Previously Treated Metastatic Colorectal CancerPhase 3NCT03522649
A Phase III Clinical Study of Napabucasin (GB201) Plus FOLFIRI in Adult Patients With Metastatic Colorectal Cancer
A Phase 3 study testing Napabucasin, Fluorouracil and Leucovorin in people with Previously Treated Metastatic Colorectal Cancer, run by 1Globe Health Institute LLC at 37 sites in China.
Trial summary
This is a randomized, open-label, multi-center, phase III study of Napabucasin plus bi-weekly FOLFIRI (Arm 1) vs. Napabucasin (Arm 2) for adult patients with metastatic CRC who have failed standard chemotherapy regimens. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Previously Treated Metastatic Colorectal Cancer
- What is being tested?
- Napabucasin, Fluorouracil and Leucovorin
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 668 participants
- Where
- 37 sitesChina
- Study dates
- 12 Apr 2018to Nov 2021
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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
- Histologically confirmed adenocarcinoma of the colon or rectum that is metastatic (Stage IV)
- Progression during or within 3 months following the last administration of standard chemotherapy based regimens containing a fluoropyrimidine, irinotecan and oxaliplatin. Patients treated with oxaliplatin or irinotecan in an adjuvant setting should have progressed during or within 6 months of completion of adjuvant therapy
- Patients who are candidates for and have access to anti-VEGF therapy (i.e. bevacizumab and regorafenib) and anti-EGFR therapy (i.e. cetuximab and panitumumab) and/or TAS-102 must have received appropriate therapy.
- Patients with measurable or non measurable disease
- Eastern Cooperative Oncology Group (ECOG) Performance Status of </= 1
- Adequate bone marrow, liver and renal function
Who cannot join
- Anti-cancer chemotherapy, biologic therapy or any other systemic therapy if administered prior to the first planned dose of study medication within period of time equivalent to the usual cycle length of the regimen. An exception is made for oral fluoropyrimidines (e.g. capecitabine, S-1), where a minimum of 10 days since last dose must be observed prior to the first planned dose of protocol treatment.
- Major surgery within 4 weeks prior to randomization.
- Any known brain or leptomeningeal metastases are excluded, even if treated.
- Known hypersensitivity to 5-FU/LV or patients who as a result of toxicity had to reduce or stop 5-FU infusion at the dose of 900 mg/m^2/day (total 1800 mg/m^2/day).
- Known hypersensitivity to irinotecan or patients who as a result of toxicity had to reduce or stop irinotecan infusion at the dose of 120 mg/m^2.
- Known history of human immunodeficiency virus (HIV) infection. Known chronic hepatitis B or C active infection.
Show all 10Show fewer
- Known microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR).
- Known dihydropyrimidine dehydrogenase (DPD) deficiency.
- Patients with QTc interval > 470 millisecond.
- Uncontrolled intercurrent illness
Trial locations and contacts
37 sites in 1 country.
37 sites in 1 country
China37 sites, 37 recruiting
- Recruiting
Cancer Hospital Chinese Academy of Medical Sciences
Beijing, Beijing Municipality, 100021
- Recruiting
Beijng Cancer Hospital
Beijing, Beijing Municipality, 100142
- Recruiting
Chinese PLA General Hospital
Beijing, Beijing Municipality, 100853
- Recruiting
First Affiliated Hospital of Bengbu Medical College
Bengbu, Anhui, 233004
- Recruiting
Jilin Cancer Hospital
Changchun, Jilin, 130021
- Recruiting
The First Bethune Hospital of Jilin University
Changchun, Jilin, 130021
- Not yet recruiting
Hunan Cancer Hospital
Changsha, Hunan, 410013
- Recruiting
Fujian Medical University Union Hospital
Fuzhou, Fujian, 350001
- Recruiting
Sun Yat-sen University Cancer Center
Guangzhou, Guangdong, 510060
- Recruiting
Guangdong General Hospital
Guangzhou, Guangdong, 510080
- Recruiting
Nanfang Hospital
Guangzhou, Guangdong, 510515
- Recruiting
The Sixth Affiliated Hospital of Sun Yat - sen University
Guangzhou, Guangdong, 510655
- Recruiting
The First Affiliated Hospital, Zhejiang University
Hangzhou, Zhejiang, 310006
- Recruiting
The Second Affiliated Hospital, Zhejiang University
Hangzhou, Zhejiang, 310009
- Recruiting
Sir Run Shaw Hospital, School of Medicine, Zhejiang University
Hangzhou, Zhejiang, 310016
- Recruiting
Zhejiang Cancer Hospital
Hangzhou, Zhejiang, 310022
- Recruiting
Harbin Medical University Cancer Hospital
Harbin, Heilongjiang, 150040
- Recruiting
The First Affiliated Hospital of Anhui Medical University
Hefei, Anhui, 230022
- Recruiting
The Second Affiliated Hospital of Anhui Medical University
Hefei, Anhui, 230601
- Recruiting
Shandong Cancer Hospital
Jinan, Shandong, 250117
- Recruiting
The First Affiliated Hospital of Nanchang University
Nanchang, Jiangxi, 330006
- Recruiting
The 81 Hospital of the Chinese People's Liberation Army
Nanjing, Jiangsu, 210002
- Recruiting
Nanjing Drum Tower Hospital
Nanjing, Jiangsu, 210008
- Recruiting
Jiangsu Cancer Hospital
Nanjing, Jiangsu, 210009
- Recruiting
Jiangsu Provence Hospital
Nanjing, Jiangsu, 210029
- Recruiting
The Affiliated Hospital Qingdao University
Qingdao, Shandong, 266103
- Recruiting
Shanghai General Hospital
Shanghai, Shanghai Municipality, 200080
- Recruiting
Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, 200092
- Recruiting
Shanghai East Hospital
Shanghai, Shanghai Municipality, 200120
- Recruiting
Ren Ji Hospital, Shanghai Jiaotong University School of Medicine
Shanghai, Shanghai Municipality, 200127
- Recruiting
Liaoning Provincial Cancer Hospital
Shenyang, Liaoning, 110042
- Recruiting
Forth Hospital of Hebei Medical University
Shijiazhuang, Hebei, 050011
- Recruiting
Union Hospital of Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, 430023
- Recruiting
Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, 430030
- Recruiting
The First Affiliated Hospital of Xi' AnJiaotong University
Xi’an, Shanxi, 710061
- Recruiting
Henan Cancer Hospital
Zhengzhou, Henan, 450008
- Recruiting
First Affiliated Hospital of Zhengzhou University
Zhengzhou, Henan, 450052
About this study
Official title: A Phase III, Randomized, Open-Label Clinical Study of Napabucasin (GB201) in Combination With FOLFIRI Versus Napabucasin in Adult Patients With Previously Treated Metastatic Colorectal Cancer (CRC)
This is a randomized, open-label, multi-center, phase III study of Napabucasin plus bi-weekly FOLFIRI (Arm 1) vs. Napabucasin (Arm 2) for adult patients with metastatic CRC who have failed standard chemotherapy regimens. For patients who have failed bevacizumab with irinotecan-based chemotherapies (treatment failure is defined as radiologic progression of disease during or within 3 months following the last dose), bevacizumab maybe administered in combination with FOLFIRI to patients randomized to Arm 1.
- Being tested
- Napabucasin, Fluorouracil, Leucovorin, Irinotecan
- Keywords
- CRC
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
NapabucasinDrug
Also called GB201
Napabucasin 240 mg will be administered orally, twice daily, with doses separated by approximately 8~12 hours.
FluorouracilDrug
Also called 5-FU, Benda-5 FU
Fluorouracil 400 mg/m^2 bolus will be administered intravenously immediately following irinotecan/leucovorin infusion, followed by Fluorouracil 1200 mg/m^2/day (total 2400 mg/m^2) continuous infusion.
