A Study in Second Line Metastatic Colorectal Cancer
A Randomized, Double-blind, Multicenter Phase 3 Study of Irinotecan, Folinic Acid, and 5-Fluorouracil (FOLFIRI) Plus Ramucirumab or Placebo in Patients With Metastatic Colorectal Carcinoma Progressive During or Following First-Line Combination Therapy With Bevacizumab, Oxaliplatin, and a Fluoropyrimidine
5 other identifiers
interventional
1,072
25 countries
210
Brief Summary
The purpose of this study is to compare overall survival in participants with metastatic colorectal cancer treated with either ramucirumab and FOLFIRI or placebo and FOLFIRI.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for phase_3 colorectal-cancer
Started Dec 2010
Typical duration for phase_3 colorectal-cancer
210 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
August 4, 2010
CompletedFirst Posted
Study publicly available on registry
August 18, 2010
CompletedStudy Start
First participant enrolled
December 2, 2010
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 17, 2014
CompletedResults Posted
Study results publicly available
July 15, 2015
CompletedStudy Completion
Last participant's last visit for all outcomes
June 20, 2016
CompletedSeptember 25, 2019
September 1, 2019
3.6 years
August 4, 2010
June 19, 2015
September 10, 2019
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Overall Survival (OS)
OS was defined as the time in months from the date of randomization to the date of death from any cause. For participants not known to have died as of the cut-off date, OS was censored at the last known date alive.
Randomization to Date of Death from Any Cause Up to 39.36 Months
Secondary Outcomes (6)
Progression-free Survival (PFS) Time
Randomization to Measured PD or Date of Death from Any Cause Up to 38.01 Months
Percentage of Participants Achieving an Objective Response (Objective Response Rate)
Randomization until Disease Progression Up to 38.01 Months
Change From Baseline in European Organisation for Research and Treatment of Cancer [EORTC] QLQ-C30 Global Health Status
Baseline Up to 171 Weeks
Change From Baseline in EuroQol- 5D (EQ-5D)
Baseline and 30-Day Follow-Up (FU) up to 171 Weeks
Percentage of Participants With Treatment-Emergent Anti-Ramucirumab Antibodies
Cycles 1, 3, 5, and 30-Day FU
- +1 more secondary outcomes
Study Arms (2)
FOLFIRI + Ramucirumab
EXPERIMENTALFOLFIRI + Placebo
PLACEBO COMPARATORInterventions
8 milligrams / kilogram (mg/kg) administered intravenously every 2 weeks until disease progression, unacceptable toxicity, noncompliance or withdrawal of consent by the participant or investigator decision
Administered intravenously every 2 weeks until disease progression, unacceptable toxicity, noncompliance or withdrawal of consent by the participant or investigator decision
180 milligrams/square meter (mg/m\^2) administered intravenously every 2 weeks until disease progression, unacceptable toxicity, noncompliance or withdrawal of consent by the participant or investigator decision
400 mg/m\^2 administered intravenously every 2 weeks until disease progression, unacceptable toxicity, noncompliance or withdrawal of consent by the participant or investigator decision
400 mg/m\^2 bolus immediately followed by 2400 mg/m\^2 continuous infusion every 2 weeks until disease progression, unacceptable toxicity, noncompliance or withdrawal of consent by the participant or investigator decision
Eligibility Criteria
You may qualify if:
- Histologically or cytologically confirmed colorectal cancer, excluding primary tumors of appendiceal origin (participants are eligible to enroll irrespective of KRAS mutation status)
- Confirmed metastatic colorectal cancer (Stage IV)
- The participant has received first-line combination therapy of bevacizumab, oxaliplatin, and a fluoropyrimidine for metastatic disease and, a) Experienced radiographic disease progression during first-line therapy, or b) Experienced radiographic disease progression ≤6 months after the last dose of first-line therapy, or c) Discontinued part or all of first-line therapy due to toxicity and experienced radiographic disease progression ≤6 months after the last dose of first-line therapy. Note that a participant must have received a minimum of 2 doses of bevacizumab as part of a first-line regimen containing chemotherapy; in addition, a participant must have received at least 1 cycle of first-line therapy that included bevacizumab, oxaliplatin and a fluoropyrimidine in the same cycle. Note that a participant must not have received more than 2 different fluoropyrimidines as part of a first-line regimen; disease progression is not an acceptable reason for discontinuing 1 fluoropyrimidine and starting a second fluoropyrimidine
- Receipt of no more than 2 prior systemic chemotherapy regimens in any setting (only 1 prior regimen for metastatic disease is permitted). For participants with rectal cancer, sequential neoadjuvant and adjuvant therapy will count as a single systemic regimen. Note that rechallenge with oxaliplatin is permitted and will be considered part of the first-line regimen for metastatic disease, both initial oxaliplatin treatment and subsequent rechallenge are considered as 1 regimen
- Measurable or nonmeasurable disease based on the Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1)
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1
- Adequate hematologic, renal and hepatic function
- Adequate coagulation function \[International Normalized Ratio (INR) ≤1.5 and Partial Thromboplastin Time (PTT) or activated PTT (aPTT) ≤1.5 x upper limit of normal (ULN)). Participants on full-dose anticoagulation must be on a stable dose of anticoagulant therapy and if on oral anticoagulation, must have an INR ≤3 and have no clinically significant active bleeding or pathological condition that carries a high risk of bleeding
- Consent to provide a historical colorectal cancer tissue sample for assessment of biomarkers and the tumor tissue sample is available
- Ability to provide signed informed consent
You may not qualify if:
- Receipt of bevacizumab ≤28 days prior to randomization
- Receipt of any investigational therapy for non-oncology clinical indication ≤28 days prior to randomization
- Receipt of any previous systemic therapy, other than a combination of bevacizumab, oxaliplatin, and a fluoropyrimidine, for first-line treatment of metastatic colorectal cancer
- Known leptomeningeal disease or brain metastases or uncontrolled spinal cord compression (currently or in the past)
- Experience of any arterial thrombotic or arterial thromboembolic events, including, but not limited to, myocardial infarction, transient ischemic attack, or cerebrovascular accident, ≤12 months prior to randomization
- Pregnant (confirmed by serum beta human chorionic gonadotropin (ß HCG) test ≤7 days prior to randomization) or lactating
