UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000002388
Receipt number R000002870
Scientific Title A multicenter phase II study of FOLFIRI as first-line chemotherapy for metastatic colorectal cancer with reduced starting dose of irinotecan in patients with homozygous for UGT1A1(FLIGHT1)
Date of disclosure of the study information 2009/09/01
Last modified on 2018/09/20 08:20:29

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Basic information

Public title

A multicenter phase II study of FOLFIRI as first-line chemotherapy for metastatic colorectal cancer with reduced starting dose of irinotecan in patients with homozygous for UGT1A1(FLIGHT1)

Acronym

A multicenter phase II study of FOLFIRI for metastatic colorectal cancer(FLIGHT1)

Scientific Title

A multicenter phase II study of FOLFIRI as first-line chemotherapy for metastatic colorectal cancer with reduced starting dose of irinotecan in patients with homozygous for UGT1A1(FLIGHT1)

Scientific Title:Acronym

A multicenter phase II study of FOLFIRI for metastatic colorectal cancer(FLIGHT1)

Region

Japan


Condition

Condition

colorectal cancer

Classification by specialty

Gastroenterology Hematology and clinical oncology Surgery in general
Gastrointestinal surgery

Classification by malignancy

Malignancy

Genomic information

YES


Objectives

Narrative objectives1

The objective of this study is to evaluate the tumor response rate and the incidence and severity of adverse events during first-line chemotherapy with FOLFIRI in patients with metastatic colorectal cancer .

Basic objectives2

Safety,Efficacy

Basic objectives -Others


Trial characteristics_1

Exploratory

Trial characteristics_2

Pragmatic

Developmental phase

Phase II


Assessment

Primary outcomes

(1)response rate
(2)incidence and severity of adverse events

Key secondary outcomes

(1) Determination of the time to response, the duration of response, the progression-free survival (PFS) time, and the overall survival (OS) time.
(2) Evaluation of the causal relationship of each adverse event with the protocol treatment, its reversibility, its cumulative dose-response relationship, and its course over time.
(3) Detection of genetic variation (when possible) and correlation of genetic variations with the pharmacokinetics of CPT-11, SN-38, and SN-38G as well as with the toxicities of CPT-11 (as an ancillary investigation).


Base

Study type

Interventional


Study design

Basic design

Single arm

Randomization

Non-randomized

Randomization unit


Blinding

Open -no one is blinded

Control

Uncontrolled

Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms

1

Purpose of intervention

Treatment

Type of intervention

Medicine Gene

Interventions/Control_1

On Day 1, patients treated with FOLFIRI therapy received a 2-hour intravenous infusion of CPT-11 (150 mg/m2) combined with 1-LV (200 mg/m2), followed by a rapid intravenous infusion of 5-FU (400 mg/m2), and then a 46-hour continuous infusion of 5-FU (2,400 mg/m2). This regimen comprised one course of therapy and was repeated once every 2 weeks. Cycles of treatment will be continued for this study until disease progression (PD) occurs.
Patients will undergo UGT1A1 genotyping before starting to receive the protocol treatment. As recommended in the US prescribing information for Camptosar;, the starting dose of CPT-11 will be reduced to 100 mg/m2 in patients who are homozygous for the *28 allelic variant of UGT1A1 (further reduced to 75 mg/m2 in such patients aged 76-80 years). No dose adjustments will be made in patients who undergo UGT1A1 genotyping after starting to receive the protocol treatment.

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



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit

80 years-old >=

Gender

Male and Female

Key inclusion criteria

(1) Histopathologically diagnosed colon carcinoma or rectal carcinoma.
(2) Advanced or recurrent disease that is not amenable to curative resection.
(3) No history of chemotherapy, immunotherapy, or radiotherapy (including palliative local radiation).
(4) At least 4 weeks after surgery.
(5) ECOG performance status of 0-1.
(6) Age between 20 and 80 years (inclusive).
(7) Life expectancy of at least 12 weeks.
(8) Presence of at least one measurable lesion (outside the radiation field). A measurable lesion is defined as one that can be measured in a single dimension by palpation (together with a scale-containing radiographic image that permits objective assessment of the lesion size), CT, MRI, or any other radiographic method and which has a larger diameter >=2 cm (or >=1 cm and >=twice the slice width when measured by MRI or spiral CT).
(9) Adequate function of vital organs (e.g., bone marrow, heart, lungs, liver, and kidneys), as demonstrated by laboratory data obtained within 14 days of enrollment that are in the following ranges:
White blood cell count: 3,000-12,000/mm3.
Neutrophil count: >=1,500/mm3
(calculated from the white blood cell count and the differential neutrophil count [%]).
Platelet count: >=100,000/mm3.
Serum bilirubin: =<1.50 mg/dL.
AST and ALT: =<100 IU/L or 100 U/L.
Serum creatinine: =<1.20 mg/dL.
(10) Personally signed and dated written informed consent to participation in this study (including submission of biological specimens) prior to enrollment.

