Influence of BRAF and PIK3K Status on the Efficacy of 5-Fluorouracil/Leucovorin/Oxaliplatin (FOLFIRI) Plus Bevacizumab or Cetuximab in Patients With RAS Wild-type Metastatic Colorectal Carcinoma and < 3 Circulating Tumor Cells (CTC)
VISNU-2
Randomized Phase II Study to Explore the Influence of BRAF and PIK3K Status on the Efficacy of FOLFIRI Plus Bevacizumab or Cetuximab, as First Line Therapy of Patients With RAS Wild-type Metastatic Colorectal Carcinoma and < 3 Circulating Tumor Cells
2 other identifiers
interventional
240
1 country
1
Brief Summary
The purpose of the study is to explore the influence of BRAF and PIK3K status on the efficacy of FOLFIRI plus Bevacizumab or Cetuximab, as first line therapy of patients with RAS wild-type metastatic colorectal carcinoma and \< 3 circulating tumor cells
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for phase_2
Started Jul 2012
Longer than P75 for phase_2
1 active site
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
June 13, 2012
CompletedStudy Start
First participant enrolled
July 1, 2012
CompletedFirst Posted
Study publicly available on registry
July 13, 2012
CompletedPrimary Completion
Last participant's last visit for primary outcome
November 1, 2018
CompletedStudy Completion
Last participant's last visit for all outcomes
November 1, 2018
CompletedApril 11, 2019
August 1, 2018
6.3 years
June 13, 2012
April 10, 2019
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
progression free survival (PFS)
5 years
Secondary Outcomes (6)
Overall survival (OS)
5 years
Response rate (RR)
5 years
Radical Resection (R0) surgery rate
5 years
CTC count basal and correlate to PFS, OS, RR
5 years
Adverse events
5 years
- +1 more secondary outcomes
Study Arms (2)
A
EXPERIMENTALFOLFIRI+bevacizumab
B
EXPERIMENTALFOLFIRI + cetuximab
Interventions
* Bevacizumab 5 mg/kg iv, followed by * Irinotecan 180 mg/m2 iv administered over a period of 30-90 minutes, followed by * Leucovorin (LV) 400 mg/m2 iv administered over a period of 2 hours, followed by * 5-FU 400 mg/m2 iv bolus, followed by * 5-FU 2,400 mg/m2 for 46 h continuous infusion. This treatment will start on day 1 and will be repeated every 2 weeks (1 cycle).
* Cetuximab in an initial 120-minute infusion on day 1 of 400 mg/m2, followed by 60-minute infusions of cetuximab at a dose of 250 mg/m2, once weekly * FOLFIRI: * Irinotecan 180 mg/m2 iv administered over a period of 30-90 minutes, followed by * Leucovorin (LV) 400 mg/m2 iv administered over a period of 2 hours, followed by * 5-FU 400 mg/m2 iv bolus, followed by * 5-FU 2,400 mg/m2 for 46 h continuous infusion FOLFIRI will be given after the cetuximab infusion on day 1 of each period (every 2 weeks: 1 cycle).
Eligibility Criteria
You may qualify if:
- Patient's Informed consent in written.
- Age between 18-70 years old.
- ECOG 0-1.
- Life expectancy of at least 3 months.
- Histological confirmation of adenocarcinoma of the colon or rectum.
- Sample of tumour tissue available for evaluation of genes RAS, BRAF and PI3K. To be included in the study patients should present \< 3 CTC in peripheral blood and RAS wild-type present in the sample of tumor tissue.
- Prior radiotherapy is allowed but must be completed at least 4 weeks before randomization (if applicable).
- Adequate bone marrow, liver and renal function.
- Women of childbearing potential must have a negative serum or urine pregnancy test. Postmenopausal women must have been amenorrheic for at least 12 months.Both men and women participating in this study must use adequate contraception.
- Subject must have the ability, in the opinion of the investigator, to comply with all the study procedures and follow-up examinations.
You may not qualify if:
- Previous chemotherapy for metastatic disease.
- Prior treatment with Bevacizumab, or EGFR inhibitors
- Any anticancer treatment (chemotherapy, hormonal treatment, radiation treatment, surgery , immunotherapy, biologic therapy or tumour embolization) within 4 weeks before randomization.
- Use of any investigational drug within 4 weeks before start the treatment.
- Clinical or radiographic evidence of brain metastasis.
