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Encorafenib, Binimetinib and Cetuximab in Subjects With Previously Untreated BRAF-mutant ColoRectal Cancer (ANCHOR-CRC)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03693170
Recruitment Status : Completed
First Posted : October 2, 2018
Results First Posted : August 30, 2022
Last Update Posted : February 2, 2024
Sponsor:
Collaborators:
Pfizer
Merck KGaA, Darmstadt, Germany
Ono Pharmaceutical Co. Ltd
Information provided by (Responsible Party):
Pierre Fabre Medicament

Brief Summary:
The purpose of this study is to evaluate the efficacy and safety of the combination of study drugs encorafenib, binimetinib and cetuximab in patients who have BRAF V600 mutant metastatic colorectal cancer and have not received any prior treatment for their metastatic disease.

Condition or disease Intervention/treatment Phase
BRAF V600E-mutant Metastatic Colorectal Cancer Drug: encorafenib Drug: Binimetinib Drug: Cetuximab Phase 2

Detailed Description:
The presence of a BRAFV600E mutation is considered a marker of poor prognosis in subjects with mCRC. The preclinical results and preliminary clinical data together justify the evaluation of this triple combination in the first-line setting of this population. The primary objective of the study is to evaluate the antitumor activity of the combination of encorafenib, binimetinib and cetuximab by assessing the overall response rate in adult subjects with previously untreated BRAFV600E-mutant metastatic colorectal cancer. It will also assess the effect of the triple combination on the duration of response, time to response, progression-free survival and overall survival and assess the effect on quality of life. It will also characterize the safety and tolerability of the triple combination as well as describe the pharmacokinetics (PK) of encorafenib, binimetinib, and cetuximab.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 95 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Masking Description: All involved know the identity of the intervention assignment.
Primary Purpose: Treatment
Official Title: Phase II, Open-label, Single Arm, Multicenter Study of Encorafenib, Binimetinib Plus Cetuximab in Subjects With Previously Untreated BRAF V600E -Mutant Metastatic Colorectal Cancer
Actual Study Start Date : January 17, 2019
Actual Primary Completion Date : June 29, 2020
Actual Study Completion Date : April 27, 2023

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: 1 Arm
encorafenib plus binimetinib plus cetuximab
Drug: encorafenib
300 mg administered orally once daily (QD)
Other Name: Braftovi

Drug: Binimetinib
Binimetinib 45 mg administered orally twice daily (BID)
Other Name: Mektovi

Drug: Cetuximab

Standard of care for the 28 first weeks(*) and then every 2 weeks (**) :

(*) 400 mg/m2 administered as a 120-min infusion on Cycle 1 Day 1, followed by 250 mg/m2 administered as a 60-min infusion once weekly (QW) for the first 28 weeks. (**) 500 mg/m2 administered as a 120-min infusion twice weekly (Q2W) from Week 29 (Cycle 8 Day 1) onward.

Following implementation of an Urgent Safety Measure on 26 Mar 2020 due to the outbreak of COVID-19 pandemic, cetuximab infusions could be administered Q2W regardless of the cycle number, after investigator's evaluation of the benefit/risk ratio for the subject, with regards to COVID-19 pandemic.

Other Name: Erbitux




Primary Outcome Measures :
  1. Confirmed Overall Response Rate (cORR) Based on Local Tumor Assessments [ Time Frame: From initiation of treatment to disease progression up to a maximum of 17.6 months. ]

    The confirmed overall response rate (cORR) is the percentage of confirmed responses, defined as complete response (CR) or partial response (PR), as assessed by local radiologist/investigator review based on the Response Evaluation Criteria in Solid Tumors (RECIST 1.1).

    Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI:

    Complete Response (CR): Disappearance of all target lesions; Partiel response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Overall Response (OR) = CR + PR.



Secondary Outcome Measures :
  1. Confirmed Overall Response Rate (cORR) Based on Central Tumor Assessment [ Time Frame: From initiation of treatment to disease progression up to a maximum of 17.6 months ]

    The confirmed overall response rate (cORR) is the percentage of confirmed responses, defined as complete response (CR) or partial response (PR), as assessed by central radiologist review based on the Response Evaluation Criteria in Solid Tumors (RECIST 1.1).

    Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI:

    Complete Response (CR): Disappearance of all target lesions; Partiel response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Overall Response (OR) = CR + PR.


  2. Overall Response Rate (ORR) Based on Local Tumor Assessments [ Time Frame: From initiation of treatment to disease progression up to a maximum of 17.6 months ]

    The overall response rate (ORR) is the percentage of responses, defined as complete response (CR) or partial response (PR), as assessed by local radiologist/investigator review based on the Response Evaluation Criteria in Solid Tumors (RECIST 1.1).

    Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI:

    Complete Response (CR): Disappearance of all target lesions; Partiel response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Overall Response (OR) = CR + PR.


  3. Overall Response Rate (ORR) Based on Central Tumor Assessments [ Time Frame: From initiation of treatment to disease progression up to a maximum of 17.6 months ]

    The overall response rate (ORR) is the percentage of responses, defined as complete response (CR) or partial response (PR), as assessed by central radiologist review based on the Response Evaluation Criteria in Solid Tumors (RECIST 1.1).

    Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI:

    Complete Response (CR): Disappearance of all target lesions; Partiel response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Overall Response (OR) = CR + PR.


  4. Duration of Response (DOR) Per Local Assessment [ Time Frame: From first radiographic evidence of response to disease progression up to a maximum of 17.6 months ]
    Time from first radiographic evidence of response based on local radiologist/investigator review to the earliest documented PD or death due to underlying disease

  5. Duration of Response (DOR) Per Central Assessment [ Time Frame: From first radiographic evidence of response to disease progression up to a maximum of 17.6 months ]
    Time from first radiographic evidence of response based on central review to the earliest documented PD or death due to underlying disease

  6. Time to Response (TTR) Per Local Review [ Time Frame: From initiation of treatment to the first radiographic evidence of response up to a maximum of 17.6 months ]
    The TTR is defined as the time from the first dose until the first documented radiographic evidence of response of CR or PR per local review

  7. Time to Response (TTR) Per Central Review [ Time Frame: From initiation of treatment to the first radiographic evidence of response up to a maximum of 17.6 months ]
    The TTR is defined as the time from the first dose until the first documented radiographic evidence of response of CR or PR per central review

  8. Progression-Free Survival (PFS) Per Local Review [ Time Frame: From initiation of treatment to disease progression or death up to a maximum of 17.6 months ]
    Time from first dose to the earliest documented date of disease progression based on local radiologist/investigator review or death due to any cause

  9. Progression of Free Survival (PFS) Per Central Review [ Time Frame: From initiation of treatment to disease progression or death up to a maximum of 17.6 months ]
    Time from first dose to the earliest documented date of disease progression based on central review or death due to any cause

  10. Overall Survival (OS) [ Time Frame: From initiation of treatment to death up to a maximum of 17.6 months ]
    Time from first dose to death due to any cause

  11. Plasma Concentration of Encorafenib [ Time Frame: 2 hours and 6 hours after dose on Day 1 cycle 1; Predose and 2 hours post dose on Day 1 cycle 2 (cycle length = 28 days) ]
    Plasma concentration of encorafenib

  12. Plasma Concentration of Binimetinib [ Time Frame: 2 hours and 6 hours after dose on Day 1 cycle 1; Predose and 2 hours post dose on Day 1 cycle 2 (cycle length = 28 days) ]
    Plasma concentration of binimetinib

  13. Plasma Concentration of Cetuximab [ Time Frame: 2 hours and 6 hours after dose on Day 1 cycle 1; Predose and 2 hours post dose on Day 1 cycle 2 (cycle length = 28 days) ]
    Plasma concentration of cetuximab

  14. Change From Baseline in EORTC QLQ-C30 Over Time [ Time Frame: From Cycle 1 Day 1 (C1D1) Visit to the 30-day Safety Follow-up Visit up to a maximum of 17.6 months ]

    The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for cancer subjects (EORTC QLQ-C30) includes a global health status/QoL. The scale ranges in score from 0 to 100, higher score on the global health status/QoL scale indicate higher QoL.

