Metastatic Colorectal CancerPhase 2/3REPROGRAM-02NCT05462613
Regorafenib With Low-dose Chemotherapies and Aspirin Followed by Standard Chemotherapies in Metastatic Colorectal Cancer
A Phase 2/3 study testing quality of life questionnaires, Blood sample and Regorafenib in people with Metastatic Colorectal Cancer, run by Centre Hospitalier Universitaire de Besancon at 14 sites in France.
Trial summary
This study evaluates the interest of regorafenib in combination of metronomic chemotherapies and low-dose aspirin as a 2 months induction therapy before chemotherapy initiation in the second-line metastatic colorectal carcinoma Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Metastatic Colorectal Cancer
- What is being tested?
- quality of life questionnaires, Blood sample and Regorafenib
- Type of treatment
- Pill or oral medicine, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 446 participants
- Where
- 14 sitesFrance
- Study dates
- 9 May 2023to Nov 2030
- Phase
- Phase 2/3
- Are there results?
- Not yet: the study is under way
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
- Patients with histologically proven metastatic colorectal cancer in progression after a first line of chemotherapy +/- targeted therapy
- Patients must have been treated for their metastatic disease with one of the following regimens as first-line therapy:
- FOLFOX (Oxaliplatine, 5-Fluoro-uracil)
- FOLFIRI (Irinotecan, 5-Fluoro-uracil)
- FOLFIRINOX (Irinotecan, oxaplipatin, 5-Fluoro-uracil) or FOLFOXIRI (irinotecan, oxaliplatin, 5-Fluoro-uracil)
- FOLFOX and anti-VEGFA (bevacizumab only)
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- FOLFIRI and anti-VEGFA (bevacizumab only)
- FOLFIRINOX or FOLFOXIRI and anti-VEGFA (bevacizumab only)
- FOLFOX and anti-EGFR (Epiderman Growth Factor Recepto)
- FOLFIRI and anti-EGFR
- FOLFIRINOX or FOLFOXIRI and anti-EGFR
- Of note, a chemotherapy prescribed for metastases occurring within six months after the end of an adjuvant chemotherapy are considered as a second line of therapy.
- Patients should have a history of resistance to first line chemotherapy defined by:
- Disease progression during the first line of their metastatic disease, less than 3 months after the last exposition to chemotherapy (even a chemotherapy regimen mentioned above or a 5-Fluoro-uracil-based maintenance therapy).
- Disease relapse within 6 months after the end of an adjuvant FOLFOX based chemotherapy.
- Disease relapse within 6 months after the surgical resection of metastases following a first line of chemotherapy.
- Life expectancy of at least 3 months
- Female or male with age ≥18 years old
- Performance status Eastern Cooperative Oncology Group World Health Organization (ECOG-WHO) ≤1 (Appendix 1),
- Measurable disease defined according to RECIST v1.1 (scanner or MRI)
- Molecular status: patients eligible should have microsatellite-stable (MSS) status, absence of BRAF V600E (B(Raf gene, val600-to-glu) mutation and a known RAS (Retrovirus Associated Sequences) status.
- Adequate bone marrow, liver and renal functions.
- Haemoglobin ≥ 9 g/dL; absolute neutrophil count (ANC) ≥ 1.5 x 109/L; platelets ≥ 100 x 109/L
- Total serum bilirubin ≤ 1.5 times upper normal value (ULN), serum alkaline phosphatase < 5 times ULN, aminotransferases (AST/ALT) ≤ 3 × ULN in absence of hepatic metastasis or ≤ 5 if presence of hepatic lesions
- Cockcroft glomerular filtration rate > 50 ml/min
- Proteinuria <2+ (dipstick urinalysis) or ≤1g/24hour
- No contraindication to Iodine contrast media injection during CT
- For female patients of childbearing potential, negative pregnancy test within 14 days before starting the study drug through at 210 days after the last dose of regorafenib. Men and women are required to use adequate birth control during the study (when applicable),
- Signed and dated informed consent,
- Ability to comply with the study protocol, in the Investigator's judgment.
- Registration in a national health care system (CMU included).
Who cannot join
- Diagnosis of additional malignancy within 2 years prior to the inclusion (exception of curatively treated basal cell carcinoma of the skin and/or curatively resected in situ cervical and/or bladder cancer),
- Current participation in a study of an investigational agent. Patients might be included at least 21 days following the last investigational agent administration.
- Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before inclusion in the trial;
- Patient under judicial protection (curators, autorship) and/or deprived of freedom,
- Planned surgical procedure within the first month of treatment or any procedure that might change the timing of regorafenib administration during the first month of treatment,
- Previous exposure to regorafenib,
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- Previous exposure to other anti-angiogenic treatment than bevacizumab,
- Complete deficit in dihydropyrimidine dehydrogenase (DPD),
- Major surgical procedure, open biopsy or significant traumatic injury within 28 days before start of study medication,
- Pregnant or breast-feeding subjects,
- Congestive Heart Failure ≥ New York Heart Association (NYHA) class 2, unstable angina (anginal symptomatology at rest),
- Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months),
- Myocardial infarction less than 6 months before start of study drug,
- Cardiac arrhythmias requiring anti-arrhythmic therapy (beta-blockers or digoxin are permitted),
- Uncontrolled hypertension (Systolic blood pressure >150 mmHg and/or diastolic pressure >100 mmHg despite optimal medical management), or history of hypertensive crisis, or hypertensive encephalopathy
- Pleural effusion or ascites that causes respiratory compromise (≥ CTCAE grade 2 dyspnea),
- Ongoing infection >grade 2 CTCAE V5 (Appendix 6 ),
- Known History of human immunodeficiency virus (HIV) infection,
- Active hepatitis B or C or chronic hepatitis B or C requiring treatment with antiviral therapy,
- Subjects with seizure disorder requiring medication,
- History of organ allograft,
- Subjects with evidence or history of any bleeding diathesis, irrespective of severity,
- Any haemorrhage or bleeding event ≥ CTCAE Grade 3 within 4 weeks prior to the start of study medication,
- Serious, Non-healing wound, active ulcer or untreated bone fracture,
- History of abdominal fistula, GI perforation, intra-abdominal abscess or active GI bleeding within 6 months prior to inclusion,
- Dehydration CTCAE v4 grade ≥1,
- Known hypersensitivity to any of the study drugs, study drug classes or excipient in the formulation,
- Interstitial lung disease with ongoing signs or symptoms,
- Persistent proteinuria of CTCAE Grade 3 (>3.5 g/24 hours),
- Subject unable to swallow oral medications,
- Any malabsorption condition, unresolved toxicity higher than CTCAE (V4) Grade 1 attributed to any prior therapy/procedure excluding alopecia, hypothyroidism and oxaliplatin induced neuropathy ≤ Grade 2,
- Systemic anticancer therapy including cytotoxic therapy, signal transduction inhibitors, immunotherapy, and hormonal therapy during this trial or within 3 weeks,
- Treatment with any other investigational medicinal product within 28 days prior to study entry, EXCEPT for ASPIRIN,
- Co-administration of drugs potentially interacting with regorafenib i.e. CYP3A4 or UGT1A9 (UDP-glucuronosyltransferase 1-9) inducers/inhibitors.
Trial locations and contacts
14 sites in 1 country.
14 sites in 1 country
France14 sites
CHU de Besançon
Besançon
CHU Estain
Clermont-Ferrand
Hôpital Henri Mondor
Créteil
Centre Georges François Leclerc
Dijon
Hôpital Privé Jean Mermoz
Lyon
Hôpital Nord Franche Comté
Montbéliard
CHU Montpellier
Montpellier
Groupe hospitalier de la région de Mulhouse et Sud Alsace
Mulhouse
Centre Antoine Lacassagne
Nice
Hôpital Européen Georges Pompidou
Paris
Hôpital la Pitié-Salpétrière
Paris
Hôpital Saint antoine
Paris
Institut Mutualiste Montsouris
Paris
CHU de Reims - Hôpital Robert Debré
Reims
About this study
Official title: Induction Regorafenib in Combination With Metronomic Cyclophosphamide, Capecitabine, and Low-dose Aspirin Followed by Chemotherapy in Second Line Metastatic Colorectal Cancer Carcinoma An Open-label Randomized Phase II-III Study
This study evaluates the interest of regorafenib in combination of metronomic chemotherapies and low-dose aspirin as a 2 months induction therapy before chemotherapy initiation in the second-line metastatic colorectal carcinoma
- Conditions
- Metastatic Colorectal Cancer
- Being tested
- quality of life questionnaires, Blood sample, Regorafenib, Metronomic chemotherapies, Aspirin
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
quality of life questionnairesOther
EORTC QLQ-C30 questionnaire (Quality of life questionnaire- Cancer 30) CR29 questionnaire (Colo-rectal cancer 29) EQ-5D3L questionnaire (EuroQol-5 Dimensions, 3 levels)
Blood sampleProcedure or surgery
Blood sample for plasma collection Blood sample for ctDNA (circulating tumoral DNA) collection
RegorafenibDrug
- Regorafenib will be administered 3 weeks out of 4 for two months or unacceptable toxicity.