LeucovorinDrug
Also called Folinic Acid
Irinotecan 180 mg/m^2 followed by or concurrent with leucovorin 400 mg/m^2 will be administered intravenously, over approximately 90 minutes and 2 hours, respectively.
IrinotecanDrug
Also called Irinotecan Aurobindo
Irinotecan 180 mg/m^2 followed by or concurrent with leucovorin 400 mg/m^2 will be administered intravenously, over approximately 90 minutes and 2 hours, respectively.
| Study group | Role | What they receive |
|---|---|---|
| Napabucasin plus FOLFIRI | Experimental | Napabucasin 240 mg will be administered orally, twice daily, with doses separated by approximately 8~12 hours. For patients who have failed bevacizumab with irinotecan-based chemotherapies, bevacizumab may be administered with FOLFIRI. FOLFIRI infusion will start at least 2 hours following the first daily dose of napabucasin and will be administered every 2 weeks, starting on C1D1. If bevacizumab is added to FOLFIRI, bevacizumab infusion should start at least 2 hours following the first daily dose of napabucasin and will be administered every 2 weeks. Irinotecan/leucovorin infusion will follow bevacizumab infusion. 5-FU 400 mg/ m^2 bolus will be administered intravenously immediately following irinotecan/leucovorin infusion, followed by 5-FU 1200 mg/ m^2/day continuous infusion. For patients who could not tolerate FOLFIRI at the full dose previously, FOLFIRI should be started at the same dose level the patient tolerated FOLFIRI previously. Receives: Drug: Napabucasin; Drug: Fluorouracil; Drug: Leucovorin; Drug: Irinotecan |
| Napabucasin | Other | Napabucasin 240 mg will be administered orally, twice daily, with doses separated by approximately 8~12 hours. Receives: Drug: Napabucasin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival (OS)
To assess the effect of Napabucasin plus biweekly FOLFIRI versus Napabucasin on the Overall Survival of patients with previously treated metastatic colorectal cancer.
Measured: 43 months
Secondary outcomes (9)
Progression free survival (PFS)
Defined as the time from randomization to the first objective documentation of disease progression or death due to any cause.
Measured: 43 months
Objective response rate (ORR)
Defined as the proportion of patients with a documented complete response or partial response (CR + PR) based on RECIST 1.1.
Measured: 43 months
Disease control rate (DCR)
Defined as the proportion of patients with a documented complete response, partial response, and stable disease (CR + PR + SD) based on RECIST 1.1.
Measured: 43 months
Number of Patients with Adverse Events
All patients who have received at least one dose of Napabucasin will be included in the safety analysis according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) version 4.0. The incidence of adverse events will be summarized by type of adverse event and severity.
Measured: 43 months
Quality of Life (QoL)
QoL will be measured using the European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC-QLQ-C30) in patients with pretreated metastatic CRC treated with Napabucasin plus biweekly FOLFIRI versus Napabucasin.
Measured: 43 months
Overall Survival in biomarker positive patients
To assess the effect of Napabucasin plus FOLFIRI versus Napabucasin on the Overall Survival of patients with metastatic colorectal cancer in biomarker positive patients. This biomarker-positive sub-population is defined as those patients with phospho-STAT3/nuclear β-catenin positivity on immunohistochemical (IHC) staining of Formalin Fixed Paraffin Embedded (FFPE) archival tissue.
Measured: 43 months
Progression Free Survival in biomarker positive patients
Defined as the time from randomization to the first objective documentation of disease progression or death due to any cause. This biomarker-positive sub-population is defined as those patients with nuclear β-catenin and/or phospho-STAT3 positivity on immunohistochemical (IHC) staining of Formalin Fixed Paraffin Embedded (FFPE) archival tissue.
