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Metastatic Colorectal Cancer (mCRC)Phase 3NEXT-REGIRINCT03829462

Assessing a Regorafenib-irinotecan Combination Versus Regorafenib Alone in Metastatic Colorectal Cancer Patients

A Phase 3 study testing Regorafenib and Irinotecan in people with Metastatic Colorectal Cancer (mCRC), run by Institut du Cancer de Montpellier - Val d'Aurelle at 11 sites in France.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

Patients with metastatic colorectal cancer (mCRC) who have received all approved standard treatments (except Regorafenib and Lonsurf) no longer have treatment options available while maintaining a good performance status which would allow them to receive a new treatment Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Metastatic Colorectal Cancer (mCRC)
What is being tested?
Regorafenib and Irinotecan
Could I receive a placebo?
No, everyone receives an active treatment
How many people
377 participants
Where
11 sitesFrance
Study dates
28 Mar 2019to Sep 2026
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

  • Signed informed consent obtained before any study specific procedures
  • Male or female ≥ 18 years of age
  • Histological documentation of adenocarcinoma of the colon or rectum
  • Patients with metastatic colorectal cancer
  • Progression during or within 3 months following the last administration of approved standard therapies, which must include a fluoropyrimidine (or raltitrexed), oxaliplatin, irinotecan, anti Vascular endothelial growth factor (VEGF) therapy and an anti Epithelial Growth Factor Receptor (EGFR) therapy (for RAS wild-type tumors)
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤1
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  • Life expectancy of at least 3 months
  • Patients with A/A cycline D1 (CCND1) genotype of rs603965 CCND1
  • Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements conducted within 7 days of starting study treatment: Amylase and lipase ≤1.5 x Upper Limit Normal (ULN),Total bilirubin ≤ 1.5 x ULN,Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3.0 x ULN (≤ 5 x ULN for patients with liver involvement of their cancer), Alkaline phosphatase (ALP) ≤ 2.5 x ULN (≤ 5.0 x ULN for patients with liver involvement for their cancer and/or have bone metastases), Platelet count ≥ 100,000/mm3; Hemoglobin (Hb) ≥ 9 g/dL; Absolute neutrophil count (ANC) ≥ 1,500/ mm3. Transfusion to meet the inclusion criterion, Serum creatinine ≤ 1.5 x ULN
  • International normalized ratio (INR) ≤ 1.5 x ULN and partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) ≤ 1.5 x ULN unless receiving treatment with therapeutic anticoagulation. Patients being treated with anticoagulant, e.g., heparin, will be allowed to participate provided no prior evidence of an underlying abnormality in these parameters exists. Close monitoring of at least weekly evaluations will be performed until INR and PTT are stable based on a pre-dose measurement as defined by the local standard of care
  • Women of childbearing potential must have a blood or urine pregnancy test performed a maximum of 7 days before start of study treatment, and a negative result must be documented before start of study treatment
  • Women of childbearing potential and men must agree to use adequate contraception before entering the study until at least respectively 7 months and 4 months after the last study drug administration of Regorafenib and respectively 6 months and 3 months after the last study drug administration of Irinotecan. The investigator or a designated associate is requested to advise the patient on how to achieve an adequate birth control. Adequate contraception is defined in the study as any medically recommended method (or combination of methods) as per standard of care.

