Clinical trial • Phase III • Oncology

Trifluridine; Tipiracil hydrochloride for Metastatic colorectal cancer

Phase III trial of Trifluridine; Tipiracil hydrochloride for Metastatic colorectal cancer.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Metastatic colorectal cancer
Trial Stage
Phase III
Drug Modality
Monoclonal antibody|Small molecule

Key dates

Initial CTIS Submission Date
18-09-2024
First CTIS Authorization Date
15-10-2024

Trial design

Randomised, open-label, arm experimental: s 95005 (35 mg/m2/dose) administered orally bid, within 1 hour after completion of morning and evening meals, 5 days on/2 days off for 2 weeks followed by a 14-day rest (cycle repeated every 4 weeks) plus bevacizumab 5 mg/kg iv every 2 weeks (day 1 and day 15). arm active comparator: capecitabine 1250 mg/m² orally bid on days 1–14 of each cycle (starting dose may be reduced to 1000 mg/m²/dose per local practice), with bevacizumab 7.5 mg/kg iv on day 1 of each cycle (cycle repeated every 3 weeks).-controlled Phase III trial across 4 sites in Sweden, Slovakia, Denmark and others.

Randomised
Yes
Open Label
Yes
Comparator
Arm experimental: S 95005 (35 mg/m2/dose) administered orally BID, within 1 hour after completion of morning and evening meals, 5 days on/2 days off for 2 weeks followed by a 14-day rest (cycle repeated every 4 weeks) plus bevacizumab 5 mg/kg IV every 2 weeks (Day 1 and Day 15). Arm active comparator: Capecitabine 1250 mg/m² orally BID on Days 1–14 of each cycle (starting dose may be reduced to 1000 mg/m²/dose per local practice), with bevacizumab 7.5 mg/kg IV on Day 1 of each cycle (cycle repeated every 3 weeks).
Target Sample Size
382

Stratification factors

  • ECOG performance status (0 vs. 1 vs. 2)
  • Primary tumour localisation (right vs. left)
  • Reason why the patient is not candidate to intensive therapy (clinical condition reason vs. non-clinical condition reason)

Eligibility

Recruits 382 Vulnerable population selected. Informed consent handled via subject information and informed consent forms; country-specific ICF documents are available (documents listed for Denmark, Sweden, Slovakia and Poland). No specific assent procedures for minors are specified in the available documents..

Pregnancy Exclusion
Pregnancy, breastfeeding or possibility of becoming pregnant during the study.
Vulnerable Population
Vulnerable population selected. Informed consent handled via subject information and informed consent forms; country-specific ICF documents are available (documents listed for Denmark, Sweden, Slovakia and Poland). No specific assent procedures for minors are specified in the available documents.

Inclusion criteria

  • {"criterion_text":"- Has definitive histologically confirmed adenocarcinoma of the colon or rectum (all other histological types are excluded). Primary tumour localisation must be known.\n- RAS status based on local biological assessment of tumour biopsy must be available. If RAS status is not available at the time of randomisation, tumour biopsy must be available for RAS status determination (based on local biological assessment).\n- Patient is not a candidate for standard full dose combination chemotherapy with irinotecan or oxaliplatin\n- Patient is not a candidate for curative resection of metastatic lesions\n- No previous systemic anticancer therapy for unresectable metastatic colorectal cancer\n- ECOG (Eastern Cooperative Oncology Group) performance status ≤2.\n- Adequate organ function (renal, haematological, hepatic, coagulation) as described in the study protocol'"}

