This phase I trial studies the side effects and best dose of trametinib and trifluridine and tipiracil hydrochloride in treating patients with colon or rectal cancer that has spread to other places in the body (advanced/metastatic) or cannot be removed by surgery. Trametinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as trifluridine and tipiracil 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 trametinib and trifluridine and tipiracil hydrochloride may prevent cancer cells from dividing and work better in treating patients with colon and rectal cancer.
PRIMARY OBJECTIVES: I. Determine the maximum tolerated dose (MTD) for the combination of trametinib and trifluridine and tipiracil hydrochloride (TAS-102) in patients with chemotherapy-resistant metastatic colorectal cancer. SECONDARY OBJECTIVES: I. Describe the safety of the combination of trametinib and TAS-102 across all investigated dose levels. II. Describe the clinical activity including objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) of the combination in an expansion cohort using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. OUTLINE: Patients receive trifluridine and tipiracil hydrochloride orally (PO) twice daily (BID) on days 1-5 and 8-12 and trametinib PO once daily (QD) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days and then bi-annually thereafter.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
26
City of Hope Corona
Corona, California, United States
City of Hope Medical Center
Duarte, California, United States
City of Hope Antelope Valley
Lancaster, California, United States
City of Hope Mission Hills
Mission Hills, California, United States
City of Hope Rancho Cucamonga
Rancho Cucamonga, California, United States
City of Hope - Santa Clarita
Santa Clarita, California, United States
City of Hope South Pasadena
South Pasadena, California, United States
City of Hope West Covina
West Covina, California, United States
Maximum tolerated dose defined for the combination of trametinib, and Trifluridine and Tipiracil Hydrochloride (TAS?102) as the highest dose level at which 0-1 out of 6 patients experience dose limiting toxicities
Toxicities observed at each dose level will be categorized by type (organ affected or laboratory determination such as absolute neutrophil count), severity (by National Cancer Institute \[NCI\] Common Terminology Criteria for Adverse Events \[CTCAE\] 4.0 and nadir or maximum values for the laboratory measures), time of onset (i.e., course number), duration, and reversibility or outcome.
Time frame: Up to 28 days
Incidence of adverse events assessed using NCI) CTCAE 4.0
Will be summarized in terms of type and severity, along with dose modification/delays that resulted. Analysis will be primarily descriptive.
Time frame: Up to 30 after last dose
Objective response rate using Response Evaluation Criteria in Solid Tumor (RECIST) guideline, version 1.1
Time frame: Up to 1 year
Time to progression using RECIST guideline, version 1.1
Time frame: From start of treatment to time of progression or death, whichever occurs first, assessed up to 1 year
Overall survival
Time frame: From start of treatment to death (any cause), assessed up to 1 year
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