Phase III Randomized Study of FOLFOXIRI Plus Bevacizumab and Atezolizumab Versus FOLFOXIRI Plus Bevacizumab as First-Line Treatment of Unresectable pMMR and Immunoscore IC-High Metastatic Colorectal Cancer Patients

Status: Recruiting
Location: See all (21) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 3
SUMMARY

The aim of this study is to evaluate the efficacy of the addition of Atezolizumab to FOLFOXIRI plus bevacizumab as first line treatment of patients with pMMR and Immunoscore IC-high metastatic colorectal cancer in terms of Progression Free Survival (PFS).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 75
Healthy Volunteers: f
View:

• Histologically proven diagnosis of colorectal cancer;

• Initially unresectable metastatic colorectal cancer not previously treated with chemotherapy for metastatic disease;

• Proficient mismatch repair (pMMR) status in tumour tissue (primary or metastatic), as determined by a local laboratory assay in a CLIA- or similarly certified;

• Immunoscore IC-high status in tumour tissue (primary or metastatic), as determined by a sponsor-defined central laboratory (HEGP, AP-HP, INSERM, France).

• At least one measurable lesion according to RECIST criteria (version 1.1);

• Availability of adequate tumour specimen (primary or metastatic);

• Male or female of 18-75 years of age;

• ECOG PS ≤ 2 if aged \< 71 years, ECOG PS = 0 if aged 71-75 years;

• Life expectancy of at least 12 weeks;

• Previous adjuvant chemotherapy allowed only if with fluoropyrimidine monotherapy and more than 6 months elapsed between the end of adjuvant and first relapse;

• Neutrophils \>1.5 x 109/L, Platelets \>100 x 109/L, Hb \>9 g/dl;

• Total bilirubin ≤1.5 times the upper-normal limits (UNL) of the normal values and AST (SGOT) and/or ALT (SGPT) \<2.5 x UNL (or \<5 x UNL in case of liver metastases) alkaline phosphatase \<2.5 x UNL (or \<5 x UNL in case of liver metastases);

• Creatinine clearance ≥50 mL/min or serum creatinine ≤1.5 x UNL;

• INR or aPTT ≤1.5 x ULN. This applies only to patients who are not receiving therapeutic anticoagulation;

• Urine dipstick of proteinuria \<2+. Patients discovered to have 2+ proteinuria on dipstick urinalysis at baseline, should undergo a 24-hour urine collection and must demonstrate ≤1 g of protein/24 h;

• Women of childbearing potential must have a negative blood pregnancy test at the baseline visit. For this trial, women of childbearing potential are defined as all women following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilization methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a post-menopausal state in women not using hormonal contraception or hormonal replacement therapy. However, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient;

• Male subjects with female partners of childbearing potential and female subjects of childbearing potential must, therefore, be willing to use adequate contraception as approved by the investigator (barrier contraceptive measure or oral contraception) and outlined in Section 6.5 - Contraception, starting with the first dose of study therapy through 6 months after the last dose of bevacizumab and fluorouracil and within 5 months after the last dose of atezolizumab.

• Females of childbearing potential must have a negative blood pregnancy test at the baseline visit (i.e., performed maximum 7 days before the treatment start);

• Will and ability to comply with the protocol;

• Written informed consent to study procedures.

Locations
Other Locations
Italy
IRCCS Centro di Riferimento Oncologico
RECRUITING
Aviano
Fondazione Poliambulanza, Istituto Ospedaliero
RECRUITING
Brescia
Azienda Ospedaliero Universitaria Policlinico Rodolico - S. Marco
RECRUITING
Catania
AOU Careggi
RECRUITING
Florence
Azienda USL Toscana Nord Ovest
RECRUITING
Livorno
Ospedale San Luca
RECRUITING
Lucca
Istituto Romagnolo per lo Studio dei Tumori Dino Amadori
RECRUITING
Meldola
Fondazione IRCCS INT - Milano
RECRUITING
Milan
Ospedale San Raffaele
RECRUITING
Milan
Azienda Ospedaliero Universitaria di Modena
RECRUITING
Modena
Azienda Ospedaliera Universitaria Luigi Vanvitelli
RECRUITING
Naples
Istituto Oncologico Veneto Irccs
RECRUITING
Padua
Azienda Usl di Piacenza
RECRUITING
Piacenza
U.O. Oncologia Medica 2 Universitaria - Azienda Ospedaliero-Universitaria Pisana Dipartimento di Ricerca Traslazionale e Nuove Tecnologie - University of Pisa
RECRUITING
Pisa
Nuovo Ospedale di Prato S. Stefano
RECRUITING
Prato
Azienda USL della Romagna
RECRUITING
Ravenna
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
RECRUITING
Roma
Policlinico Universitario Tor Vergata
RECRUITING
Rome
Fondazione Casa Sollievo della Sofferenza
RECRUITING
San Giovanni Rotondo
Azienda Ospedaliera Card. G. Panico
RECRUITING
Tricase
Azienda Sanitaria Universitaria Friuli Centrale
RECRUITING
Udine
Contact Information
Primary
Carlotta Antoniotti, MD, PhD
carlotta.antoniotti@unipi.it
+39050992192
Backup
Laura Delliponti
atezotribe2@gmail.com
+39050992192
Time Frame
Start Date: 2024-11-15
Estimated Completion Date: 2029-04-01
Participants
Target number of participants: 238
Treatments
Active_comparator: Arm A - FOLFOXIRI plus bevacizumab
Every 2 weeks for a maximum of 8 cycles:~* Bevacizumab 5 mg/kg iv 90 minutes at cycle 1 (if well tolerated, it is administered over 60 minutes at cycle 2, and over 30 minutes at cycle 3) day 1, followed by~* Irinotecan 165 mg/sqm iv over 60 minutes day 1, followed by~* Oxaliplatin 85 mg/sqm iv over 2 hours day 1, in two-way with~* L-Leucovorin 200 mg/sqm iv over 2 hours day 1, followed by~* 5-fluorouracil 3200 mg/sqm 48 h-continuous infusion, starting on day 1.~If no progression occurs during FOLFOXIRI plus bev, patients will receive maintenance 5-FU/LV plus bev at the same dose used at the last cycle of the induction treatment. 5-FU/LV plus bev will be repeated biweekly until disease progression, unacceptable toxicity or patient's refusal.
Experimental: Arm B - FOLFOXIRI plus bevacizumab plus atezolizumab
Every 2 weeks for a maximum of 8 cycles:~* Atezolizumab 840 mg iv over 30 minutes (60 minutes at first infusion) day 1 followed by~* Bevacizumab 5 mg/kg iv over 90 minutes at cycle 1 (if well tolerated, it is administered over 60 minutes at cycle 2, and over 30 minutes at cycle 3) day 1 followed by~* Irinotecan 165 mg/sqm iv over 60 minutes day 1, followed by~* Oxaliplatin 85 mg/sqm iv over 2 hours day 1, in two-way with~* L-Leucovorin 200 mg/sqm iv over 2 hours day 1, followed by~* 5-fluorouracil 3200 mg/sqm 48 h-continuous infusion, starting on day 1.~If no progression occurs during FOLFOXIRI plus bev plus atezolizumab, patients will receive maintenance 5-FU/LV plus bev plus atezolizumab at the same dose used at the last cycle of the induction treatment. 5-FU/LV plus bev plus atezolizumab will be repeated biweekly until disease progression, unacceptable toxicity or patient's refusal.
Related Therapeutic Areas
Sponsors
Leads: Gruppo Oncologico del Nord-Ovest
Collaborators: Hoffmann-La Roche

This content was sourced from clinicaltrials.gov