NCT02292758

Brief Summary

This randomized phase II trial studies how well irinotecan and cetuximab with or without bevacizumab work in treating patients with RAS wild-type colorectal cancer that has spread to other places in the body (locally advanced/metastatic) and cannot be removed by surgery. Irinotecan may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as cetuximab and bevacizumab, may help the body?s immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving irinotecan and cetuximab with or without bevacizumab may work betting in treating patients with colorectal cancer.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
36

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Dec 2014

Longer than P75 for phase_2

Geographic Reach
1 country

13 active sites

Status
completed

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

November 13, 2014

Completed
4 days until next milestone

First Posted

Study publicly available on registry

November 17, 2014

Completed
25 days until next milestone

Study Start

First participant enrolled

December 12, 2014

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 20, 2019

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 27, 2019

Completed
5 months until next milestone

Results Posted

Study results publicly available

February 28, 2020

Completed
Last Updated

January 31, 2022

Status Verified

August 1, 2019

Enrollment Period

4.3 years

First QC Date

November 13, 2014

Results QC Date

January 31, 2020

Last Update Submit

January 27, 2022

Conditions

Outcome Measures

Primary Outcomes (2)

  • Progression-Free Survival (PFS)

    The distribution of PFS by group will be estimated using the method of Kaplan-Meier. Median by treatment group with confidence intervals will be estimated based on Kaplan-Meier curves. The hazard ratio (HR) with confidence interval will be estimated based on stratified Cox models (stratified by levels of stratification factors), without and with adjusting for baseline clinical/pathological factors. Progression (PD) is defined according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. PD: Any new lesion or increase by ≥50% of previously involved sites from nadir).

    From the date of randomization to the date of 1st documented disease progression or death due to any cause, whichever occurs first, assessed up to 24 months

  • 6-month and 12-month Progression-free Survival (PFS) Rates

    The distribution of PFS by group will be estimated using the method of Kaplan-Meier. Six and 12 month PFS rates by treatment group with confidence intervals will be estimated based on Kaplan-Meier curves. The hazard ratio (HR) with confidence interval will be estimated based on stratified Cox models (stratified by levels of stratification factors), without and with adjusting for baseline clinical/pathological factors. Progression (PD) is defined according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. PD: Any new lesion or increase by ≥50% of previously involved sites from nadir).

    From the date of randomization to the date of 1st documented disease progression or death due to any cause, whichever occurs first, assessed up to 24 months

Secondary Outcomes (8)

  • Number of Participants Who Experienced at Least One Grade 3 or Higher Adverse Events

    Up to 30 days from last dose of study treatment

  • Overall Survival (OS)

    From randomization to the date of death due to any cause, assessed up to 24 months

  • 12-month, 18-month, and 24-month Overall Survival (OS) Rates

    From randomization to the date of death due to any cause, assessed up to 24 months

  • Disease Control Rate (DCR)

    Up to 2 years

  • Overall Response Rate (ORR)

    Up to 2 years

  • +3 more secondary outcomes

Other Outcomes (2)

  • Change in Genotype Concentrations of Prespecified Gene Mutations in Circulating Cell-free Deoxyribonucleic Acid (DNA) (cfDNA)

    Baseline up to 2 years

  • Dynamic Change in Mutation Concentration While the Patient is Receiving Cetuximab Treatment

    Baseline up to 2 years

Study Arms (2)

Arm I (cetuximab, bevacizumab, irinotecan)

EXPERIMENTAL

Patients receive cetuximab IV over 90-120 minutes, bevacizumab IV over 30-90 minutes, and irinotecan IV over 90 minutes on day 1. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity.

Biological: BevacizumabBiological: CetuximabDrug: IrinotecanOther: Laboratory Biomarker Analysis

Arm II (cetuximab, placebo, irinotecan)

ACTIVE COMPARATOR

Patients receive cetuximab IV over 90-120 minutes, placebo IV over 30-90 minutes, and irinotecan IV over 90 minutes on day 1. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity.

