This phase I trial studies the side effects and best dose of MEK inhibitor MEK162 when given together with leucovorin calcium, fluorouracil, and oxaliplatin in treating patients with advanced metastatic colorectal cancer. MEK inhibitor MEK162 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as leucovorin calcium, fluorouracil, and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving MEK inhibitor MEK162 with leucovorin calcium, fluorouracil, and oxaliplatin may kill more tumor cells.
PRIMARY OBJECTIVES: I. Determine the maximum tolerated dose (MTD) for the combination of MEK162 (MEK inhibitor MEK162) plus leucovorin calcium, fluorouracil, oxaliplatin (FOLFOX) in patients with metastatic colorectal cancer. SECONDARY OBJECTIVES: I. Describe the safety of the combination of MEK162 across all investigated dose levels. II. Describe the pharmacokinetics of MEK162 and FOLFOX in 6 patients in the expanded MTD cohort. III. Describe any clinical activity to the combination using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. IV. Determine the recommended Phase II dose (RP2D) which may be less than the MTD for both intermittent and continuous dosing of MEK162. OUTLINE: This is a dose-escalation study of MEK inhibitor MEK162. Patients are assigned to 1 of 2 treatment arms. ARM I: Patients receive MEK inhibitor MEK162 orally (PO) twice daily (BID) on days 1-14, and leucovorin calcium intravenously (IV) over 2 hours, oxaliplatin IV over 2 hours, and fluorouracil IV continuously over 46 hours on days 1 and 2. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive MEK inhibitor MEK162 PO BID on days 1-5, and leucovorin calcium IV over 2 hours, oxaliplatin IV over 2 hours, and fluorouracil IV continuously over 46 hours on days 6 and 7. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 30 days.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
26
Given PO
Given IV
Given IV
Given IV
Correlative studies
Correlative Studies
City of Hope Medical Center
Duarte, California, United States
MTD of MEK inhibitory MEK162 on a continuous and an intermittent schedule in combination with FOLFOX assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.03
The MTD for each schedule will be defined as the highest level safely tested or the level below the level at which 2 or more patients (in a cohort of up to 6 patients) develop a dose-limiting toxicity (DLT).
Time frame: Up to 4 weeks
DLT defined as an adverse event or abnormal laboratory value assessed as at least possibly related to the combination of MEK inhibitor MEK162 and FOLFOX graded according to NCI CTCAE v4.03
The toxicities observed at each dose level will be summarized in terms of type (organ affected or laboratory determination such as absolute neutrophil count), severity (by NCI CTCAE 4.03 and nadir or maximum values for the laboratory measures), time of onset (i.e. cycle number), duration, and reversibility or outcome. Tables will be created to summarize these toxicities, cycles delivered and total dose delivered, and side effects by dose and by cycle. Tabular and graphical summaries will be used to explore the relationship of type and grade of toxicity to dose, cycle, and pharmacokinetics.
Time frame: Up to 4 weeks
Progression-free survival
Time frame: Time from start of treatment to time of progression or death, assessed up to 2 years
Time to failure
Time frame: Up to 2 years
Survival
Time frame: Up to 2 years
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