Methotrexate in Metastatic Colorectal Cancer With MSH2 Deficiency

Phase 2TerminatedNCT00952016

Royal Marsden NHS Foundation Trust2 enrolled

Overview

To assess the efficacy of methotrexate in a genetically selected population of patients with advanced colorectal cancer, who have loss of a particular gene, MSH2. The efficacy of methotrexate will be evaluated by the proportion of cases that have a significant response to treatment (objective response rate).

The study will involve treating 29 subjects with methotrexate given intravenously. All subjects will receive treatment; there is no control arm or randomisation. The subjects will be known to have deficiency of MSH2, or a mutation (genetic change) in MSH2 that stops it functioning normally. This can either be demonstrated by testing for loss of MSH2 protein in the tumour itself, or by the demonstration of a mutation in the MSH2 gene in the subject's blood.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Advanced Colorectal Cancer

Interventions

MethotrexateDRUG

study subjects will receive methotrexate intravenously on day 1 and day 8 of a 3 weekly cycle.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Confirmed diagnosis of metastatic or locally recurrent colorectal carcinoma * Aged 18 years or older * Paraffin embedded histological material available for analysis * Either confirmed loss of expression of MSH2 on immunohistochemistry IHC or confirmed mutation in MSH2 on gene sequencing * Life expectancy of \> 3 months Exclusion Criteria: * Previous treatment with methotrexate, either for malignant or non-malignant disease, except when methotrexate was given at low dose with other drugs to modify their effects * Concomitant uncontrolled medical conditions * Concomitant metastatic malignancy apart from non-melanotic skin cancers and carcinoma in situ of the uterine cervix in the last 10 years * Any contraindication to treatment with methotrexate (as this will affect safety)

Locations (1)

The Royal Marsden NHS Foundation Trust

Sutton, Surrey, United Kingdom

Outcomes

Primary Outcomes

Objective response rate, to include complete response and partial response, as defined radiologically using RECIST (Response, Evaluation Criteria in Solid Tumours) on imaging CT scans performed during treatment.

Secondary Outcomes

Disease stabilisation rate; progression free survival; 1 year survival and median overall survival; Quality of Life assessment; toxicity assessment.

Data from ClinicalTrials.gov

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