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Brief Title: Cetuximab With or Without Brivanib in Treating Patients With K-Ras Wild Type Tumours and Metastatic Colorectal Cancer
Official Title: A Phase III Randomized Study of Brivanib Alaninate (BMS-582664) in Combination With Cetuximab (Erbitux®) Versus Placebo in Combination With Cetuximab (Erbitux®) in Patients With K-RAS Wild Type Tumors Previously Treated With Combination Chemotherapy for Metastatic Colorectal Carcinoma
Study ID: NCT00640471
Brief Summary: RATIONALE: Brivanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. It is not yet known whether giving brivanib together with cetuximab is more effective than cetuximab alone in treating patients with metastatic colorectal cancer. PURPOSE: This randomized phase III trial is studying cetuximab to see how well it works compared with cetuximab given together with brivanib in treating patients with metastatic colorectal cancer.
Detailed Description: OBJECTIVES: Primary * To compare the overall survival of patients with previously treated K-Ras wild type metastatic colorectal carcinoma treated with brivanib alaninate in combination with cetuximab versus placebo in combination with cetuximab. Secondary * To compare the progression-free survival of these patients. * To compare the objective response rate and duration of response in these patients. * To compare the quality of life of these patients. * To compare the health utilities of these patients. * To conduct a comparative economic evaluation of these patients. * To evaluate the safety profile of this regimen in these patients. * To explore an association between FGF-2, BRAF mutations, amphiregulin (AREG) and epiregulin (EREG) as determined from paraffin embedded tumor specimens and the potential for clinical benefit from the addition of brivanib alaninate or placebo to cetuximab in terms of overall survival, progression-free survival and objective response rate compared to cetuximab alone. * To explore associations with mRNA and/or protein expression and/or variations in genes associated with epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), angiogenesis, and other related pathways and the potential for clinical benefit from the addition of brivanib alaninate to cetuximab in terms of overall survival, progression-free survival, and objective response rate compared to cetuximab alone. * To explore an association with changes of Collagen IV in the blood and the potential for clinical benefit from the addition of brivanib alaninate to cetuximab in terms of overall survival, progression-free survival and objective response rate compared to cetuximab alone. * To establish a comprehensive tumor bank linked to a clinical database for the further study of molecular markers in colorectal cancer. OUTLINE: This is a multicenter study. Patients are stratified according to participating center and ECOG performance status (0-1 vs 2). Patients are randomized to 1 of 2 arms. * Arm I: Patients receive oral brivanib alaninate once daily and cetuximab IV over 60-120 minutes once weekly. * Arm II: Patients receive oral placebo once daily and cetuximab IV over 60-120 minutes once weekly. In both arms, treatment continues in the absence of disease progression or unacceptable toxicity. Tumor tissue and blood samples are collected for correlative studies. Samples are analyzed for biomarker levels (Collagen IV, FGF-2, and epiregulin, amphiregulin, and BRAF mutation status) and correlation with response. After completion of study treatment, patients are followed at 4 weeks and then every 8 weeks thereafter.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Tom Baker Cancer Centre, Calgary, Alberta, Canada
Cross Cancer Institute, Edmonton, Alberta, Canada
BCCA - Abbotsford Centre, Abbotsford, British Columbia, Canada
BCCA - Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada
BCCA - Fraser Valley Cancer Centre, Surrey, British Columbia, Canada
BCCA - Vancouver Cancer Centre, Vancouver, British Columbia, Canada
CancerCare Manitoba, Winnipeg, Manitoba, Canada
The Moncton Hospital, Moncton, New Brunswick, Canada
The Vitalite Health Network - Dr. Leon Richard, Moncton, New Brunswick, Canada
Atlantic Health Sciences Corporation, Saint John, New Brunswick, Canada
Dr. H. Bliss Murphy Cancer Centre, St. John's, Newfoundland and Labrador, Canada
The Royal Victoria Hospital, Barrie, Ontario, Canada
Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, Ontario, Canada
Cancer Centre of Southeastern Ontario at Kingston, Kingston, Ontario, Canada
Grand River Regional Cancer Centre, Kitchener, Ontario, Canada
London Regional Cancer Program, London, Ontario, Canada
Stronach Regional Health Centre at Southlake, Newmarket, Ontario, Canada
Lakeridge Health Oshawa, Oshawa, Ontario, Canada
Ottawa Health Research Institute - General Division, Ottawa, Ontario, Canada
Algoma District Cancer Program, Sault Ste. Marie, Ontario, Canada
Niagara Health System, St. Catharines, Ontario, Canada
Thunder Bay Regional Health Science Centre, Thunder Bay, Ontario, Canada
Toronto East General Hospital, Toronto, Ontario, Canada
Odette Cancer Centre, Toronto, Ontario, Canada
St. Michael's Hospital, Toronto, Ontario, Canada
Univ. Health Network-Princess Margaret Hospital, Toronto, Ontario, Canada
PEI Cancer Treatment Centre,Queen Elizabeth Hospital, Charlottetown, Prince Edward Island, Canada
Hopital Charles LeMoyne, Greenfield Park, Quebec, Canada
L'Hotel-Dieu de Levis, Levis, Quebec, Canada
CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada
McGill University - Dept. Oncology, Montreal, Quebec, Canada
Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
CHUQ-Pavillon Hotel-Dieu de Quebec, Quebec City, Quebec, Canada
CHA-Hopital Du St-Sacrement, Quebec City, Quebec, Canada
Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
Allan Blair Cancer Centre, Regina, Saskatchewan, Canada
Saskatoon Cancer Centre, Saskatoon, Saskatchewan, Canada
Name: Lillian L. Siu, MD, FRCPC
Affiliation: Princess Margaret Hospital, Canada
Role: STUDY_CHAIR