    Changes from baseline in EORTC QLQ-C30 global health status/quality of life (QoL) over time are presented in this record.


  15. Change From Baseline in EQ-5D-5L Over Time [ Time Frame: From Cycle 1 Day 1 (C1D1) Visit to the 30-day Safety Follow-up Visit up to a maximum of 17.6 months ]
    The EQ-5D-5L consists of the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The EQ-5D-5L VAS records the patient's self-rated health on a vertical visual analogue scale numbered from 0 ("The worst health you can imagine") to 100 ("The best health you can imagine"). Changes from baseline in EQ-5D-5L VAS over time are presented in this record.

  16. PGIC Scores Over Time [ Time Frame: From Cycle 1 Day 1 (C1D1) Visit to the 30-day Safety Follow-up Visit up to a maximum of 17.6 months ]
    The Patient Global Impression of Change (PGIC) is a measure of patients' perceptions of change in their symptoms over time. For this assessment, subjects answered the following question: "Since starting treatment, my colorectal cancer symptoms are: (1) very much improved, (2) much improved, (3) minimally improved, (4) no change, (5) minimally worse, (6) much worse or (7) very much worse."



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female ≥ 18 years of age
  • Histologically or cytologically confirmed CRC that is metastatic
  • Presence of BRAF V600E in tumor tissue determined by local assay at any time prior to screening
  • Evidence of measurable disease as per RECIST, v1.1
  • Subject able to receive cetuximab as per approved label with regards to RAS status
  • Eastern Cooperative Oncology Group Status (ECOG) 0 or 1
  • Adequate renal, hepatic, cardiac and bone marrow functions and adequate electrolytes as per protocol
  • Subject able to take oral medications

Exclusion Criteria:

  • Prior systemic therapy for metastatic disease
  • Prior treatment with any RAF inhibitor, MEK inhibitor, cetuximab or other anti-EGFR inhibitors
  • Symptomatic brain metastasis or Leptomeningeal disease
  • History or current evidence of Retinal Vein Occlusion (RVO) or current risk factors for RVO
  • History of chronic inflammatory bowel disease or Crohn's disease requiring medical intervention (immunomodulatory or immunosuppressive medications or surgery) ≤ 12 months prior to first dose.
  • Impaired cardiovascular function or clinically significant cardiovascular diseases: history of myocardial infarction or coronary disorders within 6 months prior to start of study treatment, symptomatic congestive heart failure (grade 2 or higher), past or current clinically significant arrhythmia and/or conduction disorder within 6 months prior to study treatment start
  • History of thromboembolic or cerebrovascular events within 6 months prior to start of study treatment
  • Concurrent neuromuscular disorder that is associated with potential elevation of Creatine Kinase
  • Known contraindication to cetuximab administration as per SPC/approved label

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03693170


Locations
Show Show 45 study locations
Sponsors and Collaborators
Pierre Fabre Medicament
Pfizer
Merck KGaA, Darmstadt, Germany
Ono Pharmaceutical Co. Ltd
Investigators
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Study Director: Isabelle KLAUCK, MD Corporate Medical&Patient/Consumer Division, Pierre Fabre Medicament
  Study Documents (Full-Text)

Documents provided by Pierre Fabre Medicament:
Study Protocol  [PDF] July 17, 2020
Statistical Analysis Plan  [PDF] January 22, 2021

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Responsible Party: Pierre Fabre Medicament
ClinicalTrials.gov Identifier: NCT03693170    
Other Study ID Numbers: W00090 GE 2 01
First Posted: October 2, 2018    Key Record Dates
Results First Posted: August 30, 2022
Last Update Posted: February 2, 2024
Last Verified: January 2024

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Pierre Fabre Medicament:
Metastatic Colorectal Cancer
Additional relevant MeSH terms:
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Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Cetuximab
Antineoplastic Agents, Immunological
Antineoplastic Agents