- History of inflammatory bowel disease or Crohn's disease requiring medical intervention (immunomodulatory or immunosuppressive medications or surgery) ≤12 months prior to randomization
- Acute or subacute bowel obstruction or history of chronic diarrhea which is considered clinically significant in the opinion of the investigator
- Grade 3 or higher bleeding event ≤3 months prior to randomization
- Experience of any of the following during first-line therapy with a bevacizumab-containing regimen: an arterial thrombotic/thromboembolic event, Grade 4 hypertension, Grade 3 proteinuria, a Grade 3-4 bleeding event, or bowel perforation
- Known history or clinical evidence of Gilbert's Syndrome, or is known to have any of the following genotypes: UGT1A1\*6/\*6, UGT1A1\*28/\*28, or UGT1A1\*6/\*28
- Known allergy to any of the study treatment components, including any components used in the preparation of ramucirumab, or other contraindication to receive the study treatments
- Cirrhosis at a level of Child-Pugh B (or worse) or cirrhosis (any degree) and a history of hepatic encephalopathy or clinical meaningful ascites resulting from cirrhosis; Clinically meaningful ascites is defined as ascites resulting from cirrhosis and requiring ongoing treatment with diuretics and/or paracentesis
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (213)
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Sedona, Arizona, 86336, United States
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Tucson, Arizona, 85715, United States
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Fayetteville, Arkansas, 72703, United States
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Little Rock, Arkansas, 72205, United States
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Duarte, California, 91010, United States
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Escondido, California, 92025, United States
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Fresno, California, 93720, United States
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Greenbrae, California, 94904, United States
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La Jolla, California, 92093, United States
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Rancho Cucamonga, California, 91730, United States
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San Diego, California, 92108, United States
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Denver, Colorado, 80218, United States
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Waterbury, Connecticut, 06708, United States
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Boynton Beach, Florida, 33426, United States
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Fort Lauderdale, Florida, 33308, United States
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Fort Myers, Florida, 33916, United States
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Miami, Florida, 33176, United States
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Ocala, Florida, 34471, United States
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Port Saint Lucie, Florida, 34952, United States
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St. Petersburg, Florida, 33705, United States
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Titusville, Florida, 32796, United States
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Athens, Georgia, 30607, United States
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Augusta, Georgia, 30901, United States
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Macon, Georgia, 31201, United States
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Marietta, Georgia, 30060, United States
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Rome, Georgia, 30165, United States
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Thomasville, Georgia, 31792, United States
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Honolulu, Hawaii, 96819, United States
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Harvey, Illinois, 60426, United States
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Peoria, Illinois, 61615, United States
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Warrenville, Illinois, 60555, United States
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Goshen, Indiana, 46526, United States
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Indianapolis, Indiana, 46237, United States
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Muncie, Indiana, 47303, United States
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Bethesda, Maryland, 20817, United States
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Minneapolis, Minnesota, 55404, United States
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Columbia, Missouri, 65201, United States
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St Louis, Missouri, 63110, United States
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Billings, Montana, 59101, United States
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Las Vegas, Nevada, 89169, United States
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Cherry Hill, New Jersey, 08003, United States
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Hackensack, New Jersey, 07601, United States
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Morristown, New Jersey, 07962, United States
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Albuquerque, New Mexico, 87109, United States
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Hudson, New York, 12534, United States
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Jamaica, New York, 11432, United States
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New York, New York, 10029, United States
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The Bronx, New York, 10467, United States
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Raleigh, North Carolina, 27607, United States
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Cincinnati, Ohio, 45242, United States
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Columbus, Ohio, 43219, United States
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Tulsa, Oklahoma, 74136, United States
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Bend, Oregon, 97701, United States
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Portland, Oregon, 97227, United States
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Kingston, Pennsylvania, 18704, United States
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Philadelphia, Pennsylvania, 19106, United States
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Willow Grove, Pennsylvania, 19090, United States
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Columbia, South Carolina, 29210, United States
