Colorectal CancerPhase 2NCT01478594
A Study Combining mFOLFOX6 With Tivozanib or Bevacizumab in Patients With Metastatic Colorectal Cancer as First Line Therapy
A Phase 2 study testing Tivozanib, Bevacizumab and mFOLFOX6 in people with Colorectal Cancer, run by AVEO Pharmaceuticals, Inc. at 73 sites in 12 countries.
Trial summary
The objective of this study is to compare the progression free survival (PFS), overall survival (OS), objective response rate (ORR), time to treatment failure (TTF), duration of response (DoR), quality of life, safety and tolerability of tivozanib in combination with mFOLFOX6 and bevacizumab in combination with… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Colorectal Cancer
- What is being tested?
- Tivozanib, Bevacizumab and mFOLFOX6
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 265 participants
- Where
- 73 sitesin 12 countries
- Study dates
- Dec 2011to Jan 2015
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Documented diagnosis of metastatic colorectal cancer
- One measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
- No prior systemic chemotherapy for advanced colorectal cancer; no fluorouracil containing adjuvant therapy in previous 6 months
- Eastern Cooperative Oncology Group (ECOG) status of 0 or 1
Who cannot join
- Any prior Vascular Endothelial Growth Factor (VEGF)-directed therapy or any other agent or investigational agent targeting the VEGF pathway
- Primary Central Nervous System (CNS) malignancies or CNS metastases
- Hematologic abnormalities:
- Hemoglobin < 9.0 g/dL,
- Absolute neutrophil count (ANC) < 2000 per mm^3,
- Platelet count < 100,000 per mm^3,
Show all 31Show fewer
- Prothrombin (PT) or Partial Thromboplastin Time (PTT) > 1.5 X Upper Limit of Normal (ULN)
- Serum chemistry abnormalities:
- Total bilirubin > 1.5 X ULN,
- Aspartate aminotransferase (AST) or Alanine Aminotransferase (ALT) > 2.5 X ULN,
- Alkaline phosphatase > 2.5 X ULN,
- Serum albumin < 2.0 g/dL,
- Creatinine > 1.5 X ULN,
- Proteinuria > 2+ by urine dipstick
- Significant cardiovascular disease
- Significant thromboembolic or vascular disorders within 6 months prior to administration of first dose of study drug
- Non-healing wound, bone fracture, or skin ulcer
- Inadequate recovery from any prior surgical procedure or major surgical procedure within 8 weeks prior to administration, or anticipation of major surgical procedure during the course of the study
- History of significant gastrointestinal (GI) toxicity, diarrhea, or stomatitis within the last 6 weeks
- An active peptic ulcer disease, inflammatory bowel disease, ulcerative colitis, or other gastrointestinal condition with increased risk of perforation
- History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 4 weeks prior to administration of first dose of study drug
- Serious/active infection or infection requiring antibiotics
- Significant bleeding disorders within 6 months prior to administration of first dose of study drug
- Active second primary malignancy, other than non-melanoma skin cancers, non-metastatic prostate cancer, in situ cervical cancer and ductal or lobular carcinoma in situ of the breast. Subject is not considered to have a currently active malignancy if they have completed anti-cancer therapy and have been disease free for > 5 years
- History of allergic reactions, or intolerance, attributed to compounds of similar chemical or biologic composition to 5-fluorouracil, history of Grade 3 hypersensitivity to oxaliplatin, history of allergic reaction to folic acid
- Female subject is pregnant or lactating
- Known history of genetic or acquired immune suppression disease including Human Immunodeficiency Virus (HIV); subjects on immune suppressive therapy for organ transplant
- Inability to swallow pills, malabsorption syndrome or gastrointestinal disease, major resection of the stomach or small bowel, or gastric bypass
- Uncontrolled neuro-psychiatric disorder or altered mental status
- Peripheral neuropathy ≥ Grade 2
- Participating in another interventional protocol
Trial locations and contacts
73 sites in 12 countries.
73 sites in 12 countries
United States27 sites
University of Michigan Health
Ann Arbor, Michigan, 48109
Oncology Hematology of Lehigh Valley
Bethlehem, Pennsylvania, 18015
Alamance Regional Medical Center
Burlington, North Carolina, 27215
Tri Country Hematology / Oncology
Canton, Ohio, 44718
Northwestern University
Chicago, Illinois, 60611
University of Florida, Davis Cancer Center (VA)
Gainesville, Florida, 32610
Banner MD Anderson Cancer Research Center
Gilbert, Arizona, 85234
Mountain Blue Cancer Care Center
Golden, Colorado, 80033
Queen's Medical Center
Honolulu, Hawaii, 96813
University of Hawaii
Honolulu, Hawaii, 96813
Kaiser Foundation Hospitals
Honolulu, Hawaii, 96819
Genesis Cancer Center
Hot Springs, Arizona, 71913
Investigative Clinical Research of Indiana, LLC
Indianapolis, Indiana, 46260
University of California San Diego-Morris Cancer Center
La Jolla, California, 92093
Horizon Oncology Research, Inc.
Lafayette, Indiana, 47905
Signal Point Clinical Research Center, LLC
Middletown, Ohio, 45042
NYU Cancer Institute
New York, New York, 10016
Northern Utah Associates
Ogden, Utah, 84403
UC Irvine Medical Center, Division of Hematology/Oncology
Orange, California, 92868
Illinios Cancer Care
Peoria, Illinois, 61615
Oregon Health and Science University
Portland, Oregon, 97239
Desert Hematology Oncology Medical Group, Inc.
Rancho Mirage, California, 92270
Associates of Oncology Hematology, P.C.
Rockville, Maryland, 20850
Seattle Cancer Care Alliance
Seattle, Washington, 98109
Arizona Clinical Research Center
Tucson, Arizona, 85715
Cancer Care Associates
Tulsa, Oklahoma, 74136
Cleveland Clinic Florida
Weston, Florida, 33331
Australia8 sites
Ballarat Health Services
Ballarat, Victoria, 3350
Flinders Medical Centre
Bedford Park, South Australia, 5042
Royal Hobart Hospital
Hobart, Tasmania, 7000
St George Hospital
Kogarah, New South Wales, 2217
Cabrini Hospital Malvern
Malvern, Victoria, 3144
Tweed Hospital
Tweed Heads, New South Wales, 2485
Calvary Mater Newcastle
Waratah, New South Wales, 2298
Border Medical Oncology
Wodonga, Victoria, 3690
United Kingdom7 sites
Addenbrooke's Hospital
Cambridge, CB2 2QQ
Western General Hospital
Edinburgh, EH4 2XU
Beatson West of Scotland Cancer Center
Glasgow, G12 0YN
University College Hospital
London, NW1 2BU
Maidstone Hospital
Maidstone, ME16 9QQ
Christie Hospital
Manchester, M20 4BX
Peterborough and Stamford Hospitals NHS Foundation Trust
Peterborough, PE3 6DA
Spain6 sites
Centro Oncologico de Galicia
Galicia, 15009
Centro Integral Oncologico Clara Campal
Madrid, 28050
Corporacio Sanitaria Parc Tauli
Sabadell, Catalonia, 08208
Hospital Universitario Marques de Valdecilla
Santander, Cantabria, 39008
Hospital Mutua de Terrassa
Terrassa, Catalonia, 08221
Hospital Universitario Miguel Servet
Zaragoza, Aragon, 50009
Canada5 sites
QEII Health Science Centre
Halifax, Nova Scotia, B3H 2Y9
Hopital De La Cite-De-La-Sante
Laval, Quebec, H7M 3L9
Hopital Saint-Luc - Pavillon Principal
Montreal, Quebec, H2X 3J4
Chuq Centre Hospitalier Universitaire De Quebec
Québec, Quebec, G1R 2J6
British Columbia Cancer Agency
Vancouver, British Columbia, V5Z 4E6
Belgium4 sites
Ziekenhuisnetwerk Antwerpen - AZ Middelheim
Antwerp, 2020
Imelda VZW
Bonheiden, 2820
AZ Sint-Lucas Brugge
Bruges, 8310
AZ Groeninge - Campus Sint-Niklaas
Kortrijk, 8500
Hungary4 sites
Orszagos Onkologiai Intezet
Budapest, 1122
Petz Aladar Megyei Oktato Korhaz
Győr, 9024
Bekes Megyei Kepviselotestulet Pandy Kalman Korhaza
Gyula, 5700
Fejer Megyei Szent Gyorgy Korhaz
Székesfehérvár, 8000
Italy4 sites
Azienda Ospedaliero- Universitaria di Bologna - Policlinico S.Orsola-Malpighi
Bologna, 40128
Fondazione del Piemonte per I'Oncologia IRCC
Candiolo, 10060
IRCCS Azienda Ospedaliera Universitaria San Martino - Istituto Nazionale per la Ricerca sul Cancro
Genova, 16132
Istituto Clinico Humanitas
Rozzano (MI), 20089
Austria3 sites
Medizinische Universitat Graz
Graz, 8036
Salzburger Landesklinken
Salzburg, 5020
Klinikum Wels-Grieskirchen GmbH
Wels, 4600
Czechia2 sites
Masarykuv onkologicky ustav
Brno, 656 53
Fakultni nemocnice Hradec Kralove
Hradec Králové, 500 05
Finland2 sites
Tampereen yliopistollinen sairaala
Tampere, FI-33520
Turun yliopistollinen keskussairaala
Turku, FI-20520
About this study
Official title: A Phase 2, Open Label, Multicenter, Randomized Trial Comparing Tivozanib in Combination With mFOLFOX6 to Bevacizumab in Combination With mFOLFOX6, In Stage IV Metastatic Colorectal Cancer (mCRC) Subjects
The objective of this study is to compare the progression free survival (PFS), overall survival (OS), objective response rate (ORR), time to treatment failure (TTF), duration of response (DoR), quality of life, safety and tolerability of tivozanib in combination with mFOLFOX6 and bevacizumab in combination with mFOLFOX6.
Read the detailed description
Imaging scans (computed tomography [CT]/magnetic resonance imaging [MRI]) to assess disease progression were to be completed within 28 days prior to first study drug administration, approximately every 8 weeks for the first 18 months and then approximately every 12 weeks until the patient showed progressive disease (PD) per the investigator, withdrew consent, was lost to follow-up or died. Per the original protocol, all patients were to be contacted by the study site every 12 weeks for survival following the end-of-treatment visit until death or for no more than 3 years after the end-of-treatment visit.
The interim futility analysis was conducted in December 2013, based on a pre-specified analysis cutoff date of 13 September 2013. The study was brought to a close as specified in the protocol due to the results of the interim futility analysis and only those participants who were deriving benefit (per the treating physician) from their current treatment remained on study until one of the discontinuation criteria was met.
Given the early closure of the study, no updated or additional efficacy analyses were performed after the interim analysis. A biomarker analysis was conducted in January 2014, based on the data from the cutoff date of 13 September 2013. The safety analysis was updated with a new cutoff date of 28 February 2014.
