Colorectal CancerPhase 3NCT02788279
A Study to Investigate Efficacy and Safety of Cobimetinib Plus Atezolizumab and Atezolizumab Monotherapy Versus Regorafenib in Participants With Metastatic Colorectal Adenocarcinoma (COTEZO IMblaze370)
A Phase 3 study testing Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody, Cobimetinib and Regorafenib in people with Colorectal Cancer, run by Hoffmann-La Roche at 73 sites in 11 countries.
Trial summary
This is a Phase III, multicenter, open-label, three-arm, randomized study in participants with unresectable locally advanced or metastatic colorectal cancer (CRC) who have received at least two prior regimens of cytotoxic chemotherapy for metastatic disease. 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?
- Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody, Cobimetinib and Regorafenib
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 363 participants
- Where
- 73 sitesin 11 countries
- Study dates
- 5 Jul 2016to 26 Dec 2018
- Phase
- Phase 3
- 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
- Disease-specific inclusion criteria:
- Histologically confirmed adenocarcinoma originating from the colon or rectum (Stage 4 American Joint Committee on Cancer [AJCC] 7th edition)
- Experienced disease progression or was intolerant to at least two systemic chemotherapy regimens for metastatic colorectal cancer that must have included fluroropyrimidines, irinotecan, and oxaliplatin; adjuvant regimen can be considered as one chemotherapy regimen for metastatic disease if the participant had disease recurrence within 6 months of completion; disease progression must have occurred within 3 months of the last systemic therapy administration
- General inclusion criteria:
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Anticipated life expectancy greater than or equal to (>=) 3 months
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- Adequate hematologic and end organ function
- Women of childbearing potential must agree to appropriately use an effective form of contraception (failure rate of less than [<] 1 percent [%] per year) during the treatment period, within 5 months after the last dose of atezolizumab, and within 3 months after the last dose of cobimetinib and regorafenib
- Men must agree not to donate sperm or have intercourse with a female partner without using appropriate barrier contraception during the treatment period and for 3 months after the last dose of either cobimetinib or regorafenib
- Provide an archival or newly obtained tumor tissue sample
Who cannot join
- After the approximate 5% cap for microsatellite (MSI)-high participants is reached, only MSI-stable participants will be eligible
- Once the 50% cap for wild-type RAS has been reached, only extended RAS-mutant participants will be eligible
- Major surgery or radiotherapy within 21 days prior to Cycle 1 Day 1 or anticipation of needing such procedure while receiving study treatment
- Treatment with any anti-cancer agent within 14 days prior to Cycle 1 Day 1
- Uncontrolled tumor-related pain. Participants requiring narcotic pain medication must be on a stable regimen at study entry
- Uncontrolled pleural effusion, pericardial effusion or ascites requiring repeated drainage more than once every 28 days. Indwelling drainage catheters (e.g., PleurX®) are allowed
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- Active or untreated central nervous system (CNS) metastases are excluded
- Prior therapy with any cancer immunotherapy, MEK inhibitor, or regorafenib
- Participants with active malignancy (other than CRC) or a prior malignancy within the past 3 years are excluded. Participants with completely resected cutaneous melanoma (early stage), basal cell carcinoma, cutaneous squamous cell carcinoma, cervical carcinoma in-situ, breast carcinoma in-situ, and localized prostate cancer are eligible
- Unstable angina, new onset angina within last 3 months, myocardial infarction within last 6 months and current congestive heart failure New York Heart Association Class II or higher
- Left ventricular ejection fraction (LVEF) below institutional lower limit of normal or below 50%, whichever is lower
- Poorly controlled hypertension, defined as a blood pressure consistently above 150/90 millimeters of Mercury (mmHg) despite optimal medical management
- Human immunodeficiency virus (HIV) infection
- Active tuberculosis infection
- Severe infections within 2 weeks prior to Cycle 1 Day 1
- Active or chronic viral hepatitis B or C infection
- History of or evidence of retinal pathology on ophthalmologic examination that is considered a risk factor for central serous retinopathy, retinal vein occlusion, or neovascular macular degeneration
- Participants will be excluded if they currently have any of the risk factors as defined in the study protocol for retinal vein occlusion
- History of autoimmune disease
- History of idiopathic pulmonary fibrosis, organizing pneumonia, bronchiolitis obliterans, drug-induced pneumonitis, or idiopathic pneumonitis
- History of organ transplantation including allogeneic bone marrow transplantation
- Inability to swallow medications
- Malabsorption condition that would alter the absorption of orally administered medications
- Pregnant, lactating, breastfeeding, or intending to become pregnant during the study
- Administration of a live, attenuated vaccine within 4 weeks before randomization or anticipation of a live attenuated vaccine will be required during the study
Trial locations and contacts
73 sites in 11 countries.
