5-fluorouracil (5-FU) is a standard of care in frail/elderly patients with an unresectable colorectal adenocarcinoma (CRC) in first-line setting. Panitumumab plus Sotorasib are promising in advanced line in KRAS G12C mutated CRC. In this study, We assess the safety and efficacy of 5FU combination with Panitumumab and Sotorasib as first-line treatment in frail/elderly patients with unresectable KRAS G12C mutated CRC
COLOSOTO is a multicenter, open-label, prospective single-arm phase II trial, sponsored and cordinated by the Fédération Francophone de Cancérologie Digestive (FFCD) in collaboration with the ENGIC group (European Network in GastroIntestinal Cancer), evaluating 5-FU plus Panitumumab and Sotorasib as first line treatment in patients with MSS/pMMR KRAS G12C mutated unresectable CRC. Inclusion will begin in September 2025, for 36 months. Overall, patients from 40 European sites will be included (in France, Germany, Italy and Spain). The main inclusion and exclusion criteria are summarized in Table 1. Main inclusion criteria are patients ≥18 years old, with unresectable MSS/pMMR KRASG12C metastatic CRC histologically proven, with altered WHO Performance Status... Eligible patients will receive LV5FU2 (a 400mg/m2 intravenous (IV) bolus of 5-FU at day 1 (D1) with 400mg/m2 of folinic acid, followed by a continuous 5-FU infusion of 2400mg/m2 over 46 hours) plus Panitumumab (6mg/kg IV at D1) and Sotorasib (960mg PO once daily, every day) in 2-week-cycles (Q2W) until progression or intolerance (cf Figure 1). Adverse events requiring dose adjustment or treatment discontinuation will all be assessed using the NCI-CTCAE v5.0 scale and manage in accordance with the standard guidelines and the "Summaries of Product Characteristics". The primary objective is to evaluate the progression-free survival (PFS) of 5FU plus Panitumumab and Sotorasib at 8 months in first-line treatment of patients non-eligible for a doublet/triplet chemotherapy with advanced unresectable KRAS G12C mutated CRC. The progression will be defined as the radiological progression according to RECIST v1.1 criteria assessed by the investigator. A centralized review of CT-scans will be performed to confirm RECIST 1.1 criteria. Secondary objectives include median progression-free survival (mPFS), disease control rate (DCR), time to progression (TTP), overall survival (OS), best objective response rate (ORR), duration of response (DoR), safety profile, Quality of life (QoL) (with EORTC QLQC30 and FACIT-GP5 questionnaires), and Geriatric assessment (based on G8 score and " Geriatric COre Data sEt " (G-CODE)). Toxicity will all be evaluated according to the National cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE v4.0) scale. A safety analysis will be done when 10 patients have been treated for at least 2 months to check the good tolerability of 5-FU plus Panitumumab and Sotorasib combination
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
300
Panitumumab is administered at a dose of 6 mg/kg via intravenous infusion over one hour during the first cycle, and over 30 minutes from the second cycle onward. The LV5FU2 regimen includes folinic acid (400 mg/m², or 200 mg/m² if levo-leucovorin is used) as a two-hour IV infusion, followed by a 5-FU bolus (400 mg/m² over 10 minutes), and a continuous 5-FU infusion (2400 mg/m² over 46 hours). Sotorasib is given orally at a dose of 960 mg once daily on a continuous basis.
ICO site Paul Papin
Angers, France
Centre Hospitalier Annecy Genevois
Annecy, France
Hôpital Privé
Antony, France
Centre Hospitalier
Aurillac, France
Centre Hospitalier
Bayeux, France
Ch Cote Basque
Bayonne, France
Percentage of patient alive or without progression 8 months after inclusion.
Progression will be assessed by the investigator according to recist 1.1 based on images performed every 8 weeks even in case of deferred treatments. Clinical progression will not be considered as an event.
Time frame: at 8 months after the inclusion.
Overall survival (OS)
Overall survival was defined as the time from the date of inclusion to the patient's death (all causes). For alive patients, the date of the latest news was taken into account.
Time frame: up to 2 years after inclusion.
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Ch Simone Veille
Beauvais, France
Chu Jean Minjoz
Besançon, France
Polyclinique Courlancy
Bezannes, France
Centre Hospitalier Béthune Beuvry
Béthune, France
...and 70 more locations