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Memphis, Tennessee, 38138, United States
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Nashville, Tennessee, 37203, United States
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Abilene, Texas, 79606, United States
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Arlington, Texas, 76014, United States
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Beaumont, Texas, 77702, United States
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Bedford, Texas, 76022, United States
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Dallas, Texas, 75246, United States
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Denton, Texas, 76210, United States
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Flower Mound, Texas, 75028, United States
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Fort Worth, Texas, 76104, United States
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Garland, Texas, 75042, United States
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McAllen, Texas, 78503, United States
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Odessa, Texas, 79761, United States
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Paris, Texas, 75460, United States
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Round Rock, Texas, 78665, United States
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San Antonio, Texas, 78229, United States
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Sherman, Texas, 75090, United States
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Sugar Land, Texas, 77479, United States
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Temple, Texas, 76508, United States
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The Woodlands, Texas, 77380, United States
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Tyler, Texas, 75702, United States
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Waco, Texas, 76712, United States
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Webster, Texas, 77598, United States
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Wichita Falls, Texas, 76310, United States
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Ogden, Utah, 84403, United States
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Salt Lake City, Utah, 84106, United States
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Fairfax, Virginia, 22031, United States
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Newport News, Virginia, 23606, United States
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Richmond, Virginia, 23230, United States
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Winchester, Virginia, 22601, United States
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Kennewick, Washington, 99336, United States
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Seattle, Washington, 98109, United States
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Spokane Valley, Washington, 99216, United States
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Milwaukee, Wisconsin, 53226, United States
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Buenos Aires, B8000FJI, Argentina
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Caba, C1180AAX, Argentina
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Rosario, 2000, Argentina
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Santa Fe, 3000, Argentina
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Tucumain, 4000, Argentina
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Viedma, 8500, Argentina
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Liverpool, New South Wales, 2170, Australia
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Randwick, New South Wales, 2031, Australia
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St Leonards, New South Wales, 2065, Australia
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Wodonga, New South Wales, 3690, Australia
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Wollongong, New South Wales, 2500, Australia
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Woolloongabba, Queensland, 4102, Australia
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Bedford Park, South Australia, 5042, Australia
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Elizabeth Vale, South Australia, 5112, Australia
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Innsbruck, 6020, Austria
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Krems, 3500, Austria
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Vienna, A1090, Austria
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Bonheiden, 2820, Belgium
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Brussels, 1070, Belgium
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Charleroi, 6000, Belgium
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Edegem, 2650, Belgium
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Haine-St.- Paul, 7100, Belgium
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Leuven, 3000, Belgium
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Liège, 4000, Belgium
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Ijuí, 98700 000, Brazil
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Itajaí, 88301-220, Brazil
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Rio de Janeiro, 20231-050, Brazil
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Salvador, 41823-010, Brazil
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São José do Rio Preto, 15025-100, Brazil
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São Paulo, 01308-050, Brazil
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Brno, 656 53, Czechia
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Pardubice, 532 03, Czechia
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Prague, 150 06, Czechia
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Copenhagen, 2100, Denmark
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Odense, 5000, Denmark
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Helsinki, 00029 HUS, Finland
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Tampere, 33521, Finland
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Bordeaux, 33076, France
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La Chaussée-Saint-Victor, 41260, France
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Le Mans, 72000, France
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Nantes, 44202, France
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Paris, 75015, France
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Poitiers, 86021, France
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Strasbourg, 67000, France
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Augsburg, 86150, Germany
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Balingen, 72336, Germany
