NCT03475953

Brief Summary

Assessment of the efficacy and safety of Regorafenib and Avelumab in patients with advanced or metastatic solid tumors (ten cohorts), once the Recommanded Phase II Dose (RP2D) has been determined (phase I trial). Assessement of the efficacy and safety of a low-dose of regorafenib (80mg/day) with avelumab in patients with advanced or metastatic colorectal tumors.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
747

participants targeted

Target at P75+ for phase_1

Timeline
Completed

Started May 2018

Longer than P75 for phase_1

Geographic Reach
1 country

7 active sites

Status
unknown

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

February 20, 2018

Completed
1 month until next milestone

First Posted

Study publicly available on registry

March 23, 2018

Completed
1 month until next milestone

Study Start

First participant enrolled

May 4, 2018

Completed
6.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2024

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2025

Completed
Last Updated

March 3, 2023

Status Verified

March 1, 2023

Enrollment Period

6.7 years

First QC Date

February 20, 2018

Last Update Submit

March 2, 2023

Conditions

Keywords

Advanced solid tumorMetastatic tumorPhase Ib/II trialColorectal cancer not MSI-H or MMR-deficientGISTOesophageal or Gastric CarcinomaBiliary Tract cancerHepatocellular CarcinomaSoft-tissue sarcomaThyroid cancerNeuroendocrine gastroenteropancreatic tumorsNon-small cell lung cancerTertiary lymphoid structurestriple negative brest cancerurothelial cancerHPV-associated cancermalignant pleural mesotheliomanon clear-cell renal carcinomaTMB-high solid tumorsMSI-high solid tumors

Outcome Measures

Primary Outcomes (4)

  • PHASE I : Recommended phase II dose (RP2D)

    Recommended phase II dose (RP2D) evaluated on the first cycle (Day 1 to Day 28) of regorafenib when prescribed in association with avelumab.

    During the first cycle (28 days)

  • PHASE II (7cohorts A, C, D, E, F and G) : Assessment of the antitumor activity of regorafenib

    Assessment of the antitumor activity of regorafenib when prescribed in association with avelumab based on objective response under treatment defined as CR or PR following RECIST v1.1 criteria.

    Throughout the treatment period, an average of 6 months

  • Phase II (cohorts B, H, I, M, N, O and P): Assessment of the antitumor activity of regorafenib

    Assessment of the antitumor activity of regorafenib when prescribed in association with avelumab based on 6-month progression-free rate, defined as CR, PR and SD following RECIST v1.1 criteria.

    6 months

  • Phase II (cohort A'): Assessment of the antitumor activity of regorafenib

    Assessment of the antitumor activity of regorafenib when prescribed in association with avelumab based on 4-months progression-free rate, defined as CR, PR and SD following RECIST v1.1 criteria.

    4 months

Secondary Outcomes (33)

  • PHASE I : Maximum Tolerated Dose (MTD)

    During the first cycle (28 days)

  • PHASE I : Dose Limiting Toxicities (DLT)

    During the first cycle (28 days)

  • PHASE I : Toxicity

    Throughout the treatment period, an average of 6 months

  • PHASE I : Assessment of the antitumor activity of regorafenib - Best overall response

    Throughout the treatment period, an average of 6 months

  • PHASE I :Assessment of the antitumor activity of regorafenib - objective response rate under treatment

    Throughout the treatment period, an average of 6 months

  • +28 more secondary outcomes

Study Arms (18)

Phase 1 : Regorafenib + Avelumab

EXPERIMENTAL

Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 1 : RegorafenibDrug: Phase 1 : Avelumab

Phase 2 : cohort A Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab + Regorafenib Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort B Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort C Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort D Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort E Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort F Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort G Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort H Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort I Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort A' Regorafenib low-dose + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : AvelumabDrug: Phase 2: low-dose Regorafenib

Phase 2 : cohort J Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort K Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort L Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort M Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort N Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort O Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Phase 2 : cohort P Regorafenib + Avelumab

EXPERIMENTAL

Treatment by Avelumab will be administrated by intravenous 1-hour infusion every 2 weeks starting at Cycle 1 Day 15. Regorafenib will be taken orally once daily for three weeks on/ one week off.