Measured: 43 months
Objective Response Rate in biomarker positive patients
Defined as the proportion of patients with a documented complete response or partial response (CR + PR) based on RECIST 1.1. This biomarker-positive sub-population is defined as those patients with nuclear β-catenin and/or phospho-STAT3 positivity on immunohistochemical (IHC) staining of Formalin Fixed Paraffin Embedded (FFPE) archival tissue.Defined as the proportion of patients with a documented complete response or partial response (CR + PR) based on RECIST 1.1. This biomarker-positive sub-population is defined as those patients with nuclear β-catenin and/or phospho-STAT3 positivity on immunohistochemical (IHC) staining of Formalin Fixed Paraffin Embedded (FFPE) archival tissue.
Measured: 43 months
Disease Control Rate in biomarker positive patients
Defined as the proportion of patients with a documented complete response, partial response, and stable disease (CR + PR + SD) based on RECIST 1.1. This biomarker-positive sub-population is defined as those patients with nuclear β-catenin and/or phospho-STAT3 positivity on immunohistochemical (IHC) staining of Formalin Fixed Paraffin Embedded (FFPE) archival tissue.
Measured: 43 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 May 2018
- Study start12 Apr 2018
- Primary completionNov 2021 (estimated)
- Study completionNov 2021 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Previously Treated Metastatic 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 668 participants (estimated)
Sponsor and investigators
- Lead sponsor
- 1Globe Health Institute LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03522649
- Sponsor's protocol ID
- STEMNESS-CRC
- Status last verified
- May 2019
- First submitted
- 1 May 2018
- Last updated
- 18 Jun 2019
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 18 Jun 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III, Randomized, Open-Label Clinical Study of Napabucasin (GB201) in Combination With FOLFIRI Versus Napabucasin in Adult Patients With Previously Treated Metastatic Colorectal Cancer (CRC)
- ClinicalTrials.gov ID
- NCT03522649
- Acronym / sponsor ID
- STEMNESS-CRC
- Keywords
- CRC
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 668 participants (estimated)
- Lead sponsor
- 1Globe Health Institute LLCIndustry (pharma, biotech, devices)
- Study start
- 12 Apr 2018 (actual)
- Primary completion
- Nov 2021 (estimated)
- Study completion
- Nov 2021 (estimated)
- First posted
- 11 May 2018 (actual)
- Results
- Not posted in the source record
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 randomized, open-label, multi-center, phase III study of Napabucasin plus bi-weekly FOLFIRI (Arm 1) vs. Napabucasin (Arm 2) for adult patients with metastatic CRC who have failed standard chemotherapy regimens. For patients who have failed bevacizumab with irinotecan-based chemotherapies (treatment failure is defined as radiologic progression of disease during or within 3 months following the last dose), bevacizumab maybe administered in combination with FOLFIRI to patients randomized to Arm 1.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Napabucasin plus FOLFIRI | Experimental | Drug: Napabucasin, Drug: Fluorouracil, Drug: Leucovorin, Drug: IrinotecanNapabucasin 240 mg will be administered orally, twice daily, with doses separated by approximately 8~12 hours. For patients who have failed bevacizumab with irinotecan-based chemotherapies, bevacizumab may be administered with FOLFIRI. FOLFIRI infusion will start at least 2 hours following the first daily dose of napabucasin and will be administered every 2 weeks, starting on C1D1. If bevacizumab is added to FOLFIRI, bevacizumab infusion should start at least 2 hours following the first daily dose of napabucasin and will be administered every 2 weeks. Irinotecan/leucovorin infusion will follow bevacizumab infusion. 5-FU 400 mg/ m^2 bolus will be administered intravenously immediately following irinotecan/leucovorin infusion, followed by 5-FU 1200 mg/ m^2/day continuous infusion. For patients who could not tolerate FOLFIRI at the full dose previously, FOLFIRI should be started at the same dose level the patient tolerated FOLFIRI previously. |
| Napabucasin | Other | Drug: NapabucasinNapabucasin 240 mg will be administered orally, twice daily, with doses separated by approximately 8~12 hours. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Histologically confirmed adenocarcinoma of the colon or rectum that is metastatic (Stage IV)
- Progression during or within 3 months following the last administration of standard chemotherapy based regimens containing a fluoropyrimidine, irinotecan and oxaliplatin. Patients treated with oxaliplatin or irinotecan in an adjuvant setting should have progressed during or within 6 months of completion of adjuvant therapy
- Patients who are candidates for and have access to anti-VEGF therapy (i.e. bevacizumab and regorafenib) and anti-EGFR therapy (i.e. cetuximab and panitumumab) and/or TAS-102 must have received appropriate therapy.