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Bamberg, 96049, Germany
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Dresden, 01307, Germany
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Frankfurt, 60488, Germany
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Halle, 06120, Germany
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Hamburg, 20249, Germany
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Lübeck, 23562, Germany
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Mönchengladbach, 41063, Germany
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Munich, 81925, Germany
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Weiden, 92637, Germany
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Athens, 10676, Greece
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Chania, 73300, Greece
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Ioannina, 45500, Greece
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Budapest, 1115, Hungary
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Kecskemét, 6000, Hungary
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Bangalore, 560027, India
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Kochi, 628040, India
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Kolkata, 700053, India
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New Delhi, 110 060, India
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Trivandrum, 695 011, India
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Beersheba, 84101, Israel
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Haifa, 31096, Israel
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Tel Aviv, 64239, Israel
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Tel Litwinsky, 52621, Israel
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Genova, 16132, Italy
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Livorno, 57124, Italy
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Macerata, 62100, Italy
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Padua, 35128, Italy
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Reggio Emilia, 42100, Italy
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Rome, 00168, Italy
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Aichi, 464, Japan
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Chiba, 277 8577, Japan
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Ehime, 790-0007, Japan
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Fukuoka, 811-1395, Japan
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Gifu, 501-1194, Japan
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Hokkaido, 060-8638, Japan
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Hyōgo, 650-0046, Japan
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Kanagawa, 216-8511, Japan
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Kochi, 781-8555, Japan
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Osaka, 569-8686, Japan
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Saitama, 362-0806, Japan
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Shizuoka, 411-8777, Japan
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Tochigi, 329-0498, Japan
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Tokyo, 104-0045, Japan
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Breda, 4819 EV, Netherlands
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Deventer, 7416 SE, Netherlands
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Eindhoven, 5623 EJ, Netherlands
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Groningen, 9728 NT, Netherlands
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Sittard - Geleen, 6162 BG, Netherlands
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Coimbra, 3000-075, Portugal
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Porto, 4200-072, Portugal
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Bayamón, 00959, Puerto Rico
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Bucharest, 022328, Romania
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Cluj-Napoca, 400015, Romania
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Iași, 700106, Romania
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Oradea, 410469, Romania
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Ljubljana, 1001, Slovenia
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Anyang, 431-070, South Korea
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Goyang-si, 411-764, South Korea
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Incheon, 405-760, South Korea
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Seoul, 134-791, South Korea
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Suwon, 442-721, South Korea
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Barcelona, 08035, Spain
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Madrid, 28097, Spain
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Oviedo, 33006, Spain
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Pamplona, 31008, Spain
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Sabadell, 08208, Spain
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Seville, 41013, Spain
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Valencia, 46014, Spain
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Stockholm, 17176, Sweden
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Uppsala, 75185, Sweden
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Kaohsiung City, 807, Taiwan
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Kuei Shan Hsiang, 33305, Taiwan
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Taichung, 40705, Taiwan
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Tainan, 70403, Taiwan
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Taipei, 100, Taiwan
Related Publications (8)
Mitani S, Chen Y, Inoue K, Mori J, Gao L, Long A, Wakabayashi S. Clinical Impact of a Shortened Infusion Duration of Ramucirumab in Japanese Patients -A Model-Based Approach. Gan To Kagaku Ryoho. 2021 Nov;48(11):1381-1387.
PMID: 34795131DERIVEDTaniguchi H, Yoshino T, Yamaguchi K, Yamazaki K, Nixon AB, Tabernero J, Van Cutsem E, Robling KR, Abada PB, Hozak RR, Siegel R, Fill JA, Wijayawardana S, Walgren RA, Giles B, Jones A, Pitts KR, Drove N, Muro K. Clinical development and evaluation of a VEGF-D assay in plasma from patients with metastatic colorectal cancer in the RAISE study. Curr Med Res Opin. 2021 Oct;37(10):1769-1778. doi: 10.1080/03007995.2021.1940908. Epub 2021 Jul 28.
PMID: 34229554DERIVEDLim HH, Hopkins AM, Rowland A, Yuen HY, Karapetis CS, Sorich MJ. Effect of Early Adverse Events on Survival Outcomes of Patients with Metastatic Colorectal Cancer Treated with Ramucirumab. Target Oncol. 2019 Dec;14(6):743-748. doi: 10.1007/s11523-019-00683-z.
