5-fluorouracil Plus Panitumumab (Anti-EGFR) and Sotorasib (KRAS G12C Inhibitor) in First-line Treatment of Patients Non-eligible for a Doublet/Triplet Chemotherapy With Advanced Unresectab
Colorectal CarcinomaKRAS G12C MutationUnresectable Colorectal Cancer
Investigational drug(s) / intervention(s)
Administration of experimental treatment association (sotorasib, panitumumab 5FU)
Administration of experimental treatment association (sotorasib, panitumumab 5FU): Panitumumab is administered at a dose of 6 mg/kg via intravenous infusion over one hour during the first cycle, and over 30 minutes from the second cycle onward. The LV5FU2 regimen includes folinic acid (400 mg/m², or 200 mg/m² if levo-leucovorin is used) as a two-hour IV infusion, followed by a 5-FU bolus (400 mg/m² over 10 minutes), and a continuous 5-FU infusion (2400 mg/m² over 46 hours). Sotorasib is given orally at a dose of 960 mg once daily on a continuous basis.
Study summary
5-fluorouracil (5-FU) is a standard of care in frail/elderly patients with an unresectable colorectal adenocarcinoma (CRC) in first-line setting. Panitumumab plus Sotorasib are promising in advanced line in KRAS G12C mutated CRC. In this study, We assess the safety and efficacy of 5FU combination with Panitumumab and Sotorasib as first-line treatment in frail/elderly patients with unresectable KRAS G12C mutated CRC
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Age ≥ 18 years.
* Histologically proven advanced-stage unresectable locally advanced or metastatic colorectal adenocarcinoma.
* Proven KRAS G12C mutation as locally assessed by means of an IVDR-compliant test
* Agreement to participate to biological studies (blood samples for ctDNA and send tumour block).
* Patient with one these criteria:
Patient with WHO PS=2 Patient between 70 and 75 years old with WHO PS 1 Patient ≥ 75 years old
* Measurable lesion according to the Response Evaluation Criteria in Solid Tumours 1.1 (RECIST 1.1).
* No prior treatment for the metastatic disease. Prior adjuvant chemotherapy is allowed if there is more than 6 months between the end of adjuvant treatment and relapse.
* Adequate organ function: Hemoglobin \> 9 g/dl, Absolute neutrophil count \> 1500 /mm3, Platelets \> 80 000/mm3, Creatinine clearance rate ≥50 mL/min as calculated using MDRD formula, ALT/AST ≤5×ULN and total bilirubin ≤1.5×ULN.
* Ability to understand and sign written informed consent to participate in the study.
* Provides written informed consent for the study.
* Life expectancy \>6 months.
* Women of childbearing potential must agree to use contraception during the trial treatment and for at least 6 months after discontinuation of the experimental treatments. Men who have sexual relationship with women of childbearing potential must agree to use contraception during treatment and for at least 3 months after discontinuation of the experimental treatments.
* Patient affiliated to a social security scheme for France, or equivalent for other countries.
Exclusion Criteria:
\- Patient with one of these criteria: Patient fit for doublet/triplet regimen Patient with WHO PS 3 or 4 Patient \< 75 years old with WHO PS 0 Patient \< 70 years old with WHO PS 0 or 1
* Uncontrolled intercurrent illness including liver (liver cirrhosis Child Pugh B or C) and lung (one second forced expiratory volume \<50%) severe insufficiency.
* Patients with high microsatellite instability (MSI-H) or a tumour with mismatched repair (dMMR).
* Clinically significant cardiac abnormalities including prior history of any of the following: severe cardiomyopathy, congestive heart failure of New York Heart Association grade ≥3, history of clinically significant (i.e., active) atherosclerotic cardiovascular disease (myocardial infarction, unstable angina, cerebrovascular accident within 6 months prior to the first dose of study treatments).
* Patients with Dihydropyrimidine Dehydrogenase (DPD) enzyme deficiencies (uracilemia ≥ 16 ng/mL).
