SNPMiner Trials by Shray Alag


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Report for Mutation R451C

Developed by Shray Alag, 2020.
SNP Clinical Trial Gene

There is one clinical trial.

Clinical Trials


1 PULSE: A Randomized, Phase II Open Label Study of PanitUmumab RechaLlenge Versus Standard Therapy After Progression on Anti-EGFR Therapy in Patients With Metastatic and/or Unresectable RAS Wild-Type Colorectal Cancer

This phase II trial studies how well retreatment with panitumumab works compared to standard of care regorafenib or trifluridine and tipiracil hydrochloride (TAS-102) in treating patients with colorectal cancer that is negative for RAS wild-type colorectal cancer has spread to other places in the body, and/or cannot be removed by surgery, and is negative for resistance mutations in blood. Treatment with panitumumab may interfere with the ability of tumor cells to grow and spread. Some tumors need growth factors to keep growing. Growth factor antagonists, such as regorafenib, may interfere with the growth factor and stop the tumor from growing. Drugs used in chemotherapy, such as TAS-102, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving panitumumab may work better in treating patients with colorectal cancer than with the usual treatment of regorafenib or TAS-102.

NCT03992456 BRAF V600 Wild Type KRAS Gene Mutation Negative Metastatic Colon Adenocarcinoma Metastatic Colorectal Carcinoma Metastatic Rectal Adenocarcinoma NRAS Gene Mutation Negative Progressive Disease RAS Wild Type Stage IV Colon Cancer AJCC v8 Stage IV Colorectal Cancer AJCC v8 Stage IV Rectal Cancer AJCC v8 Stage IVA Colon Cancer AJCC v8 Stage IVA Colorectal Cancer AJCC v8 Stage IVA Rectal Cancer AJCC v8 Stage IVB Colon Cancer AJCC v8 Stage IVB Colorectal Cancer AJCC v8 Stage IVB Rectal Cancer AJCC v8 Stage IVC Colon Cancer AJCC v8 Stage IVC Colorectal Cancer AJCC v8 Stage IVC Rectal Cancer AJCC v8 Biological: Panitumumab Other: Quality-of-Life Assessment Other: Questionnaire Administration Drug: Regorafenib Drug: Trifluridine and Tipiracil Hydrochloride
MeSH: Colorectal Neoplasms Adenocarcinoma Rectal Neoplasms Colonic Neoplasms Disease Progression
HPO: Colon cancer Neoplasm of the colon Neoplasm of the large intestine Neoplasm of the rectum

Note: EGFR S492R, K467, and R451C mutations are not an exclusion. --- S492R --- --- R451C ---

Primary Outcomes

Description: 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 unstratified log-rank test.

Measure: Overall survival (OS)

Time: Time from randomization to death from any cause, assessed for up to 3 years

Secondary Outcomes

Description: 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.

Measure: Progression free survival (PFS)

Time: Time from randomization to documentation of disease progression or death due to any cause, whichever is first, assessed for up to 3 years

Description: 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 at 12 months post randomization. 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.

Measure: Overall response rate (ORR)

Time: At 12 months

Description: Defined as the number of patients with a complete response (CR), partial response (PR), or stable disease for >= 6 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.

Measure: Clinical benefit rate

Time: At 6 months

Description: The maximum grade for each type of adverse event will be recorded for each patient, and frequency tables will be reviewed to determine adverse event patterns. The overall adverse event rates for grade 3 or higher adverse events will be compared using Chi-Square or Fisher?s Exact tests.

Measure: Incidence of adverse events

Time: Up to 3 years

Description: 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.

Measure: Patient-reported quality of life

Time: Up to 3 years

Other Outcomes

Description: 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.

Measure: Cell free tumor deoxyribonucleic acid (cfDNA)

Time: Baseline, at restaging, and at disease progression

Description: 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.

Measure: Circulating protein studies

Time: Up to 3 years

Description: 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.

Measure: Tumor tissue studies

Time: Up to 3 years


HPO Nodes


Colon cancer
Genes 59
TP53 TRIP13 COL14A1 SMAD4 BRCA2 MLH1 MSH6 HABP2 PMS2 APC BUB1B PALLD BUB1 GREM1 NTHL1 PMS1 MSH6 AXIN2 APC EPCAM BUB3 MSH2 APC KRAS TGFBR2 FAN1 MINPP1 APC MSH3 SH3KBP1 TP53 KRAS AAGAB SMAD4 BMPR1A MSH2 BMPR1A MLH3 MSH2 PALB2 MUTYH FLCN PIK3CA BMPR1A FOXE1 MSH2 SMAD7 MLH1 CEP57 MLH1 BRCA1 RPS19 PRKAR1A PMS1 APC CDKN2A APC MLH1 APC
Neoplasm of the rectum
Genes 45
FAN1 PDGFRA POLE SMAD4 MSH3 KIT POLD1 BMPR1A KRAS RNF43 KEAP1 DICER1 MSH2 BMPR1A POLE SDHC BMPR1A MLH1 MLH3 PMS2 SDHA SDHC PIK3CA MUTYH SDHB ENG GREM1 NTHL1 RPS20 STK11 SDHB MSH6 AXIN2 EPCAM KIT KLLN PMS1 SDHD SEC23B PTEN TGFBR2 SEMA4A POLD1 PIK3CA AKT1
Neoplasm of the large intestine
Genes 120
FLCN SDHC MLH1 PMS2 APC EPCAM SDHC PALLD SRC BUB1 APC GREM1 NTHL1 PMS1 PTEN SDHB MSH6 APC KIT SDHD KRAS BMPR1A FAN1 CTNNB1 MSH3 POLD1 KRAS RNF43 KEAP1 DICER1 DLC1 BMPR1A MSH2 MSH6 PIK3CA CDKN2A FGFR3 BMPR1A MUTYH PIK3CA BMPR1A EP300 FOXE1 ENG SMAD7 AXIN2 CHEK2 MLH1 RPS20 BRCA1 RPS19 PRKAR1A APC GPR35 MLH1 AKT1 POLE SMAD4 KIT TP53 TRIP13 COL14A1 MDM2 SMAD4 POLE BRCA2 AKT1 MSH6 HABP2 NRAS MUTYH BUB1B DOCK8 TGFBR2 STK11 AXIN2 EPCAM BUB3 DCC AXIN2 TCF4 KLLN MSH2 APC TP53 SEC23B PTEN TGFBR2 SEMA4A POLD1 PIK3CA PDGFRA MINPP1 APC SH3KBP1 BMPR1A TP53 BUB1 AAGAB SMAD4 BMPR1A MST1 MLH3 MSH2 PALB2 FLCN SDHA PMS2 SDHB BUB1B MSH2 MLH1 CEP57 MLH3 TP53 PTPRJ PMS1 APC CDKN2A APC