Biological: CetuximabDrug: IrinotecanOther: Laboratory Biomarker AnalysisOther: Placebo

Interventions

BevacizumabBIOLOGICAL

Given IV

Also known as: Anti-VEGF, Anti-VEGF Humanized Monoclonal Antibody, Anti-VEGF rhuMAb, Avastin, Bevacizumab awwb, Bevacizumab Biosimilar BEVZ92, Bevacizumab Biosimilar BI 695502, Bevacizumab Biosimilar CBT 124, Bevacizumab Biosimilar CT-P16, Bevacizumab Biosimilar FKB238, Bevacizumab Biosimilar HD204, Bevacizumab Biosimilar HLX04, Bevacizumab Biosimilar IBI305, Bevacizumab Biosimilar LY01008, Bevacizumab Biosimilar MIL60, Bevacizumab Biosimilar QL 1101, Bevacizumab Biosimilar RPH-001, Bevacizumab Biosimilar SCT501, BP102, BP102 Biosimilar, HD204, Immunoglobulin G1 (Human-Mouse Monoclonal rhuMab-VEGF Gamma-Chain Anti-Human Vascular Endothelial Growth Factor), Disulfide With Human-Mouse Monoclonal rhuMab-VEGF Light Chain, Dimer, Recombinant Humanized Anti-VEGF Monoclonal Antibody, rhuMab-VEGF, SCT501
Arm I (cetuximab, bevacizumab, irinotecan)
CetuximabBIOLOGICAL

Given IV

Also known as: Cetuximab Biosimilar CDP-1, Cetuximab Biosimilar CMAB009, Cetuximab Biosimilar KL 140, Chimeric Anti-EGFR Monoclonal Antibody, Chimeric MoAb C225, Chimeric Monoclonal Antibody C225, Erbitux, IMC-C225
Arm I (cetuximab, bevacizumab, irinotecan)Arm II (cetuximab, placebo, irinotecan)

Given IV

Arm I (cetuximab, bevacizumab, irinotecan)Arm II (cetuximab, placebo, irinotecan)

Correlative studies

Arm I (cetuximab, bevacizumab, irinotecan)Arm II (cetuximab, placebo, irinotecan)
PlaceboOTHER

Given IV

Also known as: placebo therapy, PLCB, sham therapy
Arm II (cetuximab, placebo, irinotecan)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Metastatic or locally advanced (unresectable) colorectal cancer with histological confirmation of adenocarcinoma
  • Measurable disease
  • RAS wild-type tumor; Note: evidence of EGFR expression in the tumor is not required
  • Previous failure of at least one fluoropyrimidine- and irinotecan-containing chemotherapy regimen for metastatic disease; Note: previous failure is defined as disease progression while receiving treatment or within 6 weeks after the last dose of irinotecan; failure for this assessment is defined as any enlargement of measurable or assessable lesion(s) or the development of any new lesion; a rising tumor marker alone is not sufficient to define failure; patients can have received irinotecan in any previous line of therapy
  • Treatment with bevacizumab in at least one prior line of therapy for metastatic disease
  • Negative serum or urine pregnancy test done =\< 7 days prior to registration, for women of childbearing potential only
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS): 0 or 1
  • Total serum bilirubin =\< institutional upper limit of normal (ULN) obtained =\<14 days prior to randomization
  • Absolute neutrophil count (ANC) \>= 1500/mm\^3 obtained =\<14 days prior to randomization
  • Platelet count \>= 100,000/mm\^3 obtained =\<14 days prior to randomization
  • Hemoglobin \>= 9.0 g/dL (hemoglobin may be supported by transfusion) obtained =\<14 days prior to randomization
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =\< 2.5 x ULN (=\< 5 x ULN for subjects with liver involvement of their cancer) obtained =\<14 days prior to randomization
  • Creatinine within institutional limits of normal OR creatinine clearance \>= 60 mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal obtained =\<14 days prior to randomization
  • Urinary protein =\< 1+ obtained =\<14 days prior to randomization
  • Patients discovered to have \>= 2+ proteinuria must have a spot urine protein:creatinine ratio (UPCR) \< 1.0
  • +10 more criteria

You may not qualify if:

