UMIN-CTR Clinical Trial

Public title

Phase II study of TAS-102 plus bevacizumab as maintenance therapy after induction chemotherapy with bevacizumab, oxaliplatin, and fluoropyrimidine in patients with metastatic colorectal cancer

Acronym

Switch Maintenance Study

Scientific Title

Phase II study of TAS-102 plus bevacizumab as maintenance therapy after induction chemotherapy with bevacizumab, oxaliplatin, and fluoropyrimidine in patients with metastatic colorectal cancer

Scientific Title:Acronym

Switch Maintenance Study

Region

Japan

Condition

Colorectal cancer

Classification by specialty

Gastroenterology	Hematology and clinical oncology	Gastrointestinal surgery

Classification by malignancy

Malignancy

Genomic information

NO

Narrative objectives1

We conduct a first line induction chemotherapy with bevacizumab, oxaliplatin, and fluoropyrimidine in patients with metastatic colorectal cancer. Induction therapy will be stop systematically for 3 to 4 months then; the chemotherapy switch to TAS-102 plus bevacizumab. Aim of this study is to evaluate efficiency and safety of TAS-102 plus bevacizumab as maintenance therapy.

Basic objectives2

Safety,Efficacy

Basic objectives -Others

Trial characteristics_1

Confirmatory

Trial characteristics_2

Pragmatic

Developmental phase

Phase II

Primary outcomes

Progression free survival

Key secondary outcomes

Overall survival, Response rate, Disease control rate, Rechallenge rate of oxaliplatin, Safety; periods of maintenance therapy, dose intensity, adverse event, total dose of oxaliplatin

Study type

Interventional

Basic design

Single arm

Randomization

Non-randomized

Randomization unit

Blinding

Open -no one is blinded

Control

Historical

Stratification

Dynamic allocation

Institution consideration

Blocking

Concealment

No. of arms

1

Purpose of intervention

Treatment

Type of intervention

Medicine

Interventions/Control_1

TAS-102 plus Bevacizumab
TAS-102 35 mg/time, twice a day, oral intake Day1-5,8-12
Bevacizumab venous injection, 5.0 mg/kg Day1,15

Patients will continue study treatment until disease progression

Interventions/Control_2

Interventions/Control_3

Interventions/Control_4

Interventions/Control_5

Interventions/Control_6

Interventions/Control_7

Interventions/Control_8

Interventions/Control_9

Interventions/Control_10

Age-lower limit

20

years-old

<=

Age-upper limit

Not applicable

Gender

Male and Female

Key inclusion criteria

1) Historical or cytological documentation of adenocarcinoma of the colon or rectum
2) First line chemotherapy and non-resectable advanced colorectal cancer. If patients were performed adjuvant chemotherapy, the period until first line chemotherapy has to be at least 6 months.
3) Male or female patients >= 20
4) Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1.
5) Adequate bone marrow, liver and renal functions as assessed by the following laboratory requirements conducted within 14 days of starting study treatment:
1. Absolute neutrophil count >= 1500 /mm3
2. Hemoglobin >= 9.0 g/dl
3. Platelet >=100000 /mm3
4. Total bilirubin <=1.5 ml/dl
5. AST and ALT <=100 IU/l
6. Creatinine <= 1.5 mg/dl
6) Life expectancy of at least 90 days.
7) Patients must have measurable or non measurable disease according to RECIST version 1.1
8) Induction chemotherapy was done by CapeOX+Bevacizumb or FOLFOX+Bevacizumab. Except the induction therapy done by other approved standard therapies which include irinotecan or anti-EGFR drug.
9) Conduct a first line induction chemotherapy with bevacizumab, oxaliplatin, and fluoropyrimidine. Induction therapy will be stop systematically for 3 to 4 months then; the chemotherapy switch to TAS-102 plus bevacizumab; expected oxaliplatin dose is 610 to 680 mg/M2.
10) Confirmed the disease control; CR/PR/SD by each image after induction therapy.
11) Signed informed consent obtained before any study specific procedures. Patients must be able to understand and willing to sign a written informed consent.