Exclusion criteria

  • {"criterion_text":"- Pregnancy, breastfeeding or possibility of becoming pregnant during the study.\n- Participation in another interventional study within 4 weeks prior to the randomisation .\n- Patients who have not recovered from clinically relevant non-hematologic CTCAE grade ≥ 3 toxicity of previous anticancer therapy prior to the randomisation.\n- Symptomatic central nervous system metastases.\n- Major surgery within 4 weeks prior to the randomisation.\n- Exclusion criteria related to S 95005 administration: History of allergic reactions attributed to compounds of similar composition to S 95005 or any of its excipients.\n- Any contraindication present in the SmPC of trifluridine/tipiracil\n- Exclusion criteria related to bevacizumab administration: Any contraindication present in the SmPC of bevacizumab\n- Exclusion criteria related to capecitabine administration: Any contraindication present in the SmPC of capecitabine"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Progression-free survival (PFS) based on investigator judgement","definition_or_measurement_approach":"Based on investigator judgement"}

Secondary endpoints

  • {"endpoint_text":"- Overall survival (OS)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Overall response rate (ORR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Disease control rate (DCR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Duration of response (DoR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Time to treatment failure (TTF)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Safety and tolerability assessed by incidence of adverse events (AE), laboratory tests, physical examination and performance status (ECOG), vital signs, 12-leads ECG parameters","definition_or_measurement_approach":"Assessed by incidence of adverse events (AE), laboratory tests, physical examination, ECOG performance status, vital signs and 12-lead ECG parameters"}
  • {"endpoint_text":"- Quality of life (QoL)","definition_or_measurement_approach":"Measured as quality-of-life outcomes (patient questionnaires). Patient-facing documents include QoL questionnaires (EORTC and EQ-5D-5L) listed in protocol documents"}

Recruitment

Planned Sample Size
382
Recruitment Window Months
75
Consent Approach
Informed consent obtained using subject information and informed consent forms; country-specific ICFs are provided (documents listed for Denmark, Sweden, Slovakia and Poland). Consent provided by the participant (adult); no age-specific assent procedures for minors are specified in the available documents.

Geography

Total Number Of Sites
4
Total Number Of Participants
84

Sweden

Earliest CTIS Part Ii Submission Date
09-09-2024
Latest Decision Or Authorization Date
16-10-2024
Processing Time Days
37
Number Of Sites
1
Number Of Participants
10

Sites

Site Name
Region Joenkoepings Laen
Department Name
Oncology department
Contact Person Name
Karin Adolfsson
Contact Person Email
karin.adolfsson@rjl.se

Slovakia

Earliest CTIS Part Ii Submission Date
09-09-2024
Latest Decision Or Authorization Date
15-10-2024
Processing Time Days
36
Number Of Sites
1
Number Of Participants
4

Sites

Site Name
Vychodoslovensky Onkologicky Ustav a.s.
Department Name
Oddelenie klinickej onkologie
Contact Person Name
Igor ANDRASINA
Contact Person Email
grega@vou.sk

Denmark

Earliest CTIS Part Ii Submission Date
10-10-2024
Latest Decision Or Authorization Date
15-10-2024
Processing Time Days
5
Number Of Sites
1
Number Of Participants
36

Sites

Site Name
Region Midtjylland
Department Name
Oncology department
Contact Person Name
Lone Duval
Contact Person Email
londuv@rm.dk

Poland

Earliest CTIS Part Ii Submission Date
09-09-2024
Latest Decision Or Authorization Date
08-11-2024
Processing Time Days
60
Number Of Sites
1
Number Of Participants
34

Sites

Site Name
Specjalistyczny Szpital Onkologiczny Nu-Med Sp. z o.o.
Department Name
Pododdzial Chemioterapii
Contact Person Name
Magdalena Ciążyńska
Contact Person Email
ciazynska.magdalena@gmail.com

Sponsor

Primary sponsor

Full Name
Institut De Recherches Internationales Servier IRIS
Organisation Type
Pharmaceutical company
Country Of Registered Address
France

Contract research organisations

Name
IQVIA Limited
Responsibilities
Clinical monitoring for DNK, POL, SWE
Name
Clario
Responsibilities
e-PRO
Name
Cerba Research
Responsibilities
Central laboratory
Name
Median Technologies
Responsibilities
Medical image analysis/ review - X-ray, MRI, ultrasound, etc.
Name
Theradis Pharma
Responsibilities
IRS (Randomisation & Drug Kit management)
Name
SAGA Diagnostics AB
Responsibilities
Third part lab for BRAF analysis
Name
Heva
Responsibilities
6