  • Presence of a RAS mutation in exons 2, 3, or 4 of KRAS or NRAS (patients with mutations in exons 2, 3, or 4 of KRAS and/or NRAS are excluded)
  • Prior treatment with cetuximab or panitumumab
  • Prior intolerance to irinotecan and/or bevacizumab despite dose reduction
  • Known or suspected brain or central nervous system (CNS) metastases, or carcinomatous meningitis
  • Active, uncontrolled infection, including hepatitis B, hepatitis C
  • Concurrent anti-cancer therapy, including chemotherapy agents, targeted agents, or biological agents not otherwise specified in this protocol
  • Anti-cancer therapy =\< 14 days prior to randomization
  • Prior radiotherapy to \> 25% of bone marrow; Note: standard rectal cancer chemoradiation will not exclude subject from study protocol
  • Radiation therapy =\< 2 weeks prior to randomization
  • Any of the following:
  • Pregnant women
  • Nursing women
  • Men or women of childbearing potential who are unwilling to employ adequate contraception
  • Co-morbid systemic illnesses or other severe concurrent disease, history of any psychiatric or addictive disorder, or laboratory abnormality, which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
  • Patients known to be human immunodeficiency virus (HIV) positive
  • +13 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (13)

Mayo Clinic in Arizona

Scottsdale, Arizona, 85259, United States

Location

Saint Luke's Mountain States Tumor Institute

Boise, Idaho, 83712, United States

Location

Siouxland Regional Cancer Center

Sioux City, Iowa, 51101, United States

Location

Cancer Center of Kansas - Wichita

Wichita, Kansas, 67214, United States

Location

Ochsner Medical Center Jefferson

New Orleans, Louisiana, 70121, United States

Location

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215, United States

Location

Michigan Cancer Research Consortium NCORP

Ann Arbor, Michigan, 48106, United States

Location

Mayo Clinic

Rochester, Minnesota, 55905, United States

Location

Heartland Regional Medical Center

Saint Joseph, Missouri, 64507, United States

Location

Missouri Baptist Medical Center

St Louis, Missouri, 63131, United States

Location

New Hampshire Oncology Hematology PA-Hooksett

Hooksett, New Hampshire, 03106, United States

Location

State University of New York Upstate Medical University

Syracuse, New York, 13210, United States

Location

Saint Vincent Regional Cancer Center CCOP

Green Bay, Wisconsin, 54301, United States

Location

Related Publications (1)

  • Lipsyc-Sharf M, Ou FS, Yurgelun MB, Rubinson DA, Schrag D, Dakhil SR, Stella PJ, Weckstein DJ, Wender DB, Faggen M, Zemla TJ, Heying EN, Schuetz SR, Noble S, Meyerhardt JA, Bekaii-Saab T, Fuchs CS, Ng K. Cetuximab and Irinotecan With or Without Bevacizumab in Refractory Metastatic Colorectal Cancer: BOND-3, an ACCRU Network Randomized Clinical Trial. Oncologist. 2022 Apr 5;27(4):292-298. doi: 10.1093/oncolo/oyab025.

MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

BevacizumabImmunoglobulin GDisulfidesCetuximabIrinotecan

Condition Hierarchy (Ancestors)

Intestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesRectal Diseases

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, HumanizedAntibodies, MonoclonalAntibodiesImmunoglobulinsImmunoproteinsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsSerum GlobulinsGlobulinsImmunoglobulin IsotypesSulfidesAnionsIonsElectrolytesInorganic ChemicalsHydrogen SulfideSulfur CompoundsOrganic ChemicalsCamptothecinAlkaloidsHeterocyclic Compounds

Results Point of Contact

Title
Kimmie Ng, M.D., M.P.H.
Organization
Dana-Farber Cancer Institute

Study Officials

  • Kimmie Ng

    Academic and Community Cancer Research United

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 13, 2014

First Posted

November 17, 2014

Study Start

December 12, 2014

Primary Completion

March 20, 2019

Study Completion

September 27, 2019

Last Updated

January 31, 2022

Results First Posted

February 28, 2020

Record last verified: 2019-08

Locations