Colorectal Cancer MetastaticPhase 3NCT01571284
Safety and Quality of Life Study of Aflibercept in Patients With Metastatic Colorectal Cancer Previously Treated With an Oxaliplatin-Based Regimen
A Phase 3 study testing AFLIBERCEPT AVE0005 and FOLFIRI in people with Colorectal Cancer Metastatic, run by Sanofi at 179 sites in 23 countries.
Trial summary
Primary Objective: To provide metastatic colorectal cancer participants with access to aflibercept and to document the overall safety in these participants Secondary Objective: To document the Health-Related Quality of Life of aflibercept in this participants population Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Colorectal Cancer Metastatic
- What is being tested?
- AFLIBERCEPT AVE0005 and FOLFIRI
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 781 participants
- Where
- 179 sitesin 23 countries
- Study dates
- 30 May 2012to 31 Jan 2017
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically or cytologically proven adenocarcinoma of the colon or rectum.
- Metastatic disease.
- Eastern Cooperative Oncology Group performance status 0-1.
- One and only one prior chemotherapeutic regimen for metastatic disease. This prior chemotherapy was an oxaliplatin containing regimen. Participants must had progressed during or after the oxaliplatin based chemotherapy. Participants relapsed within 6 months of completion of oxaliplatin adjuvant chemotherapy were eligible.
- Signed written informed consent obtained prior to inclusion.
Who cannot join
- Prior therapy with irinotecan.
- Inadequate bone marrow, liver and renal function: neutrophils < 1.5x109/L, platelets < 100x109/L, hemoglobin < 9.0 g/dL, total bilirubin >1.5 x upper normal limit (ULN), transaminases >3 x ULN (unless liver metastasis are present), alkaline phosphatase >3 x ULN (unless liver metastasis are present), serum creatinine > 1.5 x ULN.
- Less than 4 weeks from prior radiotherapy, prior chemotherapy, prior major surgery (or until the surgical wound were fully healed).
- Treatment with any investigational drug within the prior 30 days.
- Treatment with concomitant anticonvulsivant agents that were CYP3A4 inducers (phenytoin, phenobarbital, carbamazepine), unless discontinued >7 days.
- History of brain metastases, uncontrolled spinal cord compression, or carcinomatous meningitis or new evidence of brain or leptomeningeal disease.
Show all 25Show fewer
- Prior malignancy (other than colorectal) including prior malignancy from which the participants had been disease free for < 5 years (except adequately treated basal or squamous cell skin cancer or carcinoma in situ of the cervix).
- Any of the following within 6 months prior to study inclusion: myocardial infarction, severe/unstable angina pectoris, coronary/peripheral artery bypass graft, severe congestive heart failure, stroke or transient ischemic attack.
- Any of the following within 3 months prior study inclusion: severe gastrointestinal bleeding/hemorrhage, treatment resistant peptic ulcer disease, erosive oesophagitis or gastritis, infectious or inflammatory bowel disease, diverticulitis, pulmonary embolism or other uncontrolled thromboembolic event.
- Occurrence of deep vein thrombosis within 4 weeks, prior to study inclusion.
- Known acquired immunodeficiency syndrome (AIDS-related illnesses) or known HIV disease requiring antiretroviral treatment.
- Known dihydropyrimidine dehydrogenase deficiency.
- Predisposing colonic or small bowel disorders in which the symptoms were uncontrolled.
- Prior history of chronic enteropathy, inflammatory enteropathy, chronic diarrhea, unresolved bowel obstruction/sub-obstruction, more than hemicolectomy, extensive small intestine resection with chronic diarrhea.
- Known Gilbert's syndrome.
- Unresolved or unstable toxicity from any prior anti cancer therapy at the time of inclusion.
- History of anaphylaxis or known intolerance to atropine sulphate or loperamide or appropriate antiemetics to be administered in conjunction with FOLFIRI (irinotecan, 5-Fluorouracil, leucovorin).
- Severe acute or chronic medical condition, which could impair the ability of the participants to participate to the study.
- Urine protein-creatinine ratio (UPCR) >1 on morning spot urinalysis or proteinuria > 500 mg/24-h.
- Uncontrolled hypertension within 3 months prior to study inclusion.
- Participants on anticoagulant therapy with unstable dose of warfarin and/or had an out-of-therapeutic range INR within the 4 weeks prior to study inclusion.
- Evidence of clinically significant bleeding predisposition or underlying coagulopathy, non-healing wound.
- Pregnant or breast-feeding women.
- Participants with reproductive potential who were not agree to use an accepted effective method of contraception.
- The above information wass not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Trial locations and contacts
179 sites in 23 countries.