Drug: Phase 2 : RegorafenibDrug: Phase 2 : Avelumab

Interventions

A treatment cycle consists of 4 weeks. Treatment may continue until disease progression or study discontinuation (withdrawal of consent, intercurrent illness, unacceptable adverse event or any other changes unacceptable for further treatment, etc.). Patients will be allocated 3 dose levels of Regorafenib following a 3 + 3 design.

Phase 1 : Regorafenib + Avelumab

A treatment cycle consists of 4 weeks. Treatment may continue until disease progression or study discontinuation (withdrawal of consent, intercurrent illness, unacceptable adverse event or any other changes unacceptable for further treatment, etc.). Avelumab will be administered on cycle 1 Day 15 as a 1-hour intravenous (IV) infusion (10mg/kg), repeated every two weeks thereafter (ie. Day 1 and Day 15 of each subsequent cycle, as a 1-hour intravenous infusion).

Phase 1 : Regorafenib + Avelumab

Phase 2 : Regorafenib - All patients will be treated at the RP2D of regorafenib defined in the preliminary phase 1 trial with the same schedule as in the phase I.

Phase 2 : cohort A Regorafenib + AvelumabPhase 2 : cohort B Regorafenib + AvelumabPhase 2 : cohort C Regorafenib + AvelumabPhase 2 : cohort D Regorafenib + AvelumabPhase 2 : cohort E Regorafenib + AvelumabPhase 2 : cohort F Regorafenib + AvelumabPhase 2 : cohort G Regorafenib + AvelumabPhase 2 : cohort H Regorafenib + AvelumabPhase 2 : cohort I Regorafenib + AvelumabPhase 2 : cohort J Regorafenib + AvelumabPhase 2 : cohort K Regorafenib + AvelumabPhase 2 : cohort L Regorafenib + AvelumabPhase 2 : cohort M Regorafenib + AvelumabPhase 2 : cohort N Regorafenib + AvelumabPhase 2 : cohort O Regorafenib + AvelumabPhase 2 : cohort P Regorafenib + Avelumab

Phase 2 : Avelumab - All patients will be treated with avelumab with the same schedule as in the phase 1 trial.

Phase 2 : cohort A Regorafenib + AvelumabPhase 2 : cohort A' Regorafenib low-dose + AvelumabPhase 2 : cohort B Regorafenib + AvelumabPhase 2 : cohort C Regorafenib + AvelumabPhase 2 : cohort D Regorafenib + AvelumabPhase 2 : cohort E Regorafenib + AvelumabPhase 2 : cohort F Regorafenib + AvelumabPhase 2 : cohort G Regorafenib + AvelumabPhase 2 : cohort H Regorafenib + AvelumabPhase 2 : cohort I Regorafenib + AvelumabPhase 2 : cohort J Regorafenib + AvelumabPhase 2 : cohort K Regorafenib + AvelumabPhase 2 : cohort L Regorafenib + AvelumabPhase 2 : cohort M Regorafenib + AvelumabPhase 2 : cohort N Regorafenib + AvelumabPhase 2 : cohort O Regorafenib + AvelumabPhase 2 : cohort P Regorafenib + Avelumab

Phase 2 : Regorafenib - All patients will be treated at a fixed low-dose of regorafenib of 80 mg/day

Phase 2 : cohort A' Regorafenib low-dose + Avelumab

Eligibility Criteria

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

You may qualify if:

  • Histology:
  • Dose escalation part: histologically confirmed non MSI-H or deficient-MMR colorectal cancer, or GIST, or esophageal or gastric carcinoma or hepatobiliary cancers,
  • Phase II trials : histologically confirmed
  • non MSI-H or deficient-MMR colorectal cancer (cohort A),
  • or GIST (cohort B). As recommended diagnosis by INCa, patients with GIST must have histologically confirmed by central review, except if it has been already confirmed by the RRePS Network
  • or esophageal or gastric carcinoma (cohort C),
  • or hepatobiliary cancers (cohort D),
  • or soft-tissue sarcoma (STS) (cohort E). As recommended diagnosis by INCa, patients with STS must have histologically confirmed by central review, except if it has been already confirmed by the RRePS Network
  • or radioiodine-refractory differentiated thyroid cancer \[RR-DTC\] (cohort F),
  • or neuroendocrine gastroenteropancreatic tumors grade 2 and 3
  • or Non-small cell lung cancer (cohort H)
  • or Solid tumors including soft-tissue sarcoma with immune signature (cohort I), i.e. presence of tertiary lymphoid structures on tumor sample as determined by central review.
  • or urothelial cancer (cohort J)
  • or HPV-associated cancer (cohort K) with molecular confirmation p16 positive status,
  • triple negative breast cancer (cohort L)
  • +43 more criteria

You may not qualify if:

  • Previous treatment with Avelumab or Regorafenib,
  • Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumab or any other antibody or drug specifically targeting T-cell costimulation or checkpoint pathways), except for cohort H (NSCLC), Cohort I (Solid tumors (including Soft Tissue Sarcoma) with immune signature (TLS+)) and cohort P (malignant pleural mesothelioma),
  • Evidence of progressive or symptomatic or newly diagnosed central nervous system (CNS) or leptomeningeal metastases,
  • Men or women of childbearing potential who are not using an effective method of contraception as previously described;
  • Participation to a study involving a medical or therapeutic intervention in the last 30 days,
  • Previous enrolment in the present study,
  • Patient unable to follow and comply with the study procedures because of any geographical, familial, social or psychological reasons,
  • Known hypersensitivity to any involved study drug or of its formulation components,
  • Active autoimmune disease that might deteriorate when receiving an immunostimulatory agent :
  • Subjects with diabetes type I, vitiligo, psoriasis, hypo- or hyperthyroid disease not requiring immunosuppressive treatment are eligible
  • Subjects requiring hormone replacement with corticosteroids are eligible if the steroids are administered only for the purpose of hormonal replacement and at doses ≤ 10 mg or 10 mg equivalent prednisone per day
  • Administration of steroids through a route known to result in a minimal systemic exposure (topical, intranasal, intro-ocular, or inhalation) are acceptable
  • Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment,
  • Has known hepatitis B or hepatitis C, active and/or treated by antiviral therapy
  • Has a known history of Human Immunodeficiency Virus (HIV) (HIV1/2 antibodies) or known acquired immunodeficiency syndrome (AIDS),
  • +22 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (7)

Institut Bergonié

Bordeaux, 33076, France

RECRUITING

Centre Hospitalier Régional Universitaire - CHU Morvan

Brest, 29200, France

RECRUITING

Centre Léon Bérard

Lyon, 69008, France

RECRUITING

Institut de Cancérologie de Montpellier

Montpellier, 34298, France

RECRUITING

Institut Curie

Paris, 75248, France

RECRUITING

IUCT Oncopôle - Institut Claudius Regaud

Toulouse, 31059, France

RECRUITING

Institut Gustave Roussy

Villejuif, 94800, France

RECRUITING

Related Publications (4)

  • Toulmonde M, Guegan JP, Spalato-Ceruso M, Valentin T, Bahleda R, Peyraud F, Rey C, Kind M, Cantarel C, Bellera C, Vanhersecke L, Bessede A, Italiano A. Reshaping the tumor microenvironment of cold soft-tissue sarcomas with anti-angiogenics: a phase 2 trial of regorafenib combined with avelumab. Signal Transduct Target Ther. 2025 Jun 27;10(1):202. doi: 10.1038/s41392-025-02278-9.

  • Cousin S, Guegan JP, Palmieri LJ, Metges JP, Pernot S, Bellera CA, Assenat E, Korakis I, Cassier PA, Hollebecque A, Cantarel C, Kind M, Soubeyran I, Sokol H, Vanhersecke L, Bessede A, Italiano A. Regorafenib plus avelumab in advanced gastroenteropancreatic neuroendocrine neoplasms: a phase 2 trial and correlative analysis. Nat Cancer. 2025 Apr;6(4):584-594. doi: 10.1038/s43018-025-00916-3. Epub 2025 Apr 9.

  • Cousin S, Cantarel C, Guegan JP, Mazard T, Gomez-Roca C, Metges JP, Bellera C, Adenis A, Korakis I, Poureau PG, Bourcier K, Toulmonde M, Kind M, Rey C, Auzanneau C, Bessede A, Soubeyran I, Italiano A. Regorafenib-avelumab combination in patients with biliary tract cancer (REGOMUNE): a single-arm, open-label, phase II trial. Eur J Cancer. 2022 Feb;162:161-169. doi: 10.1016/j.ejca.2021.11.012. Epub 2022 Jan 5.

  • Toulmonde M, Brahmi M, Giraud A, Chakiba C, Bessede A, Kind M, Toulza E, Pulido M, Albert S, Guegan JP, Cousin S, Mathoulin-Pelissier S, Perret R, Croce S, Blay JY, Ray-Coquard I, Floquet A, Italiano A. Trabectedin plus Durvalumab in Patients with Advanced Pretreated Soft Tissue Sarcoma and Ovarian Carcinoma (TRAMUNE): An Open-Label, Multicenter Phase Ib Study. Clin Cancer Res. 2022 May 2;28(9):1765-1772. doi: 10.1158/1078-0432.CCR-21-2258.

MeSH Terms

Conditions

Turcot syndromeStomach NeoplasmsBiliary Tract NeoplasmsCarcinoma, HepatocellularSarcomaThyroid NeoplasmsGastro-enteropancreatic neuroendocrine tumorCarcinoma, Non-Small-Cell LungCarcinoma, Transitional CellTriple Negative Breast NeoplasmsCarcinoma, Renal CellMesothelioma, MalignantNeoplasm MetastasisTertiary Lymphoid Structures

Interventions

Clinical Trials, Phase II as Topicregorafenib

Condition Hierarchy (Ancestors)

Gastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesStomach DiseasesBiliary Tract DiseasesAdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeLiver NeoplasmsLiver DiseasesNeoplasms, Connective and Soft TissueEndocrine Gland NeoplasmsHead and Neck NeoplasmsEndocrine System DiseasesThyroid DiseasesCarcinoma, BronchogenicBronchial NeoplasmsLung NeoplasmsRespiratory Tract NeoplasmsThoracic NeoplasmsLung DiseasesRespiratory Tract DiseasesBreast NeoplasmsBreast DiseasesSkin DiseasesSkin and Connective Tissue DiseasesKidney NeoplasmsUrologic NeoplasmsUrogenital NeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesKidney DiseasesUrologic DiseasesMale Urogenital DiseasesMesotheliomaAdenomaNeoplasms, MesothelialPleural NeoplasmsNeoplastic ProcessesPathologic ProcessesPathological Conditions, Signs and SymptomsPathological Conditions, Anatomical

Intervention Hierarchy (Ancestors)

Clinical Trials as TopicClinical Studies as TopicEpidemiologic Study CharacteristicsEpidemiologic MethodsInvestigative TechniquesHealth Care Evaluation MechanismsQuality of Health CareHealth Care Quality, Access, and EvaluationPublic HealthEnvironment and Public Health

Central Study Contacts

Simone MATHOULIN-PELISSIER, MD, PhD

CONTACT

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
SEQUENTIAL
Model Details: This is a multicenter, prospective open-labeled phase Ib trial based on a dose escalation study design (3+3 traditional design) assessing three dose levels of Regorafenib given in combination with Avelumab (no dose escalation for Avelumab) in patients with advanced solid tumors followed by 17 phase II trials : * to evaluate the association of Regorafenib at the RP2D with Avelumab in 16 distinct disease settings (advanced or metastatic tumors). * to evaluate the association of a low-dose of regorafenib with avelumab in advanced or metastatic colorectal cancer
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 20, 2018

First Posted

March 23, 2018

Study Start

May 4, 2018

Primary Completion

December 31, 2024

Study Completion

December 31, 2025

Last Updated

March 3, 2023

Record last verified: 2023-03

Locations