73 sites in 11 countries
United States17 sites
SCRI Tennessee Oncology Chattanooga
Chattanooga, Tennessee, 37404
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
North Shore Hem Onc Associates
East Setauket, New York, 11733
Southdale Cancer Clinic U of M Medical Center, Fairview- Edina
Edina, Minnesota, 55435
Florida Cancer Specialists; SCRI
Fort Myers, Florida, 33901
Ingalls Cancer Research Center
Harvey, Illinois, 60426
MD Anderson Cancer Center
Houston, Texas, 77030
Cancer Specialists; North Florida ;Jacksonville (AC Skinner Pkwy)
Jacksonville, Florida, 32256
Sarah Cannon Research Inst.
Nashville, Tennessee, 37203
Yale Cancer Center; Medical Oncology
New Haven, Connecticut, 06520
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
INTEGRIS Cancer Inst of OK
Oklahoma City, Oklahoma, 73142
University of Pittsburgh Cancer Institute; Division of Medical Oncology
Pittsburgh, Pennsylvania, 15232
Medical Oncology Associates
Spokane, Washington, 99208
Washington University School of Medicine
St Louis, Missouri, 63110
Florida Cancer Specialists.
St. Petersburg, Florida, 33705
Georgetown University
Washington D.C., District of Columbia, 20007
Canada8 sites
Tom Baker Cancer Centre-Calgary
Calgary, Alberta, T2N 4N2
Cross Cancer Institute; Clinical Trials
Edmonton, Alberta, T6G 1Z2
McGill University Health Center, Cedar Cancer Center
Montreal, Quebec, H3G 1A4
Hopital du Sacre-Coeur
Montreal, Quebec, J4B 5Z7
The Ottawa Hospital
Ottawa, Ontario, K1H 8L6
CHU de Québec
Québec, Quebec, G1J 1Z4
Sunnybrook Health Sciences Centre
Toronto, Ontario, M4N 3M5
BCCA-Vancouver Cancer Centre
Vancouver, British Columbia, V5Z 4E6
Italy7 sites
Istit. Naz. per la Ricerca sul Cancro - Az. Osped. S. Martino
Genoa, Liguria, 16132
Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 1
Milan, Lombardy, 20133
Asst Grande Ospedale Metropolitano Niguarda; Dipartimento Di Ematologia Ed Oncologia
Milan, Lombardy, 20162
A.O. Universitaria Policlinico Di Modena; Oncologia
Modena, Emilia-Romagna, 41100
Azienda Osp Uni Seconda Università Degli Studi Di Napoli; Unità Operativa Oncologia Medica
Naples, Campania, 80131
A.O. Universitaria Pisana; Oncologia
Pisa, Tuscany, 56100
IRCCS Ospedale Casa Sollievo Della Sofferenza; Oncologia
San Giovanni Rotondo, Apulia, 71013
United Kingdom7 sites
Birmingham Heartlands Hospital; Dept of Oncology
Birmingham, B9 5SS
Royal Marsden Hospital - Fulham; Oncology Department
London, SW3 6JJ
The Christie; GI Research Office
Manchester, M20 4BX
Churchill Hospital; Department of Oncology
Oxford, OX3 7LE
Queen's Hospital
Romford, RM7 0AG
Weston Park Hospital; Cancer Clinical Trials Centre
Sheffield, S10 2SJ
Royal Marsden Hospital; Dept of Medical Oncology
Sutton, SM2 5PT
Australia6 sites
Monash Medical Centre; Oncology
Clayton, Victoria, 3168
Peninsula and South Eastern Haematology and Oncology Group