- Conditions
- Colorectal Cancer
- Being tested
- Tivozanib, Bevacizumab, mFOLFOX6
- Keywords
- metastatic colorectal cancer, Avastin, bevacizumab, tivozanib, mFOLFOX6, BATON-CRC, AV951, ASP4130
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TivozanibDrug
Also called AV951, ASP4130
Capsules for oral administration
BevacizumabDrug
Also called Avastin
Solution for intravenous infusion
mFOLFOX6Drug
mFOLFOX6 regimen is a combination therapy of oxaliplatin 85 mg/m^2 administered as an intravenous bolus over 2 hours on Days 1 and 15, leucovorin calcium 400 mg/m^2 administered as an intravenous bolus over 2 hours on Days 1 and 15, fluorouracil 400 mg/m^2 administered as an intravenous bolus over 5 to 15 minutes on Days 1 and 15, then 2400 mg/m^2 continuous intravenous infusion over 46 hours on Days 1 to 3 and 15 to 17.
| Study group | Role | What they receive |
|---|---|---|
| Tivozanib + mFOLFOX6 | Experimental | Participants received 1.5 mg of tivozanib orally once daily beginning on Day 1 of each cycle for 21 days followed by 7 days off treatment. Participants also received modified FOLFOX6 (mFOLFOX6) chemotherapy every 2 weeks on Days 1 and 15 of each cycle. Receives: Drug: Tivozanib; Drug: mFOLFOX6 |
| Bevacizumab + mFOLFOX6 | Active comparator | Participants received a dose of 5 mg/kg bevacizumab via intravenous infusion every 2 weeks on Days 1 and 15 of each cycle. Participants also received mFOLFOX6 chemotherapy every 2 weeks on Days 1 and 15 of each cycle. Receives: Drug: Bevacizumab; Drug: mFOLFOX6 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Investigator-assessed Progression-Free Survival (PFS)
The time from the date of randomization until objective tumor progression or death due to any cause. Objective tumor progression was determined through radiological imaging and based on the requirements of the Response Evaluation Criteria in Solid Tumors (RECIST Version 1.1):
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of existing non-target lesions or the appearance of one or more new lesions.
Participants who did not progress or had not died at the time of the analysis were censored at the date of last tumor assessment where non-progression was documented.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Secondary outcomes (20)
Progression-Free Survival (PFS) Based on Independent Radiological Review (IRR)
The time from the date of randomization until the date of radiological disease progression assessed by the IRR or until death due to any cause, even in the absence of radiological progression.
Measured: 3 years
Overall Survival (OS)
Overall survival (OS) is defined as the time from the date of randomization until the documented date of death. Participants still alive at the time of analysis were censored on the last day the participant was known to be alive.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Objective Response Rate (ORR)
Objective response rate is defined as the percentage of participants with a best overall response of complete response (CR) or partial response (PR) confirmed a minimum of four weeks apart based on RECIST 1.1 criteria.
CR: Disappearance of all target and non-target lesions and no new lesions.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters and no progression of non-target lesions and no new lesions, or, disappearance of all target lesions and persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits and no new lesions.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Duration of Response (DoR)
Duration of response (DoR) is defined as the time from the date of the first documented response of CR or PR (whichever is first recorded) to documented progression or death. If a participant did not progress or had not died at the time of analysis, the duration of response was censored at the date of last tumor assessment. Duration of response is only defined for participants whose best overall response was CR or PR.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Time to Treatment Failure (TTF)
Time to Treatment Failure (TTF) is defined as the time from randomization to last dose date of tivozanib/bevacizumab. If a participant discontinued treatment for any reason, the participant was considered as an event. Participants remaining on treatment at the time of analysis were censored at date of last dose.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Health Related Quality of Life (HRQoL)
Time to deterioration in HRQoL measured by Colorectal cancer (CRC) subscale of the Functional Assessment of cancer Therapy Colorectal (FACT-C) scale, change in score from baseline using the European Quality of Life - 5 Dimensions (EQ-5D) and Fact Colorectal Symptom Index (FCSI) were not evaluated due to study closure.
Measured: 3 years
Safety as Assessed by Physical Examination, Vital Signs, Laboratory Assessments, 12-lead Electrocardiogram (ECGs), and Adverse Events (AEs)
An abnormality identified during a medical test is defined as an AE if the abnormality induced clinical signs or symptoms, required active intervention, interruption or discontinuation of study medication or was clinically significant in the investigator's opinion.
