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Brief Title: Study of Durvalumab and Tremelimumab After Radiation for Microsatellite Stable Metastatic Colorectal Cancer Progressing on Chemotherapy
Official Title: A Phase II Study of the Dual Immune Checkpoint Blockade With Durvalumab (MEDI4736) Plus Tremelimumab Following Palliative Hypofractionated Radiation in Patients With Microsatellite Stable (MSS) Metastatic Colorectal Cancer Progressing on Chemotherapy
Study ID: NCT03007407
Brief Summary: This study is being done to look at the safety and response to the combination of two investigational drugs, tremelimumab and durvalumab, when given after radiation therapy for patients with microsatellite stable (MSS) metastatic colorectal cancer. Tremelimumab and durvalumab recognize specific proteins on the surface of cancer cells and trigger the immune system to destroy the cancer cells. In order to learn more about certain characteristics of colorectal cancer tumors, this study includes special research tests using samples from diagnostic tumors, fresh tumor samples from an area where the cancer has spread, and blood samples.
Detailed Description: The FC-9 study is designed as a phase II, open label, single arm study of the dual immune checkpoint blockade with the combination of durvalumab and tremelimumab following hypofractionated palliative radiation in patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC) who have progressed on chemotherapy. The primary aim is to determine the anti-tumor efficacy of the dual immune checkpoint blockade with durvalumab plus tremelimumab. The secondary aims are to determine the clinical benefit rate, duration of response, tolerability and correlates of response. Tumor response at unirradiated target lesions will be measured at baseline and every 2 cycles using RECIST 1.1. Following three doses of hypofractionated palliative radiation (Days -2, -1, and Day 0 prior to Cycle 1), patients will receive the combination of tremelimumab (75 mg IV infusion) and durvalumab (1500 mg IV infusion) on Day 1 for 4 cycles. Beginning with Cycle 5 through Cycle 24, patients will receive durvalumab alone (1500 mg/IV infusion) on Day 1 of each 28 day cycle. The sample size will be between 12 and 21 evaluable patients. Twelve evaluable patients will be treated in the first stage of the study. If there are no responses among the 12 evaluable patients, the study will be terminated. If the study goes on to the second stage, a total of 21 evaluable patients will be studied. Submission of tumor tissue and blood samples for FC-9 correlative science studies will be a study requirement for all patients. Requirements will include archived tumor samples from the diagnostic biopsy; additional biopsies of fresh tissue from an accessible lesion prior to radiation therapy and after 2 cycles of study therapy; and blood sample collections.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
City of Hope, Duarte, California, United States
Smilow Cancer Hospital at Yale-New Haven, New Haven, Connecticut, United States
Smilow Cancer Hospital Care Center at North Haven, North Haven, Connecticut, United States
UF Health Davis Cancer Pavilion and Shands Med Plaza, Gainesville, Florida, United States
UF Health Shands Cancer Hospital, Gainesville, Florida, United States
UF Health Shands Hospital, Gainesville, Florida, United States
University of Florida, Gainesville, Florida, United States
University of Florida Health Cancer Center at Orlando Health, Orlando, Florida, United States
Centralia Oncology Clinic, Centralia, Illinois, United States
Cancer Care Specialists of Central Illinois, Decatur, Illinois, United States
Cancer Care Specialists of Central Illinois/Crossroads Cancer Center, Effingham, Illinois, United States
Cancer Care Specialists of Central Illinois-Swansea, Swansea, Illinois, United States
Trinity Health Michigan, Ann Arbor, Michigan, United States
University of Michigan, Ann Arbor, Michigan, United States
St. Joseph Mercy-Brighton, Brighton, Michigan, United States
St. Joseph Mercy-Canton, Canton, Michigan, United States
St Joseph Mercy-Chelsea, Chelsea, Michigan, United States
Thomas Jefferson University, Philadelphia, Pennsylvania, United States
Name: Norman Wolmark, MD
Affiliation: NSABP Foundation Inc
Role: PRINCIPAL_INVESTIGATOR