Frankston, Victoria, 3199
Austin Health; Cancer Clinical Trial Centre
Heidelberg, Victoria, 3084
Port Macquarie Base Hospital;North Coast Cancer Institute
Port Macquarie, New South Wales, 2444
Northern Cancer Institute
St Leonards, New South Wales, 2065
Sydney Adventist Hospital; Clinical Trial Unit
Sydney, New South Wales, 2076
South Korea6 sites
National Cancer Center
Gyeonggi-do, 10408
Chonnam National University Hwasun Hospital
Jeollanam-do, 58128
Seoul National University Hospital
Seoul, 03080
Asan Medical Center - Oncology
Seoul, 05505
Samsung Medical Center
Seoul, 06351
Yonsei University Health System/Severance Hospital
Seoul, 120-752
Spain6 sites
Hospital Univ Vall d'Hebron; Servicio de Oncologia
Barcelona, 08035
Hospital Ramon y Cajal; Servicio de Oncologia
Madrid, 28034
Hospital Clinico San Carlos; Servicio de Oncologia
Madrid, 28040
Hospital Universitario 12 de Octubre; Servicio de Oncologia
Madrid, 28041
Hospital de Navarra; Servicio de Oncologia
Navarra, Navarre, 31008
Hospital Clínico Universitario de Valencia; Servicio de Oncología
Valencia, 46010
Belgium5 sites
Imeldaziekenhuis
Bonheiden, 2820
Cliniques Universitaires St-Luc
Brussels, 1200
GHdC Site Notre Dame
Charleroi, 6000
AZ Groeninge
Kortrijk, 8500
UZ Leuven Gasthuisberg
Leuven, 3000
Poland5 sites
Centrum Onkologii im. Prof. F. Lukaszczyka w Bydgoszczy
Bydgoszcz, 85-796
Uniwersyteckie Centrum Kliniczne; Klinika Onkologii i Radioterapii
Gdansk, 80-214
Szpitale Pomorskie Sp. z o. o.
Gdynia, 81-519
Szpital Uniwersytecki w Krakowie, Oddział Kliniczny Kliniki Onkologii
Krakow, 31-531
Woj.Wielospecjalistyczne Centrum Onkologii i Traumatologii; Oddz.Hematologii Pododz.Chemioterapii
Lodz, 93-513
Hong Kong3 sites
Queen Mary Hospital; Dept. of Clinical Oncology
Hong Kong
Tuen Mun Hospital; Clinical Oncology
Hong Kong
Prince of Wales Hosp; Dept. Of Clinical Onc
Shatin
Russia3 sites
Arkhangelsk Regional Clinical Oncology Dispensary
Arkhangelsk, 163045
N.N.Burdenko Main Military Clinical Hospital; Oncology Dept
Moscow, 105229
BHI of Omsk region Clinical Oncology Dispensary
Omsk, 644013
About this study
Official title: A Phase III, Open-Label, Multicenter, Three-Arm, Randomized Study to Investigate the Efficacy and Safety of Cobimetinib Plus Atezolizumab and Atezolizumab Monotherapy vs. Regorafenib in Patients With Previously Treated Unresectable Locally Advanced or Metastatic Colorectal Adenocarcinoma
This is a Phase III, multicenter, open-label, three-arm, randomized study in participants with unresectable locally advanced or metastatic colorectal cancer (CRC) who have received at least two prior regimens of cytotoxic chemotherapy for metastatic disease. The study compares regorafenib, a standard of care therapy in this setting, to cobimetinib plus atezolizumab and atezolizumab monotherapy.
- Conditions
- Colorectal Cancer
- Being tested
- Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody, Cobimetinib, Regorafenib
- Keywords
- Locally advanced or Metastatic colorectal adenocarcinoma
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 AntibodyDrug
Participants will receive atezolizumab IV at 840 mg on Day 1 and Day 15 in a 28-day cycle as a combination therapy or at 1200 mg on Day 1 in a 21-day cycle as a monotherapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.
CobimetinibDrug
Participants will receive cobimetinib 60 mg orally on Days 1 to 21 in a 28-day cycle as a combination therapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.
RegorafenibDrug
Participants will receive regorafenib 160 mg orally on Days 1 to 21 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first.
| Study group | Role | What they receive |
|---|---|---|
| Atezolizumab | Experimental | Participants will receive atezolizumab monotherapy 1200 milligrams (mg) intravenous (IV) on Day 1 in a 21-day cycle until disease progression according to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. Receives: Drug: Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody |
| Cobimetinib + Atezolizumab | Experimental | Participants will receive cobimetinib 60 mg orally on Days 1 to 21 plus atezolizumab 840 mg IV on Day 1 and Day 15 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. Receives: Drug: Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody; Drug: Cobimetinib |
| Regorafenib | Active comparator | Participants will receive regorafenib 160 mg orally on Days 1 to 21 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. Receives: Drug: Regorafenib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival (OS)
Overall survival is defined as the time (in months) between the date of randomization and the date of death due to any cause. Participants who were not reported as having died at the date of analysis were censored at the date when they were last known to be alive. Participants who did not have post-baseline information were censored at the date of randomization + 1 day. Median OS was estimated by Kaplan-Meier method and 95% CI was assessed using the method of Brookmeyer and Crowley.
Measured: From randomization up to death due to any cause (up to approximately 20 months)
Secondary outcomes (9)
Progression-Free Survival (PFS) as Determined by the Investigator According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
PFS was defined as the time from randomization to disease progression as determined by the investigator with the use of RECIST v1.1 or death due to any cause, whichever occurred earlier. Disease progression was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeters (mm). For non-target lesions, disease progression was defined as unequivocal progression of existing lesions. The appearance of one or more new lesions was also considered progression. Participants who did not have post-baseline information were censored at the date of randomization + 1 day. Median OS was estimated by Kaplan-Meier method and 95% CI was assessed using the method of Brookmeyer and Crowley.
Measured: From randomization up to disease progression or death due to any cause (up to approximately 20 months)
Percentage of Participants With Investigator-Assessed Objective Response of Complete Response (CR) or Partial Response (PR) According to RECIST Version 1.1
PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters. CR was defined as disappearance of all target and non-target lesions and normalization of tumor marker levels (as applicable to non-target lesions). Objective response and its 95% CI were calculated using the Clopper-Pearson method.
Measured: From randomization up to death due to any cause (up to approximately 20 months)
Duration of Response (DOR) According to RECIST Version 1.1
DOR is defined as the period measured from the date of the first occurrence of a CR or PR (whichever status is recorded first) until the first date that progressive disease or death is documented. Disease progression was determined on the basis of investigator assessment with use of RECIST v1.1. Median DOR was estimated using the Kaplan-Meier method, and the 95% CI was calculated using the method of Brookmeyer and Crowley.
Measured: From first occurrence of CR or PR up to disease progression or death due to any cause (up to approximately 20 months)
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life-C30 Questionnaire (EORTC QLQ-C30) Physical Functioning Sub-scale Score
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.
Measured: Baseline, end of the study (up to approximately 2.5 years)
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life-C30 Questionnaire (EORTC QLQ-C30) Global Quality of Life Sub-scale Score at the End of the Study
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.
Measured: Baseline, end of the study (up to approximately 2.5 years)
Percentage of Participants With Adverse Events (AEs)
Measured: Baseline, end of the study (up to approximately 2.5 years)
Plasma Concentration of Cobimetinib
Measured: Predose (0 hours) and 3 to 6 hours after dose on Day 15 of Cycles 1 and 4 (1 cycle = 28 days) (up to approximately 2.5 years).
Serum Concentration of Atezolizumab
Pre-infusion (0 hours) on Day 1 of Cycles 1 to 4; 30 minutes post-infusion on Day 1 of Cycles 1 and 4; pre-infusion (0 hours) on Day 1 of Cycle 8 and every 8 cycles thereafter; at treatment discontinuation; 120 days after treatment discontinuation (up to approximately 2.5 years) (1 cycle = 28 days)
Measured: Pre-infusion (0 hours) on Day 1 of Cycle 1 up to approximately 2.5 years. Detailed time frame is explained in the outcome measure description field.
Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to Atezolizumab
Measured: Pre-infusion (0 hours) on Day 1 of Cycles 1 to 4, 8, and every 8 cycles thereafter; at treatment discontinuation; 120 days after treatment discontinuation (up to approximately 2.5 years) (1 cycle = 28 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jun 2016 (estimated)
- Study start5 Jul 2016
- Primary completion9 Mar 2018
- Study completion26 Dec 2018
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.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Colorectal CancerStudies of the same condition, open and under way.
- More trials run by Hoffmann-La RocheThe sponsor's other registered studies.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 363 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hoffmann-La Roche
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trials, Study director, Hoffmann-La Roche
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02788279
- Sponsor's protocol ID
- GO30182
- Other IDs
- 2016-000202-11, 2016
- Status last verified
- Nov 2019
- First submitted
- 27 May 2016
- Last updated
- 11 Dec 2019
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Taraborrelli L, Senbabaoglu Y, Wang L, Lim J, Blake K, Kljavin N, Gierke S, Scherl A, Ziai J, McNamara E, Owyong M, Rao S, Calviello AK, Oreper D, Jhunjhunwala S, Argiles G, Bendell J, Kim TW, Ciardiello F, Wongchenko MJ, de Sauvage FJ, de Sousa E Melo F, Yan Y, West NR, Murthy A. Tumor-intrinsic expression of the autophagy gene Atg16l1 suppresses anti-tumor immunity in colorectal cancer. Nat Commun. 2023 Sep 23;14(1):5945. doi: 10.1038/s41467-023-41618-7.
PubMed 37741832Barteselli G, Goodman GR, Patel Y, Caro I, Xue C, McCallum S. Characterization of Serous Retinopathy Associated with Cobimetinib: Integrated Safety Analysis of Four Studies. Drug Saf. 2022 Dec;45(12):1491-1499. doi: 10.1007/s40264-022-01248-2. Epub 2022 Oct 30.
PubMed 36310331Eng C, Kim TW, Bendell J, Argiles G, Tebbutt NC, Di Bartolomeo M, Falcone A, Fakih M, Kozloff M, Segal NH, Sobrero A, Yan Y, Chang I, Uyei A, Roberts L, Ciardiello F; IMblaze370 Investigators. Atezolizumab with or without cobimetinib versus regorafenib in previously treated metastatic colorectal cancer (IMblaze370): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol. 2019 Jun;20(6):849-861. doi: 10.1016/S1470-2045(19)30027-0. Epub 2019 Apr 16.