- For the first cycle: regorafenib will be administered according to the "REDOS" schedule (80 mg daily for week 1, 120 mg daily for week 2 and 160 mg daily for the third week of the first cycle).
- For the second cycle: regorafenib will be administered at 160mg in the absence of significant toxicity during cycle 1 or at a 80/120mg daily dose according to toxicity observed with the last dose used in the first cycle.
Metronomic chemotherapiesDrug
- Capecitabine: 625mg/m²/orally twice daily continuously during the first two months
- Cyclophosphamide: 50 mg per os, daily, for two months
AspirinDrug
75 mg orally and daily during two months
BevacizumabDrug
5 mg/Kg every 2 weeks according to investigator practice, until disease progression or unacceptable toxicity
FOLFIRI or FOLFOXDrug
every 2 weeks according to investigator practice
| Study group | Role | What they receive |
|---|---|---|
| Experimental | Experimental | Regorafenib + metronomic Capecitabine + metronomic Cyclophosphamide + low-dose Aspirin followed by second line of chemotherapy (Bevacizumab + FOLFOX or FOLFIRI) Receives: Other: quality of life questionnaires; Procedure: Blood sample; Drug: Regorafenib; Drug: Metronomic chemotherapies; Drug: Aspirin; Drug: Bevacizumab; Drug: FOLFIRI or FOLFOX |
| Control | Active comparator | Second line of chemotherapy (Bevacizumab + FOLFOX or FOLFIRI) Receives: Other: quality of life questionnaires; Procedure: Blood sample; Drug: Bevacizumab; Drug: FOLFIRI or FOLFOX |
What is being measured
The primary outcome is the main question the study is designed to answer.
best objective response during treatment period (phase II)
the best response rate evaluated with RECIST v1.1 criteria per an independent radiologist committee during the treatment period defined as the number of with complete response (CR) or partial response (PR) as best response divided by the total number of patients evaluable. Patients for whom best overall tumor response is not CR or PR will be considered non-responders.
Measured: during treatment period (from first treatment administration and disease progression, an average of 14 months
overall survival (OS) (phase III)
Overall survival is defined as the time from the randomization to death from any cause.
Measured: through study completion, an average of 64 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jul 2022
- Study start9 May 2023
- Primary completionNov 2029 (estimated)
- Study completionNov 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Metastatic Colorectal CancerStudies of the same condition, open and under way.
- More trials run by Centre Hospitalier Universitaire de BesanconThe 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 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 446 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Centre Hospitalier Universitaire de Besancon
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05462613
- Sponsor's protocol ID
- 2022/702
- Acronym
- REPROGRAM-02
- Status last verified
- Nov 2026
- First submitted
- 8 Jul 2022
- Last updated
- 4 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 4 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Induction Regorafenib in Combination With Metronomic Cyclophosphamide, Capecitabine, and Low-dose Aspirin Followed by Chemotherapy in Second Line Metastatic Colorectal Cancer Carcinoma An Open-label Randomized Phase II-III Study
- ClinicalTrials.gov ID
- NCT05462613
- Acronym / sponsor ID
- REPROGRAM-02 / 2022/702
- Conditions
- Metastatic Colorectal Cancer
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 446 participants (estimated)
- Lead sponsor
- Centre Hospitalier Universitaire de BesanconUniversity, hospital or other
- Study start
- 9 May 2023 (actual)
- Primary completion
- Nov 2029 (estimated)
- Study completion
- Nov 2030 (estimated)
- First posted
- 18 Jul 2022 (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 study evaluates the interest of regorafenib in combination of metronomic chemotherapies and low-dose aspirin as a 2 months induction therapy before chemotherapy initiation in the second-line metastatic colorectal carcinoma
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Experimental | Experimental | Other: quality of life questionnaires, Procedure: Blood sample, Drug: Regorafenib, Drug: Metronomic chemotherapies, Drug: Aspirin, Drug: Bevacizumab, Drug: FOLFIRI or FOLFOXRegorafenib + metronomic Capecitabine + metronomic Cyclophosphamide + low-dose Aspirin followed by second line of chemotherapy (Bevacizumab + FOLFOX or FOLFIRI) |
| Control | Active comparator | Other: quality of life questionnaires, Procedure: Blood sample, Drug: Bevacizumab, Drug: FOLFIRI or FOLFOXSecond line of chemotherapy (Bevacizumab + FOLFOX or FOLFIRI) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (31 listed)
- Patients with histologically proven metastatic colorectal cancer in progression after a first line of chemotherapy +/- targeted therapy
- Patients must have been treated for their metastatic disease with one of the following regimens as first-line therapy:
- Of note, a chemotherapy prescribed for metastases occurring within six months after the end of an adjuvant chemotherapy are considered as a second line of therapy.