179 sites in 23 countries
Italy28 sites
Investigational Site Number 380-005
Ancona, 60100
Investigational Site Number 380-029
Bergamo, 24128
Investigational Site Number 380-021
Bologna, 40133
Investigational Site Number 380-004
Brescia
Investigational Site Number 380-007
Candiolo
Investigational Site Number 380-012
Catania
Investigational Site Number 380-019
Catanzaro
Investigational Site Number 380-023
Florence
Investigational Site Number 380-001
Genova, 16132
Investigational Site Number 380-014
Meldola
Investigational Site Number 380-016
Messina
Investigational Site Number 380-013
Milan
Investigational Site Number 380-015
Milan
Investigational Site Number 380-025
Milan
Investigational Site Number 380-022
Naples
Investigational Site Number 380-028
Novara
Investigational Site Number 380-017
Padova
Investigational Site Number 380-002
Pisa
Investigational Site Number 380-008
Reggio Emilia, 42125
Investigational Site Number 380-024
Roma, 00189
Investigational Site Number 380-010
Roma
Investigational Site Number 380-011
Roma
Investigational Site Number 380-006
San Giovanni Rotondo
Investigational Site Number 380-026
Sassari
Investigational Site Number 380-020
Terni
Investigational Site Number 380-009
Torino
Investigational Site Number 380-003
Udine
Investigational Site Number 380-018
Verona
Germany20 sites
Investigational Site Number 276-016
Aschaffenburg, 63739
Investigational Site Number 276-010
Augsburg, 86150
Investigational Site Number 276-011
Berlin, 10707
Investigational Site Number 276-012
Erlangen, 91054
Investigational Site Number 276-009
Frankfurt am Main, 60389
Investigational Site Number 276-013
Frankfurt am Main, 60590
Investigational Site Number 276-004
Halle, 06120
Investigational Site Number 276-007
Krefeld, 47805
Investigational Site Number 276-003
Lebach, 66822
Investigational Site Number 276-019
Leipzig, 04103
Investigational Site Number 276-008
Ludwigsburg, 71640
Investigational Site Number 276-018
Magdeburg, 39104
Investigational Site Number 276-014
Magdeburg, 39130
Investigational Site Number 276-006
Moers, 47441
Investigational Site Number 276-001
München, 81377
Investigational Site Number 276-002
München, 81737
Investigational Site Number 276-015
Northeim, 37154
Investigational Site Number 276-017
Velbert, 42551
Investigational Site Number 276-005
Weiden/Oberpfalz, 92637
Investigational Site Number 276-020
Wolfsburg, 38440
Spain16 sites
Investigational Site Number 724016
Alicante, 03010
Investigational Site Number 724008
Barakaldo, 48903
Investigational Site Number 724012
Cáceres, 10003
Investigational Site Number 724002
Córdoba, 14004
Investigational Site Number 724013
Donostia / San Sebastian, 20014
Investigational Site Number 724014
L'Hospitalet de Llobregat, 08907
Investigational Site Number 724003
Madrid, 28007
Investigational Site Number 724015
Madrid, 28034
Investigational Site Number 724005
Madrid, 28041
Investigational Site Number 724004
Málaga, 29010
Investigational Site Number 724010
Sabadell, 08208
Investigational Site Number 724011
Santander, 39008
Investigational Site Number 724006
Santiago de Compostela, 15706
Investigational Site Number 724001
Valencia, 46009
Investigational Site Number 724009
Valencia, 46009
Investigational Site Number 724007
Zaragoza, 50009
United States12 sites
Investigational Site Number 840-012
Albuquerque, New Mexico, 87106
Investigational Site Number 840-008
Corona, California, 92879
Investigational Site Number 840-009
Farmington, New Mexico, 87401
Investigational Site Number 840-007
Fountain Valley, California, 92708
Investigational Site Number 840-010
Howell Township, New Jersey, 07731
Investigational Site Number 840-006
Indianapolis, Indiana, 46254
Investigational Site Number 840-003
Lake Success, New York, 11042
Investigational Site Number 840-011
Metairie, Louisiana, 70006
Investigational Site Number 840-005
Middletown, Ohio, 45042
Investigational Site Number 840-002
Muscle Shoals, Alabama, 35661
Investigational Site Number 840-004
Riverside, California, 92501
Investigational Site Number 840-001
Rockville, Maryland, 20850
Belgium12 sites
Investigational Site Number 056010
Aalst, 9300
Investigational Site Number 056015
Arlon, 6700
Investigational Site Number 056004
Bonheiden, 2820
Investigational Site Number 056001
Edegem, 2650
Investigational Site Number 056012
Ghent, 9000
Investigational Site Number 056009
Haine-Saint-Paul, 7100
Investigational Site Number 056003
Liège, 4000
Investigational Site Number 056007
Liège, 4000
Investigational Site Number 056014
Loverval, 6280
Investigational Site Number 056013
Turnhout, 2300
Investigational Site Number 056002
Verviers, 4800
Investigational Site Number 056011
