This phase I trial studies the best dose and side effects of irinotecan hydrochloride when given with utomilumab and cetuximab in treating patients with colorectal cancer that has spread to other places in the body (metastatic). Monoclonal antibodies, such as utomilumab and cetuximab, may interfere with the ability of tumor cells to grow and spread. Drugs used in chemotherapy, such as irinotecan hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving utomilumab, cetuximab, and irinotecan hydrochloride may work better in treating patients with colorectal cancer.
PRIMARY OBJECTIVES: I. To evaluate maximal tolerated dose (MTD), and recommended phase 2 dose (RP2D) of the combination of utomilumab (PF-05082566), cetuximab and irinotecan hydrochloride (irinotecan) (PCI) in patients with metastatic colorectal cancer refractory to standard therapy. (Dose escalation) II. To determine the antitumor activity overall response rate (ORR) by immune-related Response Evaluation Criteria in Solid Tumors (irRECIST) of the study regimen specifically in patients with advanced colorectal cancer who are RAS-RAF wild type (WT) (Arm A) or RAS mutant (Arm B). (Dose expansion) SECONDARY OBJECTIVES: I. To evaluate overall safety profile. II. To evaluate the anti-tumor activity. III. To evaluate pharmacodynamics (PD) biomarkers expressed by peripheral blood mononuclear cells (PBMC) and tissue samples. IV. To characterize serum biomarkers linked to immunomodulation and cytokine release. V. To assess markers of T and natural killer (NK) cell phenotype (such as CD3, CD4, CD8, FoxP3, CD14, CD33, CCR7, CD45RO, CD16, CD56, CD69, CD25, or VCAM1), TNF alpha, IFN gamma, IL10, IL-8, IL-6, IL-4, IL-2, IL-1b, or IL-12p70, CD127, Ki67, eomesodermin, KLRG1, CD14, CD33, human leukocyte antigen- D related (HLA-DR), CD16, CD56, granzyme B, CD68, PD-1, CD11c, sCD137, and 4-1BB. OUTLINE: This is a dose escalation study of irinotecan hydrochloride. Patients receive irinotecan hydrochloride intravenously (IV) over 90 minutes and cetuximab IV over 1-2 hours on days 1 and 15, and utomilumab IV over 1 hour on day 2. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 3 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
34
M D Anderson Cancer Center
Houston, Texas, United States
Recommended phase 2 dose of irinotecan hydrochloride (Dose escalation)
A modified 3+3 design will be used to determine the maximum tolerated dose.
Time frame: Up to 4 years
Objective response rate (Dose expansion)
Assessed by using the immune-related Response Evaluation Criteria in Solid Tumors (irRECIST).
Time frame: Up to 4 years
Incidence of adverse events
Characterized by type, frequency, severity (as graded by National Cancer Institute \[NCI\] Common Terminology Criteria for Adverse Events \[CTCAE\] version \[v.\]4.03), timing, seriousness and relationship to study therapy utolimumab (PF-05082566); Laboratory abnormalities as characterized by type, frequency, severity (as graded by NCI CTCAE v.4.03) and timing.
Time frame: Up to 4 years
Progression free survival
Will be analyzed using Kaplan-Meier methods and descriptive statistics.
Time frame: Up to 4 years
Overall survival
Will be analyzed using Kaplan-Meier methods and descriptive statistics.
Time frame: Up to 4 years.
Overall response rate
Time frame: Up to 4 years
Duration of response
Time frame: Up to 4 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.