of events 2 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Respiratory, thoracic and mediastinal disorders
Sore throat
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Respiratory, thoracic and mediastinal disorders
Voice alteration
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Skin and subcutaneous tissue disorders
Alopecia
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years
Skin and subcutaneous tissue disorders
Palmar-plantar erythrodysesthesia syndrm
0.00%
0/5 • 2 years
33.3%
2/6 • Number of events 4 • 2 years
Skin and subcutaneous tissue disorders
Pruritus
20.0%
1/5 • Number of events 1 • 2 years
0.00%
0/6 • 2 years
Skin and subcutaneous tissue disorders
Rash acneiform
100.0%
5/5 • Number of events 17 • 2 years
16.7%
1/6 • Number of events 2 • 2 years
Skin and subcutaneous tissue disorders
Skin and subcut tissue disord - Oth spec
0.00%
0/5 • 2 years
16.7%
1/6 • Number of events 1 • 2 years

Additional Information

John Strickler, MD

Duke Cancer Institute

Phone: (507) 284-2511

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place