Yvoir, 5530
Turkey (Türkiye)12 sites
Investigational Site Number 792-06
Adana, 01250
Investigational Site Number 792-01
Ankara, 06100
Investigational Site Number 792-09
Ankara, 06200
Investigational Site Number 792-08
Ankara
Investigational Site Number 792-02
Çapa, 34390
Investigational Site Number 792010
Edirne
Investigational Site Number 792-05
Gaziantep
Investigational Site Number 792012
Istanbul, 34093
Investigational Site Number 792-03
Istanbul, 34865
Investigational Site Number 792-04
Istanbul
Investigational Site Number 792-007
Izmir, 35100
Investigational Site Number 792011
Izmir
United Kingdom12 sites
Investigational Site Number 826005
Dudley, DY1 2HQ
Investigational Site Number 826011
Hull, HU165JQ
Investigational Site Number 826008
Leicester, LE15WW
Investigational Site Number 826007
London, NW1 2PJ
Investigational Site Number 826012
London, SE17EH
Investigational Site Number 826003
Maidstone, ME169QQ
Investigational Site Number 826009
Manchester, M204BX
Investigational Site Number 826004
Newcastle upon Tyne, NE77DN
Investigational Site Number 826006
Northwood, HA62RN
Investigational Site Number 826002
Southampton, SO60YD
Investigational Site Number 826001
Sutton, SM25PT
Investigational Site Number 826010
Taunton, TA15DA
Brazil11 sites
Investigational Site Number 008
Brasília, 70390-150
Investigational Site Number 009
Curitiba, 80530-010
Investigational Site Number 012
Fortaleza
Investigational Site Number 006
Passo Fundo, 99010-260
Investigational Site Number 003
Porto Alegre, 90470-340
Investigational Site Number 002
Rio de Janeiro, 22793-080
Investigational Site Number 011
Salvador, 40170-070
Investigational Site Number 013
São José do Rio Preto, 15090-000
Investigational Site Number 001
São Paulo, 01246-000
Investigational Site Number 004
São Paulo, 01308-050
Investigational Site Number 005
São Paulo, 01321-000
Thailand10 sites
Investigational Site Number 764002
Bangkok, 10330
Investigational Site Number 764003
Bangkok, 10400
Investigational Site Number 764008
Bangkok, 10400
Investigational Site Number 764001
Bangkok
Investigational Site Number 764006
Bangkok
Investigational Site Number 764005
Bangkok,TH
Investigational Site Number 764009
Chiang Mai, 50200
Investigational Site Number 764004
Khon Kaen, 40002
Investigational Site Number 764010
Laksi, 10210
Investigational Site Number 764007
Lopburi, 15000
Russia7 sites
Investigational Site Number 643003
Kazan', 420029
Investigational Site Number 643001
Moscow, 115478
Investigational Site Number 643004
Moscow, 115478
Investigational Site Number 643005
Moscow, 115478
Investigational Site Number 643002
Moscow, 123448
Investigational Site Number 643006
Moscow, 129301
Investigational Site Number 643009
Saint Petersburg, 186646
Canada6 sites
Investigational Site Number 124002
Calgary, T2N 4N2
Investigational Site Number 124003
Montreal, H1T 2M4
Investigational Site Number 124005
Montreal, H2W1S6
Investigational Site Number 124004
Ottawa, K1H8L6
Investigational Site Number 124006
Québec, G1S4L8
Investigational Site Number 124001
Toronto, M4N3M5
Czechia6 sites
Investigational Site Number 203005
Brno, 65653
Investigational Site Number 203003
Olomouc, 77900
Investigational Site Number 203001
Ostrava, 70852
Investigational Site Number 203002
Prague, 12808
Investigational Site Number 203004
Prague, 15006
Investigational Site Number 203006
Zlín
Israel5 sites
Investigational Site Number 376002
Haifa, 31096
Investigational Site Number 376001
Jerusalem, 91120
Investigational Site Number 376005
Petah Tikva, 49100
Investigational Site Number 376003
Tel Aviv, 64239
Investigational Site Number 376004
Tel HaShomer, 52621
Mexico4 sites
Investigational Site Number 484002
Mexico City, 06760
Investigational Site Number 484009
Mexico City, 57205
Investigational Site Number 484010
México, D.F., 06726
Investigational Site Number 484001
Monterrey, 64060
Denmark3 sites
Investigational Site Number 208001
Cph Ø, 2100
Investigational Site Number 208003
Hillerød, 3400
Investigational Site Number 208002
Odense C, 5000
Ireland3 sites
Investigational Site Number 372002
Dublin
Investigational Site Number 372004
Galway
Investigational Site Number 372001
Wilton
Chile2 sites
Investigational Site Number 152001
Santiago
Investigational Site Number 152003
Santiago
Finland2 sites
Investigational Site Number 246001
Oulu, 90220
Investigational Site Number 246002
Turku, 20520
Netherlands2 sites
Investigational Site Number 528001
Hoofddorp, 2134TM
Investigational Site Number 528002
Zwolle, 8025AB
Norway2 sites
Investigational Site Number 578002
Bergen, 5021
Investigational Site Number 578001
Oslo, 0407
Sweden2 sites
Investigational Site Number 752_002
