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NCT01075048

ARQ 197 in Combination With Chemotherapy in Patients With Metastatic Colorectal Cancer

Completed Phase 1, PHASE2 Results posted Last updated 8 April 2021
What this trial tests

Phase 1, PHASE2 trial testing Tivantinib in Metastatic Colorectal Cancer in 131 participants. Completed in 20 February 2015.

Timeline
26 January 2010
Primary endpoint
12 October 2012
20 February 2015

Quick facts

Lead sponsorDaiichi Sankyo
PhasePhase 1, PHASE2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment131
Start date26 January 2010
Primary completion12 October 2012
Estimated completion20 February 2015
Sites40 locations across France, Italy, Russia, Germany, United States

Drugs / interventions tested

Conditions studied

Sponsor

Daiichi Sankyo — full company profile →

Who can join

18 and older, any sex, with Metastatic Colorectal Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression-Free Survival (PFS) Following Treatment With Tivantinib (ARQ 197) in Combination With Irinotecan and Cetuximab in Participants With Metastatic Colorectal Cancer With Wild-Type K-ras Oncogene (KRAS) Who Have Received Front-Line Systemic Therapy Primary · Baseline up to 80 weeks postdose

Progression-free survival is defined as the time from randomization to the date of disease progression (PD) or death due to any cause (as of data cutoff 12 Oct 2012).

GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan7.35.3 – 9.0
Phase 2: ARQ 197+Cetuximab+Irinotecan8.35.6 – 10.8
Progression-Free Survival (PFS) Using Computed Best Response Following Treatment With Tivantinib (ARQ 197) in Combination With Irinotecan and Cetuximab in Participants With Metastatic Colorectal Cancer Who Have Received Front-Line Systemic Therapy Primary · Baseline up to 80 weeks postdose

Progression-free survival is defined as the time from randomization to the date of disease progression (PD) or death due to any cause (as of data cutoff 12 Oct 2012).

GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan7.35.3 – 9.0
Phase 2: ARQ 197+Cetuximab+Irinotecan8.35.6 – 10.8
Best Overall Tumor Response and Objective Response Rate Following Treatment With Tivantinib (ARQ 197) in Combination With Irinotecan and Cetuximab in Subjects With Metastatic Colorectal Cancer Who Have Received Front-Line Systemic Therapy Secondary · Baseline up to 2 years 10 months postdose

Best overall tumor response according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria included complete response (CR) defined as the disappearance of all target lesions; partial response (PR) defined as a ≥30% decrease in the longest diameter of target lesions; stable disease (SD) defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD; at least a 20% increase in the sum of diameters of target lesions. Objective response was defined as CR+PR.

Complete response (CR)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan0
Phase 2: ARQ 197+Cetuximab+Irinotecan0
Partial response (PR)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan19
Phase 2: ARQ 197+Cetuximab+Irinotecan27
Stable disease (SD)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan22
Phase 2: ARQ 197+Cetuximab+Irinotecan22
Progressive disease (PD)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan13
Phase 2: ARQ 197+Cetuximab+Irinotecan9
Objective response (CR+PR)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan19
Phase 2: ARQ 197+Cetuximab+Irinotecan27
Inevaluable
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan3
Phase 2: ARQ 197+Cetuximab+Irinotecan2
Overall Survival (OS) Following Treatment With Tivantinib (ARQ 197) in Combination With Irinotecan and Cetuximab in Participants With Metastatic Colorectal Cancer With Wild-Type K-ras Oncogene (KRAS) Who Have Received Front-Line Systemic Therapy Secondary · Baseline up to 5 years 1 month postdose

Overall survival is defined as the time from randomization date to the date of death.