Who cannot join

  • Patients with A/G or G/G cycline d1 (CCND1) genotype of rs603965 CCND1
  • Prior treatment with regorafenib or sorafenib
  • Prior treatment with TAS 102
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of study drug
  • Pregnant or breast-feeding subjects. Women of childbearing potential must have a pregnancy test performed a maximum of 7 days before start of treatment, and a negative result must be documented before start of study drug
  • Congestive heart failure ≥ New York Heart Association (NYHA) class 2
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  • Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months)
  • Myocardial infarction less than 6 months before start of study drug
  • Cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted)
  • Uncontrolled hypertension. (Systolic blood pressure > 140 mmHg or diastolic pressure > 90 mmHg despite optimal medical management)
  • Pleural effusion or ascites that causes respiratory compromise (≥ NCI-CTCAE V5.0 Grade 2 dyspnea)
  • Ongoing infection > Grade 2 NCI-CTCAE V5.0
  • Known history of human immunodeficiency virus (HIV) infection
  • Active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy
  • Patients with seizure disorder requiring medication
  • History of organ allograft
  • Patients with evidence or history of any bleeding diathesis, irrespective of severity
  • Any hemorrhage or bleeding event ≥ NCI-CTC V5.0 Grade 3 within 4 weeks prior to the start of study medication
  • Non-healing wound, ulcer, or bone fracture
  • Dehydration NCI-CTCAE V5.0 Grade ≥ 1
  • Substance abuse, medical, psychological or social conditions that may interfere with the subject's participation in the study or evaluation of the study results
  • Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation
  • Any illness or medical conditions that are unstable or could
  • jeopardize the safety of the subject and his/her compliance in the study
  • Persistent proteinuria of NCI-CTCAE V5.0 Grade 3 (> 3.5g/24 hours)
  • Patients unable to swallow oral medications
  • Any malabsorption condition
  • Chronic inflammatory bowel disease and / or bowel obstruction
  • Unresolved toxicity higher than NCI-CTCAE V.5.0 Grade 1 attributed to any prior therapy/procedure excluding alopecia, hypothyroidism and oxaliplatin induced neurotoxicity ≤ Grade 2
  • Concomitant participation or participation within the last 30 days in another clinical trial
  • Systemic anticancer therapy during this trial or within 4 weeks before randomization
  • Concomitant intake of st John's wort
  • Live attenuated vaccines are prohibited 10 days before the treatment, during the treatment and 6 months after the termination of treatment
  • History of gastrointestinal fistula or perforation
  • Previous or concurrent cancer that is distinct in primary site or histology from colorectal cancer within 5 years prior to study inclusion, except for curatively treated cervical cancer in situ, non-melanoma skin cancer and superficial

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

France11 sites
  • Centre François Baclesse

    Caen, Basse-Normandie, 14000

  • Centre Léon Bérard

    Lyon, Rhône, 69008

  • Hôpital privé Jean Mermoz

    Lyon, Rhône, 69008

  • CRLC Val d'Aurelle-Paul Lamarque

    Montpellier, 34298

  • Centre Antoine Lacassagne

    Nice, Alpes-Maritimes, 06189

  • Hôpital Européen Georges Pompidou

    Paris, 75015

  • Hôpital Saint-Jean

    Perpignan, Pyrénées-orientales, 66000

  • Hôpital Robert Debré

    Reims, Marne, 51100

  • Institut Godinot

    Reims, Marne, 51100

  • Hôpital Pontchaillou

    Rennes, Ile Et Vilaine, 35000

  • Institut Gustave Roussy

    Villejuif, Val De Marne, 94800

Other trials in France

About this study

Official title: A Randomized Phase III Trial Assessing a Regorafenib-irinotecan Combination (REGIRI) Versus Regorafenib Alone in Metastatic Colorectal Cancer Patients After Failure of Standard Therapies, According to the A/A Genotype of Cyclin D1

Patients with metastatic colorectal cancer (mCRC) who have received all approved standard treatments (except Regorafenib and Lonsurf) no longer have treatment options available while maintaining a good performance status which would allow them to receive a new treatment

Read the detailed description

A Phase II randomized trial compared Nexiri (Nexavar® + Irinotecan) vs irinotecan or versus Sorafenib (Nexavar®). The patients treated with Irinotecan or Sorafenib alone could receive NEXIRI combination after progression (crossover to Nexiri).

Regorafenib, which is an oral signal deactivation agent with a chemical structure very similar to Sorafenib, is a standard treatment in heavily pretreated mCRC patients since the results of CORRECT study which compared Regorafenib to placebo on overall survival.

Sorafenib isn't approved in mCRC so the objective of this NEXT-REGIRI trial is compared REGIRI combination (Regorafenib-Irinotecan) to Regorafenib alone in a phase III trial in patients in progression after having received all standard treatments and bearing genotype A/A of cyclin D1. The study's hypothesis is that regorafenib could have effects similar to those of sorafenib.

Being tested
Regorafenib, Irinotecan
Keywords
REGIRI, regorafenib, irinotecan
Medical subject headings
Colorectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RegorafenibDrug

    regorafenib tab 40 mg i.e 160 mg/day

  • IrinotecanDrug

    irinotecan 120 mg/m2 cycle 1, 150 mg/m2 cycle 2, 180 mg/m2 cycle 3 and more

Study groups in NCT03829462
Study groupRoleWhat they receive
Irinotecan + regorafenib (REGIRI)Experimentalirinotecan (180 mg/m2) at day1 of each cycle + regorafenib (160 mg/day) from day 2 to day 8
Receives: Drug: Regorafenib; Drug: Irinotecan
regorafenibActive comparatorRegorafenib (160 mg/day) for 3 weeks followed by 1 week off
Receives: Drug: Regorafenib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Survival

    Measured: Up to 36 months

Secondary outcomes (6)
  1. Progression-free Survival (PFS)

    Measured: Up to 36 months

  2. Time to Deterioration

    Measured: Up to 36 months

  3. Number of Participants With Disease Control Rate

    Measured: Through study completion, up to 14 months

  4. Number of Patients With an Objective Response Rate

    Measured: Through treatment completion, up to 14 months

  5. Assessment of Adverse Events by Using the NCI-CTCAE Version 5.0 Scale (Grade Max Per Patient)

    Measured: Up to 36 months

  6. Quality of Life Questionnaire

    The Quality of Life questionnaire (QLQ-C30) is a 30-item instrument designed to measure quality of life in all cancer patients.

    The QLQ-C30 incorporates five functional scales (physical, role, cognitive, emotional, and social), three symptom scales (fatigue, pain, and nausea and vomiting), a global health status, and a number of single items assessing additional symptoms commonly reported by cancer patients (dyspnea, loss of appetite, insomnia and diarrhea) and perceived financial impact of the disease. Score 0 to 100 for all subscales.

    • Functional scale : 0 the worst outcome, 100 is the best outcome,
    • Symptomatic scale : 0 the best outcome, 100 is the worst outcome Global functioning measures how much a person's symptoms affect their day-to-day life and role functioning assesses a patient's ability to perform daily activities, leisure time activities, and work on a scale of 0 to 100 (0 the worst outcome and 100 the best outcome).

    Measured: Questionnaire is assessed until 16 weeks (baseline, 8 weeks and 16 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Feb 2019
  2. Study start28 Mar 2019
  3. Primary completion4 Sep 2024
  4. Study completionSep 2026 (estimated)

Resources

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
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
377 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03829462
Sponsor's protocol ID
PROICM 2018-01 NEX
Acronym
NEXT-REGIRI
Status last verified
Nov 2025
First submitted
23 Jan 2019
Last updated
21 Nov 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All data will be available after publication of the results in peer-reviewed revues, and in national and international meetings. It includes all disidentified participants' data, the study protocol, the statistical analysis plan, the clinical study report and the analytic code. The corresponding author will provide data and datasets generated and/or analyzed during the study upon reasonable request.

Publications

  • Samalin E, Bouche O, Thezenas S, Francois E, Adenis A, Bennouna J, Taieb J, Desseigne F, Seitz JF, Conroy T, Galais MP, Assenat E, Crapez E, Poujol S, Bibeau F, Boissiere F, Laurent-Puig P, Ychou M, Mazard T. Sorafenib and irinotecan (NEXIRI) as second- or later-line treatment for patients with metastatic colorectal cancer and KRAS-mutated tumours: a multicentre Phase I/II trial. Br J Cancer. 2014 Mar 4;110(5):1148-54. doi: 10.1038/bjc.2013.813. Epub 2014 Jan 9.

    PubMed 24407191
  • Lu F, Gladden AB, Diehl JA. An alternatively spliced cyclin D1 isoform, cyclin D1b, is a nuclear oncogene. Cancer Res. 2003 Nov 1;63(21):7056-61.

    PubMed 14612495
  • Alt JR, Cleveland JL, Hannink M, Diehl JA. Phosphorylation-dependent regulation of cyclin D1 nuclear export and cyclin D1-dependent cellular transformation. Genes Dev. 2000 Dec 15;14(24):3102-14. doi: 10.1101/gad.854900.

    PubMed 11124803
  • Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Cupit L, Wagner A, Laurent D; CORRECT Study Group. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013 Jan 26;381(9863):303-12. doi: 10.1016/S0140-6736(12)61900-X. Epub 2012 Nov 22.

    PubMed 23177514

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Regorafenib and Irinotecan in people with Metastatic Colorectal Cancer (mCRC), run by Institut du Cancer de Montpellier - Val d'Aurelle at 11 sites in France.

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 12 inclusion and 35 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: under way, not looking for participants, as of the sponsor's last update on 21 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in France. 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 18 Jul 2025). 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?

Overall Survival (time frame: Up to 36 months). 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 NCT03829462, which also lists 4 linked publications.

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 21 Nov 2025; AzTrials last refreshed its copy on 7 Nov 2026.

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