PubMed 31003911
Study at a glance
From the registry record, last updated by the sponsor on 11 Dec 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III, Open-Label, Multicenter, Three-Arm, Randomized Study to Investigate the Efficacy and Safety of Cobimetinib Plus Atezolizumab and Atezolizumab Monotherapy vs. Regorafenib in Patients With Previously Treated Unresectable Locally Advanced or Metastatic Colorectal Adenocarcinoma
- ClinicalTrials.gov ID
- NCT02788279
- Acronym / sponsor ID
- GO30182
- Conditions
- Colorectal Cancer
- Keywords
- Locally advanced or Metastatic colorectal adenocarcinoma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 363 participants (actual)
- Lead sponsor
- Hoffmann-La RocheIndustry (pharma, biotech, devices)
- Study start
- 5 Jul 2016 (actual)
- Primary completion
- 9 Mar 2018 (actual)
- Study completion
- 26 Dec 2018 (actual)
- First posted
- 2 Jun 2016 (estimated)
- Results
- Posted 18 Jun 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a Phase III, multicenter, open-label, three-arm, randomized study in participants with unresectable locally advanced or metastatic colorectal cancer (CRC) who have received at least two prior regimens of cytotoxic chemotherapy for metastatic disease. The study compares regorafenib, a standard of care therapy in this setting, to cobimetinib plus atezolizumab and atezolizumab monotherapy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Atezolizumab | Experimental | Drug: Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 AntibodyParticipants will receive atezolizumab monotherapy 1200 milligrams (mg) intravenous (IV) on Day 1 in a 21-day cycle until disease progression according to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. |
| Cobimetinib + Atezolizumab | Experimental | Drug: Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody, Drug: CobimetinibParticipants will receive cobimetinib 60 mg orally on Days 1 to 21 plus atezolizumab 840 mg IV on Day 1 and Day 15 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. |
| Regorafenib | Active comparator | Drug: RegorafenibParticipants will receive regorafenib 160 mg orally on Days 1 to 21 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Histologically confirmed adenocarcinoma originating from the colon or rectum (Stage 4 American Joint Committee on Cancer [AJCC] 7th edition)
- Experienced disease progression or was intolerant to at least two systemic chemotherapy regimens for metastatic colorectal cancer that must have included fluroropyrimidines, irinotecan, and oxaliplatin; adjuvant regimen can be considered as one chemotherapy regimen for metastatic disease if the participant had disease recurrence within 6 months of completion; disease progression must have occurred within 3 months of the last systemic therapy administration
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Anticipated life expectancy greater than or equal to (>=) 3 months
- Adequate hematologic and end organ function
Key exclusion criteria (25 listed)
- After the approximate 5% cap for microsatellite (MSI)-high participants is reached, only MSI-stable participants will be eligible
- Once the 50% cap for wild-type RAS has been reached, only extended RAS-mutant participants will be eligible
- Major surgery or radiotherapy within 21 days prior to Cycle 1 Day 1 or anticipation of needing such procedure while receiving study treatment
- Treatment with any anti-cancer agent within 14 days prior to Cycle 1 Day 1
- Uncontrolled tumor-related pain. Participants requiring narcotic pain medication must be on a stable regimen at study entry
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 |
|---|---|---|
| Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 AntibodyParticipants will receive atezolizumab IV at 840 mg on Day 1 and Day 15 in a 28-day cycle as a combination therapy or at 1200 mg on Day 1 in a 21-day cycle as a monotherapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. | Drug | Atezolizumab, Cobimetinib + Atezolizumab |
| CobimetinibParticipants will receive cobimetinib 60 mg orally on Days 1 to 21 in a 28-day cycle as a combination therapy until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. | Drug | Cobimetinib + Atezolizumab |
| RegorafenibParticipants will receive regorafenib 160 mg orally on Days 1 to 21 in a 28-day cycle until disease progression according to RECIST Version 1.1, unacceptable toxicity, death, participant's or physician decision to withdraw, or pregnancy, whichever occurs first. | Drug | Regorafenib |
Primary outcome
Overall Survival (OS)
Time frame: From randomization up to death due to any cause (up to approximately 20 months)
Overall survival is defined as the time (in months) between the date of randomization and the date of death due to any cause. Participants who were not reported as having died at the date of analysis were censored at the date when they were last known to be alive. Participants who did not have post-baseline information were censored at the date of randomization + 1 day. Median OS was estimated by Kaplan-Meier method and 95% CI was assessed using the method of Brookmeyer and Crowley.
9 secondary outcomes
Progression-Free Survival (PFS) as Determined by the Investigator According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
Time frame: From randomization up to disease progression or death due to any cause (up to approximately 20 months)
Percentage of Participants With Investigator-Assessed Objective Response of Complete Response (CR) or Partial Response (PR) According to RECIST Version 1.1
Time frame: From randomization up to death due to any cause (up to approximately 20 months)
Duration of Response (DOR) According to RECIST Version 1.1
Time frame: From first occurrence of CR or PR up to disease progression or death due to any cause (up to approximately 20 months)
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life-C30 Questionnaire (EORTC QLQ-C30) Physical Functioning Sub-scale Score
Time frame: Baseline, end of the study (up to approximately 2.5 years)
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life-C30 Questionnaire (EORTC QLQ-C30) Global Quality of Life Sub-scale Score at the End of the Study
Time frame: Baseline, end of the study (up to approximately 2.5 years)
Percentage of Participants With Adverse Events (AEs)
Time frame: Baseline, end of the study (up to approximately 2.5 years)
Plasma Concentration of Cobimetinib
Time frame: Predose (0 hours) and 3 to 6 hours after dose on Day 15 of Cycles 1 and 4 (1 cycle = 28 days) (up to approximately 2.5 years).
Serum Concentration of Atezolizumab
Time frame: Pre-infusion (0 hours) on Day 1 of Cycle 1 up to approximately 2.5 years. Detailed time frame is explained in the outcome measure description field.
Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to Atezolizumab
Time frame: Pre-infusion (0 hours) on Day 1 of Cycles 1 to 4, 8, and every 8 cycles thereafter; at treatment discontinuation; 120 days after treatment discontinuation (up to approximately 2.5 years) (1 cycle = 28 days)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Dec 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 37741832Taraborrelli L, Senbabaoglu Y, Wang L, Lim J, Blake K, Kljavin N, Gierke S, Scherl A, Ziai J, McNamara E, Owyong M, Rao S, Calviello AK, Oreper D, Jhunjhunwala S, Argiles G, Bendell J, Kim TW, Ciardiello F, Wongchenko MJ, de Sauvage FJ, de Sousa E Melo F, Yan Y, West NR, Murthy A. Tumor-intrinsic expression of the autophagy gene Atg16l1 suppresses anti-tumor immunity in colorectal cancer. Nat Commun. 2023 Sep 23;14(1):5945. doi: 10.1038/s41467-023-41618-7.
- Derived from this study: PubMed 36310331Barteselli G, Goodman GR, Patel Y, Caro I, Xue C, McCallum S. Characterization of Serous Retinopathy Associated with Cobimetinib: Integrated Safety Analysis of Four Studies. Drug Saf. 2022 Dec;45(12):1491-1499. doi: 10.1007/s40264-022-01248-2. Epub 2022 Oct 30.
- Derived from this study: PubMed 31003911Eng C, Kim TW, Bendell J, Argiles G, Tebbutt NC, Di Bartolomeo M, Falcone A, Fakih M, Kozloff M, Segal NH, Sobrero A, Yan Y, Chang I, Uyei A, Roberts L, Ciardiello F; IMblaze370 Investigators. Atezolizumab with or without cobimetinib versus regorafenib in previously treated metastatic colorectal cancer (IMblaze370): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol. 2019 Jun;20(6):849-861. doi: 10.1016/S1470-2045(19)30027-0. Epub 2019 Apr 16.
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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.
Clinical Trials study director
Hoffmann-La Roche
73 sites in 11 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Atezolizumab (MPDL3280A), an Engineered Anti-PDL1 Antibody, Cobimetinib and Regorafenib in people with Colorectal Cancer, run by Hoffmann-La Roche at 73 sites in 11 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 10 inclusion and 25 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 11 Dec 2019. 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, Canada, Italy, United Kingdom, Australia and 6 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
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 18 Jun 2019). 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?
Overall Survival (OS) (time frame: From randomization up to death due to any cause (up to approximately 20 months)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02788279, which also lists 3 linked publications.
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 11 Dec 2019.