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Report for Clinical Trial NCT03231722

Developed by Shray Alag, 2020.
SNP Clinical Trial Gene

The TRIPLETE Study RANDOMIZED PHASE III STUDY OF TRIPLET mFOLFOXIRI PLUS PANITUMUMAB Versus mFOLFOX6 PLUS PANITUMUMAB AS INITIAL THERAPY FOR UNRESECTABLE RAS AND BRAF WILDTYPE METASTATIC COLORECTAL CANCER PATIENTS

- The association of FOLFOX (5-fluoruracil, folinic acid, and oxaliplatin) and pan is a standard option for the first-line treatment of unresectable RAS and BRAF wt mCRC patients. - The phase III TRIBE trial recently demonstrated that FOLFOXIRI (5-fluoruracil, folinic acid, oxaliplatin and irinotecan) plus bev significantly prolongs PFS and OS and increases RECIST response rate, ETS and DoR, as compared to FOLFIRI (5-fluoruracil folinic acid, and irinotecan) plus bev. The advantage provided by the intensification of the upfront chemotherapy backbone is independent of RAS and BRAF mutational status. - Some phase II trials recently assessed the safety and activity of the combination of three-drugs chemotherapy regimens with an anti-EGFR monoclonal antibody. Promising activity results in terms of RECIST response rate and R0 resection rate have been achieved, with some safety concerns with special regards to gastrointestinal toxicity. - In the phase II randomized MACBETH study the combination of a modified schedule of FOLFOXIRI with cetuximab determined remarkable activity results, with an acceptable and manageable safety profile. - The optimal duration of the upfront treatment with chemotherapy plus anti-EGFRs is not established. The phase II MACRO-2 trial suggested that interrupting FOLFOX after 4 months while continuing cet alone as maintenance, is a reasonable option. - Activity parameters (RECIST response rate, ETS, DoR) are clinically relevant endpoints, associated with longer survival, in particular with anti-EGFR moAb-based treatment. On the basis of these considerations, we designed the present phase III randomized trial of first-line mFOLFOXIRI plus pan versus mFOLFOX6 plus pan in RAS and BRAF wt unresectable mCRC patients.

NCT03231722 Metastatic Colorectal Cancer
MeSH:Colorectal Neoplasms
HPO:Neoplasm of the large intestine

5 Interventions

Name: Panitumumab

Description: 6 mg/kg iv over 60 minutes, day 1
Type: Drug
Group Labels: 2

mFOLFOX6 + Panitumab mFOLFOXIRI + Panitumumab

Name: Irinotecan

Description: 150 mg/sqm iv over 60 minutes day 1
Type: Drug
Group Labels: 2

mFOLFOX6 + Panitumab mFOLFOXIRI + Panitumumab

Name: Oxaliplatin

Description: 85 mg/sqm iv over 2 hours day 1
Type: Drug
Group Labels: 1

mFOLFOXIRI + Panitumumab

Name: l-leucovorin

Description: 200 mg/sqm iv over 2 hours
Type: Drug
Group Labels: 2

mFOLFOX6 + Panitumab mFOLFOXIRI + Panitumumab

Name: 5-fluorouracil

Description: 400 mg/sqm iv bolus, day 1 followed by 2400 mg/sqm 48 h-continuous infusion, starting on day 1;
Type: Drug
Group Labels: 2

mFOLFOX6 + Panitumab mFOLFOXIRI + Panitumumab


Primary Outcomes

Description: the percentage of patients, relative to the total of enrolled subjects, achieving a complete (CR) or partial (PR) response, according to RECIST 1.1 criteria

Measure: Overall response rate

Time: 12 months

Secondary Outcomes

Description: the percentage of patients, relative to the total of enrolled subjects, experiencing any adverse event, according to National Cancer Institute Common Toxicity Criteria (version 4.0)

Measure: Overall Toxicity Rate

Time: 24 months

Description: the percentage of patients, relative to the total of enrolled subjects, experiencing a specific adverse event of grade 3/4, according to National Cancer Institute Common Toxicity Criteria (version 4.0)

Measure: Toxicity Rate

Time: 24 months

Description: the time from randomization to the first documentation of objective disease progression or death due to any cause, whichever occurs first. Documentation of disease progressive disease is defined as per RECIST 1.1 criteria based on investigator assessment

Measure: Progression Free Survival

Time: 24 months

Description: the time from randomization to the date of death due to any cause

Measure: Overall Survival

Time: 48 months

Description: the percentage of patients, relative to the total of enrolled subjects, achieving a complete (CR) or partial (PR) response, according to RECIST 1.1 criteria based on central re-evaluation of CT scan images.

Measure: Centrally assessed Overall response rate

Time: 12 months

Description: the percentage of patients, relative to the total of the enrolled subjects, achieving a ≥20% decrease in the sum of diameters of RECIST target lesions at week 8 compared to baseline.

Measure: Early Tumour Shrinkage Rate

Time: up to 2 months from randomization

Description: the relative change in the sum of longest diameters of RECIST target lesions at the nadir, in the absence of new lesions or progression of non-target lesions, when compared with baseline.

Measure: Deepness of Response

Time: 12 months

Description: the percentage of patients, relative to the total of enrolled subjects, undergoing secondary R0 resection of metastases

Measure: R0 Resection Rate

Time: 12 months

Purpose: Treatment

Allocation: Randomized

Parallel Assignment


There is one SNP

SNPs


1 V600E

- RAS (codons 12, 13, 59, 61, 117 and 146 of KRAS and NRAS genes) and BRAF (V600E mutation) wt status of primary colorectal cancer or related metastasis (local or central laboratory assessment). --- V600E ---



HPO Nodes


HPO: