The purpose of the study is to investigate the effect and side effects of personalized cancer treatment in patients with metastatic colorectal cancer (bowel cancer). All patients included must have metastatic bowel cancer and receive or have received at least two lines of standard chemotherapy. The cancer must not be available for surgery with curative intent.
The purpose of the study is to evaluate individualized systemic anti-cancer treatment of metastatic colorectal cancer (mCRC), selected by a combined pharmacogenomic drug sensitivity profile with a molecular profiling of the tumor tissue and an ex vivo drug sensitivity testing of patient-derived organoids (PDOs). The combined pharmacogenomic drug sensitivity profile will be provided by Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital (OUS) and will be a result of either i) a pre-screening performed in this study or ii) from previous biomarker analyses and drug sensitivity testing of PDOs as part of an ongoing translational research project at Dept. of Molecular Oncology. The combined pharmacogenomic profile will be interpreted by an institutional multidisciplinary tumor board (MTB), and in cases where the MTB strongly suggests that the patient will benefit from one of the interventions offered by this study, the patient will be invited to participate. No formal hypotheses testing will be performed in the study, but it aims to show that it is feasible, in an unselected population of patients with mCRC, to select patients for individualized therapy based on a broad genomic and transcriptomic profiling and ex vivo drug sensitivity testing of cultured PDOs from the patient's own tumor cells, and to provide evidence that a combined pharmacogenomic profile can predict objective antitumor responses to systemic anticancer therapies, including drugs not approved for treatment of patients with mCRC, in the setting of third-line therapy or in later lines. In addition, this study will be part of several translational research projects at the Department of Molecular Oncology.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current Summary of Product Characteristics (SMPC) and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Oslo University Hospital
Oslo, Norway
RECRUITINGPre-Screening: Obtain a combined pharmacogenomic profile which can be used to provide a MTB-nominated treatment
Number of participants that obtain a full combined pharmacogenomic profile which can be used to provide an MTB-nominated treatment in the Main Study.
Time frame: In average of 3 months
Main Study: To evaluate the anti-tumor activity, measured as objective response rate (ORR) of MTB-nominated therapies with drugs not approved or implemented in standard of care (SOC) for treatment of mCRC.
Number of patients who achieve objective response according RECIST 1.1 in the total study population and each study drug cohort of MTB-nominated therapies with drugs not approved or implemented SOC for treatment of mCRC.
Time frame: Through study completion, in average 6 months
Pre-Screening: To obtain a full combined pharmacogenomic profile from a tumor biopsy that is eligible for treatment decisions in a standard oncology practice.
Pre-Screening: Number of participants who achieve a full combined pharmacogenomic profile eligible for treatment decisions either by * An MTB-nominated treatment provided in the Main Study * An MTB-nominated treatment considered as SOC * An MTB-nominated treatment not considered as SOC and not provided in the Main Study * No MTB-nominated treatment suggested
Time frame: Through study completion, approximately 4 years
Main Study: Progression-free survival (PFS) and duration of response (DOR)
Progression-free survival (PFS) and duration of response (DOR) by RECIST 1.1, of participants receiving an MTB-nominated anti-cancer therapy, by calculation of number of days, weeks or years.
Time frame: Through study completion, approximately 6 months
Main Study: Overall survival (OS)
OS of participants receiving MTB-nominated anti-cancer therapy, defined as the time from first dose of MTB-nominated treatment to date of death from any cause by calculation of number of days, weeks or years.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Dosage form, dosage, frequency and duration are to be implemented by study investigators as described in the current SMPC and package Insert.
Time frame: Through study completion, approximately 6 months
Main Study: Safety and tolerability of the different MTB-nominated treatments
Register adverse events (AE) in accordance with CTCAE v 5.1
Time frame: Through study completion, approximately 6 months
Main Study: Objective response of an MTB-nominated anti-cancer therapy compared to objective response to the prior line(s) SOC treatment.
Number of patients who achieve objective response according to RECIST 1.1 from anti-cancer therapy (SOC) in prior lines.
Time frame: Through study completion, approximately 6 months
Main Study: Efficacy of MTB-nominated anti-cancer therapy compared to the efficacy of prior lines SOC treatment.
DOR and PFS by RECIST 1.1 of participants receiving an MTB-nominated treatment and from anti-cancer therapy received in prior lines of SOC in each patient, by calculation of number of days, weeks or years.
Time frame: Through study completion, approximately 6 months.
Main study: Objective response of an MTB-nominated anti-cancer therapy compared to objective response to the next line(s) SOC treatment.
Number of patients who achieve objective response according to RECIST 1.1 from receiving anti-cancer therapy in the next/later lines.
Time frame: Through study completion, approximately 6 months.
Main study: Efficacy of an MTB-nominated anti-cancer therapy compared to the efficacy achieved by the next line(s) of SOC treatment.
DOR and PFS by RECIST 1.1 of participants receiving an MTB-nominated treatment and from anti-cancer therapy in the next/later lines of SOC treatment in each patient, by calculation of number of days, weeks or years.
Time frame: Through study completion, approximately 6 months.
Main study: Patient-reported outcome measures.
Describe patient-reported quality of life during the MTB-nominated treatment, registered by EORTC Quality of Life Questionnaire (QLQ)-C30 questionnaire. The EORTC QLQ-C30 questionnaire consisted of 30 questions generating five functional scores (physical, role, cognitive, emotional, and social); a global health status/global quality of life scale score; three symptom scale scores (fatigue, pain, and nausea and vomiting); and six stand alone one-item scores that capture additional symptoms (dyspnea, appetite loss, sleep disturbance, constipation, and diarrhea) and perceived financial burden. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning.
Time frame: Through study completion, approximately 6 months.