Overall survival (12 Oct 2012 data cutoff)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan17.611.3 – 20.4
Phase 2: ARQ 197+Cetuximab+IrinotecanNA13.2 – NA
Overall survival (29 Mar 2013 data cutoff)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan16.912.2 – 20.4
Phase 2: ARQ 197+Cetuximab+Irinotecan19.813.4 – 27.0
Overall survival (25 Jul 2013 data cutoff)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan16.311.6 – 20.4
Phase 2: ARQ 197+Cetuximab+Irinotecan19.815.4 – 27.4
Overall survival (20 Feb 2015 data cutoff)
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan16.311.6 – 20.4
Phase 2: ARQ 197+Cetuximab+Irinotecan22.315.4 – 27
Duration of Response and Stable Disease Following Treatment With Tivantinib (ARQ 197) in Combination With Irinotecan and Cetuximab in Participants With Metastatic Colorectal Cancer With Wild-Type KRAS Who Have Received Front-Line Systemic Therapy Secondary · Baseline up to 80 weeks postdose

Duration of response was defined for participants with complete response (CR)/partial response (PR) as the time from the date of the first documentation of objective response (CR or PR) to the date of the first documentation of progressive disease. Duration of stable disease (SD) was defined for participants whose best response was SD at the time from the randomization date to the date of the first documentation of progressive disease. Based on Response Evaluation Criteria in Solid Tumors version 1.1, CR is defined as a disappearance of all target lesions, PR is defined as at least a 30% decre

Duration of response
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan29.42± 15.16
Phase 2: ARQ 197+Cetuximab+Irinotecan28.84± 16.03
Duration of stable disease
GroupValue95% CI
Phase 2: Placebo+Cetuximab+Irinotecan24.48± 11.48
Phase 2: ARQ 197+Cetuximab+Irinotecan29.76± 15.43
Treatment-Emergent Adverse Events Reported in ≥ 10% of Participants Following Treatment With Tivantinib (ARQ 197) in Combination With Irinotecan and Cetuximab in Subjects With Metastatic Colorectal Cancer Who Have Received Front-Line Systemic Therapy Secondary · Baseline up to 30 days after last dose, up to 5 years 1 month

A treatment-emergent adverse event (TEAE) was defined as an AE that had an onset date on or after the first dose of study drug, cetuximab, or irinotecan up to and including 30 days after the last dose of any study drug and worsened in severity after the first dose of study drug relative to the pre-treatment state.

Any TEAE
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan9
Phase 2: Placebo+Cetuximab+Irinotecan59
Phase 2: ARQ 197+Cetuximab+Irinotecan62
All ARQ 19771
Blood and Lymphatic System Disorders
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan4
Phase 2: Placebo+Cetuximab+Irinotecan28
Phase 2: ARQ 197+Cetuximab+Irinotecan23
All ARQ 19727
Anaemia
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan2
Phase 2: Placebo+Cetuximab+Irinotecan19
Phase 2: ARQ 197+Cetuximab+Irinotecan7
All ARQ 1979
Neutropenia
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan4
Phase 2: Placebo+Cetuximab+Irinotecan13
Phase 2: ARQ 197+Cetuximab+Irinotecan18
All ARQ 19722
Gastrointestinal Disorders
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan9
Phase 2: Placebo+Cetuximab+Irinotecan47
Phase 2: ARQ 197+Cetuximab+Irinotecan47
All ARQ 19756
Abdominal pain
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan3
Phase 2: Placebo+Cetuximab+Irinotecan16
Phase 2: ARQ 197+Cetuximab+Irinotecan12
All ARQ 19715
Constipation
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan1
Phase 2: Placebo+Cetuximab+Irinotecan11
Phase 2: ARQ 197+Cetuximab+Irinotecan10
All ARQ 19711
Diarrhea
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan5
Phase 2: Placebo+Cetuximab+Irinotecan30
Phase 2: ARQ 197+Cetuximab+Irinotecan33
All ARQ 19738
Treatment-Emergent Infection and Infestation Adverse Events Following Treatment With Tivantinib (ARQ 197) in Combination With Irinotecan and Cetuximab in Participants With Metastatic Colorectal Cancer Who Have Received Front-Line Systemic Therapy Secondary · Baseline up to 30 days after last dose, up to 5 years 1 month

A treatment-emergent adverse event (TEAE) was defined as an AE that had an onset date on or after the first dose of study drug, cetuximab, or irinotecan up to and including 30 days after the last dose of any study drug and worsened in severity after the first dose of study drug relative to the pre-treatment state.

Infections and Infestations
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan6
Phase 2: Placebo+Cetuximab+Irinotecan24
Phase 2: ARQ 197+Cetuximab+Irinotecan31
All ARQ 19737
Abscess jaw
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan0
Phase 2: Placebo+Cetuximab+Irinotecan1
Phase 2: ARQ 197+Cetuximab+Irinotecan0
All ARQ 1970
Abscess neck
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan0
Phase 2: Placebo+Cetuximab+Irinotecan1
Phase 2: ARQ 197+Cetuximab+Irinotecan0
All ARQ 1970
Bronchitis
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan0
Phase 2: Placebo+Cetuximab+Irinotecan1
Phase 2: ARQ 197+Cetuximab+Irinotecan3
All ARQ 1973
Candidiasis
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan1
Phase 2: Placebo+Cetuximab+Irinotecan0
Phase 2: ARQ 197+Cetuximab+Irinotecan0
All ARQ 1971
Cellulitis
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan1
Phase 2: Placebo+Cetuximab+Irinotecan1
Phase 2: ARQ 197+Cetuximab+Irinotecan2
All ARQ 1973
Cystitis
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan0
Phase 2: Placebo+Cetuximab+Irinotecan1
Phase 2: ARQ 197+Cetuximab+Irinotecan0
All ARQ 1970
Device-related infection
GroupValue95% CI
Phase 1: ARQ 197+Cetuximab+Irinotecan1
Phase 2: Placebo+Cetuximab+Irinotecan0
Phase 2: ARQ 197+Cetuximab+Irinotecan0
All ARQ 1971

Adverse events — posted to ClinicalTrials.gov

Time frame: Treatment-emergent adverse events (TEAE) were collected from baseline up to 30 days after last dose, up to 5 years 1 month.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Phase 1: ARQ 197+Cetuximab+Irinotecan
Serious: 3/9 (33%)
Deaths: 6/9
Phase 2: Placebo+Cetuximab+Irinotecan
Serious: 17/59 (29%)
Deaths: 35/59
Phase 2: ARQ 197+Cetuximab+Irinotecan
Serious: 13/62 (21%)
Deaths: 35/62

Serious adverse events (43 terms)

ReactionSystemPhase 1: ARQ 197+Cetuximab…Phase 2: Placebo+Cetuximab…Phase 2: ARQ 197+Cetuximab…
Small intestinal obstructionGastrointestinal disorders
NeutropeniaBlood and lymphatic system disorders
IleusGastrointestinal disorders
NauseaGastrointestinal disorders
VomitingGastrointestinal disorders
DehydrationMetabolism and nutrition disorders
Malignant neoplasm progressionNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Renal failure acuteRenal and urinary disorders
AnaemiaBlood and lymphatic system disorders
Febrile neutropeniaBlood and lymphatic system disorders
Atrial fibrillationCardiac disorders
Abdominal painGastrointestinal disorders
Colitis ulcerativeGastrointestinal disorders
DiarrheaGastrointestinal disorders
Diverticulum intestinalGastrointestinal disorders
PneumoperitoneumGastrointestinal disorders
ProctalgiaGastrointestinal disorders
Small intestinal perforationGastrointestinal disorders
General physical health deteriorationGeneral disorders
Multi-organ failureGeneral disorders
PneumatosisGeneral disorders
PyrexiaGeneral disorders
Anaphylactic reactionImmune system disorders
HypersensitivityImmune system disorders
DiverticulitisInfections and infestations
Other adverse events (98 terms — click to expand)