- Patients with measurable or non measurable disease
- Eastern Cooperative Oncology Group (ECOG) Performance Status of </= 1
Key exclusion criteria (10 listed)
- Anti-cancer chemotherapy, biologic therapy or any other systemic therapy if administered prior to the first planned dose of study medication within period of time equivalent to the usual cycle length of the regimen. An exception is made for oral fluoropyrimidines (e.g. capecitabine, S-1), where a minimum of 10 days since last dose must be observed prior to the first planned dose of protocol treatment.
- Major surgery within 4 weeks prior to randomization.
- Any known brain or leptomeningeal metastases are excluded, even if treated.
- Known hypersensitivity to 5-FU/LV or patients who as a result of toxicity had to reduce or stop 5-FU infusion at the dose of 900 mg/m^2/day (total 1800 mg/m^2/day).
- Known hypersensitivity to irinotecan or patients who as a result of toxicity had to reduce or stop irinotecan infusion at the dose of 120 mg/m^2.
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 |
|---|---|---|
| NapabucasinAlso: GB201Napabucasin 240 mg will be administered orally, twice daily, with doses separated by approximately 8~12 hours. | Drug | Napabucasin, Napabucasin plus FOLFIRI |
| FluorouracilAlso: 5-FU, Benda-5 FUFluorouracil 400 mg/m^2 bolus will be administered intravenously immediately following irinotecan/leucovorin infusion, followed by Fluorouracil 1200 mg/m^2/day (total 2400 mg/m^2) continuous infusion. | Drug | Napabucasin plus FOLFIRI |
| LeucovorinAlso: Folinic AcidIrinotecan 180 mg/m^2 followed by or concurrent with leucovorin 400 mg/m^2 will be administered intravenously, over approximately 90 minutes and 2 hours, respectively. | Drug | Napabucasin plus FOLFIRI |
| IrinotecanAlso: Irinotecan AurobindoIrinotecan 180 mg/m^2 followed by or concurrent with leucovorin 400 mg/m^2 will be administered intravenously, over approximately 90 minutes and 2 hours, respectively. | Drug | Napabucasin plus FOLFIRI |
Primary outcome
Overall Survival (OS)
Time frame: 43 months
To assess the effect of Napabucasin plus biweekly FOLFIRI versus Napabucasin on the Overall Survival of patients with previously treated metastatic colorectal cancer.
9 secondary outcomes
Progression free survival (PFS)
Time frame: 43 months
Objective response rate (ORR)
Time frame: 43 months
Disease control rate (DCR)
Time frame: 43 months
Number of Patients with Adverse Events
Time frame: 43 months
Quality of Life (QoL)
Time frame: 43 months
Overall Survival in biomarker positive patients
Time frame: 43 months
Progression Free Survival in biomarker positive patients
Time frame: 43 months
Objective Response Rate in biomarker positive patients
Time frame: 43 months
Disease Control Rate in biomarker positive patients
Time frame: 43 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jun 2019.
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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.
37 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Napabucasin, Fluorouracil and Leucovorin in people with Previously Treated Metastatic Colorectal Cancer, run by 1Globe Health Institute LLC at 37 sites in China.
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 6 inclusion and 10 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: status not confirmed, as of the sponsor's last update on 18 Jun 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 37 sites in China. 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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Liu Wang (+86-10-62336199, wangliu@1globe-china.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall Survival (OS) (time frame: 43 months). 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 18 Jun 2019.