- Uncontrolled hypertension (systolic blood pressure \>150 mmHg and/or diastolic blood pressure \>100 mmHg on repeated measurement) despite optimal medical management.
- Previous history of hypertensive encephalopathy or hypertensive crises.
- Current or history of peripheral neuropathy \> or equal to 1 NCICTCAE.
- Patients classified as fragile according to criteria listed in the protocol.
- Significant cardiovascular disease (e.g. AVC, myocardial infarction, within 6 months before randomization). Unstable angina, congestive heart failure New York Heart Association (NYHA) ≥ class II, arrhythmia that requires treatment within 3 months before randomization.
- Significant vascular disease (e.g. aortic aneurism requiring surgical intervention, pulmonary embolic, peripheral arterial thrombosis) within 6 months before randomization.
- Previous history of significant haemorrhage /severe, within 1 month before randomization.
- Major surgery, open surgical biopsy or significant traumatic injury within 4 weeks before randomization.
- Large bore needle biopsy of a major organ within 14 days before randomization. Placement of central venous access port \> or equal to 7 days before randomization is permitted.
- Evidence or history of bleeding diathesis or coagulopathy.
- +14 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Spanish Cooperative Group for Digestive Tumour Therapy
Madrid, 28046, Spain
Related Publications (3)
Valladares-Ayerbes M, Toledano-Fonseca M, Grana B, Jimenez-Fonseca P, Pulido-Cortijo G, Gil S, Sastre J, Salud A, Rivera F, Salgado M, Garcia-Alfonso P, Lopez Lopez R, Guillen-Ponce C, Rodriguez-Ariza A, Vieitez JM, Diaz-Rubio E, Aranda E; Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD). Associations of blood RNA biomarkers and circulating tumour cells in patients with previously untreated metastatic colorectal cancer. BMC Cancer. 2025 Apr 21;25(1):743. doi: 10.1186/s12885-025-14098-9.
PMID: 40259317DERIVEDJimenez-Fonseca P, Sastre J, Garcia-Alfonso P, Gomez-Espana MA, Salud A, Gil S, Rivera F, Reina JJ, Quintero G, Valladares-Ayerbes M, Safont MJ, La Casta A, Robles-Diaz L, Garcia-Paredes B, Lopez Lopez R, Guillot M, Gallego J, Alonso-Orduna V, Diaz-Rubio E, Aranda E; Spanish Cooperative Group for the Treatment of Digestive Tumors (TTD). Association of Circulating Tumor Cells and Tumor Molecular Profile With Clinical Outcomes in Patients With Previously Untreated Metastatic Colorectal Cancer: A Pooled Analysis of the Phase III VISNU-1 and Phase II VISNU-2 Randomized Trials. Clin Colorectal Cancer. 2023 Jun;22(2):222-230. doi: 10.1016/j.clcc.2023.02.004. Epub 2023 Feb 21.
PMID: 36944559DERIVEDSastre J, Orden V, Martinez A, Bando I, Balbin M, Bellosillo B, Palanca S, Peligros Gomez MI, Mediero B, Llovet P, Moral VM, Vieitez JM, Garcia-Alfonso P, Calle SG, Ortiz-Morales MJ, Salud A, Quintero G, Lopez C, Diaz-Rubio E, Aranda E; Spanish Cooperative Group for the Treatment of Digestive Tumors (TTD). Association Between Baseline Circulating Tumor Cells, Molecular Tumor Profiling, and Clinical Characteristics in a Large Cohort of Chemo-naive Metastatic Colorectal Cancer Patients Prospectively Collected. Clin Colorectal Cancer. 2020 Sep;19(3):e110-e116. doi: 10.1016/j.clcc.2020.02.014. Epub 2020 Mar 6.
PMID: 32278676DERIVED
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- STUDY CHAIR
Eduardo Díaz-Rubio, MD-PhD
Hospital San Carlos, Madrid
- STUDY CHAIR
Enrique Aranda, MD-PhD
Hospital Reina Sofía
- STUDY CHAIR
Javier Sastre, MD-PhD
Hospital San Carlos, Madrid
Study Design
- Study Type
- interventional
- Phase
- phase 2
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 13, 2012
First Posted
July 13, 2012
Study Start
July 1, 2012
Primary Completion
November 1, 2018
Study Completion
November 1, 2018
Last Updated
April 11, 2019
Record last verified: 2018-08