Key exclusion criteria

1) Prior treatment with TAS-102 and Bevacizumab.
2) Previous or concurrent cancer that is distinct in primary site or histology form colorectal cancer within 1 years prior to EXCEPT for curatively treated cervical cancer in situ, non-melanoma skin cancer and superficial bladder tumors [Ta, Tis and T1].
3) Major surgical procedure within 28 days before start of study medication.
4) Pregnant or breast-feeding patients. Woman of childbearing potential must have a pregnancy test performed a maximum of 7 days before start of treatment, and a negative result must be documented before start of treatment.
5)Congestive heart failure >=NYHA class 2.
6) Unstable angina, new-onset angina. Myocardial infarction less than 6 months before start of study medication.
7)Uncontrolled hypertension.
8) Pleural effusion or ascites with dyspnea higher than CTCAE v4.0 grade 2.
9) Arterial or venous thrombotic or embolic events such as cerebrovascular accident, deep vein thrombosis or pulmonary embolism within the 6 months before start of study medication.
10) Known history of HIV infection, or chronic hepatitis B or C.
11) Symptomatic metastatic brain or meningeal metastasis.
12) Patients with evidence or history of bleeding diathesis. Any hemorrhage or bleeding event >= CTCAE v4.0 Grade 3 within 4 weeks of start of study medication.
13) Interstitial lung disease with ongoing signs and symptoms at the time of informed consent.
14) Persistant proteinuria of CTCAE v4.0 Grade 3 or higher.
15) Patients unable to swallow oral medications.
16) Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation.
17) Non-healing wound, ulcer, or bone fracture.
18) Unsolved toxicity higher than CTCAE v4.0 Grade 1 attributed to any prior therapy/procedure excluding alopecia and oxaliplatin induced neurotoxicity <= Grade 2.
19) A responsible doctor has confirmed the candidate should be excluded from this study.

Target sample size

55

Name of lead principal investigator

1st name
Middle name
Last name	Katsuya Ohta

Organization

Higashiosaka city medical center

Division name

Department of Gastroenterological surgery

Zip code

Address

Nishiiwata 3-4-5, Higashiosaka city, Osaka, Japan

TEL

06-6781-5101

Email

ohta-k@higashiosaka-hosp.jp

Name of contact person

1st name
Middle name
Last name	Katsuya Ohta

Organization

Higashiosaka city medical center

Division name

Department of Gastroenterological surgery

Zip code

Address

Nishiiwata 3-4-5, Higashiosaka city, Osaka, Japan

TEL

06-6781-5101

Homepage URL

Email

ohta-k@higashiosaka-hosp.jp

Institute

Multicenter Clinical Study Group of Osaka, Colorectal Cancer Treatment Group

Institute

Department

Personal name

Organization

Non

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization

Co-sponsor

Name of secondary funder(s)

Organization

Address

Tel

Email

Secondary IDs

NO

Study ID_1

Org. issuing International ID_1

Study ID_2

Org. issuing International ID_2

IND to MHLW

Institutions

Date of disclosure of the study information

2018

Year

02

Month

16

Day

URL releasing protocol

Publication of results

Unpublished

URL related to results and publications

Number of participants that the trial has enrolled

Results

Results date posted

Results Delayed

Results Delay Reason

Date of the first journal publication of results

Baseline Characteristics

Participant flow

Adverse events

Outcome measures

Plan to share IPD

IPD sharing Plan description

Recruitment status

Open public recruiting

Date of protocol fixation

2017

Year

11

Month

29

Day

Date of IRB

Anticipated trial start date

2017

Year

12

Month

01

Day

Last follow-up date

Date of closure to data entry

Date trial data considered complete

Date analysis concluded

Other related information

Registered date

2018

Year

02

Month

15

Day

Last modified on

2018

Year

02

Month

15

Day

Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000035746