Key exclusion criteria

(1) Blood transfusion, administration of blood products, or hematopoietic (e.g., G-CSF) support within 7 days before enrollment.
(2) A history of severe drug allergy.
(3) Pleural effusion, ascites, or pericardial effusion requiring drainage.
(4) Concurrent active (e.g., clinically significant) infection.
(5) Confirmed or clinically suspected brain metastasis.*1
(6) Involvement of the central nervous system.
(7) Presence of bone metastasis as the sole metastasis.
(8) Any other concurrent malignancy, excluding metachronous malignancy that has been confirmed to have been cured.*2
(9) Uncontrolled hypercalcemia.
(10) Uncontrolled hypertension (despite antihypertensive medication).
(11) Uncontrolled diabetes mellitus.
(12) Any significant electrocardiographic abnormality or clinically significant heart disease.*3
(13) Fresh gastrointestinal bleeding.
(14) Intestinal paralysis or obstruction.
(15) Diarrhea (watery stools).*4
(16) Positivity for HIV antibody.
(17) Current treatment with atazanavir sulfate.
(18) Current treatment with phenytoin, warfarin potassium, or flucytosine.
(19) Pregnant or breast-feeding women, women of childbearing potential, women who wish to become pregnant, or men who wish to have a child with their female partners.
(20) Current participation in any other clinical trial/study.
(21) Any other condition that disqualifies the patient from the study in the opinion of the investigator.

Target sample size

50


Research contact person

Name of lead principal investigator

1st name
Middle name
Last name Hideyuki Mishima

Organization

Aichi Medical University

Division name

Cancer Center

Zip code


Address

1-1, Yazakokarimata, Nagakute, Aichi

TEL

0561-62-3311

Email

hmishima@aichi-med-u.ac.jp


Public contact

Name of contact person

1st name
Middle name
Last name Mai Hatta

Organization

Nagoya University Graduate School of Medicine

Division name

Young Leaders&#39;Program

Zip code


Address

65 Tsurumai Showa-ku Nagoya

TEL

052-744-2442

Homepage URL


Email

m-hatta@med.nagoya-u.ac.jp


Sponsor or person

Institute

NPO Epidemiological and Clinical Research Information Network

Institute

Department

Personal name



Funding Source

Organization

NPO Epidemiological and Clinical Research Information Network

Organization

Division

Category of Funding Organization

Other

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization


Address


Tel


Email



Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2009 Year 09 Month 01 Day


Related information

URL releasing protocol


Publication of results

Published


Result

URL related to results and publications


Number of participants that the trial has enrolled


Results

RESULTS:

After a median follow-up period of 22 months, complete response was achieved in 1.9%, partial response in 38.5 %, stable disease in 51.9% and progressive disease in 3.9%. The overall response rate was 40.4%, the disease control rate was 92.3% and the median overall survival time was 22.3 months. The major toxicity was grade 3-4 neutropenia in 44.2%. There was no definite relation between UGT1A1 28, 6 polymorphisms and toxicity. However, homozygosity for UGT1A1 28 or UGT1A1 6 and double heterozygosity for both UGT1A1 28 and UGT1A1 6 were significantly associated with severe neutropenia in metastatic colorectal cancer patients (P< 0.001).

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



Progress

Recruitment status

Completed

Date of protocol fixation

2005 Year 10 Month 21 Day

Date of IRB


Anticipated trial start date

2005 Year 11 Month 01 Day

Last follow-up date

2009 Year 07 Month 01 Day

Date of closure to data entry

2009 Year 07 Month 01 Day

Date trial data considered complete

2009 Year 07 Month 01 Day

Date analysis concluded

2009 Year 07 Month 01 Day


Other

Other related information

Jpn J Clin Oncol. 2011 Apr;41(4):477-82.
Prospective phase II study of FOLFIRI for mCRC in Japan, including the analysis of UGT1A1 28/6 polymorphisms.
Okuyama Y, Hazama S, Nozawa H, Kobayashi M, Takahashi K, Fujikawa K, Kato T, Nagata N, Kimura H, Oba K, Sakamoto J, Mishima H.


Management information

Registered date

2009 Year 08 Month 26 Day

Last modified on

2018 Year 09 Month 20 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000002870