An AE was serious if it resulted in death, was life-threatening, resulted in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, resulted in congenital anomaly or birth defect, required or prolonged inpatient hospitalization or other medically important event.
AEs, including abnormal clinical laboratory values, were graded using the National Cancer Institute Common Terminology Criteria for Grading Adverse Events (NCI-CTCAE) Version 4.03 per the following: 1=mild; 2= moderate; 3= severe; 4= life threatening; 5=death.
Treatment-related AEs were defined as events where the relationship to study drug was marked as probably or possibly, or was missing.
Measured: From first dose through 30 days after last dose of either tivozanib or bevacizumab, until the data cut-off date of 28 February 2014. The median duration of treatment was 168.0 days in the tivozanib (tiv) arm and 162.0 days in the bevacizumab (bev) arm.
Progression-free Survival Events by Lactate Dehydrogenase (LDH) Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum lactate dehydrogenase status.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-free Survival Events by Serum Vascular Endothelial Growth Factor-A (VEGF-A) Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum vascular endothelial growth factor-A (VEGF-A) level. VEGF-A protein levels were quantified using enzyme-liked immunosorbent assay (ELISA); the level of protein is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-free Survival Events by Serum Vascular Endothelial Growth Factor-C (VEGF-C) Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum VEGF-C level. VEGF-C protein levels were quantified using enzyme-liked immunosorbent assay (ELISA); the level of protein is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-free Survival Events by Serum VEGF-C / VEGF-A Ratio
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum VEGF-C/VEGF-A ratio. VEGF-A and VEGF-C protein levels were quantified using enzyme-liked immunosorbent assay (ELISA); the ratio is expressed relative to the observed median.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Soluble Vascular Endothelial Growth Factor Receptor-2 (sVEGFR-2) Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum sVEGFR-2 level. sVEGFR-2 protein levels were quantified using enzyme-liked immunosorbent assay (ELISA); the level of protein is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Soluble Vascular Endothelial Growth Factor Receptor-3 (sVEGFR-3) Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum sVEGFR-3 level. sVEGFR-3 protein levels were quantified using enzyme-liked immunosorbent assay (ELISA); the level of protein is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Serum Interleukin-8 (IL-8) Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum interleukin-8 level. IL-8 protein levels were quantified using enzyme-liked immunosorbent assay (ELISA); the level of protein is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Serum Neuropilin Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline serum neuropilin level. Neuropilin protein levels were quantified using enzyme-liked immunosorbent assay (ELISA); the level of protein is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-A Ribonucleic Acid (RNA) Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline tumor VEGF-A RNA level.
RNA was purified from biopsy tissue and measured using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Since low cycle threshold (CT) values reflect high RNA expression, the inverse of CT values were used to derive tumor categories. RNA level is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-C RNA Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline tumor VEGF-C RNA level.
RNA was purified from biopsy tissue and measured using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Since low cycle threshold (CT) values reflect high RNA expression, the inverse of CT values were used to derive tumor categories. RNA level is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-C / VEGF-A RNA Ratio
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline tumor VEGF-C/VEGF-A RNA ratio.
RNA was purified from biopsy tissue and measured using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Since low cycle threshold (CT) values reflect high RNA expression, the inverse of CT values were used to derive tumor categories. RNA level is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-D RNA Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline tumor VEGF-D RNA level.
RNA was purified from biopsy tissue and measured using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Since low cycle threshold (CT) values reflect high RNA expression, the inverse of CT values were used to derive tumor categories. RNA level is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor Placental Growth Factor (PIGF) RNA Level
The number of participants with a progression-free survival event (radiological progression assessed by the investigator or death due to any cause) reported by Baseline tumor PIGF RNA level.
RNA was purified from biopsy tissue and measured using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Since low cycle threshold (CT) values reflect high RNA expression, the inverse of CT values were used to derive tumor categories. RNA level is expressed relative to the observed median level.