Jönköping, 55185
Investigational Site Number 752_001
Vaxjo, 35185
About this study
Official title: A Multicenter, Single Arm, Open Label Clinical Trial to Evaluate the Safety and Health-Related Quality of Life of Aflibercept in Patients With Metastatic Colorectal Cancer (mCRC) Previously Treated With an Oxaliplatin-Containing Regimen
Primary Objective:
To provide metastatic colorectal cancer participants with access to aflibercept and to document the overall safety in these participants
Secondary Objective:
To document the Health-Related Quality of Life of aflibercept in this participants population
Read the detailed description
Each participants will be treated until disease progression, unacceptable toxicity, death, Investigator's decision or participant's refusal for further treatment (whichever comes first). Participants were followed-up during study treatment and for at least 30 days after last administration.
- Conditions
- Colorectal Cancer Metastatic
- Being tested
- AFLIBERCEPT AVE0005, FOLFIRI
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AFLIBERCEPT AVE0005Drug
Pharmaceutical form:Concentrate for solution for infusion Route of administration: Intravenous
FOLFIRIDrug
irinotecan, 5-FU and leucovorin
| Study group | Role | What they receive |
|---|---|---|
| Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin) | Experimental | Aflibercept 4 mg/kg IV infusion over 60 minutes followed by Irinotecan 180 mg/m^2 IV infusion over 90 minutes and Leucovorin 400 mg/m^2 IV infusion over 120 minutes at the same time followed by 5-Fluorouracil (5-FU) 400 mg/m^2 IV bolus over 2-4 minutes followed by 5-FU 2400 mg/m^2 continuous IV infusion over 46 hours on Day 1 of each cycle (1 Cycle = 2 weeks), until disease progression (DP), unacceptable toxicity, death, Investigator's decision or participant's refusal of further treatment. Receives: Drug: AFLIBERCEPT AVE0005; Drug: FOLFIRI |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Any untoward medical occurrence in a participant who received investigational medicinal product (IMP) was considered an adverse event (AE) without regard to possibility of causal relationship with this treatment. A serious AE (SAE): Any untoward medical occurrence that resulted in any of the following outcomes: death, life-threatening, required initial or prolonged in-patient hospitalization, persistent or significant disability/incapacity, congenital anomaly/birth defect, or considered as medically important event. Any TEAE included participants with both serious and non-serious AEs. National Cancer Institute Common Terminology Criteria (NCI-CTCAE) Version 4.03 was used to assess severity (Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling) of AEs.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Abnormal Hematological Parameters
Abnormal hematological parameters included: anaemia, thrombocytopenia, leukopenia and neutropenia. Number of participants with each of these parameters were analyzed by grades (All Grades and Grades 3-4 as per NCI CTCAE (Version 4.03), where Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With International Normalized Ratio (INR)
The INR is a derived measure of the prothrombin time. The INR is the ratio of a participant's prothrombin time to a normal control sample. Normal range (without anti coagulation therapy): 0.8-1.2; Targeted range (with anti coagulation therapy) 2.0-3.0.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Abnormal Electrolytes Parameters
Abnormal electrolytes parameters included: hyponatremia, hypernatremia, hypocalcemia, hypercalcemia, hypokalemia, and hyperkalemia. Number of participants with each of these parameters were analyzed by grades ( All Grades and Grades 3-4 as per NCI CTCAE Version 4.03, where Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Abnormal Renal and Liver Function Parameters
Renal and liver function parameters included: creatinine, hyperbilirubinemia, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase. Number of participants with each of these parameters were analyzed by grades (All Grades and Grades 3-4) as per NCI CTCAE version 4.03, where Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Creatinine Clearance of Aflibercept Plus FOLFIRI
Creatinine clearance is a measure of kidney function. Creatinine clearance rate is the volume of blood plasma that is cleared of creatinine by the kidneys per unit time. Creatinine clearance can be measured directly or estimated using established formulas. For this study, the creatinine clearance was calculated using the Cockroft-Gault or Modification of Diet in Renal Disease (MDRD).