- Patients should have a history of resistance to first line chemotherapy defined by:
- Life expectancy of at least 3 months
Key exclusion criteria (34 listed)
- Diagnosis of additional malignancy within 2 years prior to the inclusion (exception of curatively treated basal cell carcinoma of the skin and/or curatively resected in situ cervical and/or bladder cancer),
- Current participation in a study of an investigational agent. Patients might be included at least 21 days following the last investigational agent administration.
- Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before inclusion in the trial;
- Patient under judicial protection (curators, autorship) and/or deprived of freedom,
- Planned surgical procedure within the first month of treatment or any procedure that might change the timing of regorafenib administration during the first month of treatment,
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 |
|---|---|---|
| quality of life questionnairesEORTC QLQ-C30 questionnaire (Quality of life questionnaire- Cancer 30) CR29 questionnaire (Colo-rectal cancer 29) EQ-5D3L questionnaire (EuroQol-5 Dimensions, 3 levels) | Other | Control, Experimental |
| Blood sampleBlood sample for plasma collection Blood sample for ctDNA (circulating tumoral DNA) collection | Procedure or surgery | Control, Experimental |
| Regorafenib- Regorafenib will be administered 3 weeks out of 4 for two months or unacceptable toxicity. * For the first cycle: regorafenib will be administered according to the "REDOS" schedule (80 mg daily for week 1, 120 mg daily for week 2 and 160 mg daily for the third week of the first cycle). * For the second cycle: regorafenib will be administered at 160mg in the absence of significant toxicity during cycle 1 or at a 80/120mg daily dose according to toxicity observed with the last dose used in the first cycle. | Drug | Experimental |
| Metronomic chemotherapies* Capecitabine: 625mg/m²/orally twice daily continuously during the first two months * Cyclophosphamide: 50 mg per os, daily, for two months | Drug | Experimental |
| Aspirin75 mg orally and daily during two months | Drug | Experimental |
| Bevacizumab5 mg/Kg every 2 weeks according to investigator practice, until disease progression or unacceptable toxicity | Drug | Control, Experimental |
| FOLFIRI or FOLFOXevery 2 weeks according to investigator practice | Drug | Control, Experimental |
Primary outcome
best objective response during treatment period (phase II)
Time frame: during treatment period (from first treatment administration and disease progression, an average of 14 months
the best response rate evaluated with RECIST v1.1 criteria per an independent radiologist committee during the treatment period defined as the number of with complete response (CR) or partial response (PR) as best response divided by the total number of patients evaluable. Patients for whom best overall tumor response is not CR or PR will be considered non-responders.
overall survival (OS) (phase III)
Time frame: through study completion, an average of 64 months
Overall survival is defined as the time from the randomization to death from any cause.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Nov 2026.
- Individual participant dataSharing planned: No
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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.
The record lists no contact. Use the official record to reach the sponsor.
14 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing quality of life questionnaires, Blood sample and Regorafenib in people with Metastatic Colorectal Cancer, run by Centre Hospitalier Universitaire de Besancon at 14 sites in France.
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 31 inclusion and 34 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: under way, not looking for participants, as of the sponsor's last update on 4 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 14 sites in France. 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 combined 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.
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?
This study is still under way. Results are not available in the source record yet.
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?
best objective response during treatment period (phase II) (time frame: during treatment period (from first treatment administration and disease progression, an average of 14 months). The study lists 2 primary outcomes in all. 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 4 Nov 2026.