Dose escalation clinical trial: To explore the dose limiting toxicity (DLT) of irinotecan liposome injection combined with oxaliplatin +5-FU/LV+ bevacizumab in first-line treatment of patients with advanced metastatic colorectal cancer, and to estimate the maximum tolerated dose (MTD) of combined administration. Expansion clinical trial: To evaluate the safety and efficacy of irinotecan liposome injection combined with oxaliplatin +5-FU/LV+ bevacizumab or cetuximab in first-line treatment of patients with advanced metastatic colorectal cancer. Exploratory analysis of ctDNA changes and genetic mutations in patients at baseline.
This is a dose escalation and expansion study to evaluate the safety and efficacy of irinotecan liposome injection in patients with first-line treatment for metastatic colorectal cancer. In the dose escalation phase, patients will be treated with a combination regimen of irinotecan liposome injection at doses of 60mg/m2, 70mg/m2, and 80mg/m2, and 9 to 18 eligible patients are expected to be enrolled. In the expansion phase, approximately 60 patients will receive combination therapy with irinotecan liposome RP2D dose and exploratory analysis of genetic mutations at baseline and ctDNA changes during treatment.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
78
In dose escalation study, irinotecan liposome injection will be administered by an intravenous infusion at three doses of 60 mg/m2, 70 mg/m2 and 80 mg/m2, d1, 14 days per cycle. In expansion study, irinotecan liposome injection will be administered by an intravenous infusion at the dose of RP2D, d1, 14 days per cycle. Until the disease progresses or surgery is possible.
85 mg/m2, intravenously infusion, d1, 14 days per cycle, up to 12 cycles.
2400mg/m2, intravenous infusion, d1-2, 14 days per cycle. Until the disease progresses or surgery is possible.
400mg/m2, intravenous infusion, d1, 14 days per cycle. Until the disease progresses or surgery is possible.
5mg/kg, intravenous infusion, d1, 14 days per cycle. Until the disease progresses or surgery is possible.It is used to patients in dose escalation phase and with gene mutation in extension phase.
500mg/m2, intravenous infusion, d1, 14 days per cycle. Until the disease progresses or surgery is possible.For wild-type patients in extended phase studies.
Zhongshan Hospital Affiliated to Fudan University
Shanghai, Shanghai Municipality, China
RECRUITINGMaximum-tolerated dose
To investigate the safety.
Time frame: Up to 14 days
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
To evaluate the incidence and severity of hematological adverse events in patients.
Time frame: Start by signing the informed consent form until 4 weeks after the last dose.
Objective response rate
To investigate the preliminary antitumor efficacy of study.
Time frame: From initial medication to the date of first documented progression or end of medication, assessed up to 20 months.
Disease control rate
To investigate the preliminary antitumor efficacy of study.
Time frame: From initial medication to the date of first documented progression or end of medication , assessed up to 20 months.
Progression free survival
To investigate the preliminary antitumor efficacy of study.
Time frame: From initial medication to the date of first documented progression or date of death from any cause, whichever came first , assessed up to 22 months.
R0 resection
To assess surgical conversion rates in patients who could be surgically resected.
Time frame: From the first dose to the surgery, assessed up to 22 months.
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