PMID: 31676953DERIVEDYoshino T, Portnoy DC, Obermannova R, Bodoky G, Prausova J, Garcia-Carbonero R, Ciuleanu T, Garcia-Alfonso P, Cohn AL, Van Cutsem E, Yamazaki K, Lonardi S, Muro K, Kim TW, Yamaguchi K, Grothey A, O'Connor J, Taieb J, Wijayawardana SR, Hozak RR, Nasroulah F, Tabernero J. Biomarker analysis beyond angiogenesis: RAS/RAF mutation status, tumour sidedness, and second-line ramucirumab efficacy in patients with metastatic colorectal carcinoma from RAISE-a global phase III study. Ann Oncol. 2019 Jan 1;30(1):124-131. doi: 10.1093/annonc/mdy461.
PMID: 30339194DERIVEDGrothey A, Yoshino T, Bodoky G, Ciuleanu T, Garcia-Carbonero R, Garcia-Alfonso P, Van Cutsem E, Muro K, Mytelka DS, Li L, Lipkovich O, Hsu Y, Sashegyi A, Ferry D, Nasroulah F, Tabernero J. Association of baseline absolute neutrophil counts and survival in patients with metastatic colorectal cancer treated with second-line antiangiogenic therapies: exploratory analyses of the RAISE trial and validation in an electronic medical record data set. ESMO Open. 2018 Apr 24;3(3):e000347. doi: 10.1136/esmoopen-2018-000347. eCollection 2018.
PMID: 29713498DERIVEDTabernero J, Hozak RR, Yoshino T, Cohn AL, Obermannova R, Bodoky G, Garcia-Carbonero R, Ciuleanu TE, Portnoy DC, Prausova J, Muro K, Siegel RW, Konrad RJ, Ouyang H, Melemed SA, Ferry D, Nasroulah F, Van Cutsem E. Analysis of angiogenesis biomarkers for ramucirumab efficacy in patients with metastatic colorectal cancer from RAISE, a global, randomized, double-blind, phase III study. Ann Oncol. 2018 Mar 1;29(3):602-609. doi: 10.1093/annonc/mdx767.
PMID: 29228087DERIVEDObermannova R, Van Cutsem E, Yoshino T, Bodoky G, Prausova J, Garcia-Carbonero R, Ciuleanu T, Garcia Alfonso P, Portnoy D, Cohn A, Yamazaki K, Clingan P, Lonardi S, Kim TW, Yang L, Nasroulah F, Tabernero J. Subgroup analysis in RAISE: a randomized, double-blind phase III study of irinotecan, folinic acid, and 5-fluorouracil (FOLFIRI) plus ramucirumab or placebo in patients with metastatic colorectal carcinoma progression. Ann Oncol. 2016 Nov;27(11):2082-2090. doi: 10.1093/annonc/mdw402. Epub 2016 Aug 29.
PMID: 27573561DERIVEDTabernero J, Yoshino T, Cohn AL, Obermannova R, Bodoky G, Garcia-Carbonero R, Ciuleanu TE, Portnoy DC, Van Cutsem E, Grothey A, Prausova J, Garcia-Alfonso P, Yamazaki K, Clingan PR, Lonardi S, Kim TW, Simms L, Chang SC, Nasroulah F; RAISE Study Investigators. Ramucirumab versus placebo in combination with second-line FOLFIRI in patients with metastatic colorectal carcinoma that progressed during or after first-line therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine (RAISE): a randomised, double-blind, multicentre, phase 3 study. Lancet Oncol. 2015 May;16(5):499-508. doi: 10.1016/S1470-2045(15)70127-0. Epub 2015 Apr 12.
PMID: 25877855DERIVED
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Results Point of Contact
- Title
- Chief Medical Officer
- Organization
- Eli Lilly and Company
Study Officials
- STUDY DIRECTOR
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
Eli Lilly and Company
Publication Agreements
- PI is Sponsor Employee
- No
- Restriction Type
- OTHER
- Restrictive Agreement
- Yes
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- QUADRUPLE
- Who Masked
- PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
August 4, 2010
First Posted
August 18, 2010
Study Start
December 2, 2010
Primary Completion
July 17, 2014
Study Completion
June 20, 2016
Last Updated
September 25, 2019
Results First Posted
July 15, 2015
Record last verified: 2019-09
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, CSR
- Time Frame
- Data are available 6 months after the primary publication and approval of the indication studied in the US and EU, whichever is later. Data will be indefinitely available for requesting.
- Access Criteria
- A research proposal must be approved by an independent review panel and researchers must sign a data sharing agreement.
Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.