Third parties

  • {"country":"Switzerland","full_name":"Clario","duties_or_roles":"e-PRO","organisation_type":"Health care"}
  • {"country":"France","full_name":"Median Technologies","duties_or_roles":"Medical image analysis/ review - X-ray, MRI, ultrasound, etc.","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"Cerba Research","duties_or_roles":"Central laboratory","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United Kingdom","full_name":"IQVIA Limited","duties_or_roles":"Clinical monitoring for DNK, POL, SWE","organisation_type":"Pharmaceutical company"}
  • {"country":"France","full_name":"Heva","duties_or_roles":"6","organisation_type":"Pharmaceutical company"}
  • {"country":"Sweden","full_name":"SAGA Diagnostics AB","duties_or_roles":"Third part lab for BRAF analysis","organisation_type":"Pharmaceutical company"}
  • {"country":"France","full_name":"Theradis Pharma","duties_or_roles":"IRS (Randomisation & Drug Kit management)","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Lonsurf 20 mg/8.19 mg film-coated tablets
Active Substance
Trifluridine; Tipiracil hydrochloride
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Authorised (marketing authorisation present)
Starting Dose
35 mg/m2/dose orally BID (as S 95005 in experimental arm)
Dose Levels
35 mg/m2/dose BID (max 70 mg/m2/day)
Frequency
BID (5 days on/2 days off schedule in 2 weeks, then 14 days rest; cycle repeated every 4 weeks)
Maximum Dose
70 mg/m2/day
Investigational Product Name
Lonsurf 15 mg/6.14 mg film-coated tablets
Active Substance
Trifluridine; Tipiracil hydrochloride
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Authorised (marketing authorisation present)
Starting Dose
35 mg/m2/dose orally BID (as S 95005 in experimental arm)
Dose Levels
35 mg/m2/dose BID (max 70 mg/m2/day)
Frequency
BID (5 days on/2 days off schedule in 2 weeks, then 14 days rest; cycle repeated every 4 weeks)
Maximum Dose
70 mg/m2/day
Investigational Product Name
Avastin 25 mg/ml concentrate for solution for infusion.
Active Substance
Bevacizumab
Modality
Monoclonal antibody
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
Authorised (marketing authorisation present)
Starting Dose
5 mg/kg IV every 2 weeks in combination with S95005 (or 7.5 mg/kg IV every 3 weeks in combination with capecitabine arm)
Dose Levels
5 mg/kg q2w (with S95005) or 7.5 mg/kg q3w (with capecitabine)
Frequency
Every 2 weeks (5 mg/kg) or every 3 weeks (7.5 mg/kg) depending on arm
Maximum Dose
7.5 mg/kg
Investigational Product Name
Xeloda 150 mg film-coated tablets
Active Substance
Capecitabine
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Authorised (marketing authorisation present)
Starting Dose
1250 mg/m² orally BID on Days 1–14 of each cycle (may be started at 1000 mg/m²/dose per local practice)
Dose Levels
1250 mg/m²/dose BID (Days 1–14); starting dose may be reduced to 1000 mg/m²/dose
Frequency
BID on Days 1–14 of each 3-week cycle
Maximum Dose
2500 mg/m2/day
Investigational Product Name
Xeloda 500 mg film-coated tablets
Active Substance
Capecitabine
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Authorised (marketing authorisation present)
Starting Dose
1250 mg/m² orally BID on Days 1–14 of each cycle (may be started at 1000 mg/m²/dose per local practice)
Dose Levels
1250 mg/m²/dose BID (Days 1–14); starting dose may be reduced to 1000 mg/m²/dose
Frequency
BID on Days 1–14 of each 3-week cycle
Maximum Dose
2500 mg/m2/day
Combination Treatment
Yes

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