ReactionSystemPhase 1: ARQ 197+Cetuximab…Phase 2: Placebo+Cetuximab…Phase 2: ARQ 197+Cetuximab…
RashSkin and subcutaneous tissue disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
FatigueGeneral disorders
VomitingGastrointestinal disorders
AnaemiaBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
Abdominal painGastrointestinal disorders
AlopeciaSkin and subcutaneous tissue disorders
ConstipationGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
Dry skinSkin and subcutaneous tissue disorders
Dermatitis acneiformSkin and subcutaneous tissue disorders
AstheniaGeneral disorders
Abdominal pain upperGastrointestinal disorders
StomatitisGastrointestinal disorders
PyrexiaGeneral disorders
DehydrationMetabolism and nutrition disorders
HyperglycaemiaMetabolism and nutrition disorders
HeadacheNervous system disorders
InsomniaPsychiatric disorders
CoughRespiratory, thoracic and mediastinal disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
ParonychiaInfections and infestations
Neutrophil count decreasedInvestigations
Weight decreasedInvestigations
HypomagnesaemiaMetabolism and nutrition disorders
PruritusSkin and subcutaneous tissue disorders
Rash generalisedSkin and subcutaneous tissue disorders
LeukopeniaBlood and lymphatic system disorders
ThrombocytopeniaBlood and lymphatic system disorders
FlatulenceGastrointestinal disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders
Mucosal inflammationGeneral disorders
Oedema peripheralGeneral disorders
Hemoglobin decreasedInvestigations
HypokalaemiaMetabolism and nutrition disorders
Skin fissuresSkin and subcutaneous tissue disorders
Small intestinal obstructionGastrointestinal disorders
HyperthermiaGeneral disorders

Most-reported serious reactions: Small intestinal obstruction, Neutropenia, Ileus, Nausea, Vomiting, Dehydration, Malignant neoplasm progression, Renal failure acute.

Data from ClinicalTrials.gov NCT01075048 adverse events section.

Sponsor's own description

ARQ 197 or placebo in combination with irinotecan and cetuximab in participants with metastatic colorectal cancer (CRC), in participants with wild-type KRAS alleles who have failed front-line systemic therapy, to evaluate the safety, tolerability, and efficacy of ARQ 197, define the recommended dose for Phase 2. After the recommended dose is determined for Phase 2, participants receive study drug or placebo with irinotecan and cetuximab.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Comprehensive review of targeted therapy for colorectal cancer.
    Xie YH, Chen YX, Fang JY. · · 2020 · cited 1162× · PMID 32296018 · DOI 10.1038/s41392-020-0116-z
  2. Targeting the HGF/Met signaling pathway in cancer therapy.
    Cecchi F, Rabe DC, Bottaro DP. · · 2012 · cited 180× · PMID 22530990 · DOI 10.1517/14728222.2012.680957
  3. Drug Resistance in Colorectal Cancer: From Mechanism to Clinic.
    Wang Q, Shen X, Chen G, Du J. · · 2022 · cited 104× · PMID 35740594 · DOI 10.3390/cancers14122928
  4. Receptor tyrosine kinases and downstream pathways as druggable targets for cancer treatment: the current arsenal of inhibitors.
    Montor WR, Salas AROSE, Melo FHM. · · 2018 · cited 80× · PMID 29455659 · DOI 10.1186/s12943-018-0792-2
  5. The role of MET in chemotherapy resistance.
    Wood GE, Hockings H, Hilton DM, Kermorgant S. · · 2021 · cited 78× · PMID 33526881 · DOI 10.1038/s41388-020-01577-5
  6. High MET expression is an adverse prognostic factor in patients with triple-negative breast cancer.
    Zagouri F, Bago-Horvath Z, Rössler F, Brandstetter A, et al · · 2013 · cited 77× · PMID 23422757 · DOI 10.1038/bjc.2013.31
  7. Recent Advances in Targeting the EGFR Signaling Pathway for the Treatment of Metastatic Colorectal Cancer.
    Miyamoto Y, Suyama K, Baba H. · · 2017 · cited 76× · PMID 28368335 · DOI 10.3390/ijms18040752
  8. Early clinical development of ARQ 197, a selective, non-ATP-competitive inhibitor targeting MET tyrosine kinase for the treatment of advanced cancers.
    Adjei AA, Schwartz B, Garmey E. · · 2011 · cited 58× · PMID 21632449 · DOI 10.1634/theoncologist.2010-0380

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