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Other Abnormal Biochemistry Parameters
Other abnormal biochemistry parameters included: hypoglycemia, hyperglycemia and hypoalbuminemia. Number of participants with each of these parameters were analyzed by grades (All Grades and Grades 3-4) as per NCI CTCAE Version 4.03, where Grade 1= mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Abnormal Non-Gradable Biochemistry Parameters
Non-gradeable biochemistry parameters included; chloride, urea, total protein, blood urea nitrogen (BUN) and lactate dehydrogenase (LDH). Number of participants with <lower limit of normal ranges (LLN) and >upper limit of normal ranges (ULN) for each of these parameters were reported.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Proteinuria Events
Proteinuria is defined as the ratio of protein to creatinine. Number of participants with proteinuria were analyzed by grades (Grades 1, 2, 3 ,4) as per NCI CTCAE Version 4.03 where Grade 1= mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Proteinuria Grade >=2
Proteinuria is defined as the ratio of protein to creatinine. Number of participants with proteinuria grade >=2 (graded as per NCI CTCAE Version 4.03), where Grade>=2 represents moderate to life-threatening/disabling event.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Urinary Protein-Creatinine Ratio (UPCR)
Urinary protein creatinine ratio (UPCR) corresponds to the ratio of the urinary protein and urinary creatinine concentration (expressed in mg/dL). This ratio provides an accurate quantification of 24-hours urinary protein excretion. There is a high correlation between morning UPCR and 24-hour proteinuria in participants with normal or reduced renal functions. Normal ratio is < or = 1.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Proteinuria (Grade>=2) Concomitant With Hematuria and /or Hypertension
Proteinuria is defined as the presence of excess proteins in the urine (assessed either by spot sample, dipstick/ urine protein or 24 hour urine collection). Hematuria is defined as the presence of blood in urine (positive dipstick for RBC or reported AE). Number of participants with proteinuria grade >=2 (graded as per NCI CTCAE Version 4.03), where Grade>=2 represents moderate to life-threatening/disabling event. Hypertension (high blood pressure) is defined as having a blood pressure reading of more than 140/90 mmHg over a number of weeks.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Number of Participants With Cycle Delay and/or Dose Modification
A theoretical cycle is a 2 week period i.e. 14 days. A cycle is delayed if duration of previous cycle is greater than 14+2 days ; dose modification includes dose reduction and dose omission.
Measured: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Secondary outcomes (5)
Mean Change From Baseline in Health Related Quality of Life (HRQL) European Organization for Research and Treatment for Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 Score): Global Health Status
EORTC-QLQ-C30 is a cancer-specific instrument with 30 questions for evaluation of new chemotherapy and provides an assessment of participant reported outcome dimensions. First 28 questions used 4-point scale (1=not at all,2=a little,3=quite a bit,4=very much) for evaluating 5 functional scales (physical,role,emotional,cognitive,social), 3 symptom scales (fatigue,nausea/vomiting,pain) \& other single items. For each item,high score represented high level of symptomatology/problem. Last 2 questions represented participant's assessment of overall health \& quality of life, coded on 7-point scale (1=very poor to 7=excellent).EORTC QLQ-C30 observed values and change from baseline for global health status (scoring of questions 29 \& 30) and 5 functional scales, 3 symptom scales and other single items (scoring of questions 1 to 28). Answers were converted into grading scale, with values between 0 and 100. A high score represented a favourable outcome with a best quality of life for participant.
Measured: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at the end of treatment (EOT) (within 30 days of last treatment) (maximum exposure: 214 weeks)
Mean Change From Baseline in HRQL EORTC QLQ-C30 Score: Functional Scales
EORTC-QLQ-C30 is a cancer-specific instrument with 30 questions for evaluation of new chemotherapy and provides an assessment of participant reported outcome dimensions. First 28 questions used 4-point scale (1=not at all,2=a little,3=quite a bit,4=very much) for evaluating 5 functional scales (physical,role,emotional,cognitive,social), 3 symptom scales (fatigue,nausea/vomiting,pain) \& other single items. For each item,high score represented high level of symptomatology/problem. Last 2 questions represented participant's assessment of overall health \& quality of life, coded on 7-point scale (1=very poor to 7=excellent). EORTC QLQ-C30 observed values and change from baseline for global health status (scoring of questions 29 \& 30) and 5 functional scales, 3 symptom scales and other single items (scoring of questions 1 to 28).Answers were converted into grading scale, with values between 0 and 100. A high score represented a favourable outcome with a best quality of life for participant.
