The goal of this clinical trial is to learn if adding savolitinib to cetuximab plus FOLFOX chemotherapy works as a first-line treatment for patients with RAS/BRAF wild-type metastatic colorectal cancer, and to evaluate its safety. The main questions it aims to answer are: Does the addition of savolitinib improve the objective response rate (ORR) compared to cetuximab plus FOLFOX alone? What medical problems (adverse events) do participants experience when taking savolitinib in combination with cetuximab and FOLFOX? Researchers will compare savolitinib plus cetuximab and FOLFOX (experimental group) versus cetuximab and FOLFOX alone (control group) to see if the triplet regimen provides better tumor response and survival outcomes. Participants will: Take oral savolitinib once daily in repeated 14-day cycles (or receive control treatment), combined with weekly cetuximab and bi-weekly FOLFOX chemotherapy Visit the clinic every 2 weeks or 4 weeks for treatment administration, safety monitoring, and laboratory tests Undergo tumor imaging assessments every 8 weeks (4 cycles) to evaluate treatment response and disease progression Have regular follow-up visits for 30 days after the last dose, and then every 3 months for survival follow-up
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
138
Savolitinib dosing regimen: 200mg, qd, po. Cetuximab: Administered intravenously at an initial dose of 400 mg/m² prior to chemotherapy, followed by a weekly dose of 250 mg/m² infused over 1 hour. FOLFOX chemotherapy regimen: Oxaliplatin 85 mg/m² intravenously over 2 hours on Day 1; leucovorin (LV) 400 mg/m² intravenously over 2 hours on Day 1; 5-FU 400 mg/m² intravenous bolus on Day 1, followed by continuous intravenous infusion of 1200 mg/(m²·day) for 2 days (total dose 2400 mg/m², infused over 46-48 hours).
Cetuximab: Administered intravenously at an initial dose of 400 mg/m² prior to chemotherapy, followed by a weekly dose of 250 mg/m² infused over 1 hour. FOLFOX chemotherapy regimen: Oxaliplatin 85 mg/m² intravenously over 2 hours on Day 1; leucovorin (LV) 400 mg/m² intravenously over 2 hours on Day 1; 5-FU 400 mg/m² intravenous bolus on Day 1, followed by continuous intravenous infusion of 1200 mg/(m²·day) for 2 days (total dose 2400 mg/m², infused over 46-48 hours).
Changhai Hospital
Shanghai, China
Fudan University Shanghai Cancer Center
Shanghai, China
Renji Hospital, Shanghai Jiao Tong University, School of Medicine
Shanghai, China
Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine
Shanghai, China
Zhongshan Hospital, Fudan University
Shanghai, China
Objective response rate (ORR)
The incidence of confirmed complete response or partial response
Time frame: From date of first dose of study drug until disease progression, withdrawal of consent, death, new anticancer therapy (up to approximately 24 months)
Progression free survival (PFS)
A duration from the date of initial treatment to disease progression or death of any cause. PFS was set as a key secondary outcome.
Time frame: From date of first dose of study drug until disease progression, withdrawal of consent, death, new anticancer therapy (up to approximately 24 months)
Disease control rate (DCR)
Proportion of patients whose tumor volume control (reduced or enlarged) reaches a predetermined value and can maintain a minimum time limit.
Time frame: From date of first dose of study drug until disease progression, withdrawal of consent, death, new anticancer therapy (up to approximately 24 months)
Duration of response (DOR)
Duration from the first time reported partial response or complete response to the first time of disease progression or death.
Time frame: From date of first dose of study drug until disease progression, withdrawal of consent, death, new anticancer therapy (up to approximately 24 months)
Time to response (TTR)
A duration from the date of initial treatment to the first time reported partial response.
Time frame: From date of first dose of study drug until partial response (up to approximately 12 months)
Overall survival (OS)
Duration from the date of initial treatment to the date of death due to any cause
Time frame: From date of first dose of study drug until withdrawal of consent or death (up to approximately 24 months)
Number and Proportion of patients with treatment-related adverse events as assessed by CTCAE v6.0
Use descriptive statistical analysis to record the number and proportion of patients who experience treatment-related adverse events out of all patients receiving the study drug. The grading of adverse events follows the CTCAE V6.0.
Time frame: From the date of first dose of study drug to 90 days after the last administration
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