* Immunotherapy within 3 months before the beginning of the treatment study.
* Patient under treatment by strong CYP3A4 inducers.
* Patients treated by brivudine within 4 weeks before the first dose of study treatment, or concomitant treatment with brivudine.
* Patient with potentially serious infection.
* Administration of live or live attenuated vaccine within 30 days prior to the first dose of study treatment start.
* Poor nutritional state (albuminemia \< 25 g/L or weight loss \> 10% during the last month).
* Hereditary problems of galactose intolerance, total lactase deficiency or glucose galactose malabsorption.
* Other malignancy within 2 years prior to study enrolment, except for localized cancer in situ, basal or squamous cell skin cancer adequately treated.
* Less than 4 weeks from major surgeries and not recovered adequately from the procedure and/or any complications from the surgery.
* Patients with persistent toxicities related to prior treatment of grade greater than 1.Is c urrently participating in or has participated in a study of an investigational agent or has used an investigational device within 3 weeks or 5 half-lives (whichever longer) before study entry.
* Hypersensitivity to one of the active substances or to one of the excipients of the trial treatments.
* Patient with interstitial lung disease or pulmonary fibrosis.
* Patients with history of interstitial pneumonitis or pulmonary fibrosis.
* Has a known psychiatric or substance abuse disorder that would interfere with the patient's ability to cooperate with the requirements of the study.
* Patient who is under judicial protection and patient who is legally institutionalized or under guardianship or not able to give consent.
* Pregnant or breastfeeding woman.
* Inability to undergo the medical follow-up of the trial for geographical, social or psychological reasons.
Primary outcome measure(s)
Percentage of patient alive or without progression 8 months after inclusion. — at 8 months after the inclusion. Progression will be assessed by the investigator according to recist 1.1 based on images performed every 8 weeks even in case of deferred treatments.
Clinical progression will not be considered as an event.
Trial sites (80)
Facility
City
Region
Status
ICO site Paul Papin
Angers
France
Centre Hospitalier Annecy Genevois
Annecy
France
Hôpital Privé
Antony
France
Centre Hospitalier
Aurillac
France
Centre Hospitalier
Bayeux
France
Ch Cote Basque
Bayonne
France
Ch Simone Veille
Beauvais
France
Chu Jean Minjoz
Besançon
France
Polyclinique Courlancy
Bezannes
France
Centre Hospitalier Béthune Beuvry
Béthune
France
Bordeaux Nord Aquitaine
Bordeaux
France
TIVOLI
Bordeaux
France
Chu Morvan
Brest
France
CHU Côte de Nacre
Caen
France
Centre Hospitalier
Cholet
France
Hôpitaux civils
Colmar
France
Polyclinique Saint-Côme
Compiègne
France
Chu Francois Mitterand
Dijon
France
Gf Leclerc
Dijon
France
Institut de cancérologie de Bourgogne GRReCC
Dijon
France
Groupe Hospitalier Mutualiste
Grenoble
France
Chd Vendee
La Roche-sur-Yon
France
Hôpital Franco Britannique
Levallois-Perret
France
Hôpital Privé Le Bois
Lille
France
CHU Dupuytren
Limoges
France
Groupe Hospitalier Bretagne Sud
Lorient
France
Hôpital Jean Mermoz
Lyon
France
Chu La Timone
Marseille
France
Hôpital Européen
Marseille
France
CHRU
Nancy
France
Gh Nord Essone
Orsay
France
Chu Cochin
Paris
France
HEGP
Paris
France
Montsouris
Paris
France
Saint-Louis
Paris
France
Centre Hospitalier
Pau
France
CHU Haut Leveque
Pessac
France
Centre Cario
Plérin
France
Chu La Miletrie
Poitiers
France
CH Quimper Concarneau
Quimper
France
+ 40 more sites — see the full list on the official registry below.
More Federation Francophone de Cancerologie Digestive trials in Germany
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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