Measured: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Change From Baseline in HRQL EORTC QLQ-C30 Score: Symptom Scales
EORTC-QLQ-C30 is a cancer-specific instrument with 30 questions for evaluation of new chemotherapy and provides an assessment of participant reported outcome dimensions. First 28 questions used 4-point scale (1=not at all,2=a little,3=quite a bit,4=very much) for evaluating 5 functional scales (physical,role,emotional,cognitive,social), 3 symptom scales (fatigue,nausea/vomiting,pain) \& other single items. For each item,high score represented high level of symptomatology/problem. Last 2 questions represented participant's assessment of overall health \& quality of life, coded on 7-point scale (1=very poor to 7=excellent). EORTC QLQ-C30 observed values and change from baseline for global health status (scoring of questions 29 \& 30) and 5 functional scales, 3 symptom scales and other single items (scoring of questions 1 to 28). Answers were converted into grading scale, with values between 0 and 100. A high score represented a favorable outcome with a best quality of life for participant.
Measured: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Change From Baseline in HRQL EQ-5D-3L Quality of Life: Single Index Utility Score
EQ-5D was a standardized HRQL questionnaire consisting of EQ-5D descriptive system and Visual Analogue Scale (VAS). EQ-5D descriptive system comprised of 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression measured on 3 levels (no problem, some problems \& severe problems) within a particular EQ-5D dimension. 5 dimensional 3-level system was converted into single index utility score. Possible values for single index utility score ranged from -0.594 (severe problems in all dimensions) to 1.0 (no problem in all dimensions) on scale where 1 represented best possible health state.
Measured: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Change From Baseline in HRQL EQ-5D-3L VAS Score
EQ-5D was a standardized HRQL questionnaire consisting of EQ-5D descriptive system and VAS. EQ-5D descriptive system comprised of 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression measured on 3 levels (no problem, some problems \& severe problems) within a particular EQ-5D dimension. 5 dimensional 3-level system was converted into single index utility score. The VAS recorded the respondent's self-rated health on a vertical visual analogue scale. The VAS 'thermometer' has endpoints of 100 (Best imaginable health state) at the top and 0 (Worst imaginable health state) at the bottom. This information can be used as a quantitative measure of health outcome as judged by the individual respondents.
Measured: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Apr 2012 (estimated)
- Study start30 May 2012
- Primary completion31 Jan 2017
- Study completion31 Jan 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Colorectal Cancer MetastaticStudies of the same condition, open and under way.
- More trials run by SanofiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 781 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sanofi
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Regeneron Pharmaceuticals
- Responsible party
- Sponsor
- Investigators
- Clinical Sciences & Operations, Study director, Sanofi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01571284
- Sponsor's protocol ID
- AFLIBC06097
- Other IDs
- 2011-005724-17, U1111-1125-8949
- Status last verified
- Mar 2018
- First submitted
- 3 Apr 2012
- Last updated
- 17 Apr 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Riechelmann RP, Srimuninnimit V, Bordonaro R, Kavan P, Di Bartolomeo M, Maiello E, Cicin I, Garcia-Alfonso P, Chau I, Fedyanin MY, Martos CF, Ter-Ovanesov M, Peeters M, Ko YJ, Yalcin S, Karthaus M, Aparicio J, Heinemann V, Picard P, Bury D, Drea E, Sobrero A. Aflibercept Plus FOLFIRI for Second-line Treatment of Metastatic Colorectal Cancer: Observations from the Global Aflibercept Safety and Health-Related Quality-of-Life Program (ASQoP). Clin Colorectal Cancer. 2019 Sep;18(3):183-191.e3. doi: 10.1016/j.clcc.2019.05.003. Epub 2019 May 15.
PubMed 31221542
Study at a glance
From the registry record, last updated by the sponsor on 17 Apr 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multicenter, Single Arm, Open Label Clinical Trial to Evaluate the Safety and Health-Related Quality of Life of Aflibercept in Patients With Metastatic Colorectal Cancer (mCRC) Previously Treated With an Oxaliplatin-Containing Regimen
- ClinicalTrials.gov ID
- NCT01571284
- Acronym / sponsor ID
- AFLIBC06097
- Conditions
- Colorectal Cancer Metastatic
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 781 participants (actual)
- Lead sponsor
- SanofiIndustry (pharma, biotech, devices)
- Collaborators
- Regeneron Pharmaceuticals
- Study start
- 30 May 2012 (actual)
- Primary completion
- 31 Jan 2017 (actual)
- Study completion
- 31 Jan 2017 (actual)
- First posted
- 5 Apr 2012 (estimated)
- Results
- Posted 27 Feb 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Primary Objective:
To provide metastatic colorectal cancer participants with access to aflibercept and to document the overall safety in these participants
Secondary Objective:
To document the Health-Related Quality of Life of aflibercept in this participants population
Detailed description
Each participants will be treated until disease progression, unacceptable toxicity, death, Investigator's decision or participant's refusal for further treatment (whichever comes first). Participants were followed-up during study treatment and for at least 30 days after last administration.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin) | Experimental | Drug: AFLIBERCEPT AVE0005, Drug: FOLFIRIAflibercept 4 mg/kg IV infusion over 60 minutes followed by Irinotecan 180 mg/m^2 IV infusion over 90 minutes and Leucovorin 400 mg/m^2 IV infusion over 120 minutes at the same time followed by 5-Fluorouracil (5-FU) 400 mg/m^2 IV bolus over 2-4 minutes followed by 5-FU 2400 mg/m^2 continuous IV infusion over 46 hours on Day 1 of each cycle (1 Cycle = 2 weeks), until disease progression (DP), unacceptable toxicity, death, Investigator's decision or participant's refusal of further treatment. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Histologically or cytologically proven adenocarcinoma of the colon or rectum.
- Metastatic disease.
- Eastern Cooperative Oncology Group performance status 0-1.
- One and only one prior chemotherapeutic regimen for metastatic disease. This prior chemotherapy was an oxaliplatin containing regimen. Participants must had progressed during or after the oxaliplatin based chemotherapy. Participants relapsed within 6 months of completion of oxaliplatin adjuvant chemotherapy were eligible.
- Signed written informed consent obtained prior to inclusion.
Key exclusion criteria (25 listed)
- Prior therapy with irinotecan.
- Inadequate bone marrow, liver and renal function: neutrophils < 1.5x109/L, platelets < 100x109/L, hemoglobin < 9.0 g/dL, total bilirubin >1.5 x upper normal limit (ULN), transaminases >3 x ULN (unless liver metastasis are present), alkaline phosphatase >3 x ULN (unless liver metastasis are present), serum creatinine > 1.5 x ULN.
- Less than 4 weeks from prior radiotherapy, prior chemotherapy, prior major surgery (or until the surgical wound were fully healed).
- Treatment with any investigational drug within the prior 30 days.
- Treatment with concomitant anticonvulsivant agents that were CYP3A4 inducers (phenytoin, phenobarbital, carbamazepine), unless discontinued >7 days.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AFLIBERCEPT AVE0005Pharmaceutical form:Concentrate for solution for infusion Route of administration: Intravenous | Drug | Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin) |
| FOLFIRIirinotecan, 5-FU and leucovorin | Drug | Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin) |
Primary outcome
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Any untoward medical occurrence in a participant who received investigational medicinal product (IMP) was considered an adverse event (AE) without regard to possibility of causal relationship with this treatment. A serious AE (SAE): Any untoward medical occurrence that resulted in any of the following outcomes: death, life-threatening, required initial or prolonged in-patient hospitalization, persistent or significant disability/incapacity, congenital anomaly/birth defect, or considered as medically important event. Any TEAE included participants with both serious and non-serious AEs. National Cancer Institute Common Terminology Criteria (NCI-CTCAE) Version 4.03 was used to assess severity (Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling) of AEs.
Number of Participants With Abnormal Hematological Parameters
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Abnormal hematological parameters included: anaemia, thrombocytopenia, leukopenia and neutropenia. Number of participants with each of these parameters were analyzed by grades (All Grades and Grades 3-4 as per NCI CTCAE (Version 4.03), where Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Number of Participants With International Normalized Ratio (INR)
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
The INR is a derived measure of the prothrombin time. The INR is the ratio of a participant's prothrombin time to a normal control sample. Normal range (without anti coagulation therapy): 0.8-1.2; Targeted range (with anti coagulation therapy) 2.0-3.0.
Number of Participants With Abnormal Electrolytes Parameters
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Abnormal electrolytes parameters included: hyponatremia, hypernatremia, hypocalcemia, hypercalcemia, hypokalemia, and hyperkalemia. Number of participants with each of these parameters were analyzed by grades ( All Grades and Grades 3-4 as per NCI CTCAE Version 4.03, where Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Number of Participants With Abnormal Renal and Liver Function Parameters
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Renal and liver function parameters included: creatinine, hyperbilirubinemia, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase. Number of participants with each of these parameters were analyzed by grades (All Grades and Grades 3-4) as per NCI CTCAE version 4.03, where Grade 1=mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Creatinine Clearance of Aflibercept Plus FOLFIRI
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Creatinine clearance is a measure of kidney function. Creatinine clearance rate is the volume of blood plasma that is cleared of creatinine by the kidneys per unit time. Creatinine clearance can be measured directly or estimated using established formulas. For this study, the creatinine clearance was calculated using the Cockroft-Gault or Modification of Diet in Renal Disease (MDRD).
Number of Participants With Other Abnormal Biochemistry Parameters
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Other abnormal biochemistry parameters included: hypoglycemia, hyperglycemia and hypoalbuminemia. Number of participants with each of these parameters were analyzed by grades (All Grades and Grades 3-4) as per NCI CTCAE Version 4.03, where Grade 1= mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling. All Grades included Grades 1-4.
Number of Participants With Abnormal Non-Gradable Biochemistry Parameters
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Non-gradeable biochemistry parameters included; chloride, urea, total protein, blood urea nitrogen (BUN) and lactate dehydrogenase (LDH). Number of participants with <lower limit of normal ranges (LLN) and >upper limit of normal ranges (ULN) for each of these parameters were reported.
Number of Participants With Proteinuria Events
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Proteinuria is defined as the ratio of protein to creatinine. Number of participants with proteinuria were analyzed by grades (Grades 1, 2, 3 ,4) as per NCI CTCAE Version 4.03 where Grade 1= mild, Grade 2= moderate, Grade 3= severe, Grade 4= life-threatening/disabling.
Number of Participants With Proteinuria Grade >=2
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Proteinuria is defined as the ratio of protein to creatinine. Number of participants with proteinuria grade >=2 (graded as per NCI CTCAE Version 4.03), where Grade>=2 represents moderate to life-threatening/disabling event.
Number of Participants With Urinary Protein-Creatinine Ratio (UPCR)
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Urinary protein creatinine ratio (UPCR) corresponds to the ratio of the urinary protein and urinary creatinine concentration (expressed in mg/dL). This ratio provides an accurate quantification of 24-hours urinary protein excretion. There is a high correlation between morning UPCR and 24-hour proteinuria in participants with normal or reduced renal functions. Normal ratio is < or = 1.
Number of Participants With Proteinuria (Grade>=2) Concomitant With Hematuria and /or Hypertension
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
Proteinuria is defined as the presence of excess proteins in the urine (assessed either by spot sample, dipstick/ urine protein or 24 hour urine collection). Hematuria is defined as the presence of blood in urine (positive dipstick for RBC or reported AE). Number of participants with proteinuria grade >=2 (graded as per NCI CTCAE Version 4.03), where Grade>=2 represents moderate to life-threatening/disabling event. Hypertension (high blood pressure) is defined as having a blood pressure reading of more than 140/90 mmHg over a number of weeks.
Number of Participants With Cycle Delay and/or Dose Modification
Time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)
A theoretical cycle is a 2 week period i.e. 14 days. A cycle is delayed if duration of previous cycle is greater than 14+2 days ; dose modification includes dose reduction and dose omission.
5 secondary outcomes
Mean Change From Baseline in Health Related Quality of Life (HRQL) European Organization for Research and Treatment for Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 Score): Global Health Status
Time frame: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at the end of treatment (EOT) (within 30 days of last treatment) (maximum exposure: 214 weeks)
Mean Change From Baseline in HRQL EORTC QLQ-C30 Score: Functional Scales
Time frame: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Change From Baseline in HRQL EORTC QLQ-C30 Score: Symptom Scales
Time frame: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Change From Baseline in HRQL EQ-5D-3L Quality of Life: Single Index Utility Score
Time frame: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Change From Baseline in HRQL EQ-5D-3L VAS Score
Time frame: Pre-dose at Baseline, Day 1 of every odd cycle (from Cycle 3 to 35); at EOT (within 30 days of last treatment) (maximum exposure: 214 weeks)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Apr 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 31221542Riechelmann RP, Srimuninnimit V, Bordonaro R, Kavan P, Di Bartolomeo M, Maiello E, Cicin I, Garcia-Alfonso P, Chau I, Fedyanin MY, Martos CF, Ter-Ovanesov M, Peeters M, Ko YJ, Yalcin S, Karthaus M, Aparicio J, Heinemann V, Picard P, Bury D, Drea E, Sobrero A. Aflibercept Plus FOLFIRI for Second-line Treatment of Metastatic Colorectal Cancer: Observations from the Global Aflibercept Safety and Health-Related Quality-of-Life Program (ASQoP). Clin Colorectal Cancer. 2019 Sep;18(3):183-191.e3. doi: 10.1016/j.clcc.2019.05.003. Epub 2019 May 15.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Sciences & Operations study director
Sanofi
179 sites in 23 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing AFLIBERCEPT AVE0005 and FOLFIRI in people with Colorectal Cancer Metastatic, run by Sanofi at 179 sites in 23 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 25 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 179 sites in Italy, Germany, Spain, United States, Belgium and 18 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 27 Feb 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) (time frame: Baseline up to 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 214 weeks)). The study lists 13 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01571284, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Apr 2018.