Measured: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Nov 2011 (estimated)
- Study startDec 2011
- Primary completionSep 2013
- Study completionJan 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Colorectal CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 265 participants (actual)
Sponsor and investigators
- Lead sponsor
- AVEO Pharmaceuticals, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, AVEO Pharmaceuticals, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01478594
- Sponsor's protocol ID
- 4130-CL-0201
- Other IDs
- 2011-003502-24
- Status last verified
- Jun 2015
- First submitted
- 21 Nov 2011
- Last updated
- 8 Jul 2015
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Jul 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2, Open Label, Multicenter, Randomized Trial Comparing Tivozanib in Combination With mFOLFOX6 to Bevacizumab in Combination With mFOLFOX6, In Stage IV Metastatic Colorectal Cancer (mCRC) Subjects
- ClinicalTrials.gov ID
- NCT01478594
- Acronym / sponsor ID
- 4130-CL-0201
- Conditions
- Colorectal Cancer
- Keywords
- metastatic colorectal cancer, Avastin, bevacizumab, tivozanib, mFOLFOX6, BATON-CRC, AV951, ASP4130
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 265 participants (actual)
- Lead sponsor
- AVEO Pharmaceuticals, Inc.Industry (pharma, biotech, devices)
- Study start
- Dec 2011
- Primary completion
- Sep 2013 (actual)
- Study completion
- Jan 2015 (actual)
- First posted
- 23 Nov 2011 (estimated)
- Results
- Posted 3 Apr 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of this study is to compare the progression free survival (PFS), overall survival (OS), objective response rate (ORR), time to treatment failure (TTF), duration of response (DoR), quality of life, safety and tolerability of tivozanib in combination with mFOLFOX6 and bevacizumab in combination with mFOLFOX6.
Detailed description
Imaging scans (computed tomography [CT]/magnetic resonance imaging [MRI]) to assess disease progression were to be completed within 28 days prior to first study drug administration, approximately every 8 weeks for the first 18 months and then approximately every 12 weeks until the patient showed progressive disease (PD) per the investigator, withdrew consent, was lost to follow-up or died. Per the original protocol, all patients were to be contacted by the study site every 12 weeks for survival following the end-of-treatment visit until death or for no more than 3 years after the end-of-treatment visit.
The interim futility analysis was conducted in December 2013, based on a pre-specified analysis cutoff date of 13 September 2013. The study was brought to a close as specified in the protocol due to the results of the interim futility analysis and only those participants who were deriving benefit (per the treating physician) from their current treatment remained on study until one of the discontinuation criteria was met.
Given the early closure of the study, no updated or additional efficacy analyses were performed after the interim analysis. A biomarker analysis was conducted in January 2014, based on the data from the cutoff date of 13 September 2013. The safety analysis was updated with a new cutoff date of 28 February 2014.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Tivozanib + mFOLFOX6 | Experimental | Drug: Tivozanib, Drug: mFOLFOX6Participants received 1.5 mg of tivozanib orally once daily beginning on Day 1 of each cycle for 21 days followed by 7 days off treatment. Participants also received modified FOLFOX6 (mFOLFOX6) chemotherapy every 2 weeks on Days 1 and 15 of each cycle. |
| Bevacizumab + mFOLFOX6 | Active comparator | Drug: Bevacizumab, Drug: mFOLFOX6Participants received a dose of 5 mg/kg bevacizumab via intravenous infusion every 2 weeks on Days 1 and 15 of each cycle. Participants also received mFOLFOX6 chemotherapy every 2 weeks on Days 1 and 15 of each cycle. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Documented diagnosis of metastatic colorectal cancer
- One measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
- No prior systemic chemotherapy for advanced colorectal cancer; no fluorouracil containing adjuvant therapy in previous 6 months
- Eastern Cooperative Oncology Group (ECOG) status of 0 or 1
Key exclusion criteria (31 listed)
- Any prior Vascular Endothelial Growth Factor (VEGF)-directed therapy or any other agent or investigational agent targeting the VEGF pathway
- Primary Central Nervous System (CNS) malignancies or CNS metastases
- Hematologic abnormalities:
- Serum chemistry abnormalities:
- Significant cardiovascular disease
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TivozanibAlso: AV951, ASP4130Capsules for oral administration | Drug | Tivozanib + mFOLFOX6 |
| BevacizumabAlso: AvastinSolution for intravenous infusion | Drug | Bevacizumab + mFOLFOX6 |
| mFOLFOX6mFOLFOX6 regimen is a combination therapy of oxaliplatin 85 mg/m^2 administered as an intravenous bolus over 2 hours on Days 1 and 15, leucovorin calcium 400 mg/m^2 administered as an intravenous bolus over 2 hours on Days 1 and 15, fluorouracil 400 mg/m^2 administered as an intravenous bolus over 5 to 15 minutes on Days 1 and 15, then 2400 mg/m^2 continuous intravenous infusion over 46 hours on Days 1 to 3 and 15 to 17. | Drug | Bevacizumab + mFOLFOX6, Tivozanib + mFOLFOX6 |
Primary outcome
Investigator-assessed Progression-Free Survival (PFS)
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
The time from the date of randomization until objective tumor progression or death due to any cause. Objective tumor progression was determined through radiological imaging and based on the requirements of the Response Evaluation Criteria in Solid Tumors (RECIST Version 1.1): Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of existing non-target lesions or the appearance of one or more new lesions. Participants who did not progress or had not died at the time of the analysis were censored at the date of last tumor assessment where non-progression was documented.
20 secondary outcomes
Progression-Free Survival (PFS) Based on Independent Radiological Review (IRR)
Time frame: 3 years
Overall Survival (OS)
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Objective Response Rate (ORR)
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Duration of Response (DoR)
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Time to Treatment Failure (TTF)
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Health Related Quality of Life (HRQoL)
Time frame: 3 years
Safety as Assessed by Physical Examination, Vital Signs, Laboratory Assessments, 12-lead Electrocardiogram (ECGs), and Adverse Events (AEs)
Time frame: From first dose through 30 days after last dose of either tivozanib or bevacizumab, until the data cut-off date of 28 February 2014. The median duration of treatment was 168.0 days in the tivozanib (tiv) arm and 162.0 days in the bevacizumab (bev) arm.
Progression-free Survival Events by Lactate Dehydrogenase (LDH) Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-free Survival Events by Serum Vascular Endothelial Growth Factor-A (VEGF-A) Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-free Survival Events by Serum Vascular Endothelial Growth Factor-C (VEGF-C) Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-free Survival Events by Serum VEGF-C / VEGF-A Ratio
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Soluble Vascular Endothelial Growth Factor Receptor-2 (sVEGFR-2) Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Soluble Vascular Endothelial Growth Factor Receptor-3 (sVEGFR-3) Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Serum Interleukin-8 (IL-8) Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Serum Neuropilin Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-A Ribonucleic Acid (RNA) Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-C RNA Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-C / VEGF-A RNA Ratio
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor VEGF-D RNA Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Progression-Free Survival Events by Tumor Placental Growth Factor (PIGF) RNA Level
Time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Jul 2015.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Director study director
AVEO Pharmaceuticals, Inc.
73 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Tivozanib, Bevacizumab and mFOLFOX6 in people with Colorectal Cancer, run by AVEO Pharmaceuticals, Inc. at 73 sites in 12 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 31 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Jul 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 73 sites in United States, Australia, United Kingdom, Spain, Canada and 7 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 3 Apr 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Investigator-assessed Progression-Free Survival (PFS) (time frame: From randomization until the analysis cut-off date of 13 September 2013; median time on study drug was 167 days in the tivozanib group and 